Ignite Creation Date:
2024-05-05 @ 5:10 PM
Last Modification Date:
2024-10-26 @ 9:29 AM
Study NCT ID:
NCT00405860
Status:
COMPLETED
Last Update Posted:
2011-03-23
First Post:
2006-11-29
Brief Title:
CellCept in p-ANCA Vasculitis
Sponsor:
Mayo Clinic
Organization:
Mayo Clinic
Study Overview
Official Title:
A Pilot Study of Mycophenolate Mofetil MMF in Patients With p-ANCA Microscopic Polyangiitis and Mild to Moderate Renal Dysfunction
Status:
COMPLETED
Status Verified Date:
2011-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Microscopic polyangiitis MP is a primary systemic vasculitis predominantly affecting small blood vessels Following the widespread introduction of ANCA testing the primary systemic vasculitis SV Wegeners granulomatosis WG and microscopic polyangiitis MP appear to be more frequent than was previously thought see definitions in Appendix 6 In addition the existence of early and organ-limited forms of these diseases such as renal-limited vasculitis RLV is now clearly recognized Their annual incidence exceeds 20 per million per year and they account for at least 5 of the causes of end stage renal failure The two diseases share many features of their histology serology and response to treatment pointing to similarities in their pathogenesis which have justified a common approach to their management The standard treatment with corticosteroids CS and cyclophosphamide CYC is usually effective at controlling active disease but continued treatment is necessary to prevent disease relapse Due to the cumulative toxicity associated with CYC treatment alternatives have been looked for Mycophenolate mofetil MMF has been used to treat patients with a variety of immune-mediated nephritides including ANCA-associated vasculitis with less toxicity than CYC but with variable outcome The present trial will examine whether substitution of oral CYC with oral MMF is equally efficient for induction of remission with less adverse effects in cases of MP with mild to moderate renal involvement All patients will receive the same regimen of oral prednisone MMF Prednisone will be tapered to a stop after 24 weeks but MMF will continue for a total of 18 months unless there is worsening or persistent disease The trial ends after 18 months
Detailed Description:
1 Patients will receive IV methylprednisone or IV dexamethazone oral prednisone and oral MMF therapy as outlined in table 2
2 MMF will be initiated within the first 1-2 weeks of the start of steroids Patients will receive CellCept 750 mg po bid for the first week Dose will be increased to 1000 mg po bid for the second week and thereafter according to blood levels and patient tolerance Target blood levels are 1 35 61549gml Treatment will be for a total of 18 months This is based on the published dose-dependent adverse effect profiles in transplant patients 31-32 and on reports that lower doses are ineffective and shorter courses less then 6 months result in relapses or failure of therapy 25 Dose will be reduced in patient who can not tolerate MMF at the above dose
2 Relapse treatment to follow guidelines for relapse regimens 3 After 18 months all medications will be tapered to a full stop unless disease is active or grumbling
4 Pneumocystis pneumonia prophylaxis will be used during the trial with sulfamethoxazoletrimethoprim or Dapsone or Mepron if allergic to sulfa
2 MMF will be initiated within the first 1-2 weeks of the start of steroids Patients will receive CellCept 750 mg po bid for the first week Dose will be increased to 1000 mg po bid for the second week and thereafter according to blood levels and patient tolerance Target blood levels are 1 35 61549gml Treatment will be for a total of 18 months This is based on the published dose-dependent adverse effect profiles in transplant patients 31-32 and on reports that lower doses are ineffective and shorter courses less then 6 months result in relapses or failure of therapy 25 Dose will be reduced in patient who can not tolerate MMF at the above dose
2 Relapse treatment to follow guidelines for relapse regimens 3 After 18 months all medications will be tapered to a full stop unless disease is active or grumbling
4 Pneumocystis pneumonia prophylaxis will be used during the trial with sulfamethoxazoletrimethoprim or Dapsone or Mepron if allergic to sulfa
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None