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Mycophenolate Mofetil in Myasthenia Gravis

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: NCT00285350
Recruitment Status : Completed
First Posted : February 2, 2006
Last Update Posted : March 25, 2015
Duke University
Information provided by:
FDA Office of Orphan Products Development

Tracking Information
First Submitted Date  ICMJE January 31, 2006
First Posted Date  ICMJE February 2, 2006
Last Update Posted Date March 25, 2015
Study Start Date  ICMJE September 2002
Primary Completion Date Not Provided
Current Primary Outcome Measures  ICMJE
 (submitted: April 11, 2007)
Original Primary Outcome Measures  ICMJE Not Provided
Change History Complete list of historical versions of study NCT00285350 on Archive Site
Current Secondary Outcome Measures  ICMJE
 (submitted: April 11, 2007)
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
Descriptive Information
Brief Title  ICMJE Mycophenolate Mofetil in Myasthenia Gravis
Official Title  ICMJE A Trial of Mycophenolate Mofetil in Myasthenia Gravis
Brief Summary This is a prospective, multi-center, double-blind, placebo-controlled trial to determine the efficacy and safety of mycophenolate mofetil (MM) in combination with prednisone as the initial form of immunosuppression in patients with acquired myasthenia gravis (MG).
Detailed Description 80 patients with seropositive MG at 18 academic centers will be randomized to 3 months of treatment with 2.5 gm MM/day (1,250 mg q 12 hours, +/- 2 hours) plus 20 mg prednisone/day versus placebo plus 20 mg/day prednisone. The primary measure of efficacy will be the change from baseline in Quantitative MG (QMG) score at the end of 3 months. Secondary outcome measures include survival analysis for treatment failure, MG-related impairment of daily activities, functional assessment, manual muscle testing, SF-36 Health Status, and serum concentration of antibodies to the acetylcholine receptor. Study completers will have the option of taking open-label MM for an additional 6 months, during which prednisone will be reduced to the lowest dose necessary to maintain the optimum clinical response.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 3
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Condition  ICMJE Myasthenia Gravis
Intervention  ICMJE Drug: mycophenolate mofetil
Study Arms  ICMJE Not Provided
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Recruitment Information
Recruitment Status  ICMJE Completed
Enrollment  ICMJE
 (submitted: January 31, 2006)
Original Enrollment  ICMJE Same as current
Actual Study Completion Date  ICMJE March 2007
Primary Completion Date Not Provided
Eligibility Criteria  ICMJE

Inclusion criteria

  1. Acquired generalized MG diagnosed by one of the Principal Investigators based on:

    • Examination by site PI showing myasthenic weakness that is not limited to the ocular or peri-ocular muscles.
    • Elevated acetylcholine receptor antibodies.
    • Positive edrophonium chloride test or abnormal neuromuscular transmission demonstrated by single fiber EMG or repetitive nerve stimulation.
  2. Aged at least 18.
  3. Able to give informed consent.
  4. Taking a constant dose of Mestinon for at least 2 weeks.
  5. Symptom severity that would, in the judgment of the site investigator, justify initiation of immunosuppressive treatment.
  6. Able and willing to comply with study requirements.

Exclusion criteria

  1. Thymoma now or in the past.
  2. Plasma exchange or IVIG treatment within 90 days of randomization.
  3. Treatment with azathioprine, cyclosporine, mycophenolate mofetil, or other immunosuppressive medication since onset of MG. Treatment with prednisone or other corticosteroids within the previous 90 days.

    • Exception: patients may have taken doses of these immunosuppressant medications that are judged by the Principal Investigator to have been clinically insignificant, i.e. unlikely to produce improvement in MG.

  4. Women of childbearing potential who are pregnant, breast-feeding or not practicing effective contraception.
  5. Renal failure, active thyroid or hepatocellular disease, chronic infection, poorly controlled cardiac disease, or any other illness, including psychiatric disease, that would, in the opinion of the treating physician, make it unsafe for the patient to participate or would interfere with the interpretation of study results.
  6. Weakness affecting only ocular or peri-ocular muscles (Myasthenia Gravis Foundation of America Class I).
  7. Severe weakness predominantly affecting oropharyngeal, respiratory muscles or both (MGFA Class IVB).
  8. Crisis or impending crisis (defined as FVC <10ml/Kg or bulbar weakness severe enough to compromise airway protection.)
  9. Hemoglobin <10mg/dl; WBC <3,500.
  10. History of non-compliance with treatment and office visits.
  11. Thymectomy within 12 months before randomization.
  12. Concurrent medical condition that would pose an unacceptable risk from immunosuppression, including a positive skin test for tuberculosis (PPD), unless the patient has previously received appropriate treatment.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE Not Provided
Removed Location Countries  
Administrative Information
NCT Number  ICMJE NCT00285350
Other Study ID Numbers  ICMJE 2154
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Not Provided
Study Sponsor  ICMJE FDA Office of Orphan Products Development
Collaborators  ICMJE Duke University
Investigators  ICMJE
Principal Investigator: Donald B Sanders, MD Duke University
PRS Account FDA Office of Orphan Products Development
Verification Date March 2007

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP