search
Back to results

Rituxan in Churg Strauss Syndrome With Renal Involvement

Primary Purpose

Churg-Strauss Syndrome

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Rituximab
Prednisone
Sponsored by
Fernando Fervenza
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Churg-Strauss Syndrome focused on measuring Antineutrophil cytoplasmic antibody associated vasculitis, Glomerulonephritis, Rituximab

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with Churg-Strauss syndrome as defined by meeting one of 3 sets of criteria for Churg-Strauss Syndrome described above who have not yet been treated, who have failed steroid therapy (partial or non-responders) or who can not been tapered off oral prednisone because of documented relapsing disease
  • Renal involvement (>25% dysmorphic red cell, red blood cell casts, or pauci-immune glomerulonephritis on biopsy)
  • Age >18 years old
  • Serum creatinine less than or equal to 3.0 mg/dl
  • Able and willing to give written informed consent and comply with the requirements of the study protocol.
  • Negative serum pregnancy test (for women of child bearing age)
  • Men and women of reproductive potential must agree to use an acceptable method of birth control during treatment and for twelve months after completion of treatment.

Exclusion Criteria

  • Severe obstructive or restrictive lung disease (forced expiratory volume in one second <1)
  • Cerebral involvement
  • Rapidly progressive optic neuropathy or retinal vasculitis
  • Active gastrointestinal bleeding
  • Heart failure, including pericarditis or myocarditis.
  • Hemoglobin <8.5 gm/dL
  • Platelets <100,000/mm
  • AST or ALT >2.5 Upper Limit of Normal unless related to primary disease
  • Positive Hepatitis B or C serology
  • History of positive HIV testing
  • Treatment with any investigational agent within 4 weeks of screening or 5 half-lives of the investigational drug (whichever is longer)
  • Previous treatment with Rituximab
  • History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies
  • History of recurrent significant infection or history of recurrent bacterial infections
  • Known active bacterial, viral fungal mycobacterial, or other infection (including tuberculosis or atypical mycobacterial disease, but excluding fungal infections of nail beds) or any major episode of infection requiring hospitalization or treatment with i.v. antibiotics within 4 weeks of screening or oral antibiotics within 2 weeks prior to screening
  • Lack of peripheral venous access
  • History of drug, alcohol, or chemical abuse within 6 months prior to screening
  • Pregnancy or lactation
  • Concomitant malignancies or previous malignancies, with the exception of adequately treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix
  • Significant cardiac or pulmonary disease (including obstructive pulmonary disease)
  • Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the patient at high risk from treatment complications

Sites / Locations

  • Mayo Clinic

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Rituximab

Arm Description

375 mg/m^2/week for 4 weeks

Outcomes

Primary Outcome Measures

Participants With Remission of Renal Disease Activity at 3 Months
Remission of renal disease activity was indicated by stable or falling creatinine, absence of active urinary sediment AND reduction of oral prednisone dose to less than 50% of average dose of preceding 3 months or less than 10 mg/day (whichever smaller)

Secondary Outcome Measures

Participants With Normalization of Eosinophil Count at 6 Months
Normalization of eosinophil counts was defined as total eosinophil counts <1.5 x 10^9/L.

Full Information

First Posted
January 19, 2007
Last Updated
November 3, 2011
Sponsor
Fernando Fervenza
Collaborators
Genentech, Inc., Biogen, National Center for Research Resources (NCRR)
search

1. Study Identification

Unique Protocol Identification Number
NCT00424749
Brief Title
Rituxan in Churg Strauss Syndrome With Renal Involvement
Official Title
A Pilot Study on the Use of Rituximab in the Treatment of Churg- Strauss Syndrome With Renal Involvement
Study Type
Interventional

