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Guillain-Barre SyndromeNCT04550611

Mini-pool Intravenous Immunoglobulin (MP-IVIG) in Guillain-Barré Syndrome

A study testing Mini-pool Intravenous Immunoglobulin (MP-IVIG) and plasma exchange in people with Guillain-Barre Syndrome, run by Assiut University.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

1. study the pharmacokinetics of mini-pooled intravenous immunoglobulin( MP-IVIG) 2. to determine the efficacy of intravenous immunoglobulin (IVIg) in hastening recovery and reducing the complications of Guillain-Barré syndrome (GBS). Read more about this study

Who is it for?
Ages 18 to 40 yearsHealthy volunteers can take part
Conditions the study is for
Guillain-Barre Syndrome
What is being tested?
Mini-pool Intravenous Immunoglobulin (MP-IVIG) and plasma exchange
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
No sites listed yet
Study dates
Nov 2021to Dec 2022
Phase
Interventional
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 40 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Age group: 18-40 years.
  • Both sex are include
  • The study will include patient diagnosed as Guillain-Barré syndrome (mild) cases in neuropsychiatric hospital at Assiut university hospitals.

Who cannot join

  • • Patient has severe form of Guillain-Barré syndrome (GBS) according to GBS disability score
  • Patient with renal impairment
  • Patient with hepatic cell failure

Trial locations and contacts

No sites are listed yet.

Hend A Moubark, Specialist contact

01010326577

hindq1989@gmail.com

About this study

Official title: Efficacy of Mini-pool Intravenous Immunoglobulin (MP-IVIG) Prepared by Assiut University Hospital Blood Bank in Guillain-Barré Syndrome

  1. study the pharmacokinetics of mini-pooled intravenous immunoglobulin( MP-IVIG)
  2. to determine the efficacy of intravenous immunoglobulin (IVIg) in hastening recovery and reducing the complications of Guillain-Barré syndrome (GBS).
  • The MP-IVIG was tolerated and presented no safety issues in a previous study and we will be confirmed by monitoring any adverse events (anaphylaxis and haemolysis) ( no or mild or moderate) and reporting them to ethical committee safety monitoring group.
  • Efficacy will be confirmed by:
  1. Patient able to walk
  2. Improvement of general health.
  3. Integration in to social live
  4. to compare the efficacy of IVIg to plasma exchange (PE) in hastening recovery and improving the condition of GBS
Read the detailed description

Guillain-Barré syndrome (GBS) is a frequent cause of neuromuscular paralysis occurring at all ages. The incidence of GBS is reported to be 1.2-2.3 per 100,000 per year .

GBS is a post infectious disorder. The most frequently identified preceding infection is Campylobacter jejuni. Others are cytomegalovirus, Epstein-Barr virus, Mycoplasma pneumoniae, and Haemophilus influenzae . Many reports have documented the occurrence of GBS shortly after vaccinations, operations, or stressful events, but the causality and pathophysiology are still debated .

Rapidly progressive weakness is the core clinical feature of GBS. By definition, maximal weakness is reached within 4 weeks, but most patients reach it within 2 to 3 weeks. Thereafter, patients enter a plateau phase that ranges from days to several weeks or months . This phase is followed by a usually much slower and variable recovery phase. In Europe, about one-third of GBS patients remain able to walk ("mild patients") .about 25% of the GBS patients who are unable to walk ("severe patients") need artificial ventilation. This is predominantly due to weakness of the respiratory muscles. GBS has a great impact on social life and the ability to perform activities of daily life. therefore, GBS remains a severe disease for which better treatments are required .

. Magdy EL-Ekiaby, et al 2010 introduce the concept of small-scale ("minipool") plasma processing methods. The preparation of the Immunoglobulin G (IgG) plasma fractionation from 20 blood donations which are tested for anti-A and anti-B titre < 32. Implementable with minimum infrastructural requirements. They developed viral inactivation and protein purification technologies in single-use equipment to prepare virally safe solvent/detergent-filtered (S/D-F) plasma Producing a 90%pure immunoglobulin fraction in disposable single-use devices for transfusion .

