Valganciclovir Therapy in Infants and Children With Congenital CMV Infection and Hearing Loss
A Phase II Randomized and Controlled Investigation of Six Weeks of Oral Valganciclovir Therapy in Infants and Children With Congenital Cytomegalovirus Infection and Hearing Loss
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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Birmingham, United Kingdom, B9 5SS
- Birmingham Heartlands Hospital
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Crumpsall, United Kingdom, M8 5RB
- Pennine Acute Hospitals NHS Trust, North Manchester General Hospital - Children's and Adolescent Services
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Headington, Oxford, United Kingdom, OX3 9DU
- John Radcliffe Hospital - Children's Hospital - Paediatric Infectious Disease and Immunology
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Newcastle Upon Tyne, United Kingdom, NE14LP
- The Great North Children's Hospital - Paediatric Immunology
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Sheffield, United Kingdom, S10 2TH
- Sheffield Children's Hospital - Immunology
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Southampton, Hampshire, United Kingdom, SO16 6YD
- Southampton Children's Hospital - Allergy, Immunology and Infection
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Bristol, City Of
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Bristol, Bristol, City Of, United Kingdom, BS2 8BJ
- Bristol Royal Hospital for Children - Paediatric Immunology
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London, City Of
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London, London, City Of, United Kingdom, SW17 0QT
- Saint George's Hospital - Pediatric Infectious Diseases
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London, London, City Of, United Kingdom, WC1N 3JH
- Great Ormond Street Hospital - Infectious Diseases
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Alabama
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Birmingham, Alabama, United States, 35233-0011
- Children's of Alabama Child Health Research Unit (CHRU)
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District of Columbia
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Washington, District of Columbia, United States, 20010-2916
- Children's National Medical Center - Sheikh Zayed Campus - Infectious Disease
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Missouri
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Saint Louis, Missouri, United States, 63110-1010
- Washington University School of Medicine in St. Louis - Center for Clinical Studies
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New York
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Manhasset, New York, United States, 11030-3816
- Steven and Alexandra Cohen Childrens Medical Center of New York - New Hyde Park - Infectious Disease
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Rochester, New York, United States, 14642-0001
- University of Rochester Medical Center
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North Carolina
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Charlotte, North Carolina, United States, 28203-5812
- Carolinas Medical Center - Pediatrics - Infectious Diseases
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Ohio
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Columbus, Ohio, United States, 43205-2664
- Nationwide Children's Hospital - Neonatology - Center for Perinatal Research
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Rhode Island
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Providence, Rhode Island, United States, 02903-4923
- Rhode Island Hospital - Pediatrics
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Texas
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Houston, Texas, United States, 77030
- Texas Medical Center - Texas Children's Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Signed informed consent from parent(s) or legal guardian(s)
- Sensorineural hearing loss (>/= 21dB in one or both ears, documented within 12 weeks prior to study entry)
- Children from 1 month through 3 years of age (up to the 4th birthday)
Exclusion Criteria:
- Imminent demise
- Profound sensorineural hearing loss (> 90dB) in both ears
- Patients receiving other antiviral agents or immune globulin
- Gastrointestinal abnormality which might preclude absorption of an oral medication (e.g., a history of necrotizing enterocolitis)
- Documented renal insufficiency, as noted by a creatinine clearance < 10 mL/min/1.73m2 at time of study enrollment
- Breastfeeding from mother who is receiving ganciclovir, valganciclovir, foscarnet, cidofovir, or maribavir
- Infants known to be born to women who are HIV positive (but HIV testing is not required for study entry).
- Current receipt of other investigational drugs
- Previous receipt of ganciclovir or valganciclovir
- Known hypersensitivity to ganciclovir, valganciclovir, or components of the product
- Inability to attend follow-up hearing and clinical assessments
- Infants with Auditory neuropathy/dyssynchrony.
- Children with another known etiology for SNHL (e.g. connexin 26, syndrome or metabolic disorder associated with SNHL, inner ear malformation and widened vestibular aqueducts, meningitis).
Exclusion of each of these conditions is not required for trial enrollment.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Active
27 Children between 1 month and 3 years of age (up to 4th birthday) with sensoneural hearing loss and documented CMV infection will receive valganciclovir HCl 16.0 mg/kg orally twice a day for 6 weeks
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Valcyte (valganciclovir hydrochloride) 50 mg of valganciclovir free base per 1 mL, oral solution: given at 16.0 mg/kg, twice a day for 6 weeks.
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Placebo Comparator: Placebo
27 Children between 1 month and 3 years of age (up to 4th birthday) with sensoneural hearing loss and documented CMV infection will receive placebo orally twice a day for 6 weeks
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Simple Syrup as 60-90% sucrose in purified water: given orally twice a day for 6 weeks
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Ears That Had (1) Improved Hearing or no Change in Hearing (2) Worsened Hearing.
