- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02372149
IVIg for Demyelination in Diabetes Mellitus (IDIDM)
Treatment With Gamunex 10% Intravenous Immunoglobulin (IVIg) for Patients With Demyelination and Diabetes Mellitus: A Blinded, Placebo-Controlled Crossover Pilot Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
There is a knowledge gap with regards to the appropriate method of detecting and treating chronic inflammatory demyelinating polyneuropathy (CIDP), in patients with co-existent diabetes. In this pilot study the investigators plan to examine the overlap between diabetic polyneuropathy and CIDP by treating patients with diabetes and demyelinating abnormalities using IVIg. The investigators will enroll diabetes patients with a broad spectrum of demyelinating abnormalities.
The proposed trial will be an explanatory, blinded, single-centre, superiority, randomized controlled cross-over trial. Each patient will receive 3 months of 10% intravenous immunoglobulin and 3 months of placebo (0.9% sodium chloride in water) with a 3-month washout period. The primary outcome measure is the mean change in ONLS (Overall Neuropathy Limitation Scale), a measure of disability in polyneuropathy; however secondary outcome measures will consider impairments and quality of life.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Eduardo Ng, MD
- Phone Number: 416-340-4184
- Email: eduardo.ng@uhn.ca
Study Locations
-
-
Ontario
-
Toronto, Ontario, Canada, M5G 2C4
- Recruiting
- Toronto General Hospital / Toronto Western Hospital
-
Contact:
- Eduardo Ng, MD
- Phone Number: 416-340-4184
- Email: eduardo.ng@uhn.ca
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≥18 years.
- Diabetes, as per American Diabetes Association Criteria.
Clinical evidence of polyneuropathy and NCS shows 2 separate motor nerves (median, ulnar, tibial, or peroneal) which meet criteria for demyelination, defined as follows:
- Conduction velocity <90% lower limit of normal (LLN), distal latency >110% upper limit of normal (ULN), or minimal F-wave latency >110% ULN
- The changes are not exclusively due to median neuropathy at the wrist, ulnar neuropathy at the elbow, or peroneal neuropathy at the fibular head.
- Clinical suspicion of possible demyelinating polyneuropathy (CIDP).
Exclusion Criteria:
- Pregnant patients, or those of childbearing potential not using contraception.
- Patients <18 years of age.
- Presence of an alternative etiology of peripheral neuropathy, such as: hereditary neuropathies (Charcot Marie-Tooth disease); B-vitamin deficiency- or excess-related neuropathy; uremic neuropathy; neuropathy secondary to monoclonal gammopathy; history of cancer- or chemotherapy-related neuropathy; other toxin exposures; and alcoholic neuropathy.
- Contraindication to IVIg, including: history of recurrent thrombosis, immunoglobulin A deficiency, or severe hypersensitivity reaction to IVIg in past, renal failure, recurrent deep venous thrombosis, pulmonary embolus, stroke, or myocardial infarction.
- Presence of serious or unstable medical condition, which may preclude study completion or lead to inability to tolerate IVIg. This may include active heart failure, uncontrolled hypertension, or severe anemia, among other conditions.
- Presence of concomitant neurological illness, which may confound evaluation.
- Fails or unable to provide informed consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: IVIg--Washout--0.9% NaCl (CROSSOVER)
|
Other Names:
Other Names:
|
Experimental: 0.9% NaCl--Washout--IVIg (CROSSOVER)
|
Other Names:
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Overall Neuropathy Limitations Score (ONLS) after 3 months
Time Frame: Baseline and 3 months
|
ONLS score will be measured before and after 3 months of IVIg / placebo
|
Baseline and 3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Rasch-Built Overall Disability Scale (R-ODS) after 3 months
Time Frame: Baseline and 3 months
|
R-ODS score will be measured before and after 3 months of IVIg / placebo
|
Baseline and 3 months
|
Change in Nerve Conduction Studies (NCS) after 3 months
Time Frame: Baseline and 3 months
|
Changes in NCS parameters will be compared before and after 3 months of IVIg / placebo
|
Baseline and 3 months
|
Change in Medical Research Council (MRC) Sum Score after 3 months
Time Frame: Baseline and 3 months
|
MRC sum score will be compared before and after 3 months of IVIg / placebo
|
Baseline and 3 months
|
Change in Grip Strength after 3 months
Time Frame: Baseline and 3 months
|
Grip strength (using Martin vigorimeter) will be compared before and after 3 months of IVIg / placebo
|
Baseline and 3 months
|
Change in Short Form 36 (SF-36) Quality of Life after 3 months
Time Frame: Baseline and 3 months
|
SF-36 will be compared before and after 3 months of IVIg / placebo
|
Baseline and 3 months
|
Adverse Events
Time Frame: 30 days
|
Number of adverse events and serious adverse events within 30 days of IVIg administration
|
30 days
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Ari Breiner, MD, FRCPC, University of Toronto
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Glucose Metabolism Disorders
- Metabolic Diseases
- Nervous System Diseases
- Immune System Diseases
- Autoimmune Diseases of the Nervous System
- Autoimmune Diseases
- Endocrine System Diseases
- Neuromuscular Diseases
- Polyradiculoneuropathy
- Diabetes Mellitus
- Peripheral Nervous System Diseases
- Polyneuropathies
- Demyelinating Diseases
- Polyradiculoneuropathy, Chronic Inflammatory Demyelinating
- Physiological Effects of Drugs
- Immunologic Factors
- Antibodies
- Immunoglobulins
- Immunoglobulins, Intravenous
- gamma-Globulins
- Rho(D) Immune Globulin
Other Study ID Numbers
- 14-8297-B
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.
