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LIME Study (LFB IVIg MMN Efficacy Study) (LIME)

Primary Purpose

Motor Neuron Disease

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Biological : I10E (Human normal Immunoglobulin for intravenous administration 100mg/mL)
Biological: Kiovig® (Human normal Immunoglobulin for intravenous administration 100mg/mL)
Sponsored by
Laboratoire français de Fractionnement et de Biotechnologies
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Motor Neuron Disease focused on measuring Multifocal Motor Neuropathy

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female patient aged 18 to 80 years.
  2. Written informed consent obtained prior to any study-related procedures.
  3. Diagnosis of definite or probable MMN according to the EFNS/PNS Guideline 2010, First revision made by neuromuscular disease specialists with specific electrodiagnostic expertise.
  4. Patients treated with a stable maintenance dose within 15% of any brand of IVIg (Kiovig® excluded) at 1 g/kg for 1-3 days up to 2 g/Kg for 2-5 days every 4 to 8 weeks (+/- 7 days), according to the EFNS/PNS Guideline 2010, First revision for at least 3 months prior to enrolment.
  5. Covered by national health care insurance system if required by local regulations.

Exclusion Criteria:

  1. Upper motor neuron, bulbar, cranial nerve or significant sensory deficit.
  2. CSF protein >100 mg/dL (if available and done as part of a previous evaluation).
  3. Any other ongoing disease that may cause neuropathy, such as toxin exposure, dietary difficency, uncontrolled diabetes, hyperthyroidism, cancer, systemic lupus erythematosus or other connective diseases, infection with HIV, hepatitis B virus (HBV), or hepatitis C (HCV), Lyme disease, multiple myeloma, Waldenström's macroglobulinemia, amyloid, and hereditary neuropathy.
  4. BMI >= 40 kg/m2.
  5. Known hypersensitivity to the active substance or to any of the excipients of I10E (glycine and polysorbate 80) or Kiovig(glycine).
  6. Patient who have been treated with Kiovig shall not have received Kiovig during the last 6 months prior to enrolment.
  7. History of IgA deficiency, except if the absence of anti-IgA antibodies is documented.
  8. Protein-losing enteropathy characterised by serum protein levels <60 g/l and serum albumin levels <30 g/l or nephrotic syndrome characterised by proteinuria >=3.5 g/24 hours, serum protein levels <60 g/l and serum albumin levels <30 g/l.
  9. History of cardiac insufficiency (New York Heart Association (NYHA) III/IV), uncontrolled cardiac arrythmia, unstable ischemic heart disease, or uncontrolled hypertension.
  10. History of venous thrombo-embolic disease, myocardial infarction, or cerebrovascular accident.
  11. Risk factor for blood hyperviscosity such as cryoglobulinemia or haematological malignancy with monoclonal gammopathy.
  12. Glomerular filtration rate <80 ml/min/1.73m2 measured according to the Modified Diet in Renal Disease (MDRD) calculation.
  13. Serum levels of AST, ALT >2 times upper limit of normal range.
  14. Treatment within 12 months prior to screeening with immunomodulator or immunosuppressant agent (including but not limited to cyclophosphamide, cyclosporine, interferon-a, interferon-b 1a, anti-CD20, alemtuzumab, azathioprine, etanarcept, mycophenolate mofetil, methotrexate, haematopoietic stem cell transplantation).
  15. Administration of another investigational product within the last month prior to inclusion.
  16. Plasma exchange, blood products or derivatives administered with the last 3 months prior to screening.
  17. Woman with positive results of pregnancy test or breast-feeding woman or woman of childbearing potential without an effective contraception.

    Effective contraception are injectible, patch or combined oestro-progestative or progestative contraceptives, Cooper T or levonorgest releasing intra-uterine devices, depot intramuscular medroxyprogesterone, subcutaneous progestative contraceptive implants, condoms or occlusive caps (diaphragm or cervical/vault caps) with spermicide, true abstinence (when this is in line with the preferred and usual lifestyle of the patient).

