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Interstitial Lung DiseasePhase 2ABCVILDNCT04925375

Abatacept for the Treatment of Common Variable Immunodeficiency With Interstitial Lung Disease

A Phase 2 study testing Abatacept in people with Interstitial Lung Disease and Common Variable Immunodeficiency, run by Children's Hospital Medical Center, Cincinnati at 6 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

There is no standard of care therapy for patients with granulomatous-lymphocytic interstitial lung disease (GLILD) seen in common variable immunodeficiency (CVID). Abatacept has recently looked promising for the treatment of patients with complex CVID. Read more about this study

Who is it for?
Ages 4 years and older
What is being tested?
Abatacept
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
38 participants
Where
6 sitesUnited States
Study dates
14 Jul 2021to Jul 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 4 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Diagnosis of CVID according to the international consensus document (ICON)
  • Age 4 years or above
  • Serum IgG at least 2 standard deviations below the age adjusted normal
  • Decreased serum IgA and/or serum IgM
  • Abnormal specific antibody response to immunization
  • Exclusion of secondary immunodeficiency
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  • On replacement immunoglobulin for at least 6 months and willing to maintain throughout study
  • Granulomatous-lymphocytic interstitial lung disease with a lymphocytic component diagnosed by lung biopsy prior to study entry, wedge biopsy preferred.
  • Persistence or worsening of interstitial lung disease measured on serial CT imaging of the lung at least 6 months apart, with the latest assessment within 3 months of study entry.
  • Signed written informed consent
  • Willing to allow storage of biological specimens for future use in medical research.
  • Female subjects of childbearing potential must agree to an effective form of birth control such as hormone based contraceptive, intrauterine device, condoms/barrier, surgically sterile partner, or abstinence.
  • Fertile, non-vasectomized males with a female partner of childbearing potential should use condoms throughout the study and for 3 months after the last dose
  • Patients must have completed the abatacept for the treatment of Interstitial Lung Disease in Common Variable Immunodeficiency (ABCVILD) trial
  • Patients must have demonstrated positive response to abatacept.
  • Patients must provide informed consent to participate in the Extended Treatment Plan.

Who cannot join

  • History of hypersensitivity to abatacept or any of its components
  • Has received any lymphocyte depleting agents including anti-CD20 monoclonal antibodies, alemtuzumab, ATG in the preceding 6 months
  • Has received abatacept, cyclophosphamide, tumor necrosis factor inhibitors, or pulse steroids (defined as >15mg/kg/day of methylprednisone or corticosteroid equivalent) within the past 3 months
  • Have started or increased any of the following immune modulating drugs within 3 months of enrolling and 3 months from initial CT chest: azathioprine, cyclosporine, tacrolimus, mercaptopurine, methotrexate, mycophenolate mofetil, or sirolimus
  • History of HIV infection (positive PCR)
  • Chronic untreated hepatitis B or C (positive PCR)
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  • Active tuberculosis (TB) by positive QuantiFERON gold. If history of latent TB, then must supply evidence of completing treatment.
  • Persistent Epstein-Barr Virus (EBV) load ≥ 1,000 units/mL blood checked twice at least 1 month apart
  • Other uncontrolled infections
  • Live vaccine given within 6 weeks of the start of the trial
  • Malignancy or treated for malignancy within the past year
  • Currently pregnant or breast feeding
  • Life expectancy less than 1 month
  • Subjects unwilling to self-administer or have a parent/caregiver self-administer subcutaneous injections at home
  • Other conditions that the investigators feel contraindicate participation in the study
  • Patients who experienced SAEs during the original trial, and such SAEs were determined as related to treatment, or patients who in the opinion of the investigator would not benefit from the extended treatment option.

Trial locations and contacts

6 sites in 1 country. Contact the study team or a site near you to ask about taking part.

