Therapy of Chronic Cold Agglutinin Disease With Eculizumab (DECADE)
Therapy for Chronic Cold Agglutinin Disease: A Prospective, Non-Randomized Multi-Center Study Demonstrating the Efficacy of Terminal Complement Inhibition in Patients With Cold Agglutinin Disease Using Eculizumab
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Essen, Germany, 45122
- Department of Hematology, University Hospital Essen
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Individuals at least 18 years of age
- Diagnosis of CAD defined by the combination of chronic hemolysis, cold agglutinin titer (IgM or IgA) >64 at 4°C, positive direct antiglobulin test (DAT) when performed with polyspecific antiserum, negative (or only weakly positive) anti-IgG, and strongly positive with anti-C3d
- LDH level > 2 x upper limit of normal (ULN)
- Clinical symptoms requiring treatment, such as anemia, anemia-related symptoms or hemolysis-related symptoms
- Sufficient supplementation of iron, folic acid and vitamin B12 prior to treatment phase
- Patient must be willing and able to give written informed consent;
- Patients must be vaccinated against N. meningitidis at least 14 days prior treatment
- Patient must avoid conception during the trial using a method that is most appropriate for their physical state and culture
Exclusion Criteria:
- Active aggressive lymphoma requiring therapy or an active non-lymphatic malignant disease other than basal cell carcinoma or CIS of the cervix
- Liver disease with elevated LDH
- Absolute neutrophil count < 500/µL
- Presence or suspicion of active bacterial or viral infection, in the opinion of the Investigator, at treatment start or severe recurrent bacterial infections
- Participation in any other investigational drug trial or exposure to other investigational agent, device, or procedure within 30 days prior to screening period
- Pregnant, breast-feeding, or intending to conceive during the course of the study, including the Post-treatment Phase
- History of bone marrow/stem cell transplantation
- Inability to cooperate or any condition that, in the opinion of the investigator, could increase the patient's risk by participating in the study or confound the outcome of the study
- Hypersensitivity to eculizumab, to murine proteins or to one of the excipients
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Eculizumab
|
Weekly treatment with eculizumab (600 mg) via IV infusion for 4 doses followed the next week by eculizumab (900 mg) IV infusion and maintenance treatment with Eculizumab (900 mg) via IV infusion every other week for 21 weeks
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
LDH
Time Frame: From baseline to 26 weeks
|
Primary endpoint for this study is: lactate dehydrogenase (LDH) in U/l change from baseline to 26 weeks
|
From baseline to 26 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Transfusion avoidance
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
PRBC units transfused
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
Change in hemoglobin levels
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
Haptoglobin
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
Hemopexin
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
Free hemoglobin
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
Reticulocytes
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
SF-36v2 QLQ
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
FACIT-F SCALE version 4
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
Six-Minute Walk Test
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
Circulatory symptoms
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
|
Thrombosis record
Time Frame: From baseline to 26 weeks
|
From baseline to 26 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Alexander Roeth, MD, Department of Hematology, University Hospital Essen
Publications and helpful links
General Publications
- Roth A, Huttmann A, Rother RP, Duhrsen U, Philipp T. Long-term efficacy of the complement inhibitor eculizumab in cold agglutinin disease. Blood. 2009 Apr 16;113(16):3885-6. doi: 10.1182/blood-2009-01-196329. No abstract available.
- Roth A, Duhrsen U. Cold agglutinin disease. Eur J Haematol. 2010 Jan 1;84(1):91. doi: 10.1111/j.1600-0609.2009.01320.x. Epub 2009 Jul 14. No abstract available.
- Roth A, Bommer M, Huttmann A, Herich-Terhurne D, Kuklik N, Rekowski J, Lenz V, Schrezenmeier H, Duhrsen U. Eculizumab in cold agglutinin disease (DECADE): an open-label, prospective, bicentric, nonrandomized phase 2 trial. Blood Adv. 2018 Oct 9;2(19):2543-2549. doi: 10.1182/bloodadvances.2018024190.
Helpful Links
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 (Estimate)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CAD01
- 2009-016966-97 (EudraCT Number)
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