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Study of Combined Therapy IVIG-SN 10% and Acetylsalicylic Acid in Kawasaki Disease

Primary Purpose

Kawasaki Disease

Status
Completed
Phase
Phase 4
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Immunoglobulin G
Acetylsalicylic acid
Sponsored by
Green Cross Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Kawasaki Disease

Eligibility Criteria

3 Months - 12 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Infants and children aged 3 months to 7 years inclusive, at the time of signing the informed consent, however, patients with complete KD are eligible up to 12 years (applies to 2A)
  2. Subjects with fever 4-10 days meeting one of following criteria (A, B or C)

    A. Subjects with at least 4 of the following principal clinical findings:

    i) Bilateral bulbar conjunctival injection without exudate

    ii) Erythema and cracking of lips, strawberry tongue, and/or erythema of oral and pharyngeal mucosa

    iii) Erythema and edema of the hands and feet in acute phase and/or periungual desquamation in subacute phase

    iv) Cervical lymphadenopathy (≥1.5 cm diameter), usually unilateral

    v) Rash: maculopapular, diffuse erythroderma, or erythema multiforme-like

    B. Subjects with at least 3 of the principal clinical findings and coronary artery abnormalities detected by 2-dimensional echocardiography: Z score of left anterior descending coronary artery or right coronary artery ≥2.5

    C. Subjects without coronary artery abnormalities, but with fever ≥5 days, 2 or 3 of the principal clinical findings , CRP of ≥3.0 mg/dL and meeting 3 or more of the following laboratory findings:

    i) Albumin <3.0 g/dL

    ii) Anemia for age

    iii) Elevated alanine aminotransferase level

    iv) Platelet count of >450,000/mm3 after the 7th day of fever

    v) White blood cell count of >15,000/mm3

    vi) Urine >10 white blood cells/high-power field

  3. Subjects whose subject's parents or legally authorized representative gave voluntary written consent to participate in the clinical trial

Exclusion Criteria:

  1. Subjects with a history of KD
  2. Subjects with following laboratory findings:

    A. Platelet count <100,000/mm3

    B. WBC count <3,000 cells/mm3

    C. hemoglobin, hematocrit or red blood cell count more than 30% above the upper limit or 30% below the lower limit of the normal range

  3. Subjects who are currently receiving or who have received any investigational drug or device within 30 days prior to administration of the IP
  4. Subjects who have received TNF alpha antagonist or systemic corticosteroids within 48 hours prior to administration of the IP
  5. Subjects who are considered by the investigator to be an unsuitable candidate for the study due to a severe chronic disease (e.g. cardiovascular disease except controllable hypertension, respiratory disease with respiratory failure, metabolic disease, renal failure, hemoglobinopathy, etc.)
  6. Subjects who have received immunosuppressive or immunomodulatory drugs within 3 months prior to administration of the IP
  7. Subjects with immunodeficiency including known positive serology for human immunodeficiency virus (HIV)
  8. Subjects with a history of hypersensitivity or shock to IVIG formulations
  9. Subjects with underlying liver disease or liver dysfunction with known etiology
  10. Subjects with renal impairment whose creatinine level is more than twice the upper limit of the normal range
  11. Subjects with a history of malignant tumor
  12. Subjects with a history of IgA deficiency
  13. Subjects who are considered by the investigator to be an unsuitable candidate for the study for any reason

Sites / Locations

  • Hallym University Sacred Heart Hospital
  • Asan Medical Center
  • Kyung Hee University Hospital at Gangdong
  • Kyung Hee University Medical Center
  • Severance Hospital
  • The Catholic University of Korea Seoul St. Mary's Hospital
  • Wonju Severance Christian Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental

Arm Description

Investigational product (IP)

