LIME Study (LFB IVIg MMN Efficacy Study)

Last updated: July 18, 2016
Sponsor: Laboratoire français de Fractionnement et de Biotechnologies
Overall Status: Completed

Phase

3

Condition

Amyotrophic Lateral Sclerosis (Als)

Myasthenia Gravis (Chronic Weakness)

Treatment

N/A

Clinical Study ID

NCT01951924
I10E-0901
  • Ages 18-80
  • All Genders

Study Summary

The aim of this study is to evaluate the efficacy and safety of I10E (LFB 10% ready-to-use liquid human intravenous immunoglobulin) compared to Kiovig® for the maintenance treatment of MMN in a randomized, double-blind, active comparator-controlled, cross-over trial.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Male or female patient aged 18 to 80 years.

  2. Written informed consent obtained prior to any study-related procedures.

  3. Diagnosis of definite or probable MMN according to the EFNS/PNS Guideline 2010, Firstrevision made by neuromuscular disease specialists with specific electrodiagnosticexpertise.

  4. Patients treated with a stable maintenance dose within 15% of any brand of IVIg (Kiovig® excluded) at 1 g/kg for 1-3 days up to 2 g/Kg for 2-5 days every 4 to 8 weeks (+/- 7 days), according to the EFNS/PNS Guideline 2010, First revision for at least 3months prior to enrolment.

  5. Covered by national health care insurance system if required by local regulations.

Exclusion

Exclusion Criteria:

  1. Upper motor neuron, bulbar, cranial nerve or significant sensory deficit.

  2. CSF protein >100 mg/dL (if available and done as part of a previous evaluation).

  3. Any other ongoing disease that may cause neuropathy, such as toxin exposure, dietarydifficency, uncontrolled diabetes, hyperthyroidism, cancer, systemic lupuserythematosus or other connective diseases, infection with HIV, hepatitis B virus (HBV), or hepatitis C (HCV), Lyme disease, multiple myeloma, Waldenström'smacroglobulinemia, amyloid, and hereditary neuropathy.

  4. BMI >= 40 kg/m2.

  5. Known hypersensitivity to the active substance or to any of the excipients of I10E (glycine and polysorbate 80) or Kiovig(glycine).

  6. Patient who have been treated with Kiovig shall not have received Kiovig during thelast 6 months prior to enrolment.

  7. History of IgA deficiency, except if the absence of anti-IgA antibodies is documented.

  8. Protein-losing enteropathy characterised by serum protein levels <60 g/l and serumalbumin levels <30 g/l or nephrotic syndrome characterised by proteinuria >=3.5 g/24hours, serum protein levels <60 g/l and serum albumin levels <30 g/l.

  9. History of cardiac insufficiency (New York Heart Association (NYHA) III/IV),uncontrolled cardiac arrythmia, unstable ischemic heart disease, or uncontrolledhypertension.

  10. History of venous thrombo-embolic disease, myocardial infarction, or cerebrovascularaccident.

  11. Risk factor for blood hyperviscosity such as cryoglobulinemia or haematologicalmalignancy with monoclonal gammopathy.

  12. Glomerular filtration rate <80 ml/min/1.73m2 measured according to the Modified Dietin Renal Disease (MDRD) calculation.

  13. Serum levels of AST, ALT >2 times upper limit of normal range.

  14. Treatment within 12 months prior to screeening with immunomodulator orimmunosuppressant agent (including but not limited to cyclophosphamide, cyclosporine,interferon-a, interferon-b 1a, anti-CD20, alemtuzumab, azathioprine, etanarcept,mycophenolate mofetil, methotrexate, haematopoietic stem cell transplantation).

  15. Administration of another investigational product within the last month prior toinclusion.

  16. Plasma exchange, blood products or derivatives administered with the last 3 monthsprior to screening.

  17. Woman with positive results of pregnancy test or breast-feeding woman or woman ofchildbearing potential without an effective contraception. Effective contraception are injectible, patch or combined oestro-progestative orprogestative contraceptives, Cooper T or levonorgest releasing intra-uterine devices,depot intramuscular medroxyprogesterone, subcutaneous progestative contraceptiveimplants, condoms or occlusive caps (diaphragm or cervical/vault caps) withspermicide, true abstinence (when this is in line with the preferred and usuallifestyle of the patient).

