Multi Center Prospective Registry of Infliximab Use for Childhood Uveitis

The recruitment status of this study is unknown because the information has not been verified recently.
Verified February 2009 by Duke University.
Recruitment status was  Recruiting
Sponsor:
Collaborator:
Childhood Arthritis and Rheumatology Research Alliance
Information provided by:
Duke University
ClinicalTrials.gov Identifier:
NCT00589628
First received: December 27, 2007
Last updated: February 22, 2009
Last verified: February 2009
  Purpose

The primary objective of this study is to examine the efficacy of infliximab for the treatment of persistent uveitis in children. Participants (4-18 years of age) will be randomly assigned to either 5mg/kg or 10mg/kg dose of infliximab to be administered by intravenous infusion at four week intervals. Participant responses will be measured at at four to eight week intervals for up to ten months.


Condition Intervention Phase
Persistent Childhood Uveitis
Drug: infliximab
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Multi Center Prospective Registry of Infliximab Use for Childhood Uveitis

Resource links provided by NLM:


Further study details as provided by Duke University:

Primary Outcome Measures:
  • Effects of infliximab on uveitis disease activity. [ Time Frame: 9 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Compare efficacy of two different treatment doses of infliximab (5mg/kg & 10mg/kg) [ Time Frame: 9 months ] [ Designated as safety issue: No ]

Estimated Enrollment: 40
Study Start Date: September 2007
Estimated Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
5mg/kg/does of infliximab IV at 4 week intervals
Drug: infliximab
5mg/kg/dose IV at 4 week intervals
Other Name: Remicade
Active Comparator: 2
10mg/kg/dose of infliximab Iv at 4 week intervals
Drug: infliximab
10mg/kg/dose IV at 4 week intervals
Other Name: Remicade

Detailed Description:

Pediatric rheumatologists often use infliximab in the treatment of childhood uveitis, at this time there are no prospective studies for this use. Participants will be randomized to initial suggested dose of infliximab (5 mg/kg/dose vs 10 mg/kg/dose) and data will be collected prospectively with regard to ophthalmologic outcomes. Study participants will be followed for up to 10 months to determine efficacy and side effects, and an additional 30 days for safety reports. Descriptive statistics will be gathered on participant demographics, uveitis characteristics, change in immunosuppressive medications, number of responders, ophthalmologic measures and change in corticosteroid dose during the study period. Initial to final dose will be examined by paired t-test. The proportion of responders in the 5 mg/kg initial dose group will be compared to the 10 mg/kg/dose by a Chi-square or Fisher's exact test, depending on numbers available. Predictors of response will be examined by logistic regression.

  Eligibility

Ages Eligible for Study:   4 Years to 18 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:.

  1. Ages 4 to 18 years old,
  2. Non-infectious uveitis
  3. Persistent uveitis uncontrolled by topical medications, or unacceptable side effects of topical medications.
  4. Failure of at least six weeks of treatment with a non-biological disease modifying agent such as methotrexate, cyclosporine, mycophenolate mofetil, or azathioprine.
  5. Ability to provide informed consent (subject or parent/guardian)
  6. Onset of uveitis < 16 years of age.
  7. Topical ophthalmologic treatments allowed.
  8. Systemic corticosteroid use at entry may be allowed.
  9. Willingness to use acceptable contraception if sexually active for the duration of the study and for 6 months after receiving the last infliximab infusion.
  10. Concomitant methotrexate must be taken at time of initiation of infliximab
  11. Participant must be able to cooperate for a non-sedated slit lamp exam and visual acuity examination.
  12. Negative Purified Protein Derivative (PPD) placed and read within 1 month of initiation of infliximab
  13. The screening laboratory test results must meet the following criteria:

    • WBC (white blood cell count): within normal range for institution
    • ANC (absolute neutrophil count): within normal range for institution
    • Hemoglobin: greater than 10 grams/deciliter
    • Platelets: within normal range for institution
    • Serum Creatinine: within normal range for age
    • AST - aspartate aminotransferase - within normal range for institution
    • ALT - alanine aminotransferase- within normal range for institution

Exclusion Criteria:

  1. Previous use of biologic medications for uveitis.
  2. Intraocular steroid injection or ophthalmologic surgery within the preceding 3 months.
  3. Uveitis due to trauma or intraocular surgery
  4. Females who are pregnant, nursing, or planning pregnancy within 6 months after the last infliximab infusion.
  5. Males who plan on fathering a child within 6 months after their last infliximab infusion.
  6. A history of a known allergy to murine products.
  7. Documentation of seropositivity for human immunodeficiency virus (HIV).
  8. Documentation of a positive test for hepatitis B surface antigen or hepatitis C
  9. A known history of a serious infection (e.g., hepatitis, pneumonia, or pyelonephritis) in the previous 3 months.
  10. An opportunistic infection (e.g., herpes zoster [shingles], cytomegalovirus, Pneumocystis carinii, aspergillosis, histoplasmosis, or mycobacteria other than TB) within 6 months prior to screening.
  11. A concomitant diagnosis or history of congestive heart failure.
  12. A history of lymphoproliferative disease.
  13. Any known malignancy or a history of malignancy.
  14. Current signs or symptoms of severe, progressive or uncontrolled renal, hepatic, hematologic, gastrointestinal, endocrine, pulmonary, cardiac, neurologic, or cerebral disease.
  15. Use of any investigational drug within 30 days prior to screening or within five half-lives of the first dose of the investigational agent, whichever is longer.
  16. Presence of a transplanted solid organ.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00589628

Contacts
Contact: Egla Rabinovich, MD. MPH 919 684 6575

Locations
United States, North Carolina
Duke University Medical Center Recruiting
Durham, North Carolina, United States, 27710
Contact: Egla Rabinovich, MD, MPH     919-684-6575        
Principal Investigator: Egla Rabinovich, MD, MPH            
Sponsors and Collaborators
Duke University
Childhood Arthritis and Rheumatology Research Alliance
Investigators
Principal Investigator: Egla Rabinovich, MD. MPH Duke University
  More Information

Additional Information:
Publications:
Responsible Party: Consuela Diana Egla Rabinovich, MD, MPH, Duke University Medical Center
ClinicalTrials.gov Identifier: NCT00589628     History of Changes
Other Study ID Numbers: Pro57, IND 100646
Study First Received: December 27, 2007
Last Updated: February 22, 2009
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Uveitis
Uveal Diseases
Eye Diseases
Infliximab
Dermatologic Agents
Therapeutic Uses
Pharmacologic Actions
Gastrointestinal Agents
Antirheumatic Agents
Anti-Inflammatory Agents

ClinicalTrials.gov processed this record on October 17, 2012