Treatment of Necrotizing Vasculitides for Patients Older Than 65 Years

NCT ID: NCT00307671

Last Updated: 2011-09-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

108 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-07-31

Study Completion Date

2011-07-31

Brief Summary

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The aim of this trial is to lower the morbidity rate in elderly patients affected with systemic necrotizing vasculitides, by reducing mortality and improving global outcome.

Detailed Description

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Systemic necrotizing vasculitides are severe diseases associated with a high mortality rate in elderly.

Although corticosteroids and immunosuppressants are effective, they can induce some side-effects, especially in this latter patients.

Preliminary data indicate that systemic necrotizing vasculitides (SNV) occurring in patients over 65 years have a poorer outcome than in younger patients (mortality rate of 76 % vs. 69 % at 5 years, respectively) and that 68,4 % of the elderly experience treatment side-effects.

In this trial, patients will be randomly assigned to receive either low doses of corticosteroids systematically in combination with immunosuppressants (CYC then azathioprine) or usual regimen with corticosteroids combined with immunosuppressants only if factor(s) of poor prognosis is present (this latter regimen relying on previously published therapeutic guidelines).

Conditions

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Vasculitis Wegener's Granulomatosis Microscopic Polyangiitis Churg-Strauss Syndrome Polyarteritis Nodosa

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A

conventional treatment

Group Type OTHER

prednisone, methylprednisolone,cyclophosphamides

Intervention Type DRUG

treatment conventional

Mycophenolate mofetil,methotrexate

Intervention Type DRUG

in the treatment conventional and in the reduction dose

B

reduction dose

Group Type EXPERIMENTAL

Cyclophosphamide, Azathioprine,prednisone,methylprednisolone

Intervention Type DRUG

reduction dose

Mycophenolate mofetil,methotrexate

Intervention Type DRUG

in the treatment conventional and in the reduction dose

Interventions

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prednisone, methylprednisolone,cyclophosphamides

treatment conventional

Intervention Type DRUG

Cyclophosphamide, Azathioprine,prednisone,methylprednisolone

reduction dose

Intervention Type DRUG

Mycophenolate mofetil,methotrexate

in the treatment conventional and in the reduction dose

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Newly diagnosed WG, MPA, PAN without HBV infection, or CSS
* Patients can be still be enrolled within 1 month after starting corticosteroids if prescribed according to protocol.
* within or after the 65th of anniversary
* Age ≥ 65 years

Exclusion Criteria

* Any cytotoxic drug within previous year
* Co-existence of another systemic autoimmune disease, e.g., SLE, RA
* Virus-associated vasculitides
* HIV positivity
* Malignancy (usually excluded unless approved by the trial coordinator)
* Age \< 65 years
* Inability to give informed consent
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Loïc Guillevin, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Assistance Publique - Hôpitaux de Paris

Locations

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Hôpital Cochin

Paris, , France

Site Status

Countries

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France

References

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Pagnoux C, Quemeneur T, Ninet J, Diot E, Kyndt X, de Wazieres B, Reny JL, Puechal X, le Berruyer PY, Lidove O, Vanhille P, Godmer P, Fain O, Blockmans D, Bienvenu B, Rollot F, Ait el Ghaz-Poignant S, Mahr A, Cohen P, Mouthon L, Perrodeau E, Ravaud P, Guillevin L; French Vasculitis Study Group. Treatment of systemic necrotizing vasculitides in patients aged sixty-five years or older: results of a multicenter, open-label, randomized controlled trial of corticosteroid and cyclophosphamide-based induction therapy. Arthritis Rheumatol. 2015 Apr;67(4):1117-27. doi: 10.1002/art.39011.

Reference Type DERIVED
PMID: 25693055 (View on PubMed)

Other Identifiers

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P040425

Identifier Type: -

Identifier Source: org_study_id

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