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Polyradiculoneuropathy, Chronic Inflammatory DemyelinatingPhase 3ICENCT00220740

Immune Globulin Intravenous (IGIV) For Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

A Phase 3 study testing Immune Globulin IV (Human), 10% Caprylate/Chromatography Purified and Albumin (Human) 25%, United States Pharmacopeia (USP) in people with Polyradiculoneuropathy, Chronic Inflammatory Demyelinating, run by Grifols Therapeutics LLC at 32 sites in 10 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The intent of this study is to demonstrate the efficacy and safety of Immune Globulin Intravenous (Human), 10% Caprylate/Chromatography Purified (IGIV-C) in newly or previously diagnosed CIDP subjects. Eight courses of treatment with either placebo or IGIV-C will occur every 3 weeks. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Immune Globulin IV (Human), 10% Caprylate/Chromatography Purified and Albumin (Human) 25%, United States Pharmacopeia (USP)
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
117 participants
Where
32 sitesin 10 countries
Study dates
Apr 2004to Jun 2006
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Documented diagnosis of CIDP must be made by a neurologist specializing/experienced in neuromuscular diseases based on: a) Progressive or relapsing motor and sensory dysfunction of more than one limb resulting from neuropathy over the 2 months prior to the date informed consent is obtained, and b) Cerebrospinal fluid (CSF) less than 50 white cells/µl since CIDP diagnosis (CSF testing studies are NOT mandatory)
  • Fulfillment of INCAT neurophysiological criteria for focal demyelinating polyradiculoneuropathy
  • Overall INCAT score between 2-9 and significant disability in upper or lower limb function in at least 2 limbs. (An INCAT score of 2 must be exclusively from leg disability to qualify.)

Who cannot join

  • Treatment with IGIV or plasma within 3 months prior to entry
  • Steroids (Prednisolone or equivalent) > 10 mg/day or equivalent (i.e., > 20 mg every 2 days) during the last 3 months prior to entry
  • Treatment with immunomodulatory/immunosuppressive agents (azathioprin, tacrolimus,cyclosporin, Muromonab-CD3 (OKT3), any interferon), previous lymphoid irradiation or prior treatment with cyclophosphamide, methotrexate, mitoxantrone or any other immunosuppressant drug within the past 6 months prior to entry
  • Concomitant use of supplements containing any amount of fish oil within 30 days prior to entry
  • Respiratory impairment requiring mechanical ventilation
  • Myelopathy or evidence of central demyelination or persisting neurological deficits from stroke, central nervous system (CNS) trauma or peripheral neuropathies of other cause which include diabetes mellitus (defined as a history of type 1 or type 2 diabetes with fasting plasma glucose ≥ 7.0 mmol/L), uremic, toxic and familial neuropathies
Show all 19Show fewer
  • Pure motor syndrome fulfilling criteria for multifocal motor neuropathy with conduction block. Lower motor neuron disorder with motor weakness in an upper limb, without sensory deficit and with proximal conduction block (50% decrease in amplitude/area with proximal distal stimulation ) in motor nerves and normal sensory nerve conduction studies.
  • Clinical or known evidence of associated systemic diseases that might cause neuropathy, including but not limited to connective tissue disease, HIV infection, hepatitis, Lyme disease, cancer (with the exception of benign skin cancer), Castleman's disease and systemic lupus erythematosus, diabetes mellitus (defined as a history of type 1 or type 2 diabetes with fasting plasma glucose ≥ 7.0 mmol/L), a malignant plasma cell dysplasia, immunoglobulin M (IgM) paraproteinemia, and amiodarone therapy.
  • History of anaphylaxis or severe systemic response to immunoglobulin or with a blood product.
  • Cardiac insufficiency (NYHA III/IV), cardiomyopathy, significant cardiac dysrhythmia requiring treatment, unstable or advanced ischemic heart disease, or history of congestive heart failure, severe hypertension (diastolic pressure >120 mmHg or systolic >170 mmHg).
  • Females who are pregnant, breast feeding, or if of childbearing potential, unwilling to practice adequate contraception throughout the study.
  • Known hyperviscosity.
  • History of renal insufficiency or serum creatinine levels > 221 µmol/L (2.5 mg/dL).
  • Known selective immunoglobulin A (IgA) deficiency.
  • Other investigational drugs received within the 30 days prior to entry
  • Conditions whose symptoms and effects could alter protein catabolism and/or immunoglobulin G (IgG) utilization (e.g. protein-losing enteropathies, nephrotic syndrome).
  • Known hypercoagulable state.
  • Mentally challenged adult subjects who cannot give independent informed consent.
  • Subjects with uncompensated hypothyroidism (abnormally high thyroid-stimulating hormone (TSH) and abnormally low T4) or vitamin B12 deficiency (abnormally low) within the last 3 months prior to entry.

