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The purpose of this study is to determine whether AVONEX (Interferon Beta-1a), when compared to placebo, reduces the total dose of IVIg that is administered after Visit 5 and through Visit 9 (Week 32, End of Study).
Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) is an acquired peripheral neuropathy of unknown origin. The etiology is not well understood but is presumed to be immunological. Evidence for this comes from observed similarities to Guillain-Barre syndrome and from the favorable response with immunomodulatory treatments.
CIDP is a peripheral nervous system demyelinating neuropathy that is sometimes a corollary disorder to the central nervous system demyelination of multiple sclerosis (MS. The precise mechanisms underlying the pathogenesis are uncertain, but a number of those mechanisms support a potential role for immunomodulatory treatments such as interferon beta (e.g., Biogen Idec Inc.'s AVONEX).
The rationale for the use of AVONEX in CIDP derives from observations on the pathogenesis of the condition and its similarities to MS, the mechanism of action of AVONEX, clinical trials that have been performed in CIDP that support a role for IFN-beta, and the unmet need that currently exists because of availability and safety issues with existing therapies.
This Phase 2b study is a dose-ranging study designed to provide scientific evidence regarding the safety and efficacy of AVONEX in CIDP. In addition, the study aims to demonstrate the responsiveness and clinical relevance of changes in the MRC sum score and ODSS in CIDP patients.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Interferon Beta-1a | Drug |
| Measure | Description | Time Frame |
|---|---|---|
| The primary endpoint for the efficacy analyses is the total IVIg dose (g/Kg) administered after Visit 5 and through Visit 9 (Week 32, End of Study). |
| Measure | Description | Time Frame |
|---|---|---|
| The time to disease progression. | ||
| Percentage reduction in IVIg dose (g/Kg). | ||
| The number of days between Visit 5 and either disease progression or Visit 9 |
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Inclusion Criteria:
Exclusion Criteria*:
Associated systemic disorder that might cause neuropathy.
History of, or abnormal laboratory results indicative of any significant major disease or known drug hypersensitivity that, in the opinion of the investigator, would preclude the administration if IFN-beta or participation in this study.
Subjects with diabetes mellitus will not be eligible, unless they satisfy both of the following requirements: a) their diabetes is well-controlled, with no retinopathy or nephropathy, having been identified during the ongoing care of their diabetes; and b) they have a normal sensory nerve action potential (SNAP) amplitude recorded in the sural nerve on at least one side of the body identified during electrophysiology (EP) testing documented in their medical record.
Abnormal screening or baseline blood tests that the investigator deems clinically significant
History of a seizure disorder prior to baseline (Visit 1, Week 0).
History of suicidal ideation within 3 months prior to Baseline Visit (Week 0) or an episode of severe depression within 3 months prior to Baseline Visit (Week 0).
Pure motor syndrome fulfilling criteria for multifocal motor neuropathy with conduction block.
Pure sensory CIDP, or any other variant of CIDP without motor involvement
Serious local infection or systemic infection within the 6 months prior to Screening.
Use of IFN-beta at any time, use of plasma exchange, plasmapheresis, or any other immunosuppressant (with the exception of oral or non-systemic corticosteroids) within 6 months prior to Screening.
History of intolerance to acetaminophen (paracetamol), ibuprofen, naproxen, and/or aspirin that would preclude use of at least one of these during the study.
For female subjects, unless postmenopausal or surgically sterile, unwillingness to practice effective contraception, as defined by the Investigator, during the study.
Female subjects considering becoming pregnant while in the study
Female subjects who are currently pregnant or breast-feeding.
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| Name | Affiliation | Role |
|---|---|---|
| Allan Ropper, MD | Tufts University School of Medicine, St. Elizabeth's Medical Center | Principal Investigator |
| Kate Dawson, MD | Biogen | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Phoenix Neurological Associates, Ltd. | Phoenix | Arizona | 85006 | United States | ||
| Neuromuscular Research Center |
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| (Week 32, End of Study). |
| The proportion of subjects with disease progression at Visit 9 (Week 32, End of Study). |
| The change in MRC sum score from baseline to the time of IVIg withdrawal. |
| Change from baseline to Visit 5 and to Visit 9 (Week 32, End of Study) in a composite score of maximal conduction velocity. |
| Scottsdale |
| Arizona |
| 85258 |
| United States |
| University of Florida, Jacksonville | Jacksonville | Florida | 32209 | United States |
| University of Miami | Miami | Florida | 33136 | United States |
| University of Kansas | Kansas City | Kansas | 66160 | United States |
| Louisiana State University | New Orleans | Louisiana | 70112 | United States |
| Harvard University/MGH | Boston | Massachusetts | 02114 | United States |
| Tufts University/ St. Elizabeths | Boston | Massachusetts | 02135 | United States |
| University of Minnesota | Minneapolis | Minnesota | 55455 | United States |
| Weill Medical College of Cornell University | New York | New York | 10022 | United States |
| Raleigh Neurology Associates | Raleigh | North Carolina | 27607 | United States |
| University of Texas Southwestern | Dallas | Texas | 75390-8897 | United States |
| University of Utah | Salt Lake City | Utah | 84132 | United States |
| Liverpool Hospital | Liverpool | New South Wales | 2170 | Australia |
| Institute of Clinical Neurosciences | Sydney | New South Wales | 2006 | Australia |
| St. Vincent's Hospital | Fitzroy | Victoria | 3065 | Australia |
| Royal Melbourne Hospital | Parkville | Victoria | 3050 | Australia |
| London Health Sciences Center | London | Ontario | N6A 5A5 | Canada |
| Montreal Neurological Hospital | Montreal | Quebec | H3A 2B4 | Canada |
| Guy's Hospital/Dept. of Neuroimmunology | London | SE1 1UL | United Kingdom |
| ID | Term |
|---|---|
| D020277 | Polyradiculoneuropathy, Chronic Inflammatory Demyelinating |
| ID | Term |
|---|---|
| D011129 | Polyradiculoneuropathy |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
| D011115 | Polyneuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000068556 | Interferon beta-1a |
| ID | Term |
|---|---|
| D016899 | Interferon-beta |
| D007370 | Interferon Type I |
| D007372 | Interferons |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D001685 | Biological Factors |
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