Anti-Cytokine Therapy for Vasculitis

NCT ID: NCT00753103

Last Updated: 2008-09-16

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

PHASE2

Total Enrollment

37 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-01-31

Study Completion Date

2006-07-31

Brief Summary

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The purpose of this study is to determine whether Infliximab (monoclonal anti-tumour necrosis factor alpha antibodies) are safe and effective in the treatment of anti-neutrophil cytoplasm antibody (ANCA) associated vasculitis.

Detailed Description

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Anti-neutrophil cytoplasm antibody (ANCA) associated vasculitis is a life-threatening systemic inflammatory autoimmune disease. Current treatment regimes using corticosteroids and cyclophosphamide have improved patient survival but are associated with treatment associated morbidity and mortality. Tumour necrosis factor alpha (TNF) is a proinflammatory cytokine which has been implicated in the pathogenesis of ANCA vasculitis. Anti-TNF therapies have been used successfully in the management of other inflammatory autoimmune diseases. This phase II cohort study has been designed to investigate the safety and efficacy of anti-TNF monoclonal antibody (Infliximab) therapy for patients with ANCA associated vasculitis when used in addition to standard immunosuppressive therapy.

Conditions

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Wegener's Granulomatosis Renal Limited Vasculitis Microscopic Polyangiitis

Keywords

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Infliximab Vasculitis antitnf monoclonal antibody

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

Patients with active vasculitis who receive infliximab in addition to standard immunosuppressive therapy

Group Type EXPERIMENTAL

Infliximab

Intervention Type BIOLOGICAL

5 mg/kg intravenous infusion at weeks 0, 2, 6 and 10 of study

Cyclophosphamide

Intervention Type DRUG

Daily oral 2 mg/kg or pulsed intravenous 15mg/kg every 2-3 weeks for 3-6 months (until patient has been in remission for 3 months).

Prednisolone

Intervention Type DRUG

Daily oral 1mg/kg tapered over 12 months

Azathioprine

Intervention Type DRUG

Daily oral 2 mg/kg started once patient is in remission and cyclophosphamide has been discontinued.

Mycophenolate mofetil

Intervention Type DRUG

Daily oral up to 1.5 g twice daily as tolerated. Used as alternative to azathioprine at lead physicians discretion.

Methylprednisolone

Intervention Type DRUG

500 mg intravenous infusion daily for three days at lead physicians discretion.

2

Patients with active ANCA associated vasculitis who receive standard immunosuppression but no infliximab

Group Type ACTIVE_COMPARATOR

Cyclophosphamide

Intervention Type DRUG

Daily oral 2 mg/kg or pulsed intravenous 15mg/kg every 2-3 weeks for 3-6 months (until patient has been in remission for 3 months).

Prednisolone

Intervention Type DRUG

Daily oral 1mg/kg tapered over 12 months

Azathioprine

Intervention Type DRUG

Daily oral 2 mg/kg started once patient is in remission and cyclophosphamide has been discontinued.

Plasma exchange

Intervention Type PROCEDURE

Additional therapy for patients with severe vasculitis (creatinine \> 500 mcmol/L or pulmonary haemorrhage). 7x 4L exchanges over 10 days.

Mycophenolate mofetil

Intervention Type DRUG

Daily oral up to 1.5 g twice daily as tolerated. Used as alternative to azathioprine at lead physicians discretion.

Methylprednisolone

Intervention Type DRUG

500 mg intravenous infusion daily for three days at lead physicians discretion.

Interventions

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Infliximab

5 mg/kg intravenous infusion at weeks 0, 2, 6 and 10 of study

Intervention Type BIOLOGICAL

Cyclophosphamide

Daily oral 2 mg/kg or pulsed intravenous 15mg/kg every 2-3 weeks for 3-6 months (until patient has been in remission for 3 months).

Intervention Type DRUG

Prednisolone

Daily oral 1mg/kg tapered over 12 months

Intervention Type DRUG

Azathioprine

Daily oral 2 mg/kg started once patient is in remission and cyclophosphamide has been discontinued.

Intervention Type DRUG

Plasma exchange

Additional therapy for patients with severe vasculitis (creatinine \> 500 mcmol/L or pulmonary haemorrhage). 7x 4L exchanges over 10 days.

Intervention Type PROCEDURE

Mycophenolate mofetil

Daily oral up to 1.5 g twice daily as tolerated. Used as alternative to azathioprine at lead physicians discretion.

Intervention Type DRUG

Methylprednisolone

500 mg intravenous infusion daily for three days at lead physicians discretion.

Intervention Type DRUG

Other Intervention Names

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Remicade

Eligibility Criteria

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Inclusion Criteria

* Either newly diagnosed or relapsed ANCA associated vasculitis (Wegener's granulomatosis, microscopic polyangiitis, renal limited vasculitis)

Exclusion Criteria

* Active infection
* Malignancy
* Pregnancy
* Diagnosis of Churg-Strauss syndrome or anti-glomerular basement membrane antibody disease
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital Birmingham NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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University Hospitals Birmingham NHS Foundation Trust/University of Birmingham

Principal Investigators

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Lorraine Harper, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Birmingham

Locations

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University Hospitals Birmingham NHS Foundation Trust

Birmingham, West Midlands, United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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RRK2031

Identifier Type: -

Identifier Source: org_study_id