  18. Any serious medical condition that would interfere with the clinical assessment of I10E or prevent the patient from complying with the protocol requirements.
  19. Anticipated poor compliance of patient with study procedures during the 12 month duration of the study.
  20. Drug or alcohol abuse.

Sites / Locations

  • CHU de Bordeaux -Hôpital Haut-Lévêque
  • CHU Créteil - Groupe Hospitalier Henri Mondor
  • CHRU Lille - Hôpital Roger Salengro
  • CHU de Lyon - Hôpital Pierre Wertheimer
  • CHU de Marseille - Hôpital de La Timone
  • CHU de Nice - Hôpital l'Archet
  • CHU Paris - Hôpital Pitié Salpétrière
  • CHU de Saint Etienne - Hôpital Nord
  • Università di Genova - Ospedale San Martino
  • IRCCS Istituto Clinico Humanitas
  • Università Cattolica del Sacro Cuore
  • Azienda Ospedaliero Universitaria San Giovanni Battista
  • Hospital de la Santa Creu i Sant Pau
  • Hospital Clinico Universitario de Santiago de Compostela
  • Hospital Universitario Virgen del Rocio
  • Hospital Universitari i Politècnic La Fe
  • Queen Elizabeth Hospital
  • Southampton General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Group A: I10E then Kiovig®

Group B : Kiovig® then I10E

Arm Description

1 g/kg for 1-3 days up to 2 g/kg for 2-5 days every 4 to 8 weeks (±7 days)

1 g/kg for 1-3 days up to 2 g/kg for 2-5 days every 4 to 8 weeks (±7 days)

Outcomes

Primary Outcome Measures

Change between I10E and Kiovig® in the original MMRC 10 sum score described by Cats 2008

Secondary Outcome Measures

Change between I10E and Kiovig® in: MMRC 10 new sum score (10 slightly different muscles on both sides)
AEs observed and reported TAAEs (temporally associated AE) beginning at infusion or within 72H after infusion
Change between I10E and Kiovig® in : Rasch built MMRC sum score (Cats 2008)
Change between I10E and Kiovig® in : INCAT: upper and lower limbs
Change between I10E and Kiovig®: Grip strength
Change between I10E and Kiovig® in: MMRC 14 sum score

Full Information

First Posted
September 20, 2013
Last Updated
July 18, 2016
Sponsor
Laboratoire français de Fractionnement et de Biotechnologies
Collaborators
TFS Trial Form Support
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1. Study Identification

Unique Protocol Identification Number
NCT01951924
Brief Title
LIME Study (LFB IVIg MMN Efficacy Study)
Acronym
LIME
Official Title
A European, Randomised, Double-blind, Active Comparator Controlled, Cross-over, Efficacy and Safety Study of a New 10% Ready To-use Liquid Human Intravenous Immunoglobulin (I10E) Versus Kiovig® in Patients With Multifocal Motor Neuropathy
Study Type
Interventional

2. Study Status

Record Verification Date
July 2016
Overall Recruitment Status
Completed
Study Start Date
December 2013 (undefined)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
July 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Laboratoire français de Fractionnement et de Biotechnologies
Collaborators
TFS Trial Form Support

