Chronic Inflammatory Demyelinating PolyneuropathyNCT02111590
Immunoglobulin Dosage and Administration Form in CIDP and MMN
An observational study of Chronic Inflammatory Demyelinating Polyneuropathy and Multifocal Motor Neuropathy, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.
Trial summary
The aim of this study is to evaluate development of hemolysis and the variation in isokinetic muscle strength in two groups of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy (MMN) 1. Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Chronic Inflammatory Demyelinating Polyneuropathy, Multifocal Motor Neuropathy, Hemolytic Anemia
- What is being tested?
- Immunoglobulins
- Type of treatment
- Injection or infusion
- How many people
- 36 participants
- Where
- 1 siteDenmark
- Study dates
- Jan 2014to Jul 2015
- Phase
- Observational
- Are there results?
- None posted in the registry
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 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients diagnosed with CIDP or MMN in maintenance treatment with immunoglobulins
Who may be able to join
- Diagnosed with CIDP or MMN fulfilling the EFNS/PNS criteria
- Maintenance treatment with IVIG or SCIG for at least 3 months
- Negative result on a pregnancy test (HCG-based assay in urine) for women of childbearing potential and use of a reliable method of contraception for the duration of the study
Who cannot join
- Pure sensory or severe ataxic CIDP
- Other cause of neuropathy (incl. pressure neuropathy)
- Known history of adverse reactions to IgA in other products
- Exposure to blood or any blood product or plasma derivatives, other than Privigen, within the past 3 months prior to first infusion of Gammanorm
- Ongoing history of hypersensitivity or persistent reactions to blood or plasma derived products.
- Requirement of any routine premedication for IgG administration
Show all 17Show fewer
- History of malignancies of lymphoid cells and immunodeficiency with lymphoma
- Severe liver function impairment (ALAT 3 times above upper limit of normal)
- Known protein-losing enteropathies or proteinuria.
- Live viral vaccination (such as measles, rubella, mumps and varicella) within the last 2 months prior to first infusion of Gammanorm
- Treatment with any investigational medicinal product within 3 months prior to first infusion of Gammanorm
- Medication interfering with hematopoiesis
- Other immunomodulation therapy than low dose steroid (Prednisolone < 25 mg daily)
- Known or suspected to abuse alcohol, drugs, psychotropic agents or other chemicals within the past 12 months prior to first infusion of Gammanorm
- Known or suspected HIV, HCV, or HBV infection
- Pregnant or nursing women
- Planned pregnancy during course of the study
Trial locations and contacts
1 site in 1 country.
About this study
Official title: The Influence of Immunoglobulin Dosage and Administration on Development of Hemolytic Anemia and Variation on Muscle Strength in Patients With CIDP and MMN
The aim of this study is to evaluate development of hemolysis and the variation in isokinetic muscle strength in two groups of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy (MMN)
- Patients shifted from 3- or 6-weekly treatment with intravenous immunoglobulin (IVIG) to weekly treatment with subcutanoeus immunoglobulin (SCIG)
- Patients shifted from SCIG treatment with Subcuvia® or Hizentra® to Gammanorm®.
Read more
Hypotheses
- During treatment with IVIG blood hemoglobin will fluctuate with a decline due to infusion, whereas it will remain stable during SCIG treatment without fluctuation
- Isokinetic muscle strength in affected muscle groups is more stable during treatment with SCIG than with IVIG
- Blood hemoglobin and changes in muscle strength is comparable during Subcuvia® or Hizentra® and Gammanorm® treatment
Read the detailed description
Due to planned switch of treatment with immunoglobulin at Department of neurology (Rigshospitalet) patients treated with IVIG will be shifted to treatment with SCIG with an unaltered dosage. The medication is administered at home two or three times weekly. IVIG is often administered every 3 to 6 weeks. All patients will be trained in managing the treatment with SCIG by a nurse from the neurological department. When the patient is able to manage the treatment regimen it can be done at home.
All patients will be evaluated eight times during the study period. Four times before and four times after shift of treatment.
