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The intent of this study is to demonstrate the efficacy and safety of Immune Globulin Intravenous (Human), 10% Caprylate/Chromatography Purified (IGIV-C) in newly or previously diagnosed CIDP subjects. Eight courses of treatment with either placebo or IGIV-C will occur every 3 weeks. Neurological function will be measured by Inflammatory Neuropathy Cause and Treatment (INCAT) scores. Patients who deteriorate or show no improvement between day 16 and month 6 will receive the alternate study drug for an additional 6 months.
110 subjects, 55 per treatment group, with newly or previously diagnosed CIDP defined by INCAT neurophysiological diagnostic criteria will be enrolled into the trial. Patients will not be replaced if they discontinue prematurely.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Experimental | IGIV-C |
|
| Group 2 | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Immune Globulin IV (Human), 10% Caprylate/Chromatography Purified | Drug | 2 g/kg body weight ideally over 2-4 days . Thereafter, study drug infusion (IGIV-C) will be administered every 3 weeks at a dose of 1 g/kg bw, given over 1-2 days for a total of 7 additional infusions |
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of the Responder Rates Between Two Treatment Groups in the Efficacy Period | The primary efficacy objective was the comparison of IGIV-C and Placebo group Responder rates. An Efficacy Period Responder was defined as a subject with ≥ 1 point improvement in the adjusted Inflammatory Neuropathy Case And Treatment (INCAT) score, with the improvement maintained through the end of Week 24 in the Efficacy Period. Measurements are reported in INCAT scale of 0-5 in both lower and upper extremities, for a total score of 0 to 10. INCAT scores for arm disability: 0 = no upper limb problems; 5 = inability to use either arm for any purposeful movement. INCAT scores for leg disability: 0= walking not affected; 5 = restricted to wheelchair, unable to stand and walk a few steps with help | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Change in the Amplitude (Millivolts) in the Most Severely Affected Motor Nerve During the Efficacy Period | Mean changes in amplitude [mV] measured at most proximal site in the most severely affected motor nerve from baseline to endpoint during the Efficacy Period (Intent to treat population) | 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Norman Latov, MD | Columbia University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Yale University School of Medicine | New Haven | Connecticut | 06520-8018 | United States | ||
| Saint Louis University Medical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 18178525 | Result | Hughes RA, Donofrio P, Bril V, Dalakas MC, Deng C, Hanna K, Hartung HP, Latov N, Merkies IS, van Doorn PA; ICE Study Group. Intravenous immune globulin (10% caprylate-chromatography purified) for the treatment of chronic inflammatory demyelinating polyradiculoneuropathy (ICE study): a randomised placebo-controlled trial. Lancet Neurol. 2008 Feb;7(2):136-44. doi: 10.1016/S1474-4422(07)70329-0. | |
| 19260050 |
| Label | URL |
|---|---|
| FDA Approved Product Labeling Information - Gamunex® | View source |
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The study was conducted at 31 study centers in USA, Poland, Argentina, Czech Republic, Canada, Mexico, Italy, Israel, Germany, and Serbia.
