Infliximab (Remicade) for Patients With Acute Kawasaki Disease

NCT00271570 | Completed Phase 1 Results DMC

• 2 other identifiers: 0413742004-0548
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluates the safety of infliximab in infants and children with acute Kawasaki Disease.

Conditions

Kawasaki Disease

Outcome Measures

Primary Outcomes (2)

• Number of Adverse Events (Focused on Side Effects From IVIG or Infliximab Administration)

  The safety of giving infliximab to treat IVIG-resistant Kawasaki disease was measured by recording the number of adverse events that occurred in each group. An adverse event (AE) was defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of either IVIG or infliximab, regardless of whether it was considered related to IVIG or infliximab, that occured during the course of this study.In particular we evaluated for AEs related to side effects from infliximab or IVIG.

  2 weeks

• Area Under the Curve of Infliximab Concentration Before Infliximab Infusion and Then 2 and 24 Hours, 1 Week (5 to 9 Days), 2 Weeks (12 to 16 Days), and 4 Weeks (26 to 30 Days) After Infliximab Infusion)

  The area under the curve (AUC) from time 0 to the last measurable concentration (AUC0-last) was estimated using the trapezoidal rule up to the last measurable concentration.Samples were collected before infliximab infusion and then at 2 and 24 hours, 1 week (5 to 9 days), 2 weeks (12 to 16 days), and 4 weeks (26 to 30 days) after infliximab infusion. Subjects with detectable infliximab concentrations at week 4 had another sample drawn at week 10 (68 to 72 days).

  before infliximab infusion and then 2 and 24 hours, 1 week (5 to 9 days), 2 weeks (12 to 16 days), and 4 weeks (26 to 30 days) after infliximab infusion.

Study Arms (2)

Second Dose of IVIG (2g/kg)

ACTIVE COMPARATOR

Subjects who did not respond to the first dose of IVIG received a 2nd dose of IVIG in this arm (2g/kg)

Biological: Intravenous immunoglobulin (IVIG)

Infliximab (5mg/kg)

EXPERIMENTAL

Remicade (5mg/kg) single dose

Drug: Infliximab (Remicade)

Interventions

Infliximab (Remicade) DRUG

Remicade was 5 mg/kg IV (single dose)

Infliximab (5mg/kg)

Intravenous immunoglobulin (IVIG) BIOLOGICAL

2nd dose of IVIG (2g/kg)

Also known as: Gammagard, Gamunex

Second Dose of IVIG (2g/kg)

Eligibility Criteria

• Age: Up to 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• To be eligible for the trial, subjects must meet all of the following criteria:
• All eligible subjects, or legal representative, must provide written informed consent/assent, prior to initiation of any study procedure.
• Eligible subjects will be infants and children, under 18 years old, with acute KD who remain or become febrile (\>/= 38.3˚ C or 101.0˚ F) after the end of the 48 h-period after completing their IVIG infusion (2gm/kg).
• Patients must have persistent or reoccurrence of fever \> 48 hours of observation to be eligible for the trial.
• Prior to the initial IVIG treatment, patients must have been febrile for \>/= 3 days and have met 4/5 standard clinical criteria (Table 1) - OR - patients with fever and 3/5 clinical criteria will be eligible if echocardiogram demonstrates at least one coronary artery segment with a Z score of \> 2.
• Patients must present for their initial diagnosis and IVIG treatment within the first 14 days after fever onset (Illness Day 14).
• Females of childbearing potential and males must be using adequate contraception (abstinence, oral contraceptives, intrauterine device, barrier method with spermicide, or surgical sterilization) throughout the trial.
• All eligible subjects must have a chest radiograph within one week prior to first infusion of study drug with no evidence of malignancy, infection or fibrosis.

You may not qualify if:

• If a subject has any of the following criteria, he or she may not be enrolled in the study:
• Have been receiving corticosteroids (ie, via any route) at doses \> 1 mg/kg prednisone equivalent daily.
• Have history of TB or TB exposure.
• Have history of histoplasmosis or coccidiomycosis.
• Have received anakinra (Kineret®), etanercept (Enbrel®), or adalimumab (Humira®) within 1 month prior to first study drug administration.
• Have any chronic disease, except asthma, atopic dermatitis or controlled seizure disorder.
• Have documented history of current active hepatitis B or a history of hepatitis C infection.
• Have documented history of human immunodeficiency virus (HIV) infection
• Have received a transplanted organ (with the exception of a corneal transplant performed \> 3 months prior to first study drug administration).
• Have a known malignancy or history of malignancy within the 5-year period prior to first study drug administration (with the exception of squamous or basal cell carcinoma of the skin that has been completely excised without evidence of recurrence).
• Have a history of prior lymphoproliferative disease including lymphoma.
• Have multiple sclerosis or other central demyelinating disorder.
• Have received any previous treatment with infliximab or other monoclonal antibodies.
• Have used any investigational drug within 1 month prior to first study drug administration or within 5 half-lives of the investigational agent, whichever is longer.
• Are participating in another investigative trial, involving investigational agents, during participation in this trial.

Sponsors & Collaborators

• University of California, San Diego: lead
• Centocor, Inc.: collaborator

Study Sites (1)

Ucsd/Chhc

San Diego, California, 92103, United States

Location

MeSH Terms

Conditions

Mucocutaneous Lymph Node Syndrome

Interventions

Infliximab; Immunoglobulins, Intravenous

Condition Hierarchy (Ancestors)

Vasculitis; Vascular Diseases; Cardiovascular Diseases; Lymphatic Diseases; Hemic and Lymphatic Diseases; Skin Diseases, Vascular; Skin Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Serum Globulins; Globulins; Immunoglobulin G; Immunoglobulin Isotypes

Results Point of Contact

• Title: Jane Burns, MD, Professor
• Organization: University of California, San Diego

jcburns@ucsd.edu

858-246-0155

Study Officials

• Jane C Burns, M.D.

  UCSD/CHHC

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: December 30, 2005
• First Posted: January 2, 2006
• Study Start: April 1, 2004
• Primary Completion: October 1, 2006
• Study Completion: October 1, 2006
• Last Updated: June 14, 2010
• Results First Posted: December 29, 2009

Record last verified: 2009-11

Locations

US (1)