IVIG adverse events (AEs) are not frequent; hemolysis after IVIG is a known, rare complication. Higher doses and non-O blood group are key risk factors. The incidence of post-IVIG hemolysis is estimated at 1 per 1000 IVIG treatment episodes, most of which occur within 2 days of exposure. Although the preparation of blood group specific IVIGs in industry is a complex issue because of the pooling of thousands of plasma donations per batch, the preparation of blood group-specific mini-pool IVIG (MP-IVIG) is possible because each pool consists of only 20 plasma donations. Blood group-matched MP-IVIG is assumed to reduce the incidence of IVIG-associated hemolysis, which is largely caused by the presence of anti-A and anti-B agglutinins reacting with non-O blood group recipients.

Being tested
Mini-pool Intravenous Immunoglobulin (MP-IVIG), plasma exchange
Medical subject headings
Guillain-Barre Syndrome

What participants receive

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

  • Mini-pool Intravenous Immunoglobulin (MP-IVIG)Other

    The process of MP-IVIG preparation will involve the use of caprylic acid for purification and virus inactivation of Igs from mini-pools of 20 plasma donations collected in our CBTS in AUH. The equipment used for the process comprised disposable blood bags, hemodialyzers, and purification and microbial filters.

  • plasma exchangeOther

    Also called plasmapheresis

    plasma exchange (plasmapheresis ) in a regimen of removing of 1.3 plasma volumes in each cycle for total of five cycle for five consecutive days within four weeks of onset of symptoms.

Study groups in NCT04550611
Study groupRoleWhat they receive
Mini-pool Intravenous Immunoglobulin (MP-IVIG)Experimentalwill receive blood group -specific MP-IVIG in a regimen of 2 g/kg bodyweight, usually as 0.4 g/kg bodyweight per day for five consecutive days within two weak of onset of symptoms.
Receives: Other: Mini-pool Intravenous Immunoglobulin (MP-IVIG)
plasmapheresisExperimentalplasma exchange (plasmapheresis ) in a regimen of removing of 1.3 plasma volumes in each cycle for total of five cycle for five consecutive days within four weeks of onset of symptoms.
Receives: Other: plasma exchange

What is being measured

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

  1. Efficacy ofMini-pool Intravenous Immunoglobulin (MP-IVIG) assessed by patients achieve score more than or equal 2 according to GBS disability score

    Guillain-Barré syndrome disability scale Score Description 0 A healthy state

    1. Minor symptoms and capable of running
    2. Able to walk 10m or more without assistance but unable to run
    3. Able to walk 10m across an open space with help
    4. Bedridden or chairbound
    5. Requiring assisted ventilation for at least part of the day
    6. Dead

    Measured: 6 MONTHS

  2. Safety of MP-IVIG assessed by percentage of adverse Events: Overall percentage of adverse events

    Overall percentage of adverse events as hemolysis and anaphylaxis headache and other complains that occur during 72 hours of following an infusion of MP-IVIG will be assessed by1) vital sign(pulse,blood pressure,Respiratory rate and temperature 2)Hemolysis by hemoglobin level, Lactate dehydrogenase( LDH),bilirubin level.2)between infusions by home diaries.

    Measured: 72 hour after adminstration of MP-IVIG and between infusions period

  3. Study the pharmacokinetics- MP-IVIG trough levels

    MP-IVIG trough level concentration values of serum total IgG pre the MP-IVIG infusion (if applicable).

    Measured: predose sample

  4. Study the pharmacokinetics MP-IVIG plasma concentration -time curve [

    Blood samples for analysis of pharmacokinetics MP-IVIG plasma concentration -time curve were obtained and analysed Blood samples for analysis of pharmacokinetics MP-IVIG plasma concentration -time curve were obtained and analysed

    Measured: (1 hour, 2 hours and 1, 2, 3, 7, 14 and 21 days) post-dose ]

  5. Study the pharmacokinetics MP-IVIG half-life

    Blood samples for analysis of pharmacokinetics MP-IVIG haf-life were obtained and analysed

    Measured: (1 hour, 2 hours and 1, 2, 3, 7, 14 and 21 days) post-dose ]

  6. Study the pharmacokinetics MP-IVIG area under the curve

    Blood samples for analysis of pharmacokinetics MP-IVIG haf-life were obtained and analysed

    Measured: (1 hour, 2 hours and 1, 2, 3, 7, 14 and 21 days) post-dose ]

  7. Study the pharmacokinetics MP-IVIG Cmax

    Blood samples for analysis of pharmacokinetics MP-IVIG Cmax were obtained and analysed

    Measured: (1 hour, 2 hours and 1, 2, 3, 7, 14 and 21 days) post-dose ]