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| ID | Title | Description |
|---|---|---|
| FG000 | IGIV-C | 2 g/kg loading dose, followed by 1 g/kg maintenance dose |
| FG001 | Placebo | .1% albumin; 2g/kg loading dose and 1 g/kg maintenance dose |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Efficacy Period |
|
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|
| Albumin (Human) 25%, United States Pharmacopeia (USP) | Drug | Albumin 25%, USP diluted with dextrose 5% to a final concentration of 0.1% as an intravenous infusion. Alternatively, it may be a bottled placebo of 0.1% Albumin (Human) in 0.2 M Glycine, 1.1 mm sodium caprylate, 0.25% sodium chloride. 2 g/kg body weight ideally over 2-4 days . Thereafter, infusion (placebo) will be administered every 3 weeks at a dose of 1 g/kg bw, given over 1-2 days for a total of 7 additional infusions |
|
|
| Mean Change in Grip Strength During the Efficacy Period |
| 6 months |
| Time to Relapse for Subjects Who Were IGIV-C Responders or IGIV-C Rescue Successes, During the Randomized Withdrawal Period | 6 months |
| St Louis |
| Missouri |
| 63110 |
| United States |
| Columbia University | New York | New York | 10022 | United States |
| Wake Forest University-School of Medicine | Winston-Salem | North Carolina | 27157-1078 | United States |
| Cleveland Clinic | Cleveland | Ohio | 44195 | United States |
| University of Texas-Southwestern Medical Center at Dallas | Dallas | Texas | 75390 | United States |
| Hospital Ramos Mejia | Buenos Aires | C1221 ADC | Argentina |
| Hospital Frances | Buenos Aires | C1221ACI | Argentina |
| Fundacion para la Lucha contra Las Enfermedades Neurologicas de la Infacia (FLENI) | Buenos Aires | C1428 AQK | Argentina |
| Instituto de Neurociencias Buenos Aires (INEBA) | Capital Federal | C1192 AAW | Argentina |
| Vancouver Hospital and Health Sciences Center | Vancouver | British Columbia | V5Z 1M9 | Canada |
| Fakultní nemocnice Brno | Brno | 625 00 | Czechia |
| Fakultní nemocnice Ostrava | Ostrava-Poruba | 1790 | Czechia |
| Neurologická klinika Pardubice | Pardubice | 53003 | Czechia |
| Fakultní nemocnice Motol | Prague | 15600 | Czechia |
| Jüdisches Krankenhaus | Berlin | 13347 | Germany |
| Tel Aviv Sourasky Medical Center | Tel Aviv | 84101 | Israel |
| Chaim Sheba Medical Center | Tel Litwinsky | Israel |
| Assaf Harofe Medical Center | Zrifin | 70300 | Israel |
| Dipartimento di Neuroscienze, Sezione di Neurologia, AO Chieti | Chieti | Italy |
| Univesita delgi Studi di Genova, Dipartimento di Scienze, Neurologiche e della Visione | Genova | 16132 | Italy |
| Hospital San Raffaele | Milan | 20132 | Italy |
| Antiguo Hospital Civil de Guadalajara | Guadalajara | Jalisco | 44280 | Mexico |
| Hospital Angel Leano, Neurology Department | Guadalajara | Jalisco | Mexico |
| Hospital Central San Luis Potosi, Neurology Department | San Luis Potosí City | Mexico |
| Centre of Clinical Neurology, Neurology Department | Cracow | 31-530 | Poland |
| County Specialist Hospital, Neurology Department | Gdansk | 80-803 | Poland |
| Barlicki Hospital | Lodz | 90-153 | Poland |
| Medical Acedemy, Clinical Hospital, Neurology Department | Lubin | 20-950 | Poland |
| Central Clinical Hospital, Medical Academy Warsaw | Warsaw | Poland |
| County Hospital | Zgierz | Poland |
| University Hospital, University of Belgrade | Belgrade | 11000 | Serbia |
| Result |
| Bril V, Katzberg H, Donofrio P, Banach M, Dalakas MC, Deng C, Hanna K, Hartung HP, Hughes RA, Latov N, Merkies IS, van Doorn PA; ICE Study Group. Electrophysiology in chronic inflammatory demyelinating polyneuropathy with IGIV. Muscle Nerve. 2009 Apr;39(4):448-55. doi: 10.1002/mus.21236. |
| 19365055 | Result | Merkies IS, Bril V, Dalakas MC, Deng C, Donofrio P, Hanna K, Hartung HP, Hughes RA, Latov N, van Doorn PA; ICE Study Group. Health-related quality-of-life improvements in CIDP with immune globulin IV 10%: the ICE Study. Neurology. 2009 Apr 14;72(15):1337-44. doi: 10.1212/WNL.0b013e3181a0fd80. |
