- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03724903
Ductal Lavage Versus Corticosteroids Therapy for Idiopathic Granulomatous Mastitis
January 18, 2024 updated by: Chen Kai, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Ductal Lavage Versus Corticosteroids Therapy for Idiopathic Granulomatous Mastitis: a Multicenter, Randomized, Open-labelled, Non-inferior Trial.
A single-arm, proof-of-concept trial has shown the safety and efficacy of ductal lavage as a treatment for idiopathic granulomatous mastitis patients (Manuscript accepted in Journal of Surgical Research 2018).
In this multicenter, randomized, open-labeled, non-inferior trial, the investigators are going to enroll eligible granulomatous mastitis patients and randomized them into ductal lavage versus.
corticosteroids therapy group.
The primary endpoint of this study is the complete clinical response rate at 1 year after the enrollment.
The aim of this study is to provide evidence for the management of idiopathic granulomatous mastitis patients .
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Non-lactational mastitis (NLM) consists of a broad spectrum of inflammatory breast diseases.
Among them, periductal mastitis and idiopathic granulomatous mastitis(IGM) are the most commonly encountered in clinical practice.
IGM can be diagnosed when all possible causes of granulomatous diseases (known mycobacterial or fungal infection, Wegener granulomatosis, sarcoidosis, etc.) are excluded.
There is no consensus on the standard treatment of IGM patients.
Surgery, oral corticosteroids, topical steroids, immunosuppressive therapy, and observation alone were all proposed as the treatment for IGM patients.
However, all of the evidences are derived from retrospective studies.
In a previous study, the investigators conducted a single-arm, proof-of-concept trial that showed the safety and efficacy of ductal lavage as a treatment for IGM patients.
Ductal lavage is possible to spare the patients from corticosteroids therapy and or surgery.
To further address this issue, the investigators are going to conduct this multicenter, randomized, open-labeled, non-inferior trial, to compare the efficacy and safety of ductal lavage and corticosteroids therapy.
The aim of this study is to provide evidence for the management of IGM patients.
Study Type
Interventional
Enrollment (Actual)
140
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Guangdong
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Jiangmen, Guangdong, China, 510000
- Jiangmen Maternal and Child Health Care Population & Family Planning Service Center
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Lianjiang, Guangdong, China, 524400
- Lian Jiang People'S Hospital
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-
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
16 years to 63 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Female, age between 18 and 65 years old.
- Inform consent signed.
- Clinical diagnosis of non-lactating mastitis, defined as mastitis occurred more than 1 month after the cessation of lactation.
- Clinical and pathological diagnosis of idiopathic granulomatous mastitis.
- Never receive surgical treatments, or corticosteroids therapy after the cessation of lactation. Core needle biopsy is allowed.
- Good health, judged by clinicians, to receive ductal lavage.
- M score >=2
Exclusion Criteria:
- Grade III inverted nipple(Plastic. Reconstruction. Surgery. 104: 389, 1999.)
- Lactational mastitis patients.
- Bilateral IGM patients.
- Clinically diagnosis of periductal mastitis.
- Pathological diagnosis of breast carcinoma.
- Pregnant women.
- Evidences suggest possible diagnosis of SLE(systemic lupus erythematosus), rheumatic disorders or other systematic auto-immune diseases.
- Evidences suggest possible diagnosis of tuberculosis.
- Evidences suggest possible diagnosis of fungus infection of the breast
- History of breast trauma.
- History of taking oral corticosteroids or anti-tuberculosis treatment.
- Imaging examinations indicates foreign objects retained in the breast
- Presence of sepsis or severe inflammation caused by IGM, for which surgery is likely required.
- Patients with inappropriate coagulation function, cardiac function, pulmonary function, liver and renal function, that clinicians judges as not suitable to participate in this study.
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
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Ductal lavage
Ductal lavage and breast massage for two weeks.
|
The patients received ductal lavage and breast massage every other day for two weeks.
We used lidocaine (1%) for local anesthesia around the nipple.
We used a lacrimal probe to identify 4-5 openings in the lactiferous ducts on the nipple and inserted the infusion cannula (21-23G).
A total of 25ml of irrigation solution (5 ml of 2% lidocaine, 40 mg of triamcinolone acetonide, 20 ml of 0.9% saline and 1.0 g of ceftriaxone) was pumped into the ducts over 20-25 minutes.
The patient returned to the clinic the next day for breast massage, and the cycle was repeated for two weeks.
|
Active Comparator: Corticosteroids therapy
Oral corticosteroids therapy for 6 months.
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Methylprednisolone(Common brand names: Medrol) or prednisone 20-40mg, qd for two weeks, then temper the dose gradually, and then 20mg qd for maintenance (The total duration of the treatment is 6 months).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Complete Clinical Response(cCR)
Time Frame: 1 year since randomization
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The proportion of patients that achieve M-score <=1 at 1 year after the treatment.
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1 year since randomization
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to cCR
Time Frame: 1 year since randomization
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The median time to cCR since the randomization.
|
1 year since randomization
|
Treatment failure (TF) rate
Time Frame: 1 year since randomization
|
The proportion of patients with TF at 1 year since the randomization. The TF status is defined as the following:
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1 year since randomization
|
Relapse rate
Time Frame: 1 year since randomization
|
The proportion of patients that had M-score>4 among those patients who achieved cCR.
|
1 year since randomization
|
Adverse events
Time Frame: 1 year since randomization
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Pre-defined and any other unexpected adverse events would be recorded and compared between the two arms.
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1 year since randomization
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Protocol compliance rate
Time Frame: 1 year since randomization
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The proportion of patients who received the treatment protocol.
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1 year since randomization
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Erwei Song, MD, Sun Yat-sen Memorial Hospital,Sun Yat-sen University
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Hu T, Li S, Huang H, Huang H, Tan L, Chen Y, Deng H, Wu J, Zhu L, Zhang J, Su F, Chen K. Multicentre, randomised, open-label, non-inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis: a study protocol. BMJ Open. 2020 Oct 10;10(10):e036643. doi: 10.1136/bmjopen-2019-036643. Erratum In: BMJ Open. 2022 Aug 25;12(8):e036643corr1.
- Chen K, Zhu L, Hu T, Tan C, Zhang J, Zeng M, Li S, Song E. Ductal Lavage for Patients With Nonlactational Mastitis: A Single-Arm, Proof-of-Concept Trial. J Surg Res. 2019 Mar;235:440-446. doi: 10.1016/j.jss.2018.10.023. Epub 2018 Nov 19.
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)
April 1, 2019
Primary Completion (Actual)
April 21, 2023
Study Completion (Actual)
April 21, 2023
Study Registration Dates
First Submitted
October 28, 2018
First Submitted That Met QC Criteria
October 29, 2018
First Posted (Actual)
October 30, 2018
Study Record Updates
Last Update Posted (Estimated)
January 19, 2024
Last Update Submitted That Met QC Criteria
January 18, 2024
Last Verified
January 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Ductal-2018-Jun-14
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
The study protocol and the raw and clean data for analysis will be shared among the participated researchers.
Non-researchers could obtain relevant informations from the researchers upon reasonable requests.
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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