Rituximab in Auto-Immune Hemolytic Anemia

NCT ID: NCT01181154

Last Updated: 2017-10-19

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-03-03

Study Completion Date

2016-01-08

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The hypothesis based on retrospective data is that, the rate of overall response-rate (PR + CR) at 1 year will be much higher in the rituximab arm (80%) than in the placebo arm (20%).Thirty four patients (17 in each arm) will be include (amendment n°6 - 15/10/2013) over a 3 year period (amendment n°3 - 11/12/2012).

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The primary aim of the study is to assess the efficacy (overall response rate at 1 year) of rituximab (an anti-CD20 monoclonal antibody) in AIHA due to warm autoantibody when administered at the initial phase of the disease. All eligible patents with a newly diagnosed AIHA (within 6 weeks after diagnosis) will be treated by corticosteroids at standard dose (prednisone 1 mg/kg/day) and will be randomized into 2 arms: Rituximab or placebo 1000 mg on days 1 and 15 in a 1/1 ratio. As soon as at least a partial remission (PR) of AIHA will be achieved, the daily dose of prednisone will be tapered following the rules provided by the protocol.

The hypothesis based on retrospective data is that, the rate of overall response-rate (PR + CR) at 1 year will be much higher in the rituximab arm (80%) than in the placebo arm (20%).Thirty four patients (17 in each arm) will be include (amendment n°6 - 15/10/2013) over a 3 year period (amendment n°3 - 11/12/2012).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Warm Autoimmune Hemolytic Anemia

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Auto-Immune Hemolytic Anemia AHA AIHA Rituximab

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

equivalent volume total (=1000 ml)

Placebo : equivalent volume total (=1000 ml)

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

equivalent volume total

rituximab (Mabthera®)

rituximab (Mabthera®), 1000 mg at day 1 and day 15

Group Type EXPERIMENTAL

rituximab (Mabthera®)

Intervention Type DRUG

1000 mg at day 1 and day 15

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

rituximab (Mabthera®)

1000 mg at day 1 and day 15

Intervention Type DRUG

Placebo

equivalent volume total

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

rituximab (Mabthera®)1000 mg at day 1 and day 15 Placebo equivalent volume total

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Age \> 18 years
2. AIHA defined at time of diagnosis by a Hgb level £ 10 g/dL, with a reticulocytes count \> 120 109/L, signs of hemolysis (at least a haptoglobin level \< 4 mg/L), and a positive direct antiglobulin test (DAT) ( IgG or IgG + complement pattern).
3. Disease duration equal or less than 6 weeks at time of inclusion --\> removed by amendment n°4 and substituted by :First episode of AIHA to "hot" antibody previously untreated or treated corticosteroids for less than 6 weeks.
4. Patients with an associated autoimmune thrombocytopenia (Evans' syndrome) will be eligible for the study if the platelet count is over 30 x 109/L at inclusion.
5. Normal level gammaglobulins in the serum (i.e. \>5g/L) at inclusion.
6. Absence of detectable lymph nodes on a total body CT-scan (to be performed before inclusion if not performed at diagnosis).
7. Effective means of contraception during treatment and for six months after completion of treatment for all women of child bearing age
8. Negative serum pregnancy test within 14 days prior to study entry.
9. Written informed consent

Exclusion Criteria

Previous treatment with rituximab

1. AIHA diagnosed and treated more than 6 weeks prior to inclusion removed by amendment n°4 and substituted by AIHA relapsed or newly diagnosed but treated with corticosteroids for more than 6 weeks
2. Ongoing immunosuppressive therapy (other than corticosteroids) or previous treatment administered within 2 weeks prior to the beginning of the study treatment
3. Non-Hodgkin Lymphoma (NHL) other than stage A chronic lymphoid leukemia
4. Previous or concomitant malignancy other than basal cell or squamous cell carcinoma of the skin, carcinoma-in-situ of the cervix, or other malignancy for which the patient had not been disease-free for at least 5 years.
5. Autoimmune disorder such as SLE with at least one extra-hematological manifestation requiring a treatment with steroids and/or immunosuppressive drugs.
6. Any other associated cause congenital or acquired hemolytic anemia (except thalassemia trait or heterozygous sickle cell anemia).
7. Negative DAT or DAT positive with isolated anti-C3d pattern related to the presence of a monoclonal IgM with cold agglutinin properties.
8. Positive HIV test and/or hepatitis virus C infection and/or positive hepatitis B virus surface antigen (HbsAg).
9. Neutrophils count \< 1,000/mm 3 at inclusion.
10. Impaired renal function as indicated by a serum creatinine level \> 2 mg/d
11. Inadequate liver function as indicated by a total bilirubin level \> 2.0 mg/dL and/or an AST or ALT level \> 2x upper limit of normal.
12. New York Heart Classification III or IV heart disease.
13. Previous history of severe psychiatric disorder or are unable to comply with study and follow-up procedures
14. Pregnant or lactating women, or woman planning to become pregnant within 12 months of receiving study drug
15. Absence of written informed consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Hoffmann-La Roche

INDUSTRY

Sponsor Role collaborator

Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Marc MICHEL, MD

Role: PRINCIPAL_INVESTIGATOR

Assistance Publique - Hôpitaux de Paris

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Henri Mondor University Hospital

Créteil, , France

Site Status

Countries

Review the countries where the study has at least one active or historical site.

France

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2008-008255-42

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

P080704

Identifier Type: -

Identifier Source: org_study_id