  18. Any serious medical condition that would interfere with the clinical assessment ofI10E or prevent the patient from complying with the protocol requirements.

  19. Anticipated poor compliance of patient with study procedures during the 12 monthduration of the study.

  20. Drug or alcohol abuse.

Study Design

Total Participants: 23
Study Start date:
December 01, 2013
Estimated Completion Date:
July 31, 2016

Study Description

Multifocal motor neuropathy (MMN) is a chronic acquired, probably autoimmune, demyelinating, motor neuropathy. It is a rare disease, variable in its clinical features. The disease course is usually steadily progressive.

Intravenous immunoglobulin (IVIg) is the standard and the first line treatment for MMN. The Cochrane review of four randomized placebo-controlled studies showed a significant clinical improvement in muscle strength from IVIg in 78% of patients with MMN versus 4% with placebo but a non-significant improvement in disability (39% versus 11%) (van Schaik IN, 2005). However, IVIg treatment does not prevent a mild gradual decline in muscle strength which is probably due to ongoing axonal degeneration. In addition to its efficacy, IVIg is also a safe treatment with a positive benefit-risk ratio in MMN.

Muscle strength measured with the Modified Medical Research Council (MMRC 10) sum score as described in the study of Cats (Cats EA, 2008) including 20 movements i.e. 10 muscle groups of the upper and lower limbs on each side was selected as the primary endpoint. Other parameters of muscle strength such as measurement of grip strength by dynamometer - and functional disability will also be evaluated to reinforce the robustness of the study and substantiate the efficacy of I10E in MMN patients.

Connect with a study center

  • CHU de Bordeaux -Hôpital Haut-Lévêque

    Bordeaux, 33604
    France

    Site Not Available

  • CHU Créteil - Groupe Hospitalier Henri Mondor

    Creteil, 94010
    France

    Site Not Available

  • CHRU Lille - Hôpital Roger Salengro

    Lille, 59037
    France

    Site Not Available

  • CHU de Lyon - Hôpital Pierre Wertheimer

    Lyon, 69677
    France

    Site Not Available

  • CHU de Marseille - Hôpital de La Timone

    Marseille, 13385
    France

    Site Not Available

  • CHU de Nice - Hôpital l'Archet

    Nice, 06202
    France

    Site Not Available

  • CHU Paris - Hôpital Pitié Salpétrière

    Paris, 75651
    France

    Site Not Available

  • CHU de Saint Etienne - Hôpital Nord

    Saint Etienne, 42055
    France

    Site Not Available

  • Università di Genova - Ospedale San Martino

    Genova, 16132
    Italy

    Site Not Available

  • IRCCS Istituto Clinico Humanitas

    Milan, 20089
    Italy

    Site Not Available

  • Università Cattolica del Sacro Cuore

    Roma, 00168
    Italy

    Site Not Available

  • Azienda Ospedaliero Universitaria San Giovanni Battista

    Turin, 10126
    Italy

    Site Not Available

  • Hospital de la Santa Creu i Sant Pau

    Barcelona, 08041
    Spain

    Site Not Available

  • Hospital Clinico Universitario de Santiago de Compostela

    Santiago de Compostela, 15706
    Spain

    Site Not Available

  • Hospital Universitario Virgen del Rocio

    Sevilla, 41013
    Spain

    Site Not Available

  • Hospital Universitari i Politècnic La Fe

    Valencia, 46026
    Spain

    Site Not Available

  • Queen Elizabeth Hospital

    Birmingham, B15 2WB
    United Kingdom

    Site Not Available

  • Royal Preston Hospital

    Preston, PR2 9HT
    United Kingdom

    Site Not Available

  • Southampton General Hospital

    Southampton, SO16 6YD
    United Kingdom

    Site Not Available

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