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The aim of this study is to evaluate the efficacy and safety of I10E (LFB 10% ready-to-use liquid human intravenous immunoglobulin) compared to Kiovig® for the maintenance treatment of MMN in a randomized, double-blind, active comparator-controlled, cross-over trial.
Detailed Description
Multifocal motor neuropathy (MMN) is a chronic acquired, probably autoimmune, demyelinating, motor neuropathy. It is a rare disease, variable in its clinical features. The disease course is usually steadily progressive. Intravenous immunoglobulin (IVIg) is the standard and the first line treatment for MMN. The Cochrane review of four randomized placebo-controlled studies showed a significant clinical improvement in muscle strength from IVIg in 78% of patients with MMN versus 4% with placebo but a non-significant improvement in disability (39% versus 11%) (van Schaik IN, 2005). However, IVIg treatment does not prevent a mild gradual decline in muscle strength which is probably due to ongoing axonal degeneration. In addition to its efficacy, IVIg is also a safe treatment with a positive benefit-risk ratio in MMN. Muscle strength measured with the Modified Medical Research Council (MMRC 10) sum score as described in the study of Cats (Cats EA, 2008) including 20 movements i.e. 10 muscle groups of the upper and lower limbs on each side was selected as the primary endpoint. Other parameters of muscle strength such as measurement of grip strength by dynamometer - and functional disability will also be evaluated to reinforce the robustness of the study and substantiate the efficacy of I10E in MMN patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Motor Neuron Disease
Keywords
Multifocal Motor Neuropathy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group A: I10E then Kiovig®
Arm Type
Experimental
Arm Description
1 g/kg for 1-3 days up to 2 g/kg for 2-5 days every 4 to 8 weeks (±7 days)
Arm Title
Group B : Kiovig® then I10E
Arm Type
Experimental
Arm Description
1 g/kg for 1-3 days up to 2 g/kg for 2-5 days every 4 to 8 weeks (±7 days)
Intervention Type
Drug
Intervention Name(s)
Biological : I10E (Human normal Immunoglobulin for intravenous administration 100mg/mL)
Intervention Type
Drug
Intervention Name(s)
Biological: Kiovig® (Human normal Immunoglobulin for intravenous administration 100mg/mL)
Primary Outcome Measure Information:
Title
Change between I10E and Kiovig® in the original MMRC 10 sum score described by Cats 2008
Time Frame
at 6 months and 1 year
Secondary Outcome Measure Information:
Title
Change between I10E and Kiovig® in: MMRC 10 new sum score (10 slightly different muscles on both sides)
Time Frame
at 6 months and 1 year
Title
AEs observed and reported TAAEs (temporally associated AE) beginning at infusion or within 72H after infusion
Time Frame
from 49 to 56 weeks
Title
Change between I10E and Kiovig® in : Rasch built MMRC sum score (Cats 2008)
Time Frame
at 6 months and 1 year
Title
Change between I10E and Kiovig® in : INCAT: upper and lower limbs
Time Frame
at 6 months and 1 year
Title
Change between I10E and Kiovig®: Grip strength
Time Frame
at 6 months and 1 year
Title
Change between I10E and Kiovig® in: MMRC 14 sum score
Time Frame
at 6 months and 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patient aged 18 to 80 years. Written informed consent obtained prior to any study-related procedures. Diagnosis of definite or probable MMN according to the EFNS/PNS Guideline 2010, First revision made by neuromuscular disease specialists with specific electrodiagnostic expertise. Patients treated with a stable maintenance dose within 15% of any brand of IVIg (Kiovig® excluded) at 1 g/kg for 1-3 days up to 2 g/Kg for 2-5 days every 4 to 8 weeks (+/- 7 days), according to the EFNS/PNS Guideline 2010, First revision for at least 3 months prior to enrolment. Covered by national health care insurance system if required by local regulations. Exclusion Criteria: Upper motor neuron, bulbar, cranial nerve or significant sensory deficit. CSF protein >100 mg/dL (if available and done as part of a previous evaluation). Any other ongoing disease that may cause neuropathy, such as toxin exposure, dietary difficency, uncontrolled diabetes, hyperthyroidism, cancer, systemic lupus erythematosus or other connective diseases, infection with HIV, hepatitis B virus (HBV), or hepatitis C (HCV), Lyme disease, multiple myeloma, Waldenström's macroglobulinemia, amyloid, and hereditary neuropathy. BMI >= 40 kg/m2. Known hypersensitivity to the active substance or to any of the excipients of I10E (glycine and polysorbate 