Use of Azithromycin as Immunomodulatory Therapy in Grave's Orbitopathy
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Purpose
The purpose of this study is to examine the effects of Azithromycin (a macrolide class antibiotic), given three times weekly, for patients with active moderate-severe, non sight-threatening, Graves Orbitopathy.
Indices for follow-up will include:
- Clinical activity score
- Anti-TSH receptor antibody levels
- Thickening of extraocular muscles per ultrasound
- Quality of life score for Graves Orbitopathy patients
| Condition | Intervention | Phase |
|---|---|---|
|
Graves Ophthalmopathy |
Drug: Azithromycin |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Use of Azithromycin as Immunomodulatory Therapy in Grave's Orbitopathy |
- Change in clinical activity score between baseline and after three months [ Time Frame: Three months ] [ Designated as safety issue: No ]
Change in the clinical activity score between baseline and after 3 months
(Clinical Activity Score is a validated index of Graves Ophthalmopathy that assigns one point to the presence of: 1.spontaneous retrobulbar pain, 2. pain on up/downgaze, 3. redness of eyelids, 4. redness of conjunctiva, 5. swelling of eyelids, 6. inflammation of caruncle/plica, 7. chemosis). The maximal clinical activity score is thus 7.
- Measurement of extraocular muscle thickening [ Time Frame: 3 months ] [ Designated as safety issue: No ]Ultrasonic measurement of extraocular muscle thickening
- ANTI TSH Receptor antibody levels [ Time Frame: 0, 3 and 6 months ] [ Designated as safety issue: No ]Serum measurements of ANTI TSH Receptor antibody levels
| Estimated Enrollment: | 14 |
| Study Start Date: | May 2011 |
| Estimated Study Completion Date: | November 2012 |
| Estimated Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Azithromycin PO three times weekly
Tablets Azithromycin 500 mg PO three times weekly for three months
|
Drug: Azithromycin
Tab. Azithromycin 500 mg PO three times weekly for 3 months
|
Detailed Description:
Graves Orbitopathy (GO) is an autoimmune inflammatory disorder causing visual morbidity, cosmetic morbidity and interference with quality of life. The disease has an inflammatory stage and a non-inflammatory, fibrotic stage.
Treatment of inflammatory stage moderate-severe GO includes steroids, as recommended by the EUGOGO consortium. However, the length of treatment needed and the risk of steroid side-effects may lead to multiple undesired treatment induced morbidity.
Antibiotics of the macrolide group posses known immune-modulatory effects that are separate from their antibacterial mode of action. This mode of action has lead to the routine use of macrolide antibiotics for delaying graft rejection following lung transplants.
We propose to test the effect of this class of antibiotics for non-sight threatening, moderate-severe, inflammatory GO.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Clinical diagnosis of Graves Orbitopathy
- Clinical activity score higher than 2
- Must be able to swallow tablets
Exclusion Criteria:
- sight-threatening Graves Orbitopathy
- Diplopia in primary gaze
- Macrolide allergy or intolerance
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Hadas Stiebel-Kalish, MD, Chief, Neuro-Ophthalmology Unit,, Rabin Medical Center, Petah Tikva 49100, Israel |
| ClinicalTrials.gov Identifier: | NCT01379196 History of Changes |
| Other Study ID Numbers: | 0427-10-RMC |
| Study First Received: | May 11, 2011 |
| Last Updated: | June 22, 2011 |
| Health Authority: | Israel: Ethics Commission |
Keywords provided by Rabin Medical Center:
|
Graves Orbitopathy Macrolide antibiotics Inflammation Clinical Activity Score |
Additional relevant MeSH terms:
|
Graves Ophthalmopathy Graves Disease Eye Diseases Eye Diseases, Hereditary Exophthalmos Orbital Diseases Goiter Thyroid Diseases Endocrine System Diseases |
Hyperthyroidism Autoimmune Diseases Immune System Diseases Azithromycin Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013