Trial Outcomes & Findings for Corticosteroids for Immune Reconstitution Inflammatory Syndrome (IRIS) (NCT NCT01211665)

NCT ID: NCT01211665

Last Updated: 2014-09-05

Results Overview

The Karnofsky Performance Status Index (KPSI) is an assessment tool intended to assist clinicians and caretakers in gauging a patient's functional status and ability to carry out activities of daily living. A KPSI of 100=normal, no complaints, no evidence of disease; 90=able to carry on normal activity, minor signs or symptoms of disease; 80=normal activity with effort, some signs or symptoms of disease; 70=cares for self, unable to carry on normal activity or do active work; 60=requires occasional assistance but is able to care for most personal needs; 50=requires considerable assistance and frequent medical care; 40=disabled, requires special care and assistance; 30=severely disabled, hospitalization is indicated, although death is not imminent; 20=very sick, hospitalization is necessary, active support treatment is necessary; 10=moribund, fatal processes progressing rapidly; 0=dead.

Recruitment status

TERMINATED

Study phase

PHASE4

Target enrollment

3 participants

Primary outcome timeframe

Baseline up to 6 months

Results posted on

2014-09-05

Participant Flow

Participant milestones

Participant milestones
Measure
Pulsed IVMP
Intravenous methylprednisolone (IVMP) 1 g/day administered the first 3 days of each weekly cycle, and repeated for 3 additional cycles (totaling 4 cycles). If necessary, 2 additional weekly cycles of 1 g IVMP daily for 3 days can be administered at the discretion of the investigator.
IVMP With Oral Prednisolone Taper
Intravenous methylprednisolone (IVMP) 1g/day for 6 days followed by an oral taper over 2 months. If necessary, additional cycles of 1 g IVMP daily for 3 to 5 days can be administered at any time.
Overall Study
STARTED
2
1
Overall Study
COMPLETED
0
1
Overall Study
NOT COMPLETED
2
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Pulsed IVMP
Intravenous methylprednisolone (IVMP) 1 g/day administered the first 3 days of each weekly cycle, and repeated for 3 additional cycles (totaling 4 cycles). If necessary, 2 additional weekly cycles of 1 g IVMP daily for 3 days can be administered at the discretion of the investigator.
IVMP With Oral Prednisolone Taper
Intravenous methylprednisolone (IVMP) 1g/day for 6 days followed by an oral taper over 2 months. If necessary, additional cycles of 1 g IVMP daily for 3 to 5 days can be administered at any time.
Overall Study
Withdrawal by Subject
1
0
Overall Study
Death
1
0

Baseline Characteristics

Corticosteroids for Immune Reconstitution Inflammatory Syndrome (IRIS)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Pulsed IVMP
n=2 Participants
Intravenous methylprednisolone (IVMP) 1 g/day administered the first 3 days of each weekly cycle, and repeated for 3 additional cycles (totaling 4 cycles). If necessary, 2 additional weekly cycles of 1 g IVMP daily for 3 days can be administered at the discretion of the investigator.
IVMP With Oral Prednisolone Taper
n=1 Participants
Intravenous methylprednisolone (IVMP) 1g/day for 6 days followed by an oral taper over 2 months. If necessary, additional cycles of 1 g IVMP daily for 3 to 5 days can be administered at any time.
Total
n=3 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
2 Participants
n=99 Participants
1 Participants
n=107 Participants
3 Participants
n=206 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Sex: Female, Male
Female
2 Participants
n=99 Participants
1 Participants
n=107 Participants
3 Participants
n=206 Participants
Sex: Female, Male
Male
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants

PRIMARY outcome

Timeframe: Baseline up to 6 months

Population: This study was stopped prematurely due to lack of enrollment; this analysis was not performed.

The Karnofsky Performance Status Index (KPSI) is an assessment tool intended to assist clinicians and caretakers in gauging a patient's functional status and ability to carry out activities of daily living. A KPSI of 100=normal, no complaints, no evidence of disease; 90=able to carry on normal activity, minor signs or symptoms of disease; 80=normal activity with effort, some signs or symptoms of disease; 70=cares for self, unable to carry on normal activity or do active work; 60=requires occasional assistance but is able to care for most personal needs; 50=requires considerable assistance and frequent medical care; 40=disabled, requires special care and assistance; 30=severely disabled, hospitalization is indicated, although death is not imminent; 20=very sick, hospitalization is necessary, active support treatment is necessary; 10=moribund, fatal processes progressing rapidly; 0=dead.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: 6 months

Following the completion of rapid removal of natalizumab using PLEX or equivalent.