Trial locations and contacts

32 sites in 10 countries.

32 sites in 10 countries

United States6 sites
  • Cleveland Clinic

    Cleveland, Ohio, 44195

  • University of Texas-Southwestern Medical Center at Dallas

    Dallas, Texas, 75390

  • Yale University School of Medicine

    New Haven, Connecticut, 06520-8018

  • Columbia University

    New York, New York, 10022

  • Saint Louis University Medical Center

    St Louis, Missouri, 63110

  • Wake Forest University-School of Medicine

    Winston-Salem, North Carolina, 27157-1078

Other trials in United States

Poland6 sites
  • Centre of Clinical Neurology, Neurology Department

    Cracow, 31-530

  • County Specialist Hospital, Neurology Department

    Gdansk, 80-803

  • Barlicki Hospital

    Lodz, 90-153

  • Medical Acedemy, Clinical Hospital, Neurology Department

    Lubin, 20-950

  • Central Clinical Hospital, Medical Academy Warsaw

    Warsaw

  • County Hospital

    Zgierz

Other trials in Poland

Argentina4 sites
  • Hospital Ramos Mejia

    Buenos Aires, C1221 ADC

  • Hospital Frances

    Buenos Aires, C1221ACI

  • Fundacion para la Lucha contra Las Enfermedades Neurologicas de la Infacia (FLENI)

    Buenos Aires, C1428 AQK

  • Instituto de Neurociencias Buenos Aires (INEBA)

    Capital Federal, C1192 AAW

Other trials in Argentina

Czechia4 sites
  • Fakultní nemocnice Brno

    Brno, 625 00

  • Fakultní nemocnice Ostrava

    Ostrava-Poruba, 1790

  • Neurologická klinika Pardubice

    Pardubice, 53003

  • Fakultní nemocnice Motol

    Prague, 15600

Other trials in Czechia

Israel3 sites
  • Tel Aviv Sourasky Medical Center

    Tel Aviv, 84101

  • Chaim Sheba Medical Center

    Tel HaShomer

  • Assaf Harofe Medical Center

    Zrifin, 70300

Other trials in Israel

Italy3 sites
  • Dipartimento di Neuroscienze, Sezione di Neurologia, AO Chieti

    Chieti

  • Univesita delgi Studi di Genova, Dipartimento di Scienze, Neurologiche e della Visione

    Genova, 16132

  • Hospital San Raffaele

    Milan, 20132

Other trials in Italy

Mexico3 sites
  • Antiguo Hospital Civil de Guadalajara

    Guadalajara, Jalisco, 44280

  • Hospital Angel Leano, Neurology Department

    Guadalajara, Jalisco

  • Hospital Central San Luis Potosi, Neurology Department

    San Luis Potosí City

Other trials in Mexico

Canada1 site
  • Vancouver Hospital and Health Sciences Center

    Vancouver, British Columbia, V5Z 1M9

Other trials in Canada

Germany1 site
  • Jüdisches Krankenhaus

    Berlin, 13347

Other trials in Germany

Serbia1 site
  • University Hospital, University of Belgrade

    Belgrade, 11000

Other trials in Serbia

About this study

Official title: Multicenter, Randomized, Double-blind, Placebo-controlled, Study to Evaluate the Efficacy and Safety of IGIV-Chromatography (IGIV-C), 10% Treatment in Subjects With Chronic Inflammatory Demyelinating Polyneuropathy