Time Frame: Day 1 through Day 180
|
A single, independent study audiologist who is masked (blinded) to treatment assignment will assess the audiology test battery for each subject and assign the classifications of normal hearing, mild hearing loss, moderate hearing loss, or severe hearing loss based upon their hearing thresholds (in decibels).
The classifications will be assigned by ear (one for the left ear and one for the right ear), giving "total ear" classifications.
At the analyses stage, the "best ear" classification for the subject at that study visit will be determined; for example, if a subject had mild hearing loss in their left ear and severe hearing loss in their right ear, then the "best ear" classification will be mild hearing loss.
Not both ears are evaluable for all subjects.
In some subjects, only one ear is evaluable.
|
Day 1 through Day 180
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Best Ear That Had (1) Improved Hearing or no Change in Hearing (2) Worsened Hearing [ex. Improved+ no Change (Normal to Normal) Versus Other].
Time Frame: Day 1 through Day 180
|
A single, independent study audiologist who is masked (blinded) to treatment assignment will assess the audiology test battery for each subject and assign the classifications of normal hearing, mild hearing loss, moderate hearing loss, or severe hearing loss based upon their hearing thresholds (in decibels).
The classifications will be assigned by ear (one for the left ear and one for the right ear), giving "total ear" classifications.
At the analyses stage, the "best ear" classification for the subject at that study visit will be determined; for example, if a subject had mild hearing loss in their left ear and severe hearing loss in their right ear, then the "best ear" classification will be mild hearing loss.
For this outcome, we combine the improved hearing and no change for the special case only of normal to normal.
Other category include worsened and no change from (1) mild to mild hearing loss, (2) moderate to moderate hearing loss, or (3) severe to severe hearing loss.
|
Day 1 through Day 180
|
|
Change in Best Ear Hearing Assessments [Improved Versus Other] Between Baseline and Study Month 6.
Time Frame: Day 1 through Day 180
|
A single, independent study audiologist who is masked (blinded) to treatment assignment will assess the audiology test battery for each subject and assign the classifications of normal hearing, mild hearing loss, moderate hearing loss, or severe hearing loss based upon their hearing thresholds (in decibels).
The classifications will be assigned by ear (one for the left ear and one for the right ear), giving "total ear" classifications.
At the analyses stage, the "best ear" classification for the subject at that study visit will be determined; for example, if a subject had mild hearing loss in their left ear and severe hearing loss in their right ear, then the "best ear" classification will be mild hearing loss.
|
Day 1 through Day 180
|
|
Change in Best Ear Hearing Assessments [Worse + no Change (Abnormal to Abnormal) Versus Other] Between Baseline and Study Month 6.
Time Frame: Day 1 through Day 180
|
A single, independent study audiologist who is masked (blinded) to treatment assignment will assess the audiology test battery for each subject and assign the classifications of normal hearing, mild hearing loss, moderate hearing loss, or severe hearing loss based upon their hearing thresholds (in decibels).
The classifications will be assigned by ear (one for the left ear and one for the right ear), giving "total ear" classifications.
At the analyses stage, the "best ear" classification for the subject at that study visit will be determined; for example, if a subject had mild hearing loss in their left ear and severe hearing loss in their right ear, then the "best ear" classification will be mild hearing loss.
|
Day 1 through Day 180
|
|
Change in Best Ear Hearing Assessments [Worse Versus Other] Between Baseline and Study Month 6.
Time Frame: Day 1 through Day 180
|
A single, independent study audiologist who is masked (blinded) to treatment assignment will assess the audiology test battery for each subject and assign the classifications of normal hearing, mild hearing loss, moderate hearing loss, or severe hearing loss based upon their hearing thresholds (in decibels).
The classifications will be assigned by ear (one for the left ear and one for the right ear), giving "total ear" classifications.
At the analyses stage, the "best ear" classification for the subject at that study visit will be determined; for example, if a subject had mild hearing loss in their left ear and severe hearing loss in their right ear, then the "best ear" classification will be mild hearing loss.
|
Day 1 through Day 180
|
|
Change in Total Ear Hearing Assessments [Improved Versus Other] Between Baseline and Study Month 6.
Time Frame: Day 1 through Day 180
|
A single, independent study audiologist who is masked (blinded) to treatment assignment will assess the audiology test battery for each subject and assign the classifications of normal hearing, mild hearing loss, moderate hearing loss, or severe hearing loss based upon their hearing thresholds (in decibels).
The classifications will be assigned by ear (one for the left ear and one for the right ear), giving "total ear" classifications.
