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Activity of Valomaciclovir in Infectious Mononucleosis Due to Primary Epstein-Barr Virus Infection (Mono6)

Primary Purpose

Infectious Mononucleosis

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Valomaciclovir
placebo
Sponsored by
University of Minnesota
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Infectious Mononucleosis focused on measuring Mono, Mononucleosis, Epstein-Barr virus

Eligibility Criteria

15 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 15 years or older
  • Within 14 days of initial symptoms of present illness diagnosed by a health care provider as infectious mononucleosis and confirmed to be due to primary EBV by antibody profile. The criteria for antibody confirmation of primary EBV at the screening visit are: 1)Positive for anti-EBV VCA IgM antibody and negative for anti-EBV EBNA1 IgG antibody; 2)EBV antibody testing will be done in the Clinical Virology Research Laboratory using commercial ELISA kits (Diamedix Corporation, Miami, FL).
  • Willingness to sign the Informed Consent Form (ICF)
  • Willingness to contribute samples of blood and oral washings at regular intervals
  • Males and females must use effective contraception during treatment and for at least 90 days following treatment
  • Negative pregnancy test result at the Screening Visit for females of childbearing potential (including females who have had a bilateral tubal ligation). Female patients of childbearing potential must be willing to use an approved method of double-barrier contraception (hormonal plus barrier or barrier plus barrier, eg, diaphragm plus condom) from the time of first dose administration until 90 days after completion of dosing and male patients with female partners of childbearing potential must be willing to use a condom. Patients who are sterile or infertile (defined as those who are postmenopausal or have undergone a complete hysterectomy) are eligible.
  • Estimated creatinine clearance (Cockcroft and Gault method) ≥ 60 ml/min
  • Absolute neutrophil count ≥ 1000 cells/microliter
  • Platelets ≥ 100,000/microliter
  • Hemoglobin ≥ 9.5 g/dL

Exclusion Criteria:

  • Previous history of infectious mononucleosis-like illness
  • Immunosuppressed due to medical disease and/or immunosuppressive or immunomodulating medications (e.g., corticosteroids prior to enrollment, cytotoxic drugs, interferons)
  • Another intercurrent viral infection (including HIV), based on history or referring physician medical evaluation
  • More than 7 days elapsed since onset of illness (including screening time)
  • The following concomitant medications are prohibited: probenecid, trimethoprim, myelosuppressive therapies, and medications known to be nephrotoxic
  • Breast feeding during the study
  • Corticosteroids are not permitted. If they are prescribed by the subject's primary physician for treatment of this acute disease after the subject has enrolled, the subject will be replaced.

Sites / Locations

  • University of Minnesota

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Valomaciclovir

placebo

Arm Description

Valomaciclovir 2 grams orally twice daily for 21 days

placebo 2 tablets twice daily for 21 days

Outcomes

Primary Outcome Measures

Number of Participants With Improvement in Clinical Symptoms and Reductions in Viral Burden From Baseline
All subjects had confirmed cases of EB and will be assessed for Improvement of clinical symptoms (ie: tiredness, nausea etc)and reduction in viral burden from baseline

Secondary Outcome Measures

Number of Participants Who Experienced Adverse Events During the Study Safety and Tolerability
Assessing adverse events in participants to see if this drug causes more or less side effects

Full Information

First Posted
December 14, 2007
Last Updated
February 16, 2017
Sponsor
University of Minnesota
Collaborators
Epiphany Biosciences
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1. Study Identification

Unique Protocol Identification Number
NCT00575185
Brief Title
Activity of Valomaciclovir in Infectious Mononucleosis Due to Primary Epstein-Barr Virus Infection
Acronym
Mono6
Official Title
Randomized, Placebo-Controlled, Double-Blind Study to Assess Clinical and Antiviral Activity of Valomaciclovir (EPB 348) in Infectious Mononucleosis Due to Primary Epstein-Barr Virus Infection (Mono 6)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
November 2007 (undefined)
Primary Completion Date
July 2009 (Actual)
Study Completion Date
February 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Minnesota
Collaborators
Epiphany Biosciences