80) or Kiovig(glycine). Patient who have been treated with Kiovig shall not have received Kiovig during the last 6 months prior to enrolment. History of IgA deficiency, except if the absence of anti-IgA antibodies is documented. Protein-losing enteropathy characterised by serum protein levels <60 g/l and serum albumin levels <30 g/l or nephrotic syndrome characterised by proteinuria >=3.5 g/24 hours, serum protein levels <60 g/l and serum albumin levels <30 g/l. History of cardiac insufficiency (New York Heart Association (NYHA) III/IV), uncontrolled cardiac arrythmia, unstable ischemic heart disease, or uncontrolled hypertension. History of venous thrombo-embolic disease, myocardial infarction, or cerebrovascular accident. Risk factor for blood hyperviscosity such as cryoglobulinemia or haematological malignancy with monoclonal gammopathy. Glomerular filtration rate <80 ml/min/1.73m2 measured according to the Modified Diet in Renal Disease (MDRD) calculation. Serum levels of AST, ALT >2 times upper limit of normal range. Treatment within 12 months prior to screeening with immunomodulator or immunosuppressant agent (including but not limited to cyclophosphamide, cyclosporine, interferon-a, interferon-b 1a, anti-CD20, alemtuzumab, azathioprine, etanarcept, mycophenolate mofetil, methotrexate, haematopoietic stem cell transplantation). Administration of another investigational product within the last month prior to inclusion. Plasma exchange, blood products or derivatives administered with the last 3 months prior to screening. Woman with positive results of pregnancy test or breast-feeding woman or woman of childbearing potential without an effective contraception. Effective contraception are injectible, patch or combined oestro-progestative or progestative contraceptives, Cooper T or levonorgest releasing intra-uterine devices, depot intramuscular medroxyprogesterone, subcutaneous progestative contraceptive implants, condoms or occlusive caps (diaphragm or cervical/vault caps) with spermicide, true abstinence (when this is in line with the preferred and usual lifestyle of the patient). Any serious medical condition that would interfere with the clinical assessment of I10E or prevent the patient from complying with the protocol requirements. Anticipated poor compliance of patient with study procedures during the 12 month duration of the study. Drug or alcohol abuse.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Marc LEGER, MD
Organizational Affiliation
Hôpital de la Pitié Salpêtrière - Paris 75013
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHU de Bordeaux -Hôpital Haut-Lévêque
City
Bordeaux
ZIP/Postal Code
33604
Country
France
Facility Name
CHU Créteil - Groupe Hospitalier Henri Mondor
City
Creteil
ZIP/Postal Code
94010
Country
France
Facility Name
CHRU Lille - Hôpital Roger Salengro
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
CHU de Lyon - Hôpital Pierre Wertheimer
City
Lyon
ZIP/Postal Code
69677
Country
France
Facility Name
CHU de Marseille - Hôpital de La Timone
City
Marseille
ZIP/Postal Code
13385
Country
France
Facility Name
CHU de Nice - Hôpital l'Archet
City
Nice
ZIP/Postal Code
06202
Country
France
Facility Name
CHU Paris - Hôpital Pitié Salpétrière
City
Paris
ZIP/Postal Code
75651
Country
France
Facility Name
CHU de Saint Etienne - Hôpital Nord
City
Saint Etienne
ZIP/Postal Code
42055
Country
France
Facility Name
Università di Genova - Ospedale San Martino
City
Genova
ZIP/Postal Code
16132
Country
Italy
Facility Name
IRCCS Istituto Clinico Humanitas
City
Milan
ZIP/Postal Code
20089
Country
Italy
Facility Name
Università Cattolica del Sacro Cuore
City
Roma
ZIP/Postal Code
00168
Country
Italy
Facility Name
Azienda Ospedaliero Universitaria San Giovanni Battista
City
Turin
ZIP/Postal Code
10126
Country
Italy
Facility Name
Hospital de la Santa Creu i Sant Pau
City
Barcelona
ZIP/Postal Code
08041
Country
Spain
Facility Name
Hospital Clinico Universitario de Santiago de Compostela
City
Santiago de Compostela
ZIP/Postal Code
15706
Country
Spain
Facility Name
Hospital Universitario Virgen del Rocio
City
Sevilla
ZIP/Postal Code
41013
Country
Spain
Facility Name
Hospital Universitari i Politècnic La Fe
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Facility Name
Queen Elizabeth Hospital
City
Birmingham
ZIP/Postal Code
B15 2WB
Country
United Kingdom
Facility Name
Southampton General Hospital
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom

12. IPD Sharing Statement

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LIME Study (LFB IVIg MMN Efficacy Study)

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