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Immune Globulin Intravenous (IGIV) To Treat Relapsing, Remitting Multiple Sclerosis

Randomized, Double-Blind, Placebo-Controlled Study to Compare the Effects of Different Dose Regimens of IGIV Chromatography (IGIV-C), 10% Treatment on Relapses in Patients With Relapsing Remitting Multiple Sclerosis

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00220779
Acronym
PRIVIG
Enrollment
128
Registered
2005-09-22
Start date
2002-12-31
Completion date
2005-02-28
Last updated
2016-04-27

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

Conditions

Multiple Sclerosis, Relapsing-Remitting

Brief summary

The trial will study 2 doses of Immune Globulin Intravenous (Human), 10% Caprylate/Chromatography Purified (IGIV-C) for the number of relapses that occur in a 1 year treatment period.

Detailed description

This trial is designed as a multi-national, randomized, double-blind, placebo-controlled prospective trial with three parallel groups. One hundred twenty (120) patients, 40 per treatment arm, with relapsing-remitting (RR) multiple sclerosis will be enrolled in this trial. Eligible patients must have a diagnosis of MS as per the McDonald Criteria. In addition, patients must have a diagnosis of relapsing-remitting course of MS defined as periods of worsening of neurological function with full recovery or with sequelae and residual deficit upon recovery; periods between disease relapses characterized by lack of disease progression. Patients must also have active disease with at least 1 defined documented relapse in the last year. During a 2 month run-in period, 2 MRIs will be performed 6 weeks apart and patients will be stratified based on the presence or absence of 1 or more Gadolinium enhancing lesions on the first MRI (Gd-enhancing lesion yes-no) and will be randomized to one of two dose regimens of IGIV-C or matching placebo. Patients will receive study drug infusions every 4 weeks for 48 weeks for a total of 12 infusions. Patients will be evaluated by MRI every 6 weeks and by clinical assessments every 3 months. A follow-up visit will occur 4 weeks after the last infusion. The treatment groups are as follows: * IGIV-C - 0.2 g/kg body weight (bw)/infusion (2 ml/kg bw) * IGIV-C - 0.4 g/kg bw/infusion (4 ml/kg bw) * placebo (0.1% albumin) - 4 ml/kg bw/infusion For blinding purposes, at each infusion, all patients will receive a total volume of 4 ml/kg bw. For patients receiving 0.2 g/kg bw of IGIV-C, the final volume of 4 ml/kg bw will be adjusted by the addition of dextrose 5%. Placebo will be supplied as Albumin 5% or Albumin 25% and diluted with either dextrose 5% or saline to a final concentration of 0.1% albumin. Dose adaptation will be performed for subsequent infusions in case the patient's body weight has changed \> 10%. The maximum amount available per infusion will be 400 ml (8 vials) calculated for a patient with a body weight of 100 kg. The suggested initial infusion rate will be 0.02 ml/kg/min for the first 15 minutes. If there is no evidence of a hypersensitivity reaction, the infusion may be given at a slowly increasing rate over the next 30 minutes up to a maximum allowable rate of 0.08 ml/kg/min. As such, the infusion for a 70 kg patient will take approximately 1hour 15 min. The overall infusion time may have a range from 1 to 2 hours.

Interventions

Sponsors

Grifols Therapeutics LLC
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No

Inclusion criteria

* Symptoms consistent with Multiple Sclerosis up to 5 years * Diagnosis of multiple sclerosis according to McDonald criteria. * Diagnosis of relapsing-remitting (RR) multiple sclerosis (MS) (Defined as periods of worsening of neurological function with full recovery or with sequelae and residual deficit upon recovery; periods between disease relapses characterized by lack of disease progression * Kurtzke Extended Disability Status Scale (EDSS) \< 5.0 * At least 1 defined and documented relapse during the last year. Prior relapses where symptoms were due solely to a change in Bowel/Bladder Function or Cognitive Function will not be considered relapses as defined by this protocol and therefore not counted for inclusion into the study. * Females or males; females of childbearing potential must use adequate contraception * Clinically stable for at least 30 days prior to entry * At least 9 hyperintense T2 lesions on MRI or 1 Gd-enhancing lesion according to McDonald/Barkhof dissemination-in-space criteria at entry * Patients who have been informed about available treatments and decided, not to go on these treatments * Written informed consent obtained prior to the initiation of any study related procedures

Exclusion criteria

* Females who are pregnant, breast feeding, or if, of childbearing potential, unwilling to practice adequate contraception throughout the study * Prior therapy with azathioprine or any immunosuppressant agents within 6 months prior to study entry * Prior steroid, methylprednisolone or adrenocorticotropic hormone (ACTH) therapy within 30 days prior to study entry * Therapy with interferons (Betaseron®, Avonex®, Rebif®), glatiramer acetate (Copaxone®) or IGIV within 3 months prior to study entry or during the study * Use of an investigational compound within 6 months prior to study entry * Previous lymphoid irradiation or prior to treatment with cyclophosphamide, methotrexate or mitoxantrone * Cardiac insufficiency (NYHA III/IV), cardiomyopathy, significant cardiac dysrhythmia requiring treatment, unstable or advanced ischemic heart disease (CCS III or IV), or malignant hypertension * History of renal insufficiency or serum creatinine levels greater than 2.5 mg/dL (221 µmol/L) * Known selective immunoglobulin A (IgA) deficiency or known antibodies to IgA * Conditions whose symptoms and effects could alter protein catabolism and/or immunoglobulin G (IgG) utilization (e.g., protein-losing enteropathies, nephrotic syndrome) * Any medical, psychiatric or other circumstances which impede or restrict the patient's participation in the study or any contraindication to contrast enhanced MRI (e.g.,pacemaker, aortic clip or any metal implant) * Patients with clinically significant medical conditions including, but not limited to cardiac, pulmonary, hepatic, hematological (e.g. known coagulation disorder, history of deep venous thrombosis and/or pulmonary embolism), endocrine,or renal dysfunction, autoimmune disorders, severe environmental allergies or chronic infections

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Relapse Free Subjects (no Relapse)12 monthsA relapse was defined for the purposes of this study as the appearance or reappearance of one or more neurological symptoms or worsening of an old symptom attributed to multiple sclerosis (MS) persisting for at least 48 hours and immediately preceded by a relatively stable or improving neurological state of at least 30 days.