Clinical Trials on Diabetes Mellitus
-
University of Colorado, DenverMassachusetts General Hospital; Beta Bionics, Inc.CompletedDiabetes Mellitus, Type 1 | Type 1 Diabetes | Diabetes type1 | Type 1 Diabetes Mellitus | Autoimmune Diabetes | Diabetes Mellitus, Insulin-Dependent | Juvenile-Onset Diabetes | Diabetes, Autoimmune | Insulin-Dependent Diabetes Mellitus 1 | Diabetes Mellitus, Insulin-Dependent, 1 | Diabetes Mellitus, Brittle | Diabetes Mellitus, Juvenile-Onset and other conditionsUnited States
-
Guang NingRecruitingType 2 Diabetes Mellitus | Type1 Diabetes Mellitus | Monogenetic Diabetes | Pancreatogenic Diabetes | Drug-Induced Diabetes Mellitus | Other Forms of Diabetes MellitusChina
-
Medical College of WisconsinMedical University of South CarolinaCompletedDiabetes Mellitus | Type 2 Diabetes Mellitus | Adult-Onset Diabetes Mellitus | Non-Insulin-Dependent Diabetes Mellitus | Noninsulin Dependent Diabetes Mellitus, Type IIUnited States
-
Hanmi Pharmaceutical Company LimitedUnknownType2 Diabetes Mellitus | Type1 Diabetes MellitusUnited States
-
Meir Medical CenterCompletedDiabetes Mellitus Type 2 | Diabetes Mellitus, Non-insulin Dependant | Diabetes Mellitus, on Oral Hypoglycemic Treatment | Adult Type Diabetes MellitusIsrael
-
Peking Union Medical College HospitalUnknownType 2 Diabetes Mellitus | Type 1 Diabetes Mellitus | Gestational Diabetes Mellitus | Pancreatogenic Diabetes Mellitus | Pregestational Diabetes Mellitus | Diabetes Patients in Perioperative PeriodChina
-
SanofiCompletedType 1 Diabetes Mellitus-Type 2 Diabetes MellitusHungary, Russian Federation, Germany, Poland, Japan, United States, Finland
-
Joslin Diabetes CenterCambridge Medical Technologies, LLCCompletedType 2 Diabetes Mellitus | Type1 Diabetes MellitusUnited States
-
Medical University of South CarolinaNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)CompletedDiabetes Mellitus, Type 2 | Diabetes Mellitus, Type II | Diabetes Mellitus, Adult-Onset | Diabetes Mellitus, Non-Insulin-Dependent | Diabetes Mellitus, Noninsulin DependentUnited States
-
Medical College of WisconsinMedical University of South Carolina; National Institute of Diabetes and Digestive...Active, not recruitingDiabetes Mellitus, Type 2 | Diabetes Mellitus, Type II | Diabetes Mellitus, Adult-Onset | Diabetes Mellitus, Non-Insulin-Dependent | Diabetes Mellitus, Noninsulin DependentUnited States
Clinical Trials on 0.9% sodium chloride
-
University Hospital Birmingham NHS Foundation TrustUnknownCoronary Artery Bypass SurgeryUnited Kingdom
-
University of East AngliaUnknownVascular Diseases | Coronary Artery Disease | Diabetes Mellitus | Atherosclerosis | Cardiac DiseaseUnited Kingdom
-
Jeffrey Alan Klein, MDNot yet recruitingAnesthesia, Local | Injection Site Irritation | Injection Site Discomfort | Injection Site Bruising | Benzoic Acid Adverse ReactionUnited States
-
GlaxoSmithKlineCompletedDiabetes Mellitus, Type 2United States
-
Hospital Universitari Vall d'Hebron Research InstituteCompletedHepatic EncephalopathySpain
-
Oslo University HospitalUniversity of Oslo; Norwegian University of Science and Technology; St. Olavs... and other collaboratorsCompletedMyocardial Infarction | Coronary DiseaseNorway
-
University of EdinburghNHS LothianUnknown
-
Ottawa Heart Institute Research CorporationWithdrawn