At the analyses stage, the "best ear" classification for the subject at that study visit will be determined; for example, if a subject had mild hearing loss in their left ear and severe hearing loss in their right ear, then the "best ear" classification will be mild hearing loss.
|
Day 1 through Day 180
|
|
Change in Total Ear Hearing Assessments [Worse+ no Change (Abnormal to Abnormal) Versus Other] Between Baseline and Study Month 6.
Time Frame: Day 1 through Day 180
|
A single, independent study audiologist who is masked (blinded) to treatment assignment will assess the audiology test battery for each subject and assign the classifications of normal hearing, mild hearing loss, moderate hearing loss, or severe hearing loss based upon their hearing thresholds (in decibels).
The classifications will be assigned by ear (one for the left ear and one for the right ear), giving "total ear" classifications.
At the analyses stage, the "best ear" classification for the subject at that study visit will be determined; for example, if a subject had mild hearing loss in their left ear and severe hearing loss in their right ear, then the "best ear" classification will be mild hearing loss.
|
Day 1 through Day 180
|
|
Change in Total Ear Hearing Assessments [Worse Versus Other] Between Baseline and Study Month 6.
Time Frame: Day 1 through Day 180
|
A single, independent study audiologist who is masked (blinded) to treatment assignment will assess the audiology test battery for each subject and assign the classifications of normal hearing, mild hearing loss, moderate hearing loss, or severe hearing loss based upon their hearing thresholds (in decibels).
The classifications will be assigned by ear (one for the left ear and one for the right ear), giving "total ear" classifications.
At the analyses stage, the "best ear" classification for the subject at that study visit will be determined; for example, if a subject had mild hearing loss in their left ear and severe hearing loss in their right ear, then the "best ear" classification will be mild hearing loss.
|
Day 1 through Day 180
|
|
Association of Change in Viral Load (Blood) With Change in Total Ear Hearing at 6 Months
Time Frame: At 6 months
|
Analysis of actual viral load was done using log base 10 transformation.
Undetectable viral load value was replaced by a value of 10.
A summary measure of the viral load over time considers all time points available by calculating the average area under the curve (AUC) (trapezoidal rule) applied to the log base 10 viral load.
Average is based on the maximum period of time with viral load data for a given subject.
The average or standardize AUC units is therefore the original AUC units of log 10 copies/ml*days divided by days in study which equals log 10 copies/ml.
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At 6 months
|
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Association of Change in Viral Load (Saliva) With Change in Total Ear Hearing at 6 Months
Time Frame: At 6 months
|
Analysis of actual viral load was done using log base 10 transformation.
Undetectable viral load value was replaced by a value of 10.
A summary measure of the viral load over time considers all time points available by calculating the average area under the curve (AUC) (trapezoidal rule) applied to the log base 10 viral load.
Average is based on the maximum period of time with viral load data for a given subject.
The average or standardize AUC units is therefore the original AUC units or log 10 copies/ml*days divided by days in study which equals log 10 copies/ml.
|
At 6 months
|
|
Association of Change in Viral Load (Urine) With Change in Total Ear Hearing at 6 Months
Time Frame: At 6 months
|
Analysis of actual viral load was done using log base 10 transformation.
Undetectable viral load value was replaced by a value of 10.
A summary measure of the viral load over time considers all time points available by calculating the average area under the curve (AUC) (trapezoidal rule) applied to the log base 10 viral load.
Average is based on the maximum period of time with viral load data for a given subject.
The average or standardize AUC units is therefore the original AUC units of log 10 copies/ml*days divided by days in study which equals log 10 copies/ml.
|
At 6 months
|
|
Association of Change in Viral Load (Blood) With Change in Best Ear Hearing at 6 Months
Time Frame: At 6 months
|
Analysis of actual viral load was done using log base 10 transformation.
Undetectable viral load value was replaced by a value of 10.
A summary measure of the viral load over time considers all time points available by calculating the average area under the curve (AUC) (trapezoidal rule) applied to the log base 10 viral load.
Average is based on the maximum period of time with viral load data for a given subject.
The average or standardize AUC units is therefore the original AUC units of log 10 copies/ml*days divided by days in study which equals log 10 copies/ml.
|
At 6 months
|
|
Association of Change in Viral Load (Saliva) With Change in Best Ear Hearing at 6 Months
Time Frame: At 6 months
|
Analysis of actual viral load was done using log base 10 transformation.
Undetectable viral load value was replaced by a value of 10.
A summary measure of the viral load over time considers all time points available by calculating the average area under the curve (AUC) (trapezoidal rule) applied to the log base 10 viral load.
Average is based on the maximum period of time with viral load data for a given subject.
The average or standardize AUC units is therefore the original AUC units of log 10 copies/ml*days divided by days in study which equals log 10 copies/ml.
|
At 6 months
|
|
Association of Change in Viral Load (Urine) With Change in Best Ear Hearing at 6 Months
Time Frame: At 6 months
|
Analysis of actual viral load was done using log base 10 transformation.