Outcomes

Primary Outcome Measures

incidence of CALs
incidence of CALs at 7 weeks after treatment

Secondary Outcome Measures

incidence of CALs
incidence of CALs at 2 weeks after treatment
total duration of fever
total duration of fever after treatment
laboratory measurements : markers of inflammation and cardiovascular disease
measurement of erythrocyte sedimentation rate (ESR)
laboratory measurements : markers of inflammation and cardiovascular disease
measurement of C-reactive protein (CRP)
laboratory measurements : markers of inflammation and cardiovascular disease
measurement of N-terminal pro B-type natriuretic peptide (NTproBNP) or B-type natriuretic peptide (BNP)
laboratory measurements : markers of inflammation and cardiovascular disease
measurement of creatine kinase-myocardial band (CK-MB)
laboratory measurements : markers of inflammation and cardiovascular disease
measurement of procalcitonin
laboratory measurements : markers of inflammation and cardiovascular disease
measurement of soluble suppression of tumorigenicity 2 (sST2)
laboratory measurements : markers of inflammation and cardiovascular disease
measurement of Troponin I
IGIV resistance
frequency of IGIV resistance
adverse events, adverse drug reactions and serious adverse events
number of adverse events, adverse drug reactions and serious adverse events
laboratory measurements : hematological parameters
measurement of white blood cell (WBC)
laboratory measurements : hematological parameters
measurement of red blood cell (RBC)
laboratory measurements : hematological parameters
measurement of hemoglobin
laboratory measurements : hematological parameters
measurement of hematocrit
laboratory measurements : hematological parameters
measurement of platelet count
laboratory measurements : clinical chemistry parameters
measurement of alanine transaminase (ALT)
laboratory measurements : clinical chemistry parameters
measurement of albumin
laboratory measurements : urinalysis
measurement of WBC (urine microscopy)
vital signs: blood pressure
measurement of systolic and diastolic blood pressure
vital signs: body temperature
measurement of body temperature
physical examination
visual inspection of general appearance, head, eyes, nose-mouth-throat, lymph nodes, skin, extremities for abnormal findings

