Immune Globulin Intravenous (IGIV) For Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)



Status:Completed
Conditions:Neurology
Therapuetic Areas:Neurology
Healthy:No
Age Range:18 - Any
Updated:4/21/2016
Start Date:April 2004
End Date:June 2006

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Multicenter, Randomized, Double-blind, Placebo-controlled, Study to Evaluate the Efficacy and Safety of IGIV-Chromatography (IGIV-C), 10% Treatment in Subjects With Chronic Inflammatory Demyelinating Polyneuropathy

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.

Inclusion Criteria:

- Documented diagnosis of CIDP must be made by a neurologist specializing/experienced
in neuromuscular diseases based on: a) Progressive or relapsing motor and sensory
dysfunction of more than one limb resulting from neuropathy over the 2 months prior
to the date informed consent is obtained, and b) Cerebrospinal fluid (CSF) less than
50 white cells/µl since CIDP diagnosis (CSF testing studies are NOT mandatory)

- Fulfillment of INCAT neurophysiological criteria for focal demyelinating
polyradiculoneuropathy

- Overall INCAT score between 2-9 and significant disability in upper or lower limb
function in at least 2 limbs. (An INCAT score of 2 must be exclusively from leg
disability to qualify.)

Exclusion Criteria:

- Treatment with IGIV or plasma within 3 months prior to entry

- Steroids (Prednisolone or equivalent) > 10 mg/day or equivalent (i.e., > 20 mg every
2 days) during the last 3 months prior to entry

- Treatment with immunomodulatory/immunosuppressive agents (azathioprin,
tacrolimus,cyclosporin, Muromonab-CD3 (OKT3), any interferon), previous lymphoid
irradiation or prior treatment with cyclophosphamide, methotrexate, mitoxantrone or
any other immunosuppressant drug within the past 6 months prior to entry

- Concomitant use of supplements containing any amount of fish oil within 30 days prior
to entry

- Respiratory impairment requiring mechanical ventilation

- Myelopathy or evidence of central demyelination or persisting neurological deficits
from stroke, central nervous system (CNS) trauma or peripheral neuropathies of other
cause which include diabetes mellitus (defined as a history of type 1 or type 2
diabetes with fasting plasma glucose ≥ 7.0 mmol/L), uremic, toxic and familial
neuropathies

- Pure motor syndrome fulfilling criteria for multifocal motor neuropathy with
conduction block. Lower motor neuron disorder with motor weakness in an upper limb,
without sensory deficit and with proximal conduction block (50% decrease in
amplitude/area with proximal distal stimulation ) in motor nerves and normal sensory
nerve conduction studies.

- Clinical or known evidence of associated systemic diseases that might cause
neuropathy, including but not limited to connective tissue disease, HIV infection,
hepatitis, Lyme disease, cancer (with the exception of benign skin cancer),
Castleman's disease and systemic lupus erythematosus, diabetes mellitus (defined as a
history of type 1 or type 2 diabetes with fasting plasma glucose ≥ 7.0 mmol/L), a
malignant plasma cell dysplasia, immunoglobulin M (IgM) paraproteinemia, and
amiodarone therapy.

- History of anaphylaxis or severe systemic response to immunoglobulin or with a blood
product.

- Cardiac insufficiency (NYHA III/IV), cardiomyopathy, significant cardiac dysrhythmia
requiring treatment, unstable or advanced ischemic heart disease, or history of
congestive heart failure, severe hypertension (diastolic pressure >120 mmHg or
systolic >170 mmHg).

- Females who are pregnant, breast feeding, or if of childbearing potential, unwilling
to practice adequate contraception throughout the study.

- Known hyperviscosity.

- History of renal insufficiency or serum creatinine levels > 221 µmol/L (2.5 mg/dL).

- Known selective immunoglobulin A (IgA) deficiency.

- Other investigational drugs received within the 30 days prior to entry

- Conditions whose symptoms and effects could alter protein catabolism and/or
immunoglobulin G (IgG) utilization (e.g. protein-losing enteropathies, nephrotic
syndrome).

- Known hypercoagulable state.

- Mentally challenged adult subjects who cannot give independent informed consent.

- Subjects with uncompensated hypothyroidism (abnormally high thyroid-stimulating
hormone (TSH) and abnormally low T4) or vitamin B12 deficiency (abnormally low)
within the last 3 months prior to entry.
We found this trial at
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Winston-Salem, North Carolina 26157
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9500 Euclid Avenue
Cleveland, Ohio 44106
216.444.2200
Cleveland Clinic Cleveland Clinic is committed to principles as presented in the United Nations Global...
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Cleveland, OH
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5323 Harry Hines Blvd
Dallas, Texas 75235
(214) 648-3111
Univ of Texas, Southwestern Med Ctr of Dallas The story of UT Southwestern Medical Center...
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Dallas, TX
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116th St and Broadway
New York, New York 10027
(212) 854-1754
Columbia University In 1897, the university moved from Forty-ninth Street and Madison Avenue, where it...
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New York, NY
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Buenos Aires,
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Buenos Aires,
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333 Cedar St
New Haven, Connecticut 06504
(203) 432-4771
Yale University School of Medicine Founded in 1810, the Yale School of Medicine is a...
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New Haven, CT
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St. Louis, Missouri 63110
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St. Louis, MO
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