IVIG Treatment for Refractory Immune-Related Adult Epilepsy

NCT ID: NCT01545518

Last Updated: 2014-09-01

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-11-30

Study Completion Date

2013-08-31

Brief Summary

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The purpose of the initial screening study is to find out if immune problems are an unrecognized cause of epilepsy in some patients. This study consists of a single blood sample, which will be tested for possible immune abnormalities. If enough patients are found who show immune abnormalities, those patients who are still having uncontrolled seizures will be invited to participate in a study of immune treatment with a compound called intravenous immunoglobulin (IVIG).

The study hypothesis is that a significant proportion of the young-onset, refractory, image-negative, partial-onset epilepsy population have an underlying autoimmune disorder, and many of these patients will respond to immune therapies, including IVIG.

At present, the importance of immune abnormalities in causing epilepsy, and the proper treatment when they are found, are both poorly understood. The investigators hope that this study will help us understand the cause of some cases that are difficult to treat.

Detailed Description

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The study is divided into two phases:

Phase I: The investigators will screen for evidence of neuronal nuclear, cytoplasmic, and cell surface autoantibodies in our population of new onset refractory, imaging-negative young adult epilepsy patients. This part of the study involves obtaining a single blood sample, equal to about 2 teaspoons.

Phase 2: If a sufficient number of cases are identified, a double-blind crossover study of IVIG treatment will be performed in these patients.

Conditions

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Epilepsy, Cryptogenic Epilepsy, Partial Seizure Disorder Autoimmune Diseases, Nervous System Limbic Encephalitis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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all subjects

IVIG

Group Type EXPERIMENTAL

IVIG

Intervention Type DRUG

IVIG 2 mg/kg in two divided doses with placebo crossover

Interventions

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IVIG

IVIG 2 mg/kg in two divided doses with placebo crossover

Intervention Type DRUG

Other Intervention Names

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IVIG manufactured by Baxter Healthcare Corporation

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of uncontrolled epilepsy with at least two seizures a month for three consecutive months.
* Age 18 to 50.
* Clinical semiology or electroencephalogram (EEG) consistent with partial onset epilepsy.
* Refractory to an adequate trial of two or more main-line anti-epileptic drugs.
* Ability to keep a seizure diary.
* Normal brain magnetic resonance imaging (MRI) - 3 Tesla, seizure protocol; with the exception of hippocampal sclerosis

Exclusion Criteria

* History of severe prematurity or neonatal distress, febrile seizures, moderate or sever traumatic brain injury, stroke, brain tumor, meningitis, encephalitis, neurocutaneous syndromes, or intracranial metal objects.
* Evidence of psychogenic epilepsy.
* History of convulsive status epilepticus.
* History of primary generalized epilepsy in a first degree relative.
* Known serious medical illness.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Baxter Healthcare Corporation

INDUSTRY

Sponsor Role collaborator

Emory University

OTHER

Sponsor Role lead

Responsible Party

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Charles M. Epstein, MD

Professsor of Neurology - Divsion of Epilepsy

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Charles M. Epstein, M.D.

Role: PRINCIPAL_INVESTIGATOR

Emory University

Locations

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Grady Memorial Hospital

Atlanta, Georgia, United States

Site Status

The Emory Clinic, Inc.

Atlanta, Georgia, United States

Site Status

Countries

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United States

References

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Alamowitch S, Graus F, Uchuya M, Rene R, Bescansa E, Delattre JY. Limbic encephalitis and small cell lung cancer. Clinical and immunological features. Brain. 1997 Jun;120 ( Pt 6):923-8. doi: 10.1093/brain/120.6.923.

Reference Type BACKGROUND
PMID: 9217677 (View on PubMed)

Graus F, Keime-Guibert F, Rene R, Benyahia B, Ribalta T, Ascaso C, Escaramis G, Delattre JY. Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain. 2001 Jun;124(Pt 6):1138-48. doi: 10.1093/brain/124.6.1138.

Reference Type BACKGROUND
PMID: 11353730 (View on PubMed)

Gultekin SH, Rosenfeld MR, Voltz R, Eichen J, Posner JB, Dalmau J. Paraneoplastic limbic encephalitis: neurological symptoms, immunological findings and tumour association in 50 patients. Brain. 2000 Jul;123 ( Pt 7):1481-94. doi: 10.1093/brain/123.7.1481.

