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Assessment of Two Therapeutic Strategies in the Treatment of Children With Congenital Toxoplasmosis (TOSCANE)

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: NCT01202500
Recruitment Status : Unknown
Verified September 2010 by Centre Hospitalier Universitaire Dijon.
Recruitment status was:  Recruiting
First Posted : September 16, 2010
Last Update Posted : June 3, 2014
Information provided by (Responsible Party):
Centre Hospitalier Universitaire Dijon

Brief Summary:
Toxoplasmosis is a benign disease in healthy adults, but can be serious in the case of contamination during pregnancy: the parasite can pass through the placental barrier and infect the foetus. The severity of congenital infection varies, but in France, where maternal seroconversions during pregnancy are treated, the manifestations of the disease are often infraclinical at birth and only appear during the first years of life in the form of retinochoroiditis. In order to prevent long-term sequellae, children with confirmed congenital toxoplasmosis (TC) are treated with pyrimethamine combined with either sulfadiazine or sulfadoxine (Fansidar®). The relative efficacy of these two combinations has not yet been evaluated. Moreover, there is no consensus about the duration of the treatment, which varies, in France, from 12 to 24 months depending on the centre. Compared with the duration of parasitaemia in non-treated children, which can persist for up to 4 weeks, these treatments are very long. They are also far longer than the 3 months of treatment, which is in accordance with the World Health Organization (WHO) recommendations, given in Denmark to infants identified as being infected with the parasite during neonatal screening. A one-year treatment was developed in the United States, but it mainly concerns only symptomatic children, given the absence of generalised screening in the United States of America (USA). We have no arguments to justify the use of treatments lasting one year or more in children with asymptomatic or mildly-symptomatic TC. As these treatments carry certain risks, which may be severe, notably with regard to haematological or skin conditions, they have to be supervised closely with biological tests, which adds further constraints for both the children and their parents and increases the cost to health care systems.

Condition or disease Intervention/treatment Phase
Congenital Toxoplasmosis Procedure: reducing treatment to 3 months Procedure: registered length of treatment Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 486 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Multicentre, Randomised Study to Determine the Relative Efficacy of Two Therapeutic Strategies in the Treatment of Children With Congenital Toxoplasmosis
Study Start Date : July 2010
Actual Primary Completion Date : July 2010
Estimated Study Completion Date : September 2016

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Toxoplasmosis

Arm Intervention/treatment
12 months Procedure: registered length of treatment
The treatment procedure will follow the actual recommandation

Experimental: 3 months Procedure: reducing treatment to 3 months
The treatment will be stopped after 3 months

Primary Outcome Measures :
  1. episode of retinochoroiditis [ Time Frame: 2 years ]
    Time to the onset of a first episode of retinochoroiditis in the two years of the study (or the onset of a new episode in a child known to already have had at least one lesion), evaluated on a fundus examination using RetCam®.

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Ages Eligible for Study:   3 Months to 6 Months   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Children meeting the following criteria can be included:

  • Non-severe congenital toxoplasmosis diagnosed in utero or in the first 3 months of life, whether or not in utero treatment was given
  • Treated for 3 months with pyrimethamine combined with sulfamides.
  • age from 3 to 6 months (> 2 months and < 7 months)

Diagnostic criteria for congenital toxoplasmosis:

  • antenatal period: positive Polymerase Chain Reaction (PCR) on the amniotic fluid or positive mouse inoculation for the amniotic fluid
  • postnatal period: presence of specific Immunoglobuline M (IgM) and/or Immunoglobuline A (IgA), positive Western Blot Chemistry (WBC), increase in Immunoglobuline G (IgG).

Severe congenital toxoplasmosis is defined by the presence at birth of at least one of the following signs: > or egal 3 cerebral calcifications, hydrocephaly, microcephaly, convulsions, microphtalmy.

Informed consent must be provided by both parents.

Exclusion Criteria:

Children with the following cannot be included:

  • a severe form of congenital toxoplasmosis
  • inflammatory retinal disease at inclusion or in whom the treatment is contra-indicated (history of hypersensitivity to one of the components, severe renal or hepatic insufficiency, a history of hepatitis linked to treatment with Fansidar®).

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): NCT01202500

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Contact: Valérie JAVERLIAC 04 27 85 77 24 ext 33

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Hôpital d'Enfants Armand Trousseau Recruiting
Paris, France, 75015
Contact: François KIEFFER, MD    01 44 73 61 91 ext 33   
Principal Investigator: François KIEFFER, MD         
Sponsors and Collaborators
Centre Hospitalier Universitaire Dijon
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Study Director: Christine BINQUET, MD CHU Dijon
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Responsible Party: Centre Hospitalier Universitaire Dijon Identifier: NCT01202500    
Other Study ID Numbers: 2009-016528-30
First Posted: September 16, 2010    Key Record Dates
Last Update Posted: June 3, 2014
Last Verified: September 2010
Additional relevant MeSH terms:
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Toxoplasmosis, Congenital
Protozoan Infections
Parasitic Diseases
Central Nervous System Protozoal Infections
Central Nervous System Parasitic Infections
Central Nervous System Infections
Central Nervous System Diseases
Nervous System Diseases
Infant, Newborn, Diseases