A Pilot Study of Mitoxantrone for the Treatment of Recurrent Neuromyelitis Optica (Devic’s Disease) - Full Text View

Sponsors and Collaborators:	State University of New York at Buffalo EMD Serono
Information provided by:	State University of New York at Buffalo
ClinicalTrials.gov Identifier:	NCT00304291

Purpose

Neuromyelitis optica (NMO) is a severe demyelinating disease that selectively involves the optic nerves and the spinal cord but usually spares the brain. NMO is considered to have a B cell induced pathogenesis. Mitoxantrone (MITO, Novantrone®), a synthetic anthracenedione approved for worsening relapsing-remitting multiple sclerosis (MS) and secondary progressive MS, has been shown to primarily suppress the humoral response. We conducted a prospective 2-year study to evaluate the benefit of MITO in five relapsing NMO patients.

Condition	Intervention	Phase
Neuromyelitis Optica Myelitis, Transverse Demyelinating Autoimmune Diseases, CNS Autoimmune Diseases of the Nervous System	Drug: Mitoxantrone	Phase IV

MedlinePlus related topics: Autoimmune Diseases Multiple Sclerosis Neurologic Diseases

Drug Information available for: Mitoxantrone hydrochloride Mitoxantrone

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title:	A Pilot Study of Mitoxantrone for the Treatment of Recurrent Neuromyelitis Optica (Devic’s Disease)

Further study details as provided by State University of New York at Buffalo:

Primary Outcome Measures:

Relapse rate

Secondary Outcome Measures:

Safety

Estimated Enrollment:	5
Study Start Date:	August 2001
Estimated Study Completion Date:	May 2004

Detailed Description:

The treatment protocol consisted of monthly 12 mg/m2 MITO intravenous infusions for 6 months followed by 3 additional treatments every 3 months. Neurological assessment including the determination of the Expanded Disability Status Scale (EDSS) score was performed every 3 months and during relapses. Orbital, brain and spinal cord MRI was performed at baseline, 3, 6, 12, 18, and 24 months. Visual evoked potentials and ophthalmologic evaluations were performed at baseline and annually.

Eligibility

Ages Eligible for Study:	18 Years to 55 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Recurrent longitudinal myelitis (>3 segments of spinal cord involvement by MRI) with or without recurrent ON (unilateral or bilateral) but with normal brain MRI.
Patients with recurrent longitudinally extensive myelitis without optic neuritis have an underlying pathology and serology similar to NMO and it is appropriate to consider this a form of NMO10.
Cerebrospinal fluid required no intrathecal IgG synthesis or oligoclonal bands.
Age was required to be 18-55 years
Extended Disability Status Score ≤ 7.

Exclusion Criteria:

Cardiac risk factors (e.g history of congestive heart failure and left ventricular ejection fraction (LVEF) < 50%
Systemic diseases such as lupus, Sjogren’s syndrome, anti-phospholipid antibody syndrome, sarcoidosis, rheumatoid arthritis, or vitamin B12 deficiency
Previous treatment with mitoxantrone or anthracyclines

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00304291

Locations

United States, New York
Baird Multiple Sclerosis Center
Buffalo, New York, United States, 14203

Sponsors and Collaborators

State University of New York at Buffalo

EMD Serono

Investigators

Study Director:

Bianca Weinstock-Guttman, M.D.

Baird Multiple Sclerosis Center

More Information

Publications of Results:

Weinstock-Guttman B, Ramanathan M, Lincoff N, Napoli SQ, Sharma J, Feichter J, Bakshi R. Study of mitoxantrone for the treatment of recurrent neuromyelitis optica (Devic disease). Arch Neurol. 2006 Jul;63(7):957-63.

Study ID Numbers:	JNI-NMO-101
Study First Received:	March 15, 2006
Last Updated:	November 27, 2006
ClinicalTrials.gov Identifier:	NCT00304291
Health Authority:	United States: Food and Drug Administration

Keywords provided by State University of New York at Buffalo:

Novantrone

Study placed in the following topic categories:

Papillitis
Spinal Cord Diseases
Neuromyelitis Optica
Demyelinating diseases
Neurodegenerative Diseases
Neuritis
Multiple Sclerosis
Myelitis, Transverse
Autoimmune Diseases of the Nervous System
Nervous System Neoplasms
Optic Neuritis
Autoimmune Diseases
Devic disease
Demyelinating Diseases

Eye Diseases
Central Nervous System Diseases
Sclerosis
Optic nerve disorder
Recurrence
Virus Diseases
Paraneoplastic Syndromes
Central Nervous System Infections
Demyelinating Autoimmune Diseases, CNS
Myelitis
Optic Nerve Diseases
Mitoxantrone
Paraneoplastic Syndromes, Nervous System

Additional relevant MeSH terms:

Immune System Diseases
Antineoplastic Agents
Nervous System Diseases
Physiological Effects of Drugs
Central Nervous System Viral Diseases
Pharmacologic Actions
Neoplasms

Neoplasms by Site
Sensory System Agents
Therapeutic Uses
Cranial Nerve Diseases
Analgesics
Peripheral Nervous System Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on January 16, 2009