Secondary

MeasureTime frame
Effect on the Combined Unique Lesion Activity on Magnetic Resonance Imaging (MRI)1 year

Countries

Austria, Canada, Czechia, Germany, Greece, Hungary, Israel, Poland, Slovakia, Sweden, United Kingdom, United States

Participant flow

Recruitment details

The study was conducted in 31 study centers in Austria, Canada, Czech Republic, Germany, United Kingdom, Greece, Hungary, Israel, Poland, and the United States.

Participants by arm

ArmCount
IGIV-C 0.2 g/kg bw/Infusion (2 mL/kg bw)45
IGIV-C 0.4 g/kg bw/Infusion (4 mL/kg bw)42
Placebo (0.1% Albumin) 4 mL/kg bw/Infusion41
Total128

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyAdverse Event100
Overall StudyLack of Efficacy301
Overall StudyNon-compliance100
Overall StudyPregnancy002
Overall StudyToo time consuming100
Overall StudyWithdrawal by Subject141

Baseline characteristics

CharacteristicTotalIGIV-C 0.4 g/kg bw/Infusion (4 mL/kg bw)IGIV-C 0.2 g/kg bw/Infusion (2 mL/kg bw)Placebo (0.1% Albumin) 4 mL/kg bw/Infusion
Age, Categorical
<=18 years
1 Participants1 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
127 Participants41 Participants45 Participants41 Participants
Age, Continuous33.1 years
STANDARD_DEVIATION 8
34.4 years
STANDARD_DEVIATION 7.9
31.9 years
STANDARD_DEVIATION 7.5
33.0 years
STANDARD_DEVIATION 8.7
Region of Enrollment
Austria
6 participants1 participants3 participants2 participants
Region of Enrollment
Canada
11 participants1 participants5 participants5 participants
Region of Enrollment
Czech Republic
22 participants10 participants6 participants6 participants
Region of Enrollment
Germany
35 participants15 participants9 participants11 participants
Region of Enrollment
Greece
3 participants2 participants1 participants0 participants
Region of Enrollment
Hungary
8 participants2 participants4 participants2 participants
Region of Enrollment
Israel
3 participants0 participants1 participants2 participants
Region of Enrollment
Poland
24 participants6 participants10 participants8 participants
Region of Enrollment
United Kingdom
5 participants2 participants1 participants2 participants
Region of Enrollment
United States
11 participants3 participants5 participants3 participants
Sex: Female, Male
Female
96 Participants27 Participants38 Participants31 Participants
Sex: Female, Male
Male
32 Participants15 Participants7 Participants10 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
32 / 4526 / 4229 / 41
serious
Total, serious adverse events
2 / 452 / 421 / 41

Outcome results

Primary

Percentage of Relapse Free Subjects (no Relapse)

A relapse was defined for the purposes of this study as the appearance or reappearance of one or more neurological symptoms or worsening of an old symptom attributed to multiple sclerosis (MS) persisting for at least 48 hours and immediately preceded by a relatively stable or improving neurological state of at least 30 days.

Time frame: 12 months

Population: Intent-to-Treat (ITT) Population was all randomized subjects. This was the primary analysis population.

ArmMeasureGroupValue (NUMBER)
IGIV-C 0.2 g/kg bw/Infusion (2 mL/kg bw)Percentage of Relapse Free Subjects (no Relapse)No Relapse56.8 percentage of participants
IGIV-C 0.2 g/kg bw/Infusion (2 mL/kg bw)Percentage of Relapse Free Subjects (no Relapse)At Least One Relapse43.2 percentage of participants
IGIV-C 0.4 g/kg bw/Infusion (4 mL/kg bw)Percentage of Relapse Free Subjects (no Relapse)No Relapse59.5 percentage of participants
IGIV-C 0.4 g/kg bw/Infusion (4 mL/kg bw)Percentage of Relapse Free Subjects (no Relapse)At Least One Relapse40.5 percentage of participants
Placebo (0.1% Albumin) 4 mL/kg bw/InfusionPercentage of Relapse Free Subjects (no Relapse)No Relapse68.3 percentage of participants
Placebo (0.1% Albumin) 4 mL/kg bw/InfusionPercentage of Relapse Free Subjects (no Relapse)At Least One Relapse31.7 percentage of participants
Comparison: The primary efficacy comparison was the comparison of the proportions of relapse free subjects (relapse defined as reported, not necessarily confirmed relapse). The multiple test procedure (hierarchical procedure) was to be stopped as soon as one of the statistical tests resulted in a non-significant P value \> 0.05.p-value: 0.221Cochran-Mantel-Haenszel
Comparison: The primary efficacy comparison was the comparison of the proportions of relapse free subjects (relapse defined as reported, not necessarily confirmed relapse). The multiple test procedure (hierarchical procedure) was to be stopped as soon as one of the statistical tests resulted in a non-significant P value \> 0.05.p-value: 0.471Cochran-Mantel-Haenszel
Secondary

Effect on the Combined Unique Lesion Activity on Magnetic Resonance Imaging (MRI)

Time frame: 1 year

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