The HAM Infliximab Study (HAM06)
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Purpose
An open-label, non-randomised, uncontrolled, proof-of-concept study of eight patients with 'definite' HTLV-I-associated myelopathy/Tropical Spastic Paraparesis (HAM/TSP). Eligible patients will have either early disease (of less than 2 years duration) or progressive disease (with observed clinical deterioration during the preceding 3 months.
Following 2 baseline assessments including Magnetic Resonance Imaging (MRI) of the spinal cord and a lumbar puncture for examination of the fluid around the brain (CSF) participants will be treated with a total of 7 infusions of the anti-TNF-alpha antibody infliximab over a period of 48 weeks. After the last on therapy assessment at 48 weeks participants will be followed up for a further 24 weeks. Study assessments will be clinical, virological, immunological and radiological. MRIs of the spinal cord will be obtained at weeks 12 and 72. CSF will be examined, on therapy, at week 12.
| Condition | Intervention | Phase |
|---|---|---|
|
HTLV-I-associated Myelopathy |
Drug: Infliximab |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | An Open, Non-randomised Pilot Study of Anti-TNF-alpha Therapy in Early or Progressing HAM/TSP |
- Incidence of clinical failure [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
- Change in timed 10m walk [ Time Frame: 12, 24, 48 and 72 weeks ] [ Designated as safety issue: No ]
- Clinical Safety [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]
- HTLV-I viral load in CSF [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- HTLV-I viral load in peripheral blood [ Time Frame: 12, 24, 48 and 72 weeks ] [ Designated as safety issue: No ]
- % CD4+ T- lymphocytes expressing CD25 [ Time Frame: 24, 48 and 72 hours ] [ Designated as safety issue: No ]
| Enrollment: | 3 |
| Study Start Date: | October 2008 |
| Study Completion Date: | March 2011 |
| Primary Completion Date: | March 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Infliximab
Infliximab 3mg/kg infused intravenously at weeks 0, 2 and 8 and then every 8 weeks until and including week 40 of the study
|
Drug: Infliximab
Infliximab 3mg/kg infused intravenously at weeks 0, 2 and 8 and then every 8 weeks until and including week 40 of the study
|
Eligibility| Ages Eligible for Study: | 16 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Are able to give informed consent
- Are 16 years or older
- Have 'definite' HAM/TSP according to the criteria of "Definite HAM/TSP" agreed in Belem 200361
Have early or progressing disease as defined here:
- "Early HAM/TSP": Patients must have motor disability (minimum of stiffness or weakness) for less than 2 years. (Bladder symptoms if the original and only presenting symptoms as assessed by history are not included)
- "Progressing HAM/TSP"
- New or worsening motor symptoms in a patient with definite HAM of > 2 years duration within the last 3 months
Exclusion Criteria:
- Hepatitis B or hepatitis C infection
- HIV infection
- Overt sepsis, abscesses or opportunistic infections
- Active TB (untreated or on treatment)
- Strongyloides stercoralis (untreated)
- Known hypersensitivity to inflixmab, other murine proteins or to any of the excipients
- Malignancy
- Moderate or severe heart failure (NYHA class III/IV)
- Pregnancy or breastfeeding
- Unhealed surgical wounds
- Planned impending surgery - treatment would be withheld for 2-4 weeks prior to major surgery and started/restarted post-operatively if no evidence of infection and wound healing is satisfactory
- Current immunosuppressive or immunomodulatory therapy
Contacts and Locations| United Kingdom | |
| Imperial College Healthcare NHS Trust | |
| London, United Kingdom, W2 1PG | |
| Principal Investigator: | Graham P Taylor, MD | Imperial College London |
More Information
No publications provided
| Responsible Party: | Graham Taylor, Reader in Communicable Diseases, Imperial College London |
| ClinicalTrials.gov Identifier: | NCT00823641 History of Changes |
| Other Study ID Numbers: | cro948, EUDRACT: 2007-005554-23 |
| Study First Received: | January 14, 2009 |
| Last Updated: | April 12, 2013 |
| Health Authority: | United Kingdom: Medicines and Healthcare Products Regulatory Agency |
Keywords provided by Imperial College London:
|
HAM/TSP HTLV-I |
Additional relevant MeSH terms:
|
Bone Marrow Diseases Spinal Cord Diseases Paraparesis, Tropical Spastic Hematologic Diseases Central Nervous System Diseases Nervous System Diseases Myelitis Central Nervous System Viral Diseases Virus Diseases HTLV-I Infections Deltaretrovirus Infections |
Retroviridae Infections RNA Virus Infections Central Nervous System Infections Infliximab Dermatologic Agents Therapeutic Uses Pharmacologic Actions Gastrointestinal Agents Antirheumatic Agents Anti-Inflammatory Agents |
ClinicalTrials.gov processed this record on May 23, 2013