Treatment Response Among Chinese Neuromyelitis Optica Spectrum Disorders

NCT04101058 | Unknown

• 1 other identifier: 201809
• Study Type: observational
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

Neuromyelitis Optica (NMO)/ Neuromyelitis Optica Spectrum Disorders (NMOSD) is an immune-mediated inflammatory demyelinating disease of the central nervous system mainly involving optic nerve and spinal cord. It is clinically characterized by simultaneous or sequential involvement of the optic nerve and spinal cord, presenting a progressive or remission and relapse course, which can lead to paralysis and blindness. The objective of this study is to provide evidence regarding treat effects and factors related to prognosis which will help physicians better evaluable risk-benefit in NMOSD management and improve patients' outcome.

Conditions

Neuromyelitis Optica Spectrum Disorders

Outcome Measures

Primary Outcomes (1)

• Expansile Disability Status Score

  Compared with baseline, changes in EDSS（Expansile Disability Status Score ）at the end of the first high-dose intravenous Methylprednisone (IVMP) therapy among subjects who received high-dose IVMP. EDSS score is based on the evaluation of eight functional systems of the central nervous system.The total score of the assessment is between 0 and 10 points, and each 0.5 is divided into one grade, which is divided into 20 grades.

  at the end of the first high-dose intravenous Methylprednisone (IVMP) therapy (up to 3 weeks )among subjects who received high-dose IVMP

Secondary Outcomes (9)

• Expansile Disability Status Score

  at discharge (7 days after last treatment)

• Changes In AQP4-IgG

  at the end of the first IVMP therapy（up to 3 weeks) among subjects who received high-dose IVMP

• As Assessed By Snellen Chart

  at the end of the first high-dose IVMP theraty (up to 3 weeks) among subjects who received high-dose IVMP

• PGI-I Score

  at the end of the first high-dose IVMP therapy(up to 3 weeks) among subjects who received high-dose IVMP

• Changes In AQP4-IgG

  at discharge (7 days after the last treatment)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Acute episode of Neuromyelitis Optica Spectrum Disorders (NMOSD)

You may qualify if:

• The subject can fully understand the content of the study and voluntarily sign the informed consent form;
• Male or female ≥18 years old;
• Diagnosed as NMOSD based on 2015 NMOSD diagnostic criteria of International NMO Diagnostic Team (IPND) and currently under acute attack.
• The subject can fully understand the content of the study and voluntarily sign the informed consent form;
• Male or female,≥18 years old;
• Diagnosed as NMOSD based on 2015 NMOSD diagnostic criteria of International NMO Diagnostic Team (IPND) and currently under acute attack.
• Subjects with acute attack (including first episodes and relapse) should have an EDSS of ≥ 2 at baseline; and for patients with acute relapse, new symptoms or the primary symptoms, being judged by investigator, should have been aggravated for 24 hours or more \[11-13\];
• The subject should have typical symptoms of movement, sensation, vision, defecation/urination or nausea/vomiting at attack;
• Subjects should agree to participate in the study, and to receive AQP4-IgG examination before and after treatment;
• Subjects should agree to undergo an ophthalmologic examination before and after treatment;
• Subjects should agree to participate the study and agree to have the collected data analyzed by this study.

You may not qualify if:

• Subjects treated with study medication in another clinical trial during the last 30 days or 5 half-life periods prior to screening or during the effect period of the drug, whichever is the longest; Note: Subjects who participated in an observational study (ie, the study did not require changes to medication or other interventions) were not excluded.
• Immediate relatives of the researcher/research center staff directly related to the study, or the researcher/research center staff directly related to the study ("immediate relatives" refer to spouses, parents, children or siblings (Whether it's biological or legal adoption).