Outcome measures

Outcome measures
Measure
Pulsed IVMP
n=2 Participants
Intravenous methylprednisolone (IVMP) 1 g/day administered the first 3 days of each weekly cycle, and repeated for 3 additional cycles (totaling 4 cycles). If necessary, 2 additional weekly cycles of 1 g IVMP daily for 3 days can be administered at the discretion of the investigator.
IVMP With Oral Prednisolone Taper
n=1 Participants
Intravenous methylprednisolone (IVMP) 1g/day for 6 days followed by an oral taper over 2 months. If necessary, additional cycles of 1 g IVMP daily for 3 to 5 days can be administered at any time.
Number of Participants Who Survived at 6 Months Following Completion of Plasma Exchange (PLEX)
1 participants
1 participants

PRIMARY outcome

Timeframe: from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period

AE=any untoward medical occurrence in a participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. SAE=any untoward medical occurrence that at any dose: results in death; in the view of the Investigator, places the participant at immediate risk of death (a life-threatening event); however, this does not include an event that, had it occurred in a more severe form, might have caused death; requires hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; or results in a congenital anomaly/birth defect. An SAE may also be any other medically important event that, in the opinion of the Investigator, may jeopardize the participant or may require intervention to prevent one of the other outcomes listed in the definition above.

Outcome measures

Outcome measures
Measure
Pulsed IVMP
n=2 Participants
Intravenous methylprednisolone (IVMP) 1 g/day administered the first 3 days of each weekly cycle, and repeated for 3 additional cycles (totaling 4 cycles). If necessary, 2 additional weekly cycles of 1 g IVMP daily for 3 days can be administered at the discretion of the investigator.
IVMP With Oral Prednisolone Taper
n=1 Participants
Intravenous methylprednisolone (IVMP) 1g/day for 6 days followed by an oral taper over 2 months. If necessary, additional cycles of 1 g IVMP daily for 3 to 5 days can be administered at any time.
Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
AEs
2 participants
1 participants
Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
SAEs
2 participants
1 participants

PRIMARY outcome

Timeframe: from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period

AEs and SAEs were categorized as mild, moderate or severe according to the following criteria: Mild=barely noticeable to participant or does not make participant uncomfortable; does not influence performance or functioning; prescription drug not ordinarily needed for relief of symptom(s) but may be given because of personality of participant. Moderate=of a sufficient severity to make participant uncomfortable; performance of daily activity is influenced; participant is able to continue in study; treatment for symptom(s) may be needed. Severe=symptoms cause severe discomfort; symptoms cause incapacity or significant impact on participant's daily life; severity may cause cessation of treatment with study treatment; treatment for symptom(s) may be given and/or participant hospitalized. Please see Outcome Measure 3 for AE and SAE definitions.

Outcome measures

Outcome measures
Measure
Pulsed IVMP
n=2 Participants
Intravenous methylprednisolone (IVMP) 1 g/day administered the first 3 days of each weekly cycle, and repeated for 3 additional cycles (totaling 4 cycles). If necessary, 2 additional weekly cycles of 1 g IVMP daily for 3 days can be administered at the discretion of the investigator.
IVMP With Oral Prednisolone Taper
n=1 Participants
Intravenous methylprednisolone (IVMP) 1g/day for 6 days followed by an oral taper over 2 months. If necessary, additional cycles of 1 g IVMP daily for 3 to 5 days can be administered at any time.
Severity of AEs and SAEs
Severe SAE
2 events
0 events
Severity of AEs and SAEs
Mild AE
3 events
5 events
Severity of AEs and SAEs
Mild SAE
1 events
1 events
Severity of AEs and SAEs
Moderate SAE
1 events
1 events
Severity of AEs and SAEs
Moderate AE
3 events
1 events
Severity of AEs and SAEs
Severe AE
0 events
0 events

PRIMARY outcome

Timeframe: Screening to 6 months following completion of PLEX (participants began treatment with intravenous methylprednisolone (IVMP) within 2 weeks after PLEX [or equivalent]).

Population: This study was stopped prematurely due to lack of enrollment; this analysis was not performed.

The GCI-I scale is a 7-point scale that assesses how much the participant's illness has improved or worsened relative to a baseline state at the beginning of the intervention, and rates it as: 1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; 7=very much worse.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Screening to 6 months following completion of PLEX (participants began treatment with IVMP within 2 weeks after PLEX [or equivalent]).

Population: This study was stopped prematurely due to lack of enrollment; this analysis was not performed.

