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A Study of the Efficacy and Safety of GB-0998 in Patients With Unexplained Recurrent Miscarriage

Primary Purpose

Recurrent Miscarriage

Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
GB-0998
Placebo
Sponsored by
Japan Blood Products Organization
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Miscarriage focused on measuring IVIG, Unexplained Recurrent miscarriage, Primary Recurrent miscarriage, Intravenous immunoglobulin

Eligibility Criteria

undefined - 41 Years (Child, Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria

  1. Patients with primary recurrent miscarriage
  2. Patients with a history of at least 4 miscarriages (not including biochemical pregnancy in the count of prior miscarriages)
  3. Patients with any of the following risk factors for recurrent miscarriage

【Patients with unknown risk factors】 Patients with normal test results for each of the following risk factors who have experienced miscarriage of a fetus with normal chromosome karyotype

  1. Abnormal uterine morphology
  2. Thyroid dysfunction
  3. Chromosome abnormality in the couple
  4. Positive antiphospholipid antibody
  5. Factor XII deficiency
  6. Protein S deficiency
  7. Protein C deficiency

【Patients determined to have risk factors】 Patients with the following risk factors who have experienced miscarriage of a fetus with normal chromosome karyotype despite receiving treatment for these factors

  1. Abnormal uterine morphology (septate uterus): Patients who have undergone surgery
  2. Thyroid dysfunction: Patients receiving medical treatment
  3. Incidentally positive antiphospholipid antibody, factor XII deficiency, protein S deficiency, protein C deficiency:Patients receiving combination therapy with aspirin and heparin 4.Regardless of whether or not risk factors are present, patients should have experienced at least 1 a miscarriage of a fetus with normal chromosome karyotype 5.Patients below the age of 42 years at the time of obtaining informed consent 6.Patients who can be admitted for at least the period from the start date of administration of the study drug to the date of examination and assessment 1 week after the start of administration of the study drug 7.Patients who have given written informed consent to participate in this study

Exclusion Criteria:

  1. Patients with chromosome abnormalities in themselves or their partners that are risk factors for recurrent miscarriage, patients with antiphospholipid syndrome, and patients with incidentally positive antiphospholipid antibody (when the latest test result is positive)
  2. Patients in whom complications of diabetes mellitus or impaired glucose tolerance has been identified, but who have not received appropriate treatment for this condition
  3. Patients who have received intravenous immunoglobulin therapy as treatment for recurrent miscarriage in the past
  4. Patients with a history of stillbirth at 22 weeks of gestation or later
  5. Patients receiving treatment for malignant tumor
  6. Patients with a history of thromboembolism
  7. Patients with a history of shock or hypersensitivity in response to the ingredients of this drug or patients with hereditary fructose intolerance
  8. Patients who have been diagnosed with IgA deficiency in the past or patients who have a serum IgA level of <5 mg/dL at laboratory tests at registration
  9. Patients who have received another study drug within the period of 12 weeks prior to informed consent or who are currently participating in another clinical trial
  10. Patients who are unsuitable for this study for any other reason, in the opinion of a principal investigator or sub-investigators

Sites / Locations

  • Japan Blood Products Organization

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

GB-0998

Arm Description

Infusion of normal saline

Infusion of GB-0998 (Immunoglobulin)

Outcomes

Primary Outcome Measures

Ongoing pregnancy rate (excluding miscarriages associated with fetal chromosomal abnormalities)
To evaluate the effectiveness of the drug in preventing miscarriages, we examined the ongoing pregnancy rate at 22 weeks and 0 days of gestation in cases excluding cases of fetal chromosome aberration miscarriages.

Secondary Outcome Measures

Ongoing pregnancy rate(all patients)
To evaluate the effectiveness of the drug in preventing miscarriages, we examined the ongoing pregnancy rate at 22 weeks and 0 days of gestation in all patients.
Live birth rate (excluding miscarriages associated with fetal chromosomal abnormalities)
To evaluate the effectiveness of the drug in total outcome of pregnancy, we examined the live birth rate in cases excluding cases of fetal chromosome aberration miscarriages.
Live birth rate(all patients)
To evaluate the effectiveness of the drug in total outcome of pregnancy, we examined the live birth rate in all patients.

Full Information

First Posted
July 3, 2014
Last Updated
January 26, 2022
Sponsor
Japan Blood Products Organization
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1. Study Identification

Unique Protocol Identification Number
NCT02184741
Brief Title
A Study of the Efficacy and Safety of GB-0998 in Patients With Unexplained Recurrent Miscarriage
Official Title
A Double-Blind, Randomized, Placebo-Controlled Study of GB-0998 in Patients With Unexplained Recurrent Miscarriage.
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
June 3, 2014 (Actual)
Primary Completion Date
May 2020 (Actual)
Study Completion Date
September 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Japan Blood Products Organization