Full Information

First Posted
May 16, 2019
Last Updated
May 21, 2020
Sponsor
Green Cross Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT04003844
Brief Title
Study of Combined Therapy IVIG-SN 10% and Acetylsalicylic Acid in Kawasaki Disease
Official Title
Multicenter, Single-arm, Phase IV Study to Evaluate the Efficacy, Safety of Combined Therapy of Aspirin and IVIG-SN 10% in Pediatric Patients With Kawasaki Disease
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Completed
Study Start Date
February 1, 2019 (Actual)
Primary Completion Date
November 22, 2019 (Actual)
Study Completion Date
November 22, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Green Cross Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the efficacy and safety of high-dose human Immunoglobulin G Intravenous (IGIV) 10% in subjects with Kawasaki diseases (KD).
Detailed Description
This is a multicenter, single-arm, and open-label clinical trial to evaluate the coronary artery lesions (CALs) at 2 and 7 weeks after single dose of IGIV 10% (2 g/kg) administration for at least 12 hours to evaluate the efficacy and safety of IGIV 10%.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Kawasaki Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
45 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Experimental
Arm Type
Experimental
Arm Description
Investigational product (IP)
Intervention Type
Drug
Intervention Name(s)
Immunoglobulin G
Intervention Description
single dose of IGIV 10% (2 g/kg) administered intravenously for at least 12 hours
Intervention Type
Drug
Intervention Name(s)
Acetylsalicylic acid
Intervention Description
Coadministration
Primary Outcome Measure Information:
Title
incidence of CALs
Description
incidence of CALs at 7 weeks after treatment
Time Frame
7 weeks
Secondary Outcome Measure Information:
Title
incidence of CALs
Description
incidence of CALs at 2 weeks after treatment
Time Frame
2 weeks
Title
total duration of fever
Description
total duration of fever after treatment
Time Frame
baseline
Title
laboratory measurements : markers of inflammation and cardiovascular disease
Description
measurement of erythrocyte sedimentation rate (ESR)
Time Frame
7 weeks
Title
laboratory measurements : markers of inflammation and cardiovascular disease
Description
measurement of C-reactive protein (CRP)
Time Frame
7 weeks
Title
laboratory measurements : markers of inflammation and cardiovascular disease
Description
measurement of N-terminal pro B-type natriuretic peptide (NTproBNP) or B-type natriuretic peptide (BNP)
Time Frame
7 weeks
Title
laboratory measurements : markers of inflammation and cardiovascular disease
Description
measurement of creatine kinase-myocardial band (CK-MB)
Time Frame
7 weeks
Title
laboratory measurements : markers of inflammation and cardiovascular disease
Description
measurement of procalcitonin
Time Frame
7 weeks
Title
laboratory measurements : markers of inflammation and cardiovascular disease
Description
measurement of soluble suppression of tumorigenicity 2 (sST2)
Time Frame
7 weeks
Title
laboratory measurements : markers of inflammation and cardiovascular disease
Description
measurement of Troponin I
Time Frame
7 weeks
Title
IGIV resistance
Description
frequency of IGIV resistance
Time Frame
baseline
Title
adverse events, adverse drug reactions and serious adverse events
Description
number of adverse events, adverse drug reactions and serious adverse events
Time Frame
7 weeks
Title
laboratory measurements : hematological parameters
Description
measurement of white blood cell (WBC)
Time Frame
7 weeks
Title
laboratory measurements : hematological parameters
Description
measurement of red blood cell (RBC)
Time Frame
7 weeks
Title
laboratory measurements : hematological parameters
Description
measurement of hemoglobin
Time Frame
7 weeks
Title
laboratory measurements : hematological parameters
Description
measurement of hematocrit
Time Frame
7 weeks
Title
laboratory measurements : hematological parameters
Description
measurement of platelet count
Time Frame
7 weeks
Title
laboratory measurements : clinical chemistry parameters
Description
measurement of alanine transaminase (ALT)
Time Frame
7 weeks
Title
laboratory measurements : clinical chemistry parameters
Description
measurement of albumin
Time Frame
7 weeks
Title
laboratory measurements : urinalysis
Description
measurement of WBC (urine microscopy)
Time Frame
7 weeks
Title
vital signs: blood pressure
Description
measurement of systolic and diastolic blood pressure
Time Frame
7 weeks
Title
vital signs: body temperature
Description
measurement of body temperature
Time Frame
7 weeks
Title
physical examination
Description
visual inspection of general appearance, head, eyes, nose-mouth-throat, lymph nodes, skin, extremities for abnormal findings
Time Frame
7 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Months
Maximum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Infants and children aged 3 months to 7 years inclusive, at the time of signing the informed consent, however, patients with complete KD are eligible up to 12 years (applies to 2A) Subjects with fever 4-10 days meeting one of following criteria (A, B or C) A. Subjects with at least 4 of the following principal clinical findings: i) Bilateral bulbar conjunctival injection without exudate ii) Erythema and cracking of lips, strawberry tongue, and/or erythema of oral and pharyngeal mucosa iii) Erythema and edema of the hands and feet in acute phase and/or periungual desquamation in subacute phase iv) Cervical lymphadenopathy (≥1.5 cm diameter), usually unilateral v) Rash: maculopapular, diffuse erythroderma, or erythema multiforme-like B. Subjects with at least 3 of the principal clinical findings and coronary artery abnormalities detected by 2-dimensional echocardiography: Z score of left anterior descending coronary artery or right coronary artery ≥2.5 C. Subjects without coronary artery abnormalities, but with fever ≥5 days, 2 or 3 of the principal clinical findings , CRP of ≥3.0 mg/dL and meeting 3 or more of the following laboratory findings: i) Albumin <3.0 g/dL ii) Anemia for age iii) Elevated alanine aminotransferase level iv) Platelet count of >450,000/mm3 after the 7th day of fever v) White blood cell count of >15,000/mm3 vi) Urine >10 white blood cells/high-power field Subjects whose subject's parents or legally authorized representative gave voluntary written consent to participate in the clinical trial Exclusion Criteria: Subjects with a history of KD Subjects with following laboratory findings: A. Platelet count <100,000/mm3 B. WBC count <3,000 cells/mm3 C. hemoglobin, hematocrit or red blood cell count more than 30% above the upper limit or 30% below the lower limit of the normal range Subjects who are currently receiving or who have received any investigational drug or device within 30 days prior to administration of the IP Subjects who have received TNF alpha antagonist or systemic corticosteroids within 48 hours prior to administration of the IP Subjects who are considered by the investigator to be an unsuitable candidate for the study due to a severe chronic disease (e.g. cardiovascular disease except controllable hypertension, respiratory disease with respiratory failure, metabolic disease, renal failure, hemoglobinopathy, etc.) Subjects who have received immunosuppressive or immunomodulatory drugs within 3 months prior to administration of the IP Subjects with immunodeficiency including known positive serology for human immunodeficiency virus (HIV) Subjects with a history of hypersensitivity or shock to IVIG formulations Subjects with underlying liver disease or liver dysfunction with known etiology Subjects with renal impairment whose creatinine level is more than twice the upper limit of the normal range Subjects with a history of malignant tumor Subjects with a history of IgA deficiency Subjects who are considered by the investigator to be an unsuitable candidate for the study for any reason
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mi Young Han, MD, Ph.D.
Organizational Affiliation
Kyunghee University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hallym University Sacred Heart Hospital
City
Anyang
Country
Korea, Republic of
Facility Name
Asan Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Kyung Hee University Hospital at Gangdong
City
Seoul
Country
Korea, Republic of
Facility Name
Kyung Hee University Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Severance Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
The Catholic University of Korea Seoul St. Mary's Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Wonju Severance Christian Hospital
City
Wonju
Country
Korea, Republic of

12. IPD Sharing Statement

Learn more about this trial

Study of Combined Therapy IVIG-SN 10% and Acetylsalicylic Acid in Kawasaki Disease

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