Prior to participation the intervals will be standardized to 3 or 6 weeks giving an extra infusion for those with an interval of 3 weeks, i.e. patients on 4-week interval will be switched to 3-week interval while patients on 5-week interval will be switched to 6-week interval. The dose will be adjusted leading to an unchanged weekly dose of IVIG. All patients will be evaluated in connection to two IVIG infusions. For those receiving 3 infusions examinations will be executed before and 2 weeks after the first and last infusion. SCIG is initiated 2 weeks after the last IVIG infusion.
Patients on maintenance therapy with Subcuvia® or Hizentra® will be shifted to treatment with Gammanorm® according to guidelines from the Danish Healthcare Society, the weekly dose of immunoglobulin being unaltered. They will be evaluated 3 times (once before, at the time of shift of SCIG and once after).
All evaluations at each time point in both groups consist of measurement of isokinetic muscle strength of four affected muscle groups and blood sampling detecting blood hemoglobin and hemolytic parameters.
- Conditions
- Chronic Inflammatory Demyelinating Polyneuropathy, Multifocal Motor Neuropathy, Hemolytic Anemia
- Being tested
- Immunoglobulins
- Keywords
- Immunoglobulins, Intravenous, Immunoglobulins, Subcutaneous
- Medical subject headings
- Polyradiculoneuropathy, Chronic Inflammatory Demyelinating, Anemia, Hemolytic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ImmunoglobulinsDrug
Also called Gammanorm(R), immunoglobulin for subcutaneous use
SCIG dosage is individualized for each patient according to previous IVIG dosage
| Study group | Role | What they receive |
|---|---|---|
| IVIG to SCIG | Patients with CIDP or MMN in maintenance therapy with IVIG every 3rd to 6th week are shifted to weekly SCIG treatment in unaltered dose. Receives: Drug: Immunoglobulins | |
| SCIG to SCIG | Patients with CIDP or MMN in maintenance therapy with SCIG (Subcuvia(R) or Hizentra(R)) are shifted to treatment with Gammanorm(R) in unaltered weekly dose. Receives: Drug: Immunoglobulins |
What is being measured
The primary outcome is the main question the study is designed to answer.
Variation in blood hemoglobin during treatment with IVIG and SCIG
Patients in treated with IVIG every 6th week are shifted to weekly SCIG treatment in unaltered dose. Blood hemoglobin is measured according to two IVIG infusions, before and two weeks after, and four times with the same intervals during SCIG treatment. SCIG treatment is initiated in week 8.
Blood samples are collected at the following time points:
Week 0, 2, 6, 8, 12, 14, 18 and 20
Measured: Twenty weeks
Secondary outcomes (3)
Variation in muscle strength during treatment with two preparations of SCIG
Patients treated with SCIG (Subcuvia(R) or Hizentra(R)) are shifted to treatment with Gammanorm(R) in unaltered weekly dose. Muscle strength are evaluated at enrolment and after 10 weeks of treatment with (Subcuvia(R) or Hizentra(R)) and after 10 weeks of treatment with Gammanorm(R). Treatment is shifted in week 10.
Muscle strength is meaured at the following time points:
Week 0, 10 and 20
Measured: Twenty weeks
Variation in muscle strength during treatment with IVIG and SCIG
Patients in treated with IVIG every 6th week are shifted to weekly SCIG treatment in unaltered dose. Isokinetic muscle strength is measured according to two IVIG infusions, before and two weeks after, and four times with the same intervals during SCIG treatment. SCIG treatment is initiated in week 8.
Muscle strength is measured at the following time points:
Week 0, 2, 6, 8, 12, 14, 18 and 20
Measured: Twenty weeks
Variation in blood hemoglobin during treatment with two preparations of SCIG
Patients treated with SCIG (Subcuvia(R) or Hizentra(R)) are shifted to treatment with Gammanorm(R) in unaltered weekly dose. Blood hemoglobin is measured at enrolment and after 10 weeks of treatment with (Subcuvia(R) or Hizentra(R)) and after 10 weeks of treatment with Gammanorm(R). Treatment is shifted in week 10.