The SDMT measures the time to pair abstract symbols with specific numbers. The test requires elements of attention, visuoperceptual processing, working memory, and psychomotor speed. The score is the number of correctly coded items from 0-110 in 90 seconds. The total score provides a measure of the speed and accuracy of symbol-digit substitution.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Screening to 6 months following completion of PLEX (participants began treatment with IVMP within 2 weeks after PLEX [or equivalent]).

Population: This study was stopped prematurely due to lack of enrollment; this analysis was not performed.

The brain MRI data collected included: progressive multifocal leukoencephalopathy (PML) lesion localization, T2 hyperintense lesion volume, and signs of cerebral edema.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Screening to 6 months following completion of PLEX (participants began treatment with IVMP within 2 weeks after PLEX [or equivalent]).

Population: This study was stopped prematurely due to lack of enrollment; no data on this endpoint was collected.

MEG was used to map brain activity.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Screening to 6 months following completion of PLEX (participants began treatment with IVMP within 2 weeks after PLEX [or equivalent]).

Population: This study was stopped prematurely due to lack of enrollment; this analysis was not performed.

Clinical laboratory values included chemokines, cytokines, C-reactive protein (CRP), John Cunningham (JC) virus load, and cell count in cerebrospinal fluid.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Baseline up to 6 months

Population: This study was stopped prematurely due to lack of enrollment; this analysis was not performed.

Outcome measures

Outcome data not reported

Adverse Events

Pulsed IVMP

Serious events: 2 serious events
Other events: 2 other events
Deaths: 0 deaths

IVMP With Oral Prednisolone Taper

Serious events: 1 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Pulsed IVMP
n=2 participants at risk
Intravenous methylprednisolone (IVMP) 1 g/day administered the first 3 days of each weekly cycle, and repeated for 3 additional cycles (totaling 4 cycles). If necessary, 2 additional weekly cycles of 1 g IVMP daily for 3 days can be administered at the discretion of the investigator.
IVMP With Oral Prednisolone Taper
n=1 participants at risk
Intravenous methylprednisolone (IVMP) 1g/day for 6 days followed by an oral taper over 2 months. If necessary, additional cycles of 1 g IVMP daily for 3 to 5 days can be administered at any time.
Infections and infestations
Progressive Multifocal Leukoencephalopathy
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
100.0%
1/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Infections and infestations
Urinary Tract Infection
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
0.00%
0/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Nervous system disorders
Grand Mal Convulsion
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
0.00%
0/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Respiratory, thoracic and mediastinal disorders
Pneumonia Aspiration
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
0.00%
0/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Immune system disorders
Immune Reconstitution Syndrome
0.00%
0/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
100.0%
1/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.

Other adverse events

Other adverse events
Measure
Pulsed IVMP
n=2 participants at risk
Intravenous methylprednisolone (IVMP) 1 g/day administered the first 3 days of each weekly cycle, and repeated for 3 additional cycles (totaling 4 cycles). If necessary, 2 additional weekly cycles of 1 g IVMP daily for 3 days can be administered at the discretion of the investigator.
IVMP With Oral Prednisolone Taper
n=1 participants at risk
Intravenous methylprednisolone (IVMP) 1g/day for 6 days followed by an oral taper over 2 months. If necessary, additional cycles of 1 g IVMP daily for 3 to 5 days can be administered at any time.
Blood and lymphatic system disorders
Anaemia
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
0.00%
0/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Gastrointestinal disorders
Anal Fissure
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
0.00%
0/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Gastrointestinal disorders
Diarrhoea
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
0.00%
0/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Gastrointestinal disorders
Vomiting
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
0.00%
0/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Infections and infestations
Pneumonia
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
0.00%
0/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Skin and subcutaneous tissue disorders
Skin Haemorrhage
50.0%
1/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
0.00%
0/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Infections and infestations
Progressive Multifocal Leukoencephalopathy
0.00%
0/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
100.0%
1/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Metabolism and nutrition disorders
Hypokalaemia
0.00%
0/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
100.0%
1/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
Psychiatric disorders
Insomnia
0.00%
0/2 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.
100.0%
1/1 • AEs and SAEs were collected from the first dose of study treatment through the end of the treatment period (6 months) + a 4-week post-treatment period.

Additional Information

Biogen Idec Study Medical Director

Biogen Idec

Results disclosure agreements

  • Principal investigator is a sponsor employee Our agreement is subject to confidentiality but generally the PI can publish, for noncommercial purposes only, results and methods of the trial, but no other Sponsor Confidential Information. PI must give Sponsor no less than 60 days to review any manuscript for a proposed publication and must delay publication for up to an additional 90 days thereafter if Sponsor needs to file any patent application to protect any of Sponsor's intellectual property contained in the proposed publication.
  • Publication restrictions are in place

Restriction type: OTHER