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The Efficacy and Safety of Leflunomide or Azathioprine Therapy in Myasthenia Gravis Patients After Expand Thymectomy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01727193
Recruitment Status : Unknown
Verified September 2019 by Liu Weibin, First Affiliated Hospital, Sun Yat-Sen University.
Recruitment status was:  Recruiting
First Posted : November 15, 2012
Last Update Posted : September 18, 2019
Information provided by (Responsible Party):
Liu Weibin, First Affiliated Hospital, Sun Yat-Sen University

Brief Summary:
This is a randomized controlled clinical study. The investigators screen of eligible patients, randomized divide into the following two groups: corticosteroids + azathioprine group, corticosteroids + leflunomide group. The investigators treat the enrolled patients, estimate efficacy and observed the side effects according to the requirements of program. The investigators establish a clinical database for recording patients date and statistical analysis. Evaluation of short-term and long-term efficacy of thymectomized myasthenia gravis patients in the different group prove that what kind of treatment can improve the cure rate. The investigators will evaluate the acute toxicity (gastrointestinal side effects, liver and kidney dysfunction) and long-term toxicity (immune dysfunction, gonadal suppression) when the investigators apply these therapy in the treatment of different clinical types of myasthenia gravis.

Condition or disease Intervention/treatment Phase
Myasthenia Gravis Drug: Azathioprine Drug: Leflunomide Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 158 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Study Start Date : September 2012
Estimated Primary Completion Date : December 2019
Estimated Study Completion Date : June 2020

Arm Intervention/treatment
Active Comparator: Azathioprine
cholinesterase inhibitors+Glucocorticoid +Azathioprine
Drug: Azathioprine
The basic therapy of each group is cholinesterase inhibitors (pyridostigmine 36mg / kg / d). Group 1 glucocorticoid + Azathioprine: Glucocorticoid (0.25mg/kg/d )plus Azathioprine at a starting dose of 50mg/d for 14 days, then increase up to 2mg/kg in 2 weeks.If no adverse events occurred , maintain the dose until 48 weeks.

Active Comparator: Leflunomide
cholinesterase inhibitors+glucocorticoid+Leflunomide
Drug: Leflunomide
The basic therapy of each group is cholinesterase inhibitors (pyridostigmine 36mg / kg / d). Group 2 glucocorticoid + Leflunomide: Glucocorticoid (0.25mg/kg/d )plus Leflunomide 20mg/d for adult, 10mg/d for child. if no adverse events occurred , maintain the dose until 48 weeks.

Primary Outcome Measures :
  1. the percent of achieving good response [ Time Frame: 48 weeks ]

Secondary Outcome Measures :
  1. level of the acetylcholine receptor antibody [ Time Frame: 48 weeks ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   12 Years to 65 Years   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. 12 to 65 years;
  2. Myasthenia gravis:

    1. Patients who are diagnosed as generalized or ocular myasthenia gravis
    2. have experienced extended thymectomy (including thymic hyperplasia and thymoma), no significant complications in 6 months after operation , and does not received any immunosuppressants or glucocorticoids treatments.
    3. do not applied in plasmapheresis or immunoglobulins treatment during 3 months .
    4. women of child-bearing period do not have a plan of pregnant for at least 3 year.
    5. Written consent of the patient, after informing

Exclusion Criteria:

  1. The liver , kidney or glycometabolic function is abnormal
  2. Seriously complications, such as infection or symptom in central nervous system,
  3. The patients who suffering from malignancy or a history of malignancy, a variety of sexually transmitted diseases and HIV infection, tuberculosis infection, and other condition which need to prohibit the use of immunosuppressive patients.
  4. Be allergic to leflunomide, azathioprine
  5. Pregnant or suckling period woman
  6. Accompanied with mental disorders and have difficult to communication
  7. Experienced myasthenia crisis in 3 months.
  8. suffering from clear cardiopulmonary functional and brain abnormalities
  9. Have a history of refractory hypertension or peptic ulcer .
  10. One of the white blood cells, hemoglobin, and platelet count obvious abnormalities

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01727193

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Contact: Liu Wei bin, dean 086-020-87755766 ext 8281

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China, Guangdong
the first affiliated hospital,SUN YAT-SEN UNIVERSITY Recruiting
GuangZhou, Guangdong, China, 510000
Contact: Liu Wei bin, dean    086-020-887755766 ext 8281   
Principal Investigator: Liu Wei bin, dean         
Sponsors and Collaborators
First Affiliated Hospital, Sun Yat-Sen University
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Responsible Party: Liu Weibin, Principal Investigator, First Affiliated Hospital, Sun Yat-Sen University Identifier: NCT01727193    
Other Study ID Numbers: ZS-LEF
First Posted: November 15, 2012    Key Record Dates
Last Update Posted: September 18, 2019
Last Verified: September 2019
Keywords provided by Liu Weibin, First Affiliated Hospital, Sun Yat-Sen University:
myasthenia gravis
Additional relevant MeSH terms:
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Myasthenia Gravis
Nervous System Diseases
Paraneoplastic Syndromes, Nervous System
Nervous System Neoplasms
Neoplasms by Site
Paraneoplastic Syndromes
Autoimmune Diseases of the Nervous System
Neurodegenerative Diseases
Neuromuscular Junction Diseases
Neuromuscular Diseases
Autoimmune Diseases
Immune System Diseases
Molecular Mechanisms of Pharmacological Action
Antimetabolites, Antineoplastic
Antineoplastic Agents
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents
Enzyme Inhibitors