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Mycophenolate Mofetil for Treatment of Relapses of Wegener's Disease or Microscopic Polyangiitis (MPA)

Comparative Study of the Efficacy of Induction Therapy With Cyclophosphamide or Mycophenolate Mofetil for Non-life-threatening Relapses of PR3- or MPO-ANCA Associated Vasculitis

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00103792
Enrollment
84
Registered
2005-02-15
Start date
2004-12-31
Completion date
2015-01-31
Last updated
2024-08-27

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Vasculitis, Wegener's Granulomatosis

Keywords

Induction therapy, ANCA-associated vasculitis, Wegener's granulomatosis, microscopic polyangiitis, mycophenolate mofetil, cyclophosphamide

Brief summary

The purpose of this study is to determine the efficacy and safety of a new drug, mycophenolate mofetil, for the treatment of relapses of ANCA-associated vasculitis (Wegener's granulomatosis or microscopic polyangiitis). Therefore, we compare the standard therapy with cyclophosphamide to mycophenolate mofetil. The investigators expect mycophenolate mofetil to be less toxic and almost equally effective as cyclophosphamide.

Detailed description

Treatment of ANCA-associated vasculitis consists of two phases: remission induction with highly effective, but also relatively toxic drugs, and, secondly, after remission is achieved, maintenance therapy with less toxic drugs. The standard induction therapy of a relapse of Wegener's granulomatosis or microscopic polyangiitis consists of the combination of cyclophosphamide and prednisolone. Although this induction therapy is very effective, it is very toxic as well. Searching for an alternative for cyclophosphamide, we will test the efficacy and safety of a new combination therapy with mycophenolate mofetil and prednisolone. We will compare the effect and safety of the standard induction therapy with the new therapy. When relapses occur, patients will be randomized for either the standard therapy with cyclophosphamide or for mycophenolate mofetil.

Interventions

DRUGmycophenolate mofetil

2000 mg mycophenolate mofetil per day combined with steroids for induction remission, followed by azathioprine standard maintenance therapy

DRUGcyclophosphamide

2 mg/kg/d, combined with steroids, for remission induction, followed by standard azathioprine maintenance therapy

Sponsors

University Medical Center Groningen
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* First or second relapse ANCA-associated vasculitis * PR3- or MPO-ANCA antibodies present or histological proof of relapse * Adult

Exclusion criteria

* Severe alveolar bleeding or (imminent) respiratory failure * Renal failure (serum creatinine \>500 umol/L or dialysis) * Maintenance therapy before start of study consisting of: cyclophosphamide \> 100 mg/day or prednisolone \>25 mg/day * Intolerance or allergy for cyclophosphamide, mycophenolate mofetil or azathioprine * Gravidity or inadequate anticonception

Design outcomes

Primary

MeasureTime frame
remission induction rate6 months
disease free survival after 2 and 4 years2 and 4 years

Secondary

MeasureTime frame
time to remission9 months
cumulative organ damage4 years
side-effects4 years
ANCA titres over time4 years

Countries

Netherlands

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026