Sponsors & Collaborators

• Third Affiliated Hospital, Sun Yat-Sen University: lead
• Nanfang Hospital, Southern Medical University: collaborator
• Second Affiliated Hospital of Guangzhou Medical University: collaborator
• Guangdong 999 Brain Hospital: collaborator

Study Sites (1)

Wei Qiu

Guangzhou, China

Location

Related Publications (17)

• Papadopoulos MC, Bennett JL, Verkman AS. Treatment of neuromyelitis optica: state-of-the-art and emerging therapies. Nat Rev Neurol. 2014 Sep;10(9):493-506. doi: 10.1038/nrneurol.2014.141. Epub 2014 Aug 12.

  PMID: 25112508 BACKGROUND

• Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, Hinson SR. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med. 2005 Aug 15;202(4):473-7. doi: 10.1084/jem.20050304. Epub 2005 Aug 8.

  PMID: 16087714 BACKGROUND

• Kim SH, Kim W, Li XF, Jung IJ, Kim HJ. Repeated treatment with rituximab based on the assessment of peripheral circulating memory B cells in patients with relapsing neuromyelitis optica over 2 years. Arch Neurol. 2011 Nov;68(11):1412-20. doi: 10.1001/archneurol.2011.154. Epub 2011 Jul 11.

  PMID: 21747007 BACKGROUND

• Bizzoco E, Lolli F, Repice AM, Hakiki B, Falcini M, Barilaro A, Taiuti R, Siracusa G, Amato MP, Biagioli T, Lori S, Moretti M, Vinattieri A, Nencini P, Massacesi L, Mata S. Prevalence of neuromyelitis optica spectrum disorder and phenotype distribution. J Neurol. 2009 Nov;256(11):1891-8. doi: 10.1007/s00415-009-5171-x. Epub 2009 May 28.

  PMID: 19479168 BACKGROUND

• Kawachi I, Lassmann H. Neurodegeneration in multiple sclerosis and neuromyelitis optica. J Neurol Neurosurg Psychiatry. 2017 Feb;88(2):137-145. doi: 10.1136/jnnp-2016-313300. Epub 2016 Sep 26.

  PMID: 27671902 BACKGROUND

• Pandit L, Asgari N, Apiwattanakul M, Palace J, Paul F, Leite MI, Kleiter I, Chitnis T; GJCF International Clinical Consortium & Biorepository for Neuromyelitis Optica. Demographic and clinical features of neuromyelitis optica: A review. Mult Scler. 2015 Jun;21(7):845-53. doi: 10.1177/1352458515572406. Epub 2015 Apr 28.

  PMID: 25921037 BACKGROUND

• Optic Neuritis Study Group. Multiple sclerosis risk after optic neuritis: final optic neuritis treatment trial follow-up. Arch Neurol. 2008 Jun;65(6):727-32. doi: 10.1001/archneur.65.6.727.

  PMID: 18541792 BACKGROUND

• Weinshenker BG, O'Brien PC, Petterson TM, Noseworthy JH, Lucchinetti CF, Dodick DW, Pineda AA, Stevens LN, Rodriguez M. A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease. Ann Neurol. 1999 Dec;46(6):878-86. doi: 10.1002/1531-8249(199912)46:63.0.co;2-q.

  PMID: 10589540 BACKGROUND

• Kim SH, Kim W, Huh SY, Lee KY, Jung IJ, Kim HJ. Clinical efficacy of plasmapheresis in patients with neuromyelitis optica spectrum disorder and effects on circulating anti-aquaporin-4 antibody levels. J Clin Neurol. 2013 Jan;9(1):36-42. doi: 10.3988/jcn.2013.9.1.36. Epub 2013 Jan 3.

  PMID: 23346159 BACKGROUND

• Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T, de Seze J, Fujihara K, Greenberg B, Jacob A, Jarius S, Lana-Peixoto M, Levy M, Simon JH, Tenembaum S, Traboulsee AL, Waters P, Wellik KE, Weinshenker BG; International Panel for NMO Diagnosis. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015 Jul 14;85(2):177-89. doi: 10.1212/WNL.0000000000001729. Epub 2015 Jun 19.