6 sites in 1 country

United States6 sites, 6 recruiting
  • Lahey Hospital and Medical Center

    Burlington, Massachusetts, 01805

    Jocelyn Farmer, MD, Jocelyn.Farmer@lahey.org

    Ahmed Sanousi, Ahmed.Sanousi@lahey.org

    Recruiting
  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

    Michael Jordan, 513-803-9063, Michael.Jordan@cchmc.org

    Michael Jordan, MD

    Recruiting
  • Duke University Health System

    Durham, North Carolina, 27710

    Katherine Prince, 919-681-8931, katherine.prince@duke.edu

    Peter Bressler, MD

    Recruiting
  • Mayo Clinic

    Rochester, Minnesota, 55902

    Dahir Sharif, 507-255-1574, sharif.dahir@mayo.edu

    Avni Joshi, MD

    Recruiting
  • University of California, San Francisco

    San Francisco, California, 94143

    Alma Andrade, 415-476-7054, Alma.Andrade@ucsf.edu

    Michele Pham, MD

    Recruiting
  • University of South Florida

    Tampa, Florida, 33620

    Jolan Walter, 727-553-1258, jolanwalter@usf.edu

    Jolan Walter, MD

    Recruiting

Other trials in United States

About this study

There is no standard of care therapy for patients with granulomatous-lymphocytic interstitial lung disease (GLILD) seen in common variable immunodeficiency (CVID). Abatacept has recently looked promising for the treatment of patients with complex CVID. This study is a multi-site, phase II, randomized, blinded/placebo-controlled clinical trial in pediatric and adult subjects to determine the efficacy of abatacept compared to placebo for treatment of subjects with GLILD in the context of CVID.

Funding Source - FDA OOPD

Read the detailed description

There is no standard of care therapy for patients with granulomatous-lymphocytic interstitial lung disease (GLILD) seen in common variable immunodeficiency (CVID). Abatacept is a recombinant, human fusion protein of cytotoxic T lymphocyte-associated protein 4 (CTLA-4) and human IgG1 that blocks T cell activation by binding to CD80 and CD86, thereby blocking CD28 engagement- the "second signal" needed for T cell activation. Abatacept has recently looked promising for the treatment of patients with complex CVID.

This study is a multi-site, phase II, randomized, blinded/placebo-controlled clinical trial in pediatric subjects ≥50 kg and adult subjects (cohort 1), with an additional cohort (#2) of pediatric subjects <50 kg tested as a single arm, receiving open-label abatacept. Cohort 1 utilizes a 'delayed-start' design to obtain maximum statistical power from this cohort. Cohort 2 will be open label due to the lack of a suitable placebo for pediatric dose abatacept syringes. A total of 21-30 evaluable subjects will be treated in cohort 1 and 8 evaluable subjects in cohort 2.

Following the initial 12 months of treatment, patients will have the option of continuing abatacept for up to 3 years. Patients will have the option of continuing abatacept any time after the initial 12 months of treatment (does not have to be immediately). A separate consent form will be utilized to document a patient's decision to continue. Abatacept will be provided by BMS. Patients who decide to continue abatacept will be monitored for safety, including infections, approximately every 3 months.

Being tested
Abatacept, Placebo
Medical subject headings
Lung Diseases, Interstitial, Common Variable Immunodeficiency

What participants receive

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

  • AbataceptDrug

    Also called Orencia

    Abatacept is a selective costimulation modulator, inhibiting T lymphocyte activation by binding to CD80 and CD86, thereby blocking interaction with CD28. Orencia solution supplied in a prefilled syringe should be refrigerated at 2C to 8C (36F to 46F). Orencia should not be used beyond the expiration date on the prefilled syringe. The product should be protected from light by storing in the original package until time of use. The prefilled syringe should not be frozen.

  • PlaceboOther

    The composition of the placebo for Orencia is the same as the active study drug without the abatacept. The placebo will be packaged and labeled as described above for the Orencia prefilled syringes. To maintain the blind, injection volumes will be the same as the active treatment.

Study groups in NCT04925375
Study groupRoleWhat they receive
AbataceptExperimentalPediatric subjects weighing <50 kg will be placed in an single arm with abatacept with dosing based on weight. Pediatric subjects weighing ≥50kg and adult subjects will enter a double blinded, randomization in a 1:2 ratio of subjects to the abatacept treatment group (arm 1) or to the placebo group (arm 2) treated weekly through month 6. After month 6, all subjects will begin receiving abatacept weekly. Pediatric dosing: Abatacept subcutaneous every week: 10-25 kg: 50 mg; 25-50 kg: 87.5 mg; >50 kg: 125 mg Adult dosing: Abatacept: 125 mg subcutaneous every week
Receives: Drug: Abatacept
PlaceboPlacebo comparatorPediatric subjects weighing ≥50kg and adult subjects will enter a double blinded, randomization in a 1:2 ratio of subjects to the abatacept treatment group (arm 1) or to the placebo group (arm 2) treated weekly through month 6. The composition of the placebo is the same as the active study drug without the abatacept. To maintain the blind, injection volumes will be the same as the active treatment. After month 6, all subjects will begin receiving abatacept weekly.
Receives: Other: Placebo

