Mycophenolate After Stem Cell Transplant for Systemic Sclerosis (IMPACT-SSc)
Immunomodulatory Maintenance Therapy Post-Autologous Hematopoietic Stem Cell Transplantation for Prevention of Systemic Sclerosis Relapse: A Pilot Randomized Trial
A pilot single center randomized trial to test whether a full-scale RCT evaluating the role of post-AHSCT maintenance immunosuppression with MMF in preventing disease relapse is feasible .
We are studying whether a brief course of treatment with MMF after AHSCT will serve to prevent disease relapse.
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
This study is performed determine the feasibility of a larger pragmatic RCT to evaluate the effectiveness of post- Autologous Hemopoietic Stem Cell Transplant (AHSCT) maintenance therapy with mycophenolate mofetil (MMF) in the prevention of Systemic sclerosis (SSc) relapse.
The study will include 6 participants who will be randomized at 1:1 ratio to treatment (MMF) or control arm (no treatment) for 6 months.
The participants will have 6 visits in total : An initial clinic visit will occur prior to stem cell collection. Post-AHSCT, in-person follow-up visits are scheduled on days 30, 90, 180, 270, and 300, with windows of +/- 1 week for days 30 and 90 and +/- 2 weeks for days 180, 270 and 300.
These visits will be coordinated at an established multidisciplinary (Rheumatology + Cell Therapy) clinic that are part of the patient's clinical care. At each visit, the participants will be asked to complete health questionnaires and laboratory tests will be performed as part of the standard of care of AHSCT recipients.
Tipo di studio
Iscrizione (Stimato)
Fase
- Fase 2
Contatti e Sedi
Contatto studio
- Nome: Clinical Research Assistant
- Numero di telefono: 81630 613 738 8400
- Email: nasaidi@ohri.ca
Luoghi di studio
-
-
Ontario
-
Ottawa, Ontario, Canada
- The Ottawa Hospital
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-
Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Consenting participants 18 years of age or older who are initiating AHSCT at The Ottawa Hospital for management of SSc.
Exclusion Criteria:
- Exclusion criteria are focused on patient safety, namely inability to receive treatment with
MMF due to contraindications as determine at time of randomization (day 90 / clinic visit #3) including:
- Renal insufficiency (eGFR <25 mL/minute/1.73m2) or
- Neutropenia (ANC <1.0 x 103/mcL) or
- Thrombocytopenia (platelet count <50 000/mcL)
- Previously documented intolerance.
- Pregnant or breastfeeding - Women of childbearing potential who are not willing to use a highly effective method of contraception for the duration of study participation will be excluded
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Prevenzione
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
|
Sperimentale: Mycophenolate mofetil (MMF)
MMF 1000mg p.o. b.i.d.
starting at day 90 post-AHSCT.
This proposed MMF regimen is used in the management of rheumatic diseases and described in current literature and clinical guidelines.
Duration of 6 months
|
MMF 1000mg p.o. b.i.d.
starting at day 90 post-AHSCT and continued for 6 months.
|
|
Nessun intervento: Control arm
No scleroderma prophylaxis (current standard of care)
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Feasibility:
Lasso di tempo: 18 months
|
The number of participants enrolled at a single center over 18 months.
|
18 months
|
|
Safety : AEs/SAEs
Lasso di tempo: Day 90 (treatment start) , Day 180, day 270
|
The proportion of patients experiencing a serious AE OR an AE greater that grade 2 (see below) OR an AE requiring discontinuation of the study drug in a participant who has received at least one dose of the study intervention
|
Day 90 (treatment start) , Day 180, day 270
|
|
Efficacy :
Lasso di tempo: At day 0,90,180 and 270
|
-Proportion of patients showing an increase in mRSS of >7 between timepoints .
|
At day 0,90,180 and 270
|
|
Efficacy:
Lasso di tempo: At day 0,90,180 and 270
|
-Proportion of patients requiring initiation of immunosuppressive therapy for progressive SSc manifestations as determined by their treating physicians.
|
At day 0,90,180 and 270
|
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Feasibility: Consent rate:
Lasso di tempo: Both prior to AHSCT (clinic visit #1) and at day 90 (clinic visit #3) prior to randomization.
|
Proportion of eligible patients who provide consent .
|
Both prior to AHSCT (clinic visit #1) and at day 90 (clinic visit #3) prior to randomization.
|
|
Feasibility: Retention rate: Proportion of participants retained
Lasso di tempo: Day 270 (clinic visit #5)
|
Proportion of participants retained
|
Day 270 (clinic visit #5)
|
|
Feasibility: Study completion rate:
Lasso di tempo: Day 270
|
Proportion of participants who completed proposed clinical outcomes at all pre determined time points
|
Day 270
|
|
Feasibility: Adherence rate:
Lasso di tempo: Day 180 and Day 270
|
Adherence to study drug measured by proportion of prophylaxis doses received measured by pill counting at follow-up visits.
|
Day 180 and Day 270
|
|
Auto-antibody testing (clinical)
Lasso di tempo: Prior to AHSCT and Day 180 (visit# 4)
|
Proportion of patients with a change in auto-antibody testing
|
Prior to AHSCT and Day 180 (visit# 4)
|
|
Clinical outcomes:
Lasso di tempo: day 0, 90, 180 and 270
|
Proportion of patients showing a change between timepoints in Modified Rodnan Skin Score (mRSS): Total score range 0 to 51.
Higher scores indicate greater skin thickening and more severe skin involvement .
|
day 0, 90, 180 and 270
|
|
Clinical outcome:
Lasso di tempo: day 0,90,180 and 270
|
Proportion of patients showing a change in Scleroderma Health Assessment Questionnaire (SHAQ) Disability Index between timepoints. Score range: 0 to 3. Higher scores indicate greater functional disability and worse health status. |
day 0,90,180 and 270
|
|
Clinical outcome:
Lasso di tempo: Day 0,90,180 and 270
|
Proportion of patients showing a change in global score between timepoints Patient and physician global score: Visual analog scale (0 to 10)
|
Day 0,90,180 and 270
|
Collaboratori e investigatori
Investigatori
- Investigatore principale: Nancy Maltez, Dr, The Ottawa Hospital
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Inizio studio (Stimato)
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Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
- 20260406-01H
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