Immunomodulatory Therapy in Women With Autoimmune Premature Ovarian Insufficiency

Last updated: December 15, 2024
Sponsor: Angelica Lindén Hirschberg
Overall Status: Completed

Phase

2

Condition

Perimenopause

Connective Tissue Diseases

Collagen Vascular Diseases

Treatment

Rituximab

Clinical Study ID

NCT05586737
KarolinskaUniversityHospital
  • Ages 18-35
  • Female

Study Summary

Title: Effects of immunomodulatory therapy on gonadal function in women with autoimmune premature ovarian insufficiency (POI)

Trial objectives and purpose: To study if rituximab therapy can improve ovarian response to gonadotropin stimulation and menstrual function in women with autoimmune POI.

Treatment: Controlled ovarian hyperstimulation before and four months after an infusion of 1-gram rituximab (Mabthera®) twice with two weeks interval. Follow-up period 12 months after infusion.

Primary outcome: Number of antral follicles and the size of the largest follicle in response to ovarian stimulation.

Secondary outcomes:

  1. Reestablishment of spontaneous menstrual bleedings during the 12 months' study period

  2. Ovulation during the 12 months' study period

  3. Change in B-cell count, autoantibody indices and immunoglobulin levels (IgG) after treatment

Safety outcomes: All adverse events. Of particular relevance are any hospital admissions, infections and allergic reactions.

Study population: Fifteen women with autoimmune POI defined as absence of menstruation > 6 months and elevated serum level of follicle stimulation hormone > 40 International units (IU)/L.

Inclusion criteria: Autoimmune POI defined as presence of autoantibodies against 21-hydroxylase (OH), side chain cleavage enzyme (SCC), 17-OH and/or neuronal apoptosis inhibitory protein (NACHT) leucine-rich-repeat protein 5 (NALP5) or other relevant autoantibodies; 18-35 yrs of age; body mass index 19-30.

Exclusion criteria: Hypersensitivity to rituximab; severe infection; severe immunosuppression; cardiac disease; cancer; benign tumours of the hypothalamus, pituitary, or ovary; ovarian enlargement or ovarian cyst; vaginal bleeding of unknown aetiology.

Time plan: The study is expected to start the spring 2017. It is expected to be closed spring 2023.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Autoimmune premature ovarian insufficiency defined as presence of autoantibodiesagainst 21-OH, SCC, 17-OH and/or NALP5 or other relevant autoantibodies

  2. 18-35 yrs of age

  3. Body mass index 19-30.

  4. In fertile females, willingness to comply with effective contraceptive methods.

  5. Ability to provide informed consent

Exclusion

Exclusion Criteria:

  1. Documented hypersensitivity or intolerance to rituximab

  2. Active, severe infection

  3. Severe immunosuppression

  4. Severe cardiac disease

  5. Cancer

  6. Benign tumours of the hypothalamus, pituitary, or ovary; ovarian enlargement orovarian cyst

  7. Vaginal bleeding of unknown aetiology

  8. Hormone replacement therapy (HRT) within four weeks prior study entry.

  9. Pregnant or lactating women

  10. Concurrent treatment with other immunosuppressive drugs

  11. Vaccination within 4 weeks of infusion of study medication

  12. Severe psychiatric disorder

  13. Patient with any condition or any circumstance that in the opinion of theinvestigator would make it unsafe to undergo treatment with Rituximab.

Study Design

Total Participants: 15
Treatment Group(s): 1
Primary Treatment: Rituximab
Phase: 2
Study Start date:
April 29, 2019
Estimated Completion Date:
December 15, 2024

Connect with a study center

  • Angelica Hirshberg

    Stockholm,
    Sweden

    Site Not Available

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