A Multicenter Observational Study to Evaluate Pediatric Multiple Sclerosis in Brazil (EMOCEMP)

Pediatric Multiple sclerosis (MS) is a chronic inflammatory disease defined by multiple episodes of demyelination of the central nervous system (CNS) separated by time and space as specified in adults not explained by acute disseminated encephalomyelitis (ADEM). Several studies have indicated that at least 5% of MS patients are in the pediatric population, but no prospective study was performed in Brazil. There are particular characteristics of Pediatric MS that differs from the adult population and have been focus of interest in the last years. However, we still lack high evidence data, specially concerning treatment, of this age group.

This is an observational non-interventional multicenter study in pediatric MS patients in which participating subjects will be characterized by their clinical, MRI and immunological features. In this observational study, we will select 8 MS centers in Brazil to recruit at least 100 pediatric patients currently followed on each center with idiopathic inflammatory CNS disorders over a 2-year study period. We will collect retrospective and prospective clinical and MRI data to determine the proportion of patients who fulfill the International Pediatric Multiple Sclerosis Study Group (IPMSSG) criteria for MS,7 especially on those below 10 years where the use of McDonald 2010 criteria is not recommended routinely. Following the inclusion on the study, subjects will be followed for at least 2 years.

All subjects enrolled in this study will have serum collected to test autoantibodies including anti-AQP4 and anti-MOG using cell-based assays with transfected cells.8 Pediatric patients with positive testing for these autoantibodies will be analyzed separately.

Exploratory MRI sub-study In 10 patients recruited at Hospital São Lucas PUCRS, we will perform an exploratory substudy with advanced MRI using q-space diffusion protocol on a 3-Tesla MRI (GE Signa HDx 3.0T, General Electric, Milwaukee, WI, USA) and a 8-channel head coil to visualize remyelinating brain MS lesions. Normalized leptokurtic diffusion (NLD) data will be acquired using diffusion-weighted echo planar imaging. All MRI scans from this exploratory study will be performed at the Brain Institute of Rio Grande do Sul (BraIns). Only patients with previous brain demyelinating lesions will be included in this exploratory sub-study.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • MG
      • Uberlandia, MG, Brazil, 38405320
        • Universidade Federal de Uberlândia
    • PE
      • Recife, PE, Brazil, 50110900
        • Hospital da Restauração de Recife
    • PR
      • Curitiba, PR, Brazil, 81210310
        • Instituto de Neurologia de Curitiba
    • RJ
      • Rio de Janeiro, RJ, Brazil, 22290255
        • Universidade Federal do Estado do Rio de Janeiro
    • RS
      • Porto Alegre, RS, Brazil, 90020090
        • Santa Casa de Misericordia de Porto Alegre
      • Porto Alegre, RS, Brazil, 9061000
        • Pontifical Catholic University of Rio Grande do Sul
    • SP
      • Ribeirao Preto, SP, Brazil, 65470000
        • Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto / Universidade de São Paulo
      • Sao Paulo, SP, Brazil, 05403010
        • Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

1 month to 18 years (Child, Adult)

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

In this observational study, we will select 8 MS centers in Brazil to recruit at least 100 pediatric patients currently followed on each center with idiopathic inflammatory CNS disorders over a 2-year study period.

We will collect retrospective and prospective clinical and MRI data to determine the proportion of patients who fulfill the International Pediatric Multiple Sclerosis Study Group (IPMSSG) criteria for MS, especially on those below 10 years where the use of McDonald 2010 criteria is not recommended routinely. Following the inclusion on the study, subjects will be followed for at least 2 years.

Description

Inclusion Criteria:

  1. Parents / patient have an understanding, ability and willingness to fully comply with study procedures
  2. Parents / patient have the ability to provide voluntary written, signed and dated informed consent to participate in the study
  3. Be 6 months - 18 years of age at screening
  4. Have clinical evidence of at least 1 attack suggestive of idiopathic inflammatory CNS disorder
  5. Have at least one brain MRI with available images (for review)

    • For the exploratory MRI study, parents / patients have to agree to perform 2 MRI scans (at baseline and at the end of the study). Considering the age of the study subjects, sedation may be required during the acquisition of the MRI.

Exclusion Criteria:

  1. Current evidence or known history of clinically significant infection including:

    - Chronic or ongoing active infectious disease requiring long-term systemic treatment such as active hepatitis B or C, HIV or tuberculosis

  2. Current malignancy or history of malignancy in the past 5 years
  3. Significant concurrent, uncontrolled medical condition that could affect subject's safety or impair the subject's participation in the study.
  4. Current participation in any interventional trial.
  5. Pregnant or breastfeeding

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Convertion rate to MS
Time Frame: 2 years
To evaluate the proportion of patients (below and above 10 years-old) with idiopathic inflammatory CNS disorders converting to pediatric MS in Brazilian MS referral centers.
2 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical features
Time Frame: 2 years
• To compare the clinical and MRI features between pediatric MS patients with disease onset < 10 and > 10 years
2 years
epidemiology
Time Frame: 2 years
• To analyze the influence of latitude, ethnicity and past viral infections on the development of pediatric MS
2 years
autoantibodies
Time Frame: 2 years
• To determine the proportion of patients with pediatric MS and other inflammatory demyelinating CNS disorders with autoantibodies (anti-AQP4 and anti-MOG)
2 years
treatments
Time Frame: 2 years
• To identify the disease-modifying treatments used in pediatric MS cases by the treating physician and the occurrence of adverse events
2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Douglas K Sato, Pontifical Catholic University of Rio Grande do Sul

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2017

Primary Completion (Estimated)

March 31, 2025

Study Completion (Estimated)

March 31, 2025

Study Registration Dates

First Submitted

March 15, 2017

First Submitted That Met QC Criteria

March 15, 2017

First Posted (Actual)

March 22, 2017

Study Record Updates

Last Update Posted (Estimated)

January 8, 2024

Last Update Submitted That Met QC Criteria

January 5, 2024

Last Verified

January 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

  • 61080516.4.1001.5336

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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