What is being measured

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

  1. High Resolution CT Scan of the chest (HRCT)

    Proportion of subjects achieving a significant response (defined as >30 percent change in lung tissue disease burden by GLILD) on HRCT after 6 months of abatacept therapy.

    Measured: 6 months

Secondary outcomes (18)
  1. Forced vital capacity (FVC)

    Forced vital capacity (FVC)

    Measured: 6 months, 12 months

  2. Forced expiratory volume (FEV)

    Forced expiratory volume (FEV)

    Measured: 6 months, 12 months

  3. Diffusion capacity of carbon monoxide (DLCo)

    Diffusion capacity of carbon monoxide (DLCo)

    Measured: 6 months, 12 months

  4. Incidence

    Incidence of new onset autoimmune/inflammatory diseases while on abatacept or placebo

    Measured: 6 months, 12 months

  5. Resolution

    Resolution of existing autoimmune/inflammatory diseases while on abatacept or placebo

    Measured: 6 months, 12 months

  6. Change in Short Form-36 scores

    Short Form-36: scoring ranges from 0-100 where a higher score denotes better health

    Measured: 6 months, 12 months

  7. Change in PedsQL (Pediatric Quality of Life) Generic Core scores

    PedsQL Generic Core Scales: items are reversed scored and linearly transformed to a 0-100 scale, so that higher scores indicate better HRQOL. Range of 0-2300 for ages above 4, range of 0-2100 for 4 years old

    Measured: 6 months, 12 months

  8. Change in King's Interstitial Lung Disease scores

    King's Interstitial Lung Disease: scoring ranges from 0-100 where a higher score denotes better health

    Measured: 6 months, 12 months

  9. Steroid usage

    Cumulative number of steroids used after 6 months and 12 months

    Measured: 6months, 12 months

  10. Survival

    Survival at 12 months

    Measured: 6 months, 12 months

  11. Pediatric growth - change in height

    Change in height at 6 and 12 months.

    Measured: 6 months, 12 months

  12. Pediatric growth - change in weight

    Change in weight at 6 and 12 months.

    Measured: 6 months, 12 months

  13. Additional Immune Agents

    Rate of discontinuation of additional immune agents while on study agent

    Measured: 6 months, 12 months

  14. Adverse Events/Serious Adverse Events

    Incidence of adverse events and severe adverse events, compared to placebo

    Measured: 6 months, 12 months

  15. Dropout rate

    Study dropout rate

    Measured: 6 months, 12 months

  16. Incidence of concurrent infections

    Incidence of concurrent infections while on study

    Measured: 6 months, 12 months

  17. Treatment of concurrent infections

    Number of infections per patient which require treatment with antibiotics

    Measured: 6 months, 12 months

  18. Complications of concurrent infections

    Complications of concurrent infections while on study

    Measured: 6 months, 12 months

Timeline

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

  1. First posted14 Jun 2021
  2. Study start14 Jul 2021
  3. Primary completionJul 2028 (estimated)
  4. Study completionJul 2028 (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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized, blinded/placebo-controlled clinical trial in pediatric and adult subjects ≥50 kg (cohort 1), with an additional cohort (#2) of pediatric subjects \<50 kg tested as a single arm, receiving open-label abatacept
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
38 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04925375
Sponsor's protocol ID
2020-0876
Other IDs
R01FD007267
Acronym
ABCVILD
Status last verified
Jul 2026
First submitted
11 May 2021
Last updated
22 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Abatacept in people with Interstitial Lung Disease and Common Variable Immunodeficiency, run by Children's Hospital Medical Center, Cincinnati at 6 sites in United States.

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 16 inclusion and 16 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: looking for participants now, as of the sponsor's last update on 22 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in United States. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Michael Jordan (513-803-9063, Michael.Jordan.@cchmc.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

High Resolution CT Scan of the chest (HRCT) (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 Jul 2026.

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