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
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.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
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.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Patricia M. Stassen, M.D., Ph.D.
- Phone Number: +31433876543
- Email: p.stassen@mumc.nl
Study Contact Backup
- Name: Coen A. Stegeman, M.D., Ph.D.
- Phone Number: +31503616161
- Email: c.a.stegeman@int.umcg.nl
Study Locations
-
-
-
Groningen, Netherlands, 9700 RB
- University Medical Centre Groningen
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
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
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: 1 MMF induction
mycophenolate and steroids as remission induction, followed by azathioprine as maintenance therapy
|
2000 mg mycophenolate mofetil per day combined with steroids for induction remission, followed by azathioprine standard maintenance therapy
|
|
Active Comparator: 2 CYC induction
cyclophosphamide and steroids, followed by maintenance therapy (azathioprine)
|
2 mg/kg/d, combined with steroids, for remission induction, followed by standard azathioprine maintenance therapy
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
remission induction rate
Time Frame: 6 months
|
6 months
|
|
disease free survival after 2 and 4 years
Time Frame: 2 and 4 years
|
2 and 4 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
time to remission
Time Frame: 9 months
|
9 months
|
|
cumulative organ damage
Time Frame: 4 years
|
4 years
|
|
side-effects
Time Frame: 4 years
|
4 years
|
|
ANCA titres over time
Time Frame: 4 years
|
4 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Coen Stegeman, MD PhD, UMCG Groningen
Publications and helpful links
General Publications
- Stegeman CA; Cohen Tervaert JW. Mycophenolate mofetil for remission induction in patients with active Wegener's Granulomatosis (WG) intolerant for cyclophosphamide. J Am Soc Nephrol(11):98A, 2000
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Skin Diseases
- Respiratory Tract Diseases
- Immune System Diseases
- Autoimmune Diseases
- Lung Diseases
- Skin Diseases, Vascular
- Lung Diseases, Interstitial
- Cerebral Small Vessel Diseases
- Systemic Vasculitis
- Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
- Vasculitis
- Granulomatosis with Polyangiitis
- Microscopic Polyangiitis
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Enzyme Inhibitors
- Antirheumatic Agents
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Anti-Bacterial Agents
- Antibiotics, Antineoplastic
- Antitubercular Agents
- Antibiotics, Antitubercular
- Cyclophosphamide
- Mycophenolic Acid
Other Study ID Numbers
Other Study ID Numbers
- WG-MMF-1
- UMCG-ANCA-MMF-1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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