Blood samples are collected at the following time points:
Week 0, 10 and 20
Measured: Twenty weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Apr 2014 (estimated)
- Study startJan 2014
- Primary completionJul 2015
- Study completionJul 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Chronic Inflammatory Demyelinating PolyneuropathyStudies of the same condition, open and under way.
- More trials run by Copenhagen University Hospital, RigshospitaletThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Lead sponsor
- Copenhagen University Hospital, Rigshospitalet
- Sponsor type
- University, hospital or other
- Collaborators
- Aarhus University Hospital, Octapharma Pharmazeutika Produktionsges.m.b.H.
- Responsible party
- Principal investigator, Johannes Jakobsen, Copenhagen University Hospital, Rigshospitalet
- Investigators
- Johannes Jakobsen, DMSc, Principal investigator, Neuroscience Center, Rigshospitalet
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02111590
- Sponsor's protocol ID
- 2013-400-RH
- Status last verified
- Sep 2015
- First submitted
- 9 Apr 2014
- Last updated
- 22 Sep 2015
- Results posted
- No
- Data monitoring committee
- No
Publications
Christiansen I, Markvardsen LH, Jakobsen J. Comparisons in fluctuation of muscle strength and function in patients with immune-mediated neuropathy treated with intravenous versus subcutaneous immunoglobulin. Muscle Nerve. 2018 Apr;57(4):610-614. doi: 10.1002/mus.25967. Epub 2017 Nov 18.
PubMed 28881389
Study at a glance
From the registry record, last updated by the sponsor on 22 Sep 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Influence of Immunoglobulin Dosage and Administration on Development of Hemolytic Anemia and Variation on Muscle Strength in Patients With CIDP and MMN
- ClinicalTrials.gov ID
- NCT02111590
- Acronym / sponsor ID
- 2013-400-RH
- Conditions
- Chronic Inflammatory Demyelinating Polyneuropathy, Multifocal Motor Neuropathy, Hemolytic Anemia
- Keywords
- Immunoglobulins, Intravenous, Immunoglobulins, Subcutaneous
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 36 participants (actual)
- Lead sponsor
- Copenhagen University Hospital, RigshospitaletUniversity, hospital or other
- Collaborators
- Aarhus University Hospital, Octapharma Pharmazeutika Produktionsges.m.b.H.
- Study start
- Jan 2014
- Primary completion
- Jul 2015 (actual)
- Study completion
- Jul 2015 (actual)
- First posted
- 11 Apr 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to evaluate development of hemolysis and the variation in isokinetic muscle strength in two groups of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy (MMN)
- Patients shifted from 3- or 6-weekly treatment with intravenous immunoglobulin (IVIG) to weekly treatment with subcutanoeus immunoglobulin (SCIG)
- Patients shifted from SCIG treatment with Subcuvia® or Hizentra® to Gammanorm®.
Hypotheses
- During treatment with IVIG blood hemoglobin will fluctuate with a decline due to infusion, whereas it will remain stable during SCIG treatment without fluctuation
- Isokinetic muscle strength in affected muscle groups is more stable during treatment with SCIG than with IVIG
- Blood hemoglobin and changes in muscle strength is comparable during Subcuvia® or Hizentra® and Gammanorm® treatment
Detailed description
Due to planned switch of treatment with immunoglobulin at Department of neurology (Rigshospitalet) patients treated with IVIG will be shifted to treatment with SCIG with an unaltered dosage. The medication is administered at home two or three times weekly. IVIG is often administered every 3 to 6 weeks. All patients will be trained in managing the treatment with SCIG by a nurse from the neurological department. When the patient is able to manage the treatment regimen it can be done at home.
All patients will be evaluated eight times during the study period. Four times before and four times after shift of treatment.