The intent of this study is to demonstrate the efficacy and safety of Immune Globulin Intravenous (Human), 10% Caprylate/Chromatography Purified (IGIV-C) in newly or previously diagnosed CIDP subjects. Eight courses of treatment with either placebo or IGIV-C will occur every 3 weeks. Neurological function will be measured by Inflammatory Neuropathy Cause and Treatment (INCAT) scores. Patients who deteriorate or show no improvement between day 16 and month 6 will receive the alternate study drug for an additional 6 months.

Read the detailed description

110 subjects, 55 per treatment group, with newly or previously diagnosed CIDP defined by INCAT neurophysiological diagnostic criteria will be enrolled into the trial. Patients will not be replaced if they discontinue prematurely.

Being tested
Immune Globulin IV (Human), 10% Caprylate/Chromatography Purified, Albumin (Human) 25%, United States Pharmacopeia (USP)
Keywords
Immunoglobulin G
Medical subject headings
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Immune Globulin IV (Human), 10% Caprylate/Chromatography PurifiedDrug

    Also called IGIV-C, IGIV-Chromatography (IGIV-C), 10%, Gamunex®, Gaminex®

    2 g/kg body weight ideally over 2-4 days . Thereafter, study drug infusion (IGIV-C) will be administered every 3 weeks at a dose of 1 g/kg bw, given over 1-2 days for a total of 7 additional infusions

  • Albumin (Human) 25%, United States Pharmacopeia (USP)Drug

    Also called Albumin (Human) 25%, USP, Plasbumin®-25, Plasbumin®-25 (Low Aluminum), TAL-05-00009

    Albumin 25%, USP diluted with dextrose 5% to a final concentration of 0.1% as an intravenous infusion. Alternatively, it may be a bottled placebo of 0.1% Albumin (Human) in 0.2 M Glycine, 1.1 mm sodium caprylate, 0.25% sodium chloride. 2 g/kg body weight ideally over 2-4 days . Thereafter, infusion (placebo) will be administered every 3 weeks at a dose of 1 g/kg bw, given over 1-2 days for a total of 7 additional infusions

Study groups in NCT00220740
Study groupRoleWhat they receive
Group 1ExperimentalIGIV-C
Receives: Drug: Immune Globulin IV (Human), 10% Caprylate/Chromatography Purified
Group 2Placebo comparatorNot described
Receives: Drug: Albumin (Human) 25%, United States Pharmacopeia (USP)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Comparison of the Responder Rates Between Two Treatment Groups in the Efficacy Period

    The primary efficacy objective was the comparison of IGIV-C and Placebo group Responder rates. An Efficacy Period Responder was defined as a subject with ≥ 1 point improvement in the adjusted Inflammatory Neuropathy Case And Treatment (INCAT) score, with the improvement maintained through the end of Week 24 in the Efficacy Period.

    Measurements are reported in INCAT scale of 0-5 in both lower and upper extremities, for a total score of 0 to 10.

    INCAT scores for arm disability: 0 = no upper limb problems; 5 = inability to use either arm for any purposeful movement.

    INCAT scores for leg disability: 0= walking not affected; 5 = restricted to wheelchair, unable to stand and walk a few steps with help

    Measured: 6 months

Secondary outcomes (3)
  1. Mean Change in the Amplitude (Millivolts) in the Most Severely Affected Motor Nerve During the Efficacy Period

    Mean changes in amplitude [mV] measured at most proximal site in the most severely affected motor nerve from baseline to endpoint during the Efficacy Period (Intent to treat population)

    Measured: 6 months

  2. Mean Change in Grip Strength During the Efficacy Period

    Measured: 6 months

  3. Time to Relapse for Subjects Who Were IGIV-C Responders or IGIV-C Rescue Successes, During the Randomized Withdrawal Period