| 19496683 | Result | Hughes RA. Intravenous immunoglobulin for chronic inflammatory demyelinating polyradiculoneuropathy: the ICE trial. Expert Rev Neurother. 2009 Jun;9(6):789-95. doi: 10.1586/ern.09.30. |
| 20837852 | Derived | Donofrio PD, Bril V, Dalakas MC, Deng C, Hanna K, Hartung HP, Hughes R, Latov N, Merkies I, van Doorn P; IGIV-C CIDP Efficacy (ICE) Study Group. Safety and tolerability of immune globulin intravenous in chronic inflammatory demyelinating polyradiculoneuropathy. Arch Neurol. 2010 Sep;67(9):1082-8. doi: 10.1001/archneurol.2010.223. |
| 20647554 | Derived | Merkies IS, van Nes SI, Hanna K, Hughes RA, Deng C. Confirming the efficacy of intravenous immunoglobulin in CIDP through minimum clinically important differences: shifting from statistical significance to clinical relevance. J Neurol Neurosurg Psychiatry. 2010 Nov;81(11):1194-9. doi: 10.1136/jnnp.2009.194324. Epub 2010 Jul 20. |
| 20457948 | Derived | Latov N, Deng C, Dalakas MC, Bril V, Donofrio P, Hanna K, Hartung HP, Hughes RA, Merkies IS, van Doorn PA; IGIV-C CIDP Efficacy (ICE) Study Group. Timing and course of clinical response to intravenous immunoglobulin in chronic inflammatory demyelinating polyradiculoneuropathy. Arch Neurol. 2010 Jul;67(7):802-7. doi: 10.1001/archneurol.2010.105. Epub 2010 May 10. |
| FDA Approved Product Labeling Information - Plasbumin®-25 (Low Aluminum) | View source |
| COMPLETED |
|
| NOT COMPLETED |
|
|
| Rescue Treatment |
|
| Withdrawal Period |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | IGIV-C | 2 g/kg loading dose, followed by 1 g/kg maintenance dose |
| BG001 | Placebo | .1% albumin, 2 g/kg loading dose, followed by 1 g/kg maintenance dose |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||||
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||||
| Baseline INCAT Score | Baseline INCAT score for all subjects and subgroups for Efficacy Period, Rescue treatment, and Randomized Withdrawal Period (ITT population) Measurements are reported in Inflammatory Neuropathy Case And Treatment (INCAT) scale of 0-5 in both lower and upper extremities, for a total score of 0 to 10. INCAT scores for arm disability: 0 = no upper limb problems; 5 = inability to use either arm for any purposeful movement. INCAT scores for leg disability: 0= walking not affected; 5 = restricted to wheelchair, unable to stand and walk a few steps with help | Mean | Standard Deviation | units on a scale |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Comparison of the Responder Rates Between Two Treatment Groups in the Efficacy Period | The primary efficacy objective was the comparison of IGIV-C and Placebo group Responder rates. An Efficacy Period Responder was defined as a subject with ≥ 1 point improvement in the adjusted Inflammatory Neuropathy Case And Treatment (INCAT) score, with the improvement maintained through the end of Week 24 in the Efficacy Period. Measurements are reported in INCAT scale of 0-5 in both lower and upper extremities, for a total score of 0 to 10. INCAT scores for arm disability: 0 = no upper limb problems; 5 = inability to use either arm for any purposeful movement. INCAT scores for leg disability: 0= walking not affected; 5 = restricted to wheelchair, unable to stand and walk a few steps with help | The Intent-to-Treat Population was defined as all randomized subjects. This population was the primary efficacy population to be analyzed. | Posted | Number | percentage of responders | 6 months |
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| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Mean Change in the Amplitude (Millivolts) in the Most Severely Affected Motor Nerve During the Efficacy Period | Mean changes in amplitude [mV] measured at most proximal site in the most severely affected motor nerve from baseline to endpoint during the Efficacy Period (Intent to treat population) | Intent-to-treat | Posted | Mean | Standard Deviation | Millivolts | 6 months |
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Mean Change in Grip Strength During the Efficacy Period | Intent-to-treat | Posted | Mean | Standard Deviation | kilopascal | 6 months |