Undetectable viral load value was replaced by a value of 10.
A summary measure of the viral load over time considers all time points available by calculating the average area under the curve (AUC) (trapezoidal rule) applied to the log base 10 viral load.
Average is based on the maximum period of time with viral load data for a given subject.
The average or standardize AUC units is therefore the original AUC units of log 10 copies/ml*days divided by days in study which equals log 10 copies/ml.
|
At 6 months
|
|
Detection of Viruria (Urine) by PCR Six Weeks After Trial Entry
Time Frame: At 6 weeks (Day 42)
|
Each subject either has positive or negative PCR results.
Virus is detected if the PCR is positive.
|
At 6 weeks (Day 42)
|
|
Detection of Viruria (Urine) by PCR Six Month After Trial Entry
Time Frame: At 6 months
|
Each subject either has positive or negative PCR results.
Virus is detected if the PCR is positive.
|
At 6 months
|
|
Detection of Viremia (Blood) by PCR Six Weeks After Trial Entry
Time Frame: At 6 weeks (Day 42)
|
Each subject either has positive or negative PCR results.
Virus is detected if the PCR is positive.
|
At 6 weeks (Day 42)
|
|
Detection of Viremia (Blood) by PCR Six Month After Trial Entry
Time Frame: At 6 months
|
Each subject either has positive or negative PCR results.
Virus is detected if the PCR is positive.
|
At 6 months
|
|
Detection of CMV in Saliva by PCR Six Weeks After Trial Entry
Time Frame: At 6 weeks (Day 42)
|
Each subject either has positive or negative PCR results.
Virus is detected if the PCR is positive.
|
At 6 weeks (Day 42)
|
|
Detection of CMV in Saliva PCR Six Month After Trial Entry
Time Frame: At 6 months
|
Each subject either has positive or negative PCR results.
Virus is detected if the PCR is positive.
|
At 6 months
|
|
The Quantitative Log Change in Viremia From Baseline to Month 6.
Time Frame: Baseline to month 6
|
The quantitative change (Month 6 minus baseline) in viremia (blood) Quantitative viral load by PCR in log 10 units measured in urine after 6 weeks of therapy; if undetectable, viral load is assigned a value of 10 (1 in log 10 units).
|
Baseline to month 6
|
|
The Quantitative Log Reduction in Viruria Detected After 6 Weeks of Therapy
Time Frame: Baseline thru months 6
|
The quantitative log reduction in viruria (urine) detected after 6 weeks of therapy.
Quantitative viral load by PCR in log 10 units measured in urine after 6 weeks of therapy; if undetectable, viral load is assigned a value of 10 (1 in log 10 units)
|
Baseline thru months 6
|
|
The Quantitative Log Reduction in CMV in Saliva Detected After 6 Weeks of Therapy
Time Frame: Baseline thru months 6
|
The quantitative log reduction in CMV in saliva (urine) detected after 6 weeks of therapy.
Quantitative viral load by PCR in log 10 units measured in urine after 6 weeks of therapy; if undetectable, viral load is assigned a value of 10 (1 in log 10 units)
|
Baseline thru months 6
|
|
Number of Adverse Events in the Active Group That Resulted in Discontinuation of Valganciclovir
Time Frame: Day 1 thru day 70
|
AE resulting in discontinuation of valganciclovir (active group only).
This outcome summarizes the number of adverse events (AEs) that resulted in the discontinuation of valganciclovir in the active group only.
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Day 1 thru day 70
|
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Adverse Event (AE) Resulting in Unresolved Outcome
Time Frame: Day 1 thru day 70
|
Adverse event resulting in unresolved outcome.
This outcome summarizes the number of adverse events (AEs) that resulted in unresolved outcome of that AE.
|
Day 1 thru day 70
|
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Adverse Event (AE) Resulting in Unanticipated Medically Attended Visit
Time Frame: Day 1 thru day 70
|
Adverse event resulting in unanticipated medically attended visit.
This outcome summarizes the number of adverse events (AEs) that resulted in the unanticipated medically attended visit.
|
Day 1 thru day 70
|
Collaborators and Investigators
Sponsor
Sponsor
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
- Pathologic Processes
- Nervous System Diseases
- Virus Diseases
- Neurologic Manifestations
- Disease Attributes
- Otorhinolaryngologic Diseases
- DNA Virus Infections
- Ear Diseases
- Sensation Disorders
- Herpesviridae Infections
- Hearing Disorders
- Infections
- Communicable Diseases
- Hearing Loss
- Deafness
- Cytomegalovirus Infections
- Anti-Infective Agents
- Antiviral Agents
- Valganciclovir
Other Study ID Numbers
Other Study ID Numbers
- 11-0069
- HHSN272201100035C
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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