Kineret (Anakinra), in Adult Patients With Colchicine-Resistant Familial Mediterranean Fever (FMF)
A Randomized Placebo-Controlled Study of the Efficacy and Safety of Kineret (Anakinra), in Adult Patients With Colchicine-Resistant Familial Mediterranean Fever
FMF is the most common periodic fever with a worldwide patient population estimated as 150,000, mainly located in the Eastern Mediterranean basin. colchicine is the established therapy of choice ,however, around 20.000 patients worldwide fail to respond or cannot tolerate therapeutic doses, thereby suffering from recurrent debilitating, severe, painful attacks of peritonitis, pleuritis and synovitis and are at risk to die from reactive amyloidosis .Mutation-induced reduction in pyrin/ marenostrin activity is thought to underlie the disease by leading to NALP3 inflammasome activation ,and thereby to IL-1β related burst of inflammation.
The IL-1 receptor antagonist Kineret (Anakinra), seems to be the most appropriate response to the uncontrolled IL-1β elevation. Indeed, an increasing number of reports over the last few years indicate a good response to Kineret (Anakinra), in colchicine-resistant FMF ,also in children ,however, no controlled study has thoroughly evaluated the efficacy and safety of this treatment.
Study outline:
The study aims to run at the FMF centre in Sheba Medical Center, covering more than 10,000 patients. The study will evaluate the effect of recombinant IL-1 receptor antagonist, Kineret (Anakinra), on the frequency of FMF attacks in patients that, despite maximum tolerable dose of colchicine, present with more than one attack per month.
The study is designed as a randomised, placebo-controlled, double-blind study. 50 patients will be randomised to treatment with either Kineret (Anakinra), or placebo treatment for 4 months.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
-
Ramat- Gan, Israel, 52621
- Sheba Medical Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
A subject must fulfil the following criteria in order to be included in the study:
- FMF diagnosed as per the Tel-Hashomer criteria -(Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum.1998 Aug; 41(8):1516-7-Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, Migdal A, Padeh S, Pras M).
- 18-65 years of age
- Verified as mutations in both alleles of the MEFV gene, thus including homozygous and compound heterozygous patients
- Patient compliant with maximum tolerable dose of colchicine (up to 3 mg/day)
- At least one FMF attack per month in chest, abdomen or joints (definition of attack see above)
- Adequate contraception for sexually active male and female patients
Exclusion Criteria:
The presence of any of the following will exclude a subject from inclusion in the study:
- Patient pregnant at enrolment visit
- Prior or existing malignancy
- Active infection
- Manifest renal failure with Creatinine clearance <30mL/min as determined by the equation Creatinine clearance (ml/min) = (140-age) x Wight (Kg) /72 x serum creatinine (mg/dcl) For women one should multiply the results by 0.8
- Live vaccinations last three months before enrolment
- Sociopsychological state threatening compliance with the treatment protocol
- Alcohol or substance abuse
- Concomitant medication with biological or anti-rheumatic disease-modifying drugs or systemic steroids
- Any prior use of IL-1 inhibitory drugs
Associated disease that could interfere with clinical assessment:
- Rheumatic disorder
- Systemic disease, e.g. autoimmune or other autoinflammatory disorder, diabetes, hypertension, vasculitis, Behçet's disease
- Gastrointestinal disorder, e.g. Crohn's disease, ulcerative colitis, irritable bowel syndrome
- Cardiovascular disorder, e.g. post myocardial infarction, angina
- Pulmonary disorder, e.g. COPD, pulmonary hypertension
- Any other condition which in the opinion of the investigator makes the subject unsuitable for inclusion
- Enrolment in another concurrent clinical study, or intake of an investigational drug, within three months prior to inclusion in this study
Failure or refusal to cooperate with given instructions
-
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Vehicle
•Patients randomized to placebo will receive syringes identical to active drug (100 mg prefilled syringes for subcutaneous injection) filled with drug vehicle
|
Patients randomized to active drug will receive Kineret(Anakinra), 100 mg prefilled syringes for subcutaneous injection, once a day for 4 months.
The syringes will arrive relabeled from the supplier (SOBI) to Sheba Medical Center.
They will be stored at the PI's store room in a temperature controlled refrigerator.
Other Names:
|
|
Experimental: Kineret (Anakinra)
Patients randomized to active drug will receive Kineret (Anakinra), 100 mg prefilled syringes for subcutaneous injection, once a day for 4 months.
The syringes will arrive relabeled from the supplier (SOBI) to Sheba Medical Center.
They will be stored at the PI's store room in a temperature controlled refrigerator.
|
Patients randomized to active drug will receive Kineret(Anakinra), 100 mg prefilled syringes for subcutaneous injection, once a day for 4 months.
The syringes will arrive relabeled from the supplier (SOBI) to Sheba Medical Center.
They will be stored at the PI's store room in a temperature controlled refrigerator.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of patients with less than a mean of one FMF attack per month
Time Frame: 4 months
|
Total number of FMF attacks in abdominal, thoracic, skin or joint locations during the observational period (4 months) as recorded in the patient diary, devided by 4 for each patient will result in number of attacks per one month.
The number of patients with less than 1 attack per month will be compared between the 2 study groups
|
4 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of serious adverse events
Time Frame: 4 months
|
Secondary endpoint is defined as total number of serious adverse events per 4 months in each study group. SAE is defined as an adverse event that meets one or more of the following criteria/outcomes:
|
4 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Avi Livneh, professor, Sheba Medical Center, Tel- Hashomer, Ramat- Gan, Israel.
Publications and helpful links
Study record dates
Study Major Dates
Study Start
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
Additional Relevant MeSH Terms
- Skin Diseases
- Infections
- Genetic Diseases, Inborn
- Gram-Negative Bacterial Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Skin Diseases, Genetic
- Body Temperature Changes
- Fever
- Brucellosis
- Familial Mediterranean Fever
- Hereditary Autoinflammatory Diseases
- Antirheumatic Agents
- Interleukin 1 Receptor Antagonist Protein
Other Study ID Numbers
Other Study ID Numbers
- SHEBA-11-8557-AL-CTIL
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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