Prior to participation the intervals will be standardized to 3 or 6 weeks giving an extra infusion for those with an interval of 3 weeks, i.e. patients on 4-week interval will be switched to 3-week interval while patients on 5-week interval will be switched to 6-week interval. The dose will be adjusted leading to an unchanged weekly dose of IVIG. All patients will be evaluated in connection to two IVIG infusions. For those receiving 3 infusions examinations will be executed before and 2 weeks after the first and last infusion. SCIG is initiated 2 weeks after the last IVIG infusion.
Patients on maintenance therapy with Subcuvia® or Hizentra® will be shifted to treatment with Gammanorm® according to guidelines from the Danish Healthcare Society, the weekly dose of immunoglobulin being unaltered. They will be evaluated 3 times (once before, at the time of shift of SCIG and once after).
All evaluations at each time point in both groups consist of measurement of isokinetic muscle strength of four affected muscle groups and blood sampling detecting blood hemoglobin and hemolytic parameters.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| IVIG to SCIG | – | Drug: ImmunoglobulinsPatients with CIDP or MMN in maintenance therapy with IVIG every 3rd to 6th week are shifted to weekly SCIG treatment in unaltered dose. |
| SCIG to SCIG | – | Drug: ImmunoglobulinsPatients with CIDP or MMN in maintenance therapy with SCIG (Subcuvia(R) or Hizentra(R)) are shifted to treatment with Gammanorm(R) in unaltered weekly dose. |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients diagnosed with CIDP or MMN in maintenance treatment with immunoglobulins
Key inclusion criteria (3 listed)
- Diagnosed with CIDP or MMN fulfilling the EFNS/PNS criteria
- Maintenance treatment with IVIG or SCIG for at least 3 months
- Negative result on a pregnancy test (HCG-based assay in urine) for women of childbearing potential and use of a reliable method of contraception for the duration of the study
Key exclusion criteria (17 listed)
- Pure sensory or severe ataxic CIDP
- Other cause of neuropathy (incl. pressure neuropathy)
- Known history of adverse reactions to IgA in other products
- Exposure to blood or any blood product or plasma derivatives, other than Privigen, within the past 3 months prior to first infusion of Gammanorm
- Ongoing history of hypersensitivity or persistent reactions to blood or plasma derived products.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ImmunoglobulinsAlso: Gammanorm(R), immunoglobulin for subcutaneous useSCIG dosage is individualized for each patient according to previous IVIG dosage | Drug | IVIG to SCIG, SCIG to SCIG |
Primary outcome
Variation in blood hemoglobin during treatment with IVIG and SCIG
Time frame: Twenty weeks
Patients in treated with IVIG every 6th week are shifted to weekly SCIG treatment in unaltered dose. Blood hemoglobin is measured according to two IVIG infusions, before and two weeks after, and four times with the same intervals during SCIG treatment. SCIG treatment is initiated in week 8. Blood samples are collected at the following time points: Week 0, 2, 6, 8, 12, 14, 18 and 20
3 secondary outcomes
Variation in muscle strength during treatment with two preparations of SCIG
Time frame: Twenty weeks
Variation in muscle strength during treatment with IVIG and SCIG
Time frame: Twenty weeks
Variation in blood hemoglobin during treatment with two preparations of SCIG
Time frame: Twenty weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Sep 2015.
- Derived from this study: PubMed 28881389Christiansen I, Markvardsen LH, Jakobsen J. Comparisons in fluctuation of muscle strength and function in patients with immune-mediated neuropathy treated with intravenous versus subcutaneous immunoglobulin. Muscle Nerve. 2018 Apr;57(4):610-614. doi: 10.1002/mus.25967. Epub 2017 Nov 18.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Johannes Jakobsen, DMSc principal investigator
Neuroscience Center, Rigshospitalet
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Chronic Inflammatory Demyelinating Polyneuropathy and Multifocal Motor Neuropathy, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.
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 17 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 22 Sep 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Denmark. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Variation in blood hemoglobin during treatment with IVIG and SCIG (time frame: Twenty weeks). 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 NCT02111590, which also lists 1 linked publication.
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 22 Sep 2015.