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The present survey was conducted to evaluate the efficacy and safety of GB-0998(immunoglobulin) in the treatment of unexplained recurrent miscarriage in comparison to placebo using a multicenter, double-blind, intergroup comparison method.
Detailed Description
Among the patients whose risk factors for recurrent miscarriage are unknown who repeatedly miscarry or patients who repeatedly miscarry despite treatment for risk factors, those who have never given birth and have had four or more miscarriages. Patients were assigned into two groups, GB-0998 or placebo, and received 8 ml/kg body weight of GB-0998 (400 mg/kg body weight) or placebo once a day for 5 days. The primary efficacy endpoint was ongoing pregnancy rate at 22 weeks of gestation (excluding miscarriages associated with fetal chromosomal abnormalities) and one of the secondary endpoint was live birth rate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Miscarriage
Keywords
IVIG, Unexplained Recurrent miscarriage, Primary Recurrent miscarriage, Intravenous immunoglobulin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
99 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Infusion of normal saline
Arm Title
GB-0998
Arm Type
Experimental
Arm Description
Infusion of GB-0998 (Immunoglobulin)
Intervention Type
Drug
Intervention Name(s)
GB-0998
Other Intervention Name(s)
Intravenous Immunoglobulin (Venoglobulin®IH,2.5g/50ml)
Intervention Description
Subjects received GB-0998 at 400 mg/kg body weight once daily for 5 days until 6 weeks and 6 days of gestation after confirmation of the gestational sac by ultrasonography.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
normal saline
Intervention Description
Subjects received the same dose of saline as GB-0998 for 5 days after confirmation of the gestational sac by ultrasonography, up to 6 weeks and 6 days of gestation.
Primary Outcome Measure Information:
Title
Ongoing pregnancy rate (excluding miscarriages associated with fetal chromosomal abnormalities)
Description
To evaluate the effectiveness of the drug in preventing miscarriages, we examined the ongoing pregnancy rate at 22 weeks and 0 days of gestation in cases excluding cases of fetal chromosome aberration miscarriages.
Time Frame
At 22 weeks of gestation
Secondary Outcome Measure Information:
Title
Ongoing pregnancy rate(all patients)
Description
To evaluate the effectiveness of the drug in preventing miscarriages, we examined the ongoing pregnancy rate at 22 weeks and 0 days of gestation in all patients.
Time Frame
At 22 weeks of gestation
Title
Live birth rate (excluding miscarriages associated with fetal chromosomal abnormalities)
Description
To evaluate the effectiveness of the drug in total outcome of pregnancy, we examined the live birth rate in cases excluding cases of fetal chromosome aberration miscarriages.
Time Frame
At the time of birth
Title
Live birth rate(all patients)
Description
To evaluate the effectiveness of the drug in total outcome of pregnancy, we examined the live birth rate in all patients.
Time Frame
At the time of birth

10. Eligibility

Sex
Female
Maximum Age & Unit of Time
41 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Patients with primary recurrent miscarriage Patients with a history of at least 4 miscarriages (not including biochemical pregnancy in the count of prior miscarriages) Patients with any of the following risk factors for recurrent miscarriage 【Patients with unknown risk factors】 Patients with normal test results for each of the following risk factors who have experienced miscarriage of a fetus with normal chromosome karyotype Abnormal uterine morphology Thyroid dysfunction Chromosome abnormality in the couple Positive antiphospholipid antibody Factor XII deficiency Protein S deficiency Protein C deficiency 【Patients determined to have risk factors】 Patients with the following risk factors who have experienced miscarriage of a fetus with normal chromosome karyotype despite receiving treatment for these factors Abnormal uterine morphology (septate uterus): Patients who have undergone surgery Thyroid dysfunction: Patients receiving medical treatment Incidentally positive antiphospholipid antibody, factor XII deficiency, protein S deficiency, protein C deficiency:Patients receiving combination therapy with aspirin and heparin 4.Regardless of whether or not risk factors are present, patients should have experienced at least 1 a miscarriage of a fetus with normal chromosome karyotype 5.Patients below the age of 42 years at the time of obtaining informed consent 6.Patients who can be admitted for at least the period from the start date of administration of the study drug to the date of examination and assessment 1 week after the start of administration of the study drug 7.Patients who have given written informed consent to participate in this study Exclusion Criteria: Patients with chromosome abnormalities in themselves or their partners that are risk factors for recurrent miscarriage, patients with antiphospholipid syndrome, and patients with incidentally positive antiphospholipid antibody (when the latest test result is positive) Patients in whom complications of diabetes mellitus or impaired glucose tolerance has been identified, but who have not received appropriate treatment for this condition Patients who have received intravenous immunoglobulin therapy as treatment for recurrent miscarriage in the past Patients with a history of stillbirth at 22 weeks of gestation or later Patients receiving treatment for malignant tumor Patients with a history of thromboembolism Patients with a history of shock or hypersensitivity in response to the ingredients of this drug or patients with hereditary fructose intolerance Patients who have been diagnosed with IgA deficiency in the past or patients who have a serum IgA level of <5 mg/dL at laboratory tests at registration Patients who have received another study drug within the period of 12 weeks prior to informed consent or who are currently participating in another clinical trial Patients who are unsuitable for this study for any other reason, in the opinion of a principal investigator or sub-investigators
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hideto Yamada, Director
Organizational Affiliation
Center for Recurrent Pregnancy Loss, Teine Keijinkai Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Shigeru Saito, Professor
Organizational Affiliation
University of Toyama
Official's Role
Principal Investigator
Facility Information:
Facility Name
Japan Blood Products Organization
City
Tokyo
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35795714
Citation
Yamada H, Deguchi M, Saito S, Takeshita T, Mitsui M, Saito T, Nagamatsu T, Takakuwa K, Nakatsuka M, Yoneda S, Egashira K, Tachibana M, Matsubara K, Honda R, Fukui A, Tanaka K, Sengoku K, Endo T, Yata H. Intravenous immunoglobulin treatment in women with four or more recurrent pregnancy losses: A double-blind, randomised, placebo-controlled trial. EClinicalMedicine. 2022 Jun 29;50:101527. doi: 10.1016/j.eclinm.2022.101527. eCollection 2022 Aug.
Results Reference
derived

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A Study of the Efficacy and Safety of GB-0998 in Patients With Unexplained Recurrent Miscarriage

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