Reference Type BACKGROUND
PMID: 10869059 (View on PubMed)

Jacobs DA, Fung KM, Cook NM, Schalepfer WW, Goldberg HI, Stecker MM. Complex partial status epilepticus associated with anti-Hu paraneoplastic syndrome. J Neurol Sci. 2003 Sep 15;213(1-2):77-82. doi: 10.1016/s0022-510x(03)00130-8.

Reference Type BACKGROUND
PMID: 12873758 (View on PubMed)

Lawn ND, Westmoreland BF, Kiely MJ, Lennon VA, Vernino S. Clinical, magnetic resonance imaging, and electroencephalographic findings in paraneoplastic limbic encephalitis. Mayo Clin Proc. 2003 Nov;78(11):1363-8. doi: 10.4065/78.11.1363.

Reference Type BACKGROUND
PMID: 14601695 (View on PubMed)

Lucchinetti CF, Kimmel DW, Lennon VA. Paraneoplastic and oncologic profiles of patients seropositive for type 1 antineuronal nuclear autoantibodies. Neurology. 1998 Mar;50(3):652-7. doi: 10.1212/wnl.50.3.652.

Reference Type BACKGROUND
PMID: 9521251 (View on PubMed)

McKeon A, Ahlskog JE, Britton JW, Lennon VA, Pittock SJ. Reversible extralimbic paraneoplastic encephalopathies with large abnormalities on magnetic resonance images. Arch Neurol. 2009 Feb;66(2):268-71. doi: 10.1001/archneurol.2008.556.

Reference Type BACKGROUND
PMID: 19204167 (View on PubMed)

Nahab F, Heller A, Laroche SM. Focal cortical resection for complex partial status epilepticus due to a paraneoplastic encephalitis. Neurologist. 2008 Jan;14(1):56-9. doi: 10.1097/NRL.0b013e3181578952.

Reference Type BACKGROUND
PMID: 18195661 (View on PubMed)

Pittock SJ, Kryzer TJ, Lennon VA. Paraneoplastic antibodies coexist and predict cancer, not neurological syndrome. Ann Neurol. 2004 Nov;56(5):715-9. doi: 10.1002/ana.20269.

Reference Type BACKGROUND
PMID: 15468074 (View on PubMed)

Porta-Etessam J, Ruiz-Morales J, Millan JM, Ramos A, Martinez-Salio A, Berbel-Garcia A. Epilepsia partialis continua and frontal features as a debut of anti-Hu paraneoplastic encephalomyelitis with focal frontal encephalitis. Eur J Neurol. 2001 Jul;8(4):359-60. doi: 10.1046/j.1468-1331.2001.00213.x. No abstract available.

Reference Type BACKGROUND
PMID: 11422434 (View on PubMed)

Shavit YB, Graus F, Probst A, Rene R, Steck AJ. Epilepsia partialis continua: a new manifestation of anti-Hu-associated paraneoplastic encephalomyelitis. Ann Neurol. 1999 Feb;45(2):255-8. doi: 10.1002/1531-8249(199902)45:23.0.co;2-n.

Reference Type BACKGROUND
PMID: 9989630 (View on PubMed)

Thieben MJ, Lennon VA, Boeve BF, Aksamit AJ, Keegan M, Vernino S. Potentially reversible autoimmune limbic encephalitis with neuronal potassium channel antibody. Neurology. 2004 Apr 13;62(7):1177-82. doi: 10.1212/01.wnl.0000122648.19196.02.

Reference Type BACKGROUND
PMID: 15079019 (View on PubMed)

Matarasso N, Bar-Shira A, Rozovski U, Rosner S, Orr-Urtreger A. Functional analysis of the Aurora Kinase A Ile31 allelic variant in human prostate. Neoplasia. 2007 Sep;9(9):707-15. doi: 10.1593/neo.07322.

Reference Type BACKGROUND
PMID: 17898866 (View on PubMed)

Rudzinski LA, Pittock SJ, McKeon A, Lennon VA, Britton JW. Extratemporal EEG and MRI findings in ANNA-1 (anti-Hu) encephalitis. Epilepsy Res. 2011 Aug;95(3):255-62. doi: 10.1016/j.eplepsyres.2011.04.006. Epub 2011 May 12.

Reference Type BACKGROUND
PMID: 21570256 (View on PubMed)

Other Identifiers

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BT11-000312

Identifier Type: OTHER

Identifier Source: secondary_id

IRB00052646

Identifier Type: -

Identifier Source: org_study_id

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