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Sep 2005 (estimated)
  2. Study startApr 2004
  3. Primary completionJun 2006
  4. Study completionJun 2006

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
117 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00220740
Sponsor's protocol ID
100538
Acronym
ICE
Status last verified
Feb 2016
First submitted
13 Sep 2005
Last updated
23 Mar 2016
Data monitoring committee
No

Publications

  • Hughes RA, Donofrio P, Bril V, Dalakas MC, Deng C, Hanna K, Hartung HP, Latov N, Merkies IS, van Doorn PA; ICE Study Group. Intravenous immune globulin (10% caprylate-chromatography purified) for the treatment of chronic inflammatory demyelinating polyradiculoneuropathy (ICE study): a randomised placebo-controlled trial. Lancet Neurol. 2008 Feb;7(2):136-44. doi: 10.1016/S1474-4422(07)70329-0.

    PubMed 18178525
  • Bril V, Katzberg H, Donofrio P, Banach M, Dalakas MC, Deng C, Hanna K, Hartung HP, Hughes RA, Latov N, Merkies IS, van Doorn PA; ICE Study Group. Electrophysiology in chronic inflammatory demyelinating polyneuropathy with IGIV. Muscle Nerve. 2009 Apr;39(4):448-55. doi: 10.1002/mus.21236.

    PubMed 19260050
  • Merkies IS, Bril V, Dalakas MC, Deng C, Donofrio P, Hanna K, Hartung HP, Hughes RA, Latov N, van Doorn PA; ICE Study Group. Health-related quality-of-life improvements in CIDP with immune globulin IV 10%: the ICE Study. Neurology. 2009 Apr 14;72(15):1337-44. doi: 10.1212/WNL.0b013e3181a0fd80.

    PubMed 19365055
  • Hughes RA. Intravenous immunoglobulin for chronic inflammatory demyelinating polyradiculoneuropathy: the ICE trial. Expert Rev Neurother. 2009 Jun;9(6):789-95. doi: 10.1586/ern.09.30.

    PubMed 19496683
  • Donofrio PD, Bril V, Dalakas MC, Deng C, Hanna K, Hartung HP, Hughes R, Latov N, Merkies I, van Doorn P; IGIV-C CIDP Efficacy (ICE) Study Group. Safety and tolerability of immune globulin intravenous in chronic inflammatory demyelinating polyradiculoneuropathy. Arch Neurol. 2010 Sep;67(9):1082-8. doi: 10.1001/archneurol.2010.223.

    PubMed 20837852
  • Merkies IS, van Nes SI, Hanna K, Hughes RA, Deng C. Confirming the efficacy of intravenous immunoglobulin in CIDP through minimum clinically important differences: shifting from statistical significance to clinical relevance. J Neurol Neurosurg Psychiatry. 2010 Nov;81(11):1194-9. doi: 10.1136/jnnp.2009.194324. Epub 2010 Jul 20.

    PubMed 20647554
  • Latov N, Deng C, Dalakas MC, Bril V, Donofrio P, Hanna K, Hartung HP, Hughes RA, Merkies IS, van Doorn PA; IGIV-C CIDP Efficacy (ICE) Study Group. Timing and course of clinical response to intravenous immunoglobulin in chronic inflammatory demyelinating polyradiculoneuropathy. Arch Neurol. 2010 Jul;67(7):802-7. doi: 10.1001/archneurol.2010.105. Epub 2010 May 10.

    PubMed 20457948

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Immune Globulin IV (Human), 10% Caprylate/Chromatography Purified and Albumin (Human) 25%, United States Pharmacopeia (USP) in people with Polyradiculoneuropathy, Chronic Inflammatory Demyelinating, run by Grifols Therapeutics LLC at 32 sites in 10 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 Mar 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 32 sites in United States, Poland, Argentina, Czechia, Israel and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 10 Sep 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Comparison of the Responder Rates Between Two Treatment Groups in the Efficacy Period (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00220740, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Mar 2016.

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