  8. Study the pharmacokinetics of MP-IVIG-Tmax.

    Blood samples for analysis of pharmacokinetics MP-IVIG Tmax were obtained and analysed

    Measured: (1 hour, 2 hours and 1, 2, 3, 7, 14 and 21 days) post-dose ]

  9. Study the pharmacokinetics of MP-IVIG elimination rate constant(s). : (

    Blood samples for analysis of pharmacokinetics MP-IVIG elimination rate constant(s) were obtained and analysed

    Measured: 1 hour, 2 hours and 1, 2, 3, 7, 14 and 21 days) post-dose ]

Secondary outcomes (1)
  1. • compare the efficacy of IVIg to plasma exchange (PE) according to GBS disability score

    Guillain-Barré syndrome disability scale Score Description 0 A healthy state

    1. Minor symptoms and capable of running
    2. Able to walk 10m or more without assistance but unable to run
    3. Able to walk 10m across an open space with help
    4. Bedridden or chairbound
    5. Requiring assisted ventilation for at least part of the day
    6. Dead

    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 posted16 Sep 2020
  2. Study startNov 2021 (estimated)
  3. Primary completionNov 2022 (estimated)
  4. Study completionDec 2022 (estimated)

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The process of MP-IVIG preparation will involve the use of caprylic acid for purification and virus inactivation of Igs from mini-pools of 20 plasma donations collected in our Central blood transfusions( CBTS) in Assiut University Hospital (AUH). The equipment used for the process comprised disposable blood bags, hemodialyzers, and purification and microbial filters.
Masking
None (open label)
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04550611
Sponsor's protocol ID
Guillain-Barré syndrome
Status last verified
Sep 2020
First submitted
27 Aug 2020
Last updated
14 Jan 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barre syndrome. Lancet Neurol. 2008 Oct;7(10):939-50. doi: 10.1016/S1474-4422(08)70215-1.

    PubMed 18848313
  • El-Ekiaby M, Vargas M, Sayed M, Gorgy G, Goubran H, Radosevic M, Burnouf T. Minipool caprylic acid fractionation of plasma using disposable equipment: a practical method to enhance immunoglobulin supply in developing countries. PLoS Negl Trop Dis. 2015 Feb 26;9(2):e0003501. doi: 10.1371/journal.pntd.0003501. eCollection 2015 Feb.

    PubMed 25719558
  • El-Ekiaby M, Sayed MA, Caron C, Burnouf S, El-Sharkawy N, Goubran H, Radosevich M, Goudemand J, Blum D, de Melo L, Soulie V, Adam J, Burnouf T. Solvent-detergent filtered (S/D-F) fresh frozen plasma and cryoprecipitate minipools prepared in a newly designed integral disposable processing bag system. Transfus Med. 2010 Feb;20(1):48-61. doi: 10.1111/j.1365-3148.2009.00963.x. Epub 2009 Sep 23.

    PubMed 19778318
  • Winiecki S, Baer B, Chege W, Jankosky C, Mintz P, Baker M, Woodworth T, Nguyen M. Complementary use of passive surveillance and Mini-Sentinel to better characterize hemolysis after immune globulin. Transfusion. 2015 Jul;55 Suppl 2:S28-35. doi: 10.1111/trf.13116.

    PubMed 26174895
  • Ojha R, Karn R(2019):Clinical outcome of intravenous immunoglobulin in the treatment of Guillain Barre Syndrome in a Nepalese tertiary centre. Nep Med J 2019;2(1):133-7.

  • Hughes RA, Cornblath DR. Guillain-Barre syndrome. Lancet. 2005 Nov 5;366(9497):1653-66. doi: 10.1016/S0140-6736(05)67665-9.

    PubMed 16271648

Questions about this trial

What is this clinical trial studying?

A study testing Mini-pool Intravenous Immunoglobulin (MP-IVIG) and plasma exchange in people with Guillain-Barre Syndrome, run by Assiut University.

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 3 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: status not confirmed, as of the sponsor's last update on 14 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

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?

Results are not available in the source record.

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

Contact Hend A Moubark, Specialist (01010326577, hindq1989@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Efficacy ofMini-pool Intravenous Immunoglobulin (MP-IVIG) assessed by patients achieve score more than or equal 2 according to GBS disability score (time frame: 6 MONTHS). The study lists 9 primary outcomes in all. 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 NCT04550611, which also lists 6 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 14 Jan 2021.

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