2. Study Status

Record Verification Date
November 2011
Overall Recruitment Status
Terminated
Why Stopped
Company providing study drug terminated study due to lack of funds
Study Start Date
June 2007 (undefined)
Primary Completion Date
July 2009 (Actual)
Study Completion Date
July 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Fernando Fervenza
Collaborators
Genentech, Inc., Biogen, National Center for Research Resources (NCRR)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Churg-Strauss Syndrome (CSS) is a disease characterized by asthma, abnormally high amounts of eosinophils (a type of white blood cell), and blood vessel inflammation. About 25% of CSS patients develop kidney disease. The goal of this pilot study was to evaluate the safety and effectiveness of Rituximab in inducing remission of kidney disease in patients with CSS.
Detailed Description
Churg-Strauss syndrome (CSS) is a small vessel systemic vasculitis associated with asthma and eosinophilia that causes glomerulonephritis in about 25% of patients. Rituximab is a chimeric anti-CD20 monoclonal antibody that depletes B cells and is effective in numerous autoimmune disease including antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. The aim of this study was to evaluate the safety and efficacy of Rituximab in inducing remission of renal disease activity in patients with CSS.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Churg-Strauss Syndrome
Keywords
Antineutrophil cytoplasmic antibody associated vasculitis, Glomerulonephritis, Rituximab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Rituximab
Arm Type
Experimental
Arm Description
375 mg/m^2/week for 4 weeks
Intervention Type
Drug
Intervention Name(s)
Rituximab
Other Intervention Name(s)
Rituxan, MabThera
Intervention Description
Patients received 4 weekly doses of rituximab 375 mg/m^2.
Intervention Type
Drug
Intervention Name(s)
Prednisone
Other Intervention Name(s)
Deltasone, Liquid Pred, Meticorten, Orasone, Prednicen-M, Prednicot, Sterapred, Sterapred DS
Intervention Description
Prednisone 1 mg/kg/day (not to exceed 80 mg/day) for 4 weeks followed by a taper to 0 mg by 6 months
Primary Outcome Measure Information:
Title
Participants With Remission of Renal Disease Activity at 3 Months
Description
Remission of renal disease activity was indicated by stable or falling creatinine, absence of active urinary sediment AND reduction of oral prednisone dose to less than 50% of average dose of preceding 3 months or less than 10 mg/day (whichever smaller)
Time Frame
3 months after beginning of remission induction regimen
Secondary Outcome Measure Information:
Title
Participants With Normalization of Eosinophil Count at 6 Months
Description
Normalization of eosinophil counts was defined as total eosinophil counts <1.5 x 10^9/L.
Time Frame
6 months after beginning of remission induction regimen

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with Churg-Strauss syndrome as defined by meeting one of 3 sets of criteria for Churg-Strauss Syndrome described above who have not yet been treated, who have failed steroid therapy (partial or non-responders) or who can not been tapered off oral prednisone because of documented relapsing disease Renal involvement (>25% dysmorphic red cell, red blood cell casts, or pauci-immune glomerulonephritis on biopsy) Age >18 years old Serum creatinine less than or equal to 3.0 mg/dl Able and willing to give written informed consent and comply with the requirements of the study protocol. Negative serum pregnancy test (for women of child bearing age) Men and women of reproductive potential must agree to use an acceptable method of birth control during treatment and for twelve months after completion of treatment. Exclusion Criteria Severe obstructive or restrictive lung disease (forced expiratory volume in one second <1) Cerebral involvement Rapidly progressive optic neuropathy or retinal vasculitis Active gastrointestinal bleeding Heart failure, including pericarditis or myocarditis. Hemoglobin <8.5 gm/dL Platelets <100,000/mm AST or ALT >2.5 Upper Limit of Normal unless related to primary disease Positive Hepatitis B or C serology History of positive HIV testing Treatment with any investigational agent within 4 weeks of screening or 5 half-lives of the investigational drug (whichever is longer) Previous treatment with Rituximab History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies History of recurrent significant infection or history of recurrent bacterial infections Known active bacterial, viral fungal mycobacterial, or other infection (including tuberculosis or atypical mycobacterial disease, but excluding fungal infections of nail beds) or any major episode of infection requiring hospitalization or treatment with i.v. antibiotics within 4 weeks of screening or oral antibiotics within 2 weeks prior to screening Lack of peripheral venous access History of drug, alcohol, or chemical abuse within 6 months prior to screening Pregnancy or lactation Concomitant malignancies or previous malignancies, with the exception of adequately treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix Significant cardiac or pulmonary disease (including obstructive pulmonary disease) Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the patient at high risk from treatment complications
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Fernando C. Fervenza, M.D., Ph.D.
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
21325353
Citation
Cartin-Ceba R, Keogh KA, Specks U, Sethi S, Fervenza FC. Rituximab for the treatment of Churg-Strauss syndrome with renal involvement. Nephrol Dial Transplant. 2011 Sep;26(9):2865-71. doi: 10.1093/ndt/gfq852. Epub 2011 Feb 16.
Results Reference
result
Links:
URL
http://clinicaltrials.mayo.edu
Description
Mayo Clinic Clinical Trials

Learn more about this trial

Rituxan in Churg Strauss Syndrome With Renal Involvement

We'll reach out to this number within 24 hrs