|
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| Secondary | Time to Relapse for Subjects Who Were IGIV-C Responders or IGIV-C Rescue Successes, During the Randomized Withdrawal Period | In the Randomized Withdrawal Period, 43 subjects were randomized to IGIV-C, but only 31 out of the 41 subjects were prior IGIV-C responders or rescue successes. Similarly, 31 subjects were randomized to Placebo, but only 26 out of the 31 subjects were prior IGIV-C responders or rescue successes. | Posted | Mean | Standard Deviation | weeks | 6 months |
|
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | IGIV-C | 2 g/kg loading dose, followed by 1 g/kg maintenance dose. A total of 113 subjects were exposed to IGIV-C across all three treatments/periods. | 6 | 113 | 81 | 113 | ||
| EG001 | Placebo | .1% albumin; 2g/kg loading dose and 1 g/kg maintenance dose. A total of 95 subjects were exposed to Placebo across all three treatments/periods. | 8 | 95 | 25 | 95 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pulmonary embolism | Respiratory, thoracic and mediastinal disorders |
| |||
| Dizziness | Nervous system disorders |
| |||
| Palpitations | Cardiac disorders |
| |||
| Pyrexia | General disorders |
| |||
| Headache | Nervous system disorders |
| |||
| Dyspnea | Respiratory, thoracic and mediastinal disorders |
| |||
| Vomiting | Gastrointestinal disorders |
| |||
| Bronchopneumonia | Infections and infestations |
| |||
| Myalgia | Musculoskeletal and connective tissue disorders |
| |||
| Demyelinating polyneuropathy | Nervous system disorders |
| |||
| Back pain | Musculoskeletal and connective tissue disorders |
| |||
| Asthma | Respiratory, thoracic and mediastinal disorders |
| |||
| Medical observation (for asthma) | Investigations |
| |||
| Gastroenteritis viral | Infections and infestations |
| |||
| Cerebrovascular accident | Nervous system disorders |
| |||
| Deep vein thrombosis | Vascular disorders |
| |||
| Pregnancy | Pregnancy, puerperium and perinatal conditions |
| |||
| CIDP (relapse) | Nervous system disorders |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders |
| |||
| Pyrexia | General disorders |
| |||
| Asthenia | General disorders |
| |||
| Chills | General disorders |
| |||
| Influenza | Infections and infestations |
| |||
| Back pain | Musculoskeletal and connective tissue disorders |
| |||
| Arthralgia | Musculoskeletal and connective tissue disorders |
| |||
| Headache | Nervous system disorders |
| |||
| Dizziness | Nervous system disorders |
| |||
| Rash | Skin and subcutaneous tissue disorders |
| |||
| Hypertension | Vascular disorders |
|
The investigator must send a draft manuscript of the publication or abstract to the sponsor thirty days in advance of submission in order to obtain approval prior to submission of the final version for publication. This will be reviewed promptly and approval will not be withheld unreasonably. In case of a difference of opinion between the sponsor and the investigator(s), the contents of the publication will be discussed in order to find a solution that satisfies both parties.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Henry Li | Grifols Therapeutics | 1-800-520-2807 | henry.li@grifols.com |
| 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 |
|---|---|
| D005719 | gamma-Globulins |
| D002210 | Caprylates |
| D016756 | Immunoglobulins, Intravenous |
| D000418 | Albumins |
| ID | Term |
|---|---|
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
| D005227 | Fatty Acids |
| D008055 | Lipids |
| D007074 | Immunoglobulin G |
| D007132 | Immunoglobulin Isotypes |
| D000906 | Antibodies |
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| >=65 years |
|
| Male |
|
| Czech Republic |
|
| Mexico |
|
| Canada |
|
| Argentina |
|
| Poland |
|
| Israel |
|
| Germany |
|
| Italy |
|
| Macedonia, The Former Yugoslav Republic of |
|
| Upper Extremity Disability Score |
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| Lower Extremity Disability Score |
|
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