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This will be a randomized, placebo-controlled, double-blind single-center proof of concept study to evaluate the anti-EBV activity of 4 grams of valomaciclovir (2 grams BID) for 21 days in subjects with infectious mononucleosis documented to be caused by primary EBV infection. Otherwise healthy subjects (≥15 years old) referred to us with a clinical diagnosis of primary infectious mononucleosis will be screened and those with laboratory-confirmed primary EBV infection will be enrolled.
Detailed Description
Subjects will be seen 2 times a week for 3 weeks and then weekly for 3 weeks. Clinical findings, clinical lab tests, EBV viral loads, and EBV antibody titers will be obtained at each clinic visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infectious Mononucleosis
Keywords
Mono, Mononucleosis, Epstein-Barr virus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Valomaciclovir
Arm Type
Active Comparator
Arm Description
Valomaciclovir 2 grams orally twice daily for 21 days
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
placebo 2 tablets twice daily for 21 days
Intervention Type
Drug
Intervention Name(s)
Valomaciclovir
Intervention Description
4 grams orally of valomaciclovir (2 grams BID) for 21 days.
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
Placebo tablets orally twice daily for 21 days.
Primary Outcome Measure Information:
Title
Number of Participants With Improvement in Clinical Symptoms and Reductions in Viral Burden From Baseline
Description
All subjects had confirmed cases of EB and will be assessed for Improvement of clinical symptoms (ie: tiredness, nausea etc)and reduction in viral burden from baseline
Time Frame
21 days
Secondary Outcome Measure Information:
Title
Number of Participants Who Experienced Adverse Events During the Study Safety and Tolerability
Description
Assessing adverse events in participants to see if this drug causes more or less side effects
Time Frame
15 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
15 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 15 years or older Within 14 days of initial symptoms of present illness diagnosed by a health care provider as infectious mononucleosis and confirmed to be due to primary EBV by antibody profile. The criteria for antibody confirmation of primary EBV at the screening visit are: 1)Positive for anti-EBV VCA IgM antibody and negative for anti-EBV EBNA1 IgG antibody; 2)EBV antibody testing will be done in the Clinical Virology Research Laboratory using commercial ELISA kits (Diamedix Corporation, Miami, FL). Willingness to sign the Informed Consent Form (ICF) Willingness to contribute samples of blood and oral washings at regular intervals Males and females must use effective contraception during treatment and for at least 90 days following treatment Negative pregnancy test result at the Screening Visit for females of childbearing potential (including females who have had a bilateral tubal ligation). Female patients of childbearing potential must be willing to use an approved method of double-barrier contraception (hormonal plus barrier or barrier plus barrier, eg, diaphragm plus condom) from the time of first dose administration until 90 days after completion of dosing and male patients with female partners of childbearing potential must be willing to use a condom. Patients who are sterile or infertile (defined as those who are postmenopausal or have undergone a complete hysterectomy) are eligible. Estimated creatinine clearance (Cockcroft and Gault method) ≥ 60 ml/min Absolute neutrophil count ≥ 1000 cells/microliter Platelets ≥ 100,000/microliter Hemoglobin ≥ 9.5 g/dL Exclusion Criteria: Previous history of infectious mononucleosis-like illness Immunosuppressed due to medical disease and/or immunosuppressive or immunomodulating medications (e.g., corticosteroids prior to enrollment, cytotoxic drugs, interferons) Another intercurrent viral infection (including HIV), based on history or referring physician medical evaluation More than 7 days elapsed since onset of illness (including screening time) The following concomitant medications are prohibited: probenecid, trimethoprim, myelosuppressive therapies, and medications known to be nephrotoxic Breast feeding during the study Corticosteroids are not permitted. If they are prescribed by the subject's primary physician for treatment of this acute disease after the subject has enrolled, the subject will be replaced.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Henry H Balfour, MD
Organizational Affiliation
Professor of Laboratory Medicine & Pathology, and Pediatrics
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
16206064
Citation
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Results Reference
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PubMed Identifier
17369082
Citation
Balfour HH Jr, Hokanson KM, Schacherer RM, Fietzer CM, Schmeling DO, Holman CJ, Vezina HE, Brundage RC. A virologic pilot study of valacyclovir in infectious mononucleosis. J Clin Virol. 2007 May;39(1):16-21. doi: 10.1016/j.jcv.2007.02.002. Epub 2007 Mar 21.
Results Reference
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PubMed Identifier
11458965
Citation
Rea TD, Russo JE, Katon W, Ashley RL, Buchwald DS. Prospective study of the natural history of infectious mononucleosis caused by Epstein-Barr virus. J Am Board Fam Pract. 2001 Jul-Aug;14(4):234-42.
Results Reference
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PubMed Identifier
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Citation
Cameron B, Galbraith S, Zhang Y, Davenport T, Vollmer-Conna U, Wakefield D, Hickie I, Dunsmuir W, Whistler T, Vernon S, Reeves WC, Lloyd AR; Dubbo Infection Outcomes Study. Gene expression correlates of postinfective fatigue syndrome after infectious mononucleosis. J Infect Dis. 2007 Jul 1;196(1):56-66. doi: 10.1086/518614. Epub 2007 May 24.
Results Reference
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PubMed Identifier
10680982
Citation
Torre D, Tambini R. Acyclovir for treatment of infectious mononucleosis: a meta-analysis. Scand J Infect Dis. 1999;31(6):543-7. doi: 10.1080/00365549950164409.
Results Reference
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PubMed Identifier
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Citation
Silins SL, Sherritt MA, Silleri JM, Cross SM, Elliott SL, Bharadwaj M, Le TT, Morrison LE, Khanna R, Moss DJ, Suhrbier A, Misko IS. Asymptomatic primary Epstein-Barr virus infection occurs in the absence of blood T-cell repertoire perturbations despite high levels of systemic viral load. Blood. 2001 Dec 15;98(13):3739-44. doi: 10.1182/blood.v98.13.3739.
Results Reference
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PubMed Identifier
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Citation
Hislop AD, Taylor GS, Sauce D, Rickinson AB. Cellular responses to viral infection in humans: lessons from Epstein-Barr virus. Annu Rev Immunol. 2007;25:587-617. doi: 10.1146/annurev.immunol.25.022106.141553.
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Citation
Hislop AD, Kuo M, Drake-Lee AB, Akbar AN, Bergler W, Hammerschmitt N, Khan N, Palendira U, Leese AM, Timms JM, Bell AI, Buckley CD, Rickinson AB. Tonsillar homing of Epstein-Barr virus-specific CD8+ T cells and the virus-host balance. J Clin Invest. 2005 Sep;115(9):2546-55. doi: 10.1172/JCI24810. Epub 2005 Aug 18.
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Activity of Valomaciclovir in Infectious Mononucleosis Due to Primary Epstein-Barr Virus Infection

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