  PMID: 26092914 BACKGROUND

• Araki M, Matsuoka T, Miyamoto K, Kusunoki S, Okamoto T, Murata M, Miyake S, Aranami T, Yamamura T. Efficacy of the anti-IL-6 receptor antibody tocilizumab in neuromyelitis optica: a pilot study. Neurology. 2014 Apr 15;82(15):1302-6. doi: 10.1212/WNL.0000000000000317. Epub 2014 Mar 14.

  PMID: 24634453 BACKGROUND

• Yamasaki R, Matsushita T, Fukazawa T, Yokoyama K, Fujihara K, Ogino M, Yokota T, Miyamoto K, Niino M, Nomura K, Tomioka R, Tanaka M, Kawachi I, Ohashi T, Kaida K, Matsui M, Nakatsuji Y, Ochi H, Fukaura H, Kanda T, Nagaishi A, Togo K, Mizusawa H, Murai H, Kira J. Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica. Mult Scler. 2016 Sep;22(10):1337-48. doi: 10.1177/1352458515617248. Epub 2015 Nov 12.

  PMID: 26564994 BACKGROUND

• Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, Lublin FD, Metz LM, McFarland HF, O'Connor PW, Sandberg-Wollheim M, Thompson AJ, Weinshenker BG, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria". Ann Neurol. 2005 Dec;58(6):840-6. doi: 10.1002/ana.20703.

  PMID: 16283615 BACKGROUND

• van Winsen LM, Polman CH, Dijkstra CD, Tilders FJ, Uitdehaag BM. Suppressive effect of glucocorticoids on TNF-alpha production is associated with their clinical effect in multiple sclerosis. Mult Scler. 2010 Apr;16(4):500-2. doi: 10.1177/1352458509359721. Epub 2010 Jan 19.

  PMID: 20086025 BACKGROUND

• Abboud H, Petrak A, Mealy M, Sasidharan S, Siddique L, Levy M. Treatment of acute relapses in neuromyelitis optica: Steroids alone versus steroids plus plasma exchange. Mult Scler. 2016 Feb;22(2):185-92. doi: 10.1177/1352458515581438. Epub 2015 Apr 28.

  PMID: 25921047 BACKGROUND

• Holladay JT. Visual acuity measurements. J Cataract Refract Surg. 2004 Feb;30(2):287-90. doi: 10.1016/j.jcrs.2004.01.014. No abstract available.

  PMID: 15030802 BACKGROUND

• Wang J, Cui C, Lu Y, Chang Y, Wang Y, Li R, Shan Y, Sun X, Long Y, Wang H, Wang Z, Lee M, He S, Lu Z, Qiu W, Tan S. Therapeutic Response and Possible Biomarkers in Acute Attacks of Neuromyelitis Optica Spectrum Disorders: A Prospective Observational Study. Front Immunol. 2021 Aug 4;12:720907. doi: 10.3389/fimmu.2021.720907. eCollection 2021.

  PMID: 34421925 DERIVED

MeSH Terms

Conditions

Neuromyelitis Optica

Condition Hierarchy (Ancestors)

Myelitis, Transverse; Demyelinating Autoimmune Diseases, CNS; Autoimmune Diseases of the Nervous System; Nervous System Diseases; Optic Neuritis; Optic Nerve Diseases; Cranial Nerve Diseases; Demyelinating Diseases; Eye Diseases; Autoimmune Diseases; Immune System Diseases

Study Officials

• Wei Qiu

  Third Affiliated Hospital, Sun Yat-Sen University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: December 14, 2018
• First Posted: September 24, 2019
• Study Start: January 21, 2019
• Primary Completion: January 2, 2020
• Study Completion: June 30, 2020
• Last Updated: October 17, 2019

Record last verified: 2019-10

Locations

CN (1)