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CompletedNCT00589628Updated Aug 26, 2013Results posted

Multi Center Prospective Registry of Infliximab Use for Childhood Uveitis

A Phase 4 interventional study of infliximab and infliximab in Chronic Uveitis, sponsored by Egla C. Rabinovich. Completed at 1 site in United States. Open to participants aged 4 Years to 18 Years. Per ClinicalTrials.gov, last updated 2013-08-26.

Sponsored by Egla C. Rabinovich · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
13
Allocation
Randomized
Ages
4 Years to 18 Years
Sex
All
01

Study summary

The primary objective of this study is to examine the efficacy of infliximab for the treatment of persistent uveitis in children. Participants (4-18 years of age) will be randomly assigned to either 5mg/kg or 10mg/kg dose of infliximab to be administered by intravenous infusion at four week intervals. Participant responses will be measured at at four to eight week intervals for up to ten months.

Read the detailed description

Pediatric rheumatologists often use infliximab in the treatment of childhood uveitis, at this time there are no prospective studies for this use. Participants will be randomized to initial suggested dose of infliximab (5 mg/kg/dose vs 10 mg/kg/dose) and data will be collected prospectively with regard to ophthalmologic outcomes. Study participants will be followed for up to 10 months to determine efficacy and side effects, and an additional 30 days for safety reports. Descriptive statistics will be gathered on participant demographics, uveitis characteristics, change in immunosuppressive medications, number of responders, ophthalmologic measures and change in corticosteroid dose during the study period. Initial to final dose will be examined by paired t-test. The proportion of responders in the 5 mg/kg initial dose group will be compared to the 10 mg/kg/dose by a Chi-square or Fisher's exact test, depending on numbers available. Predictors of response will be examined by logistic regression.

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Conditions studied

  • Chronic Uveitis

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Keywords

  • Childhood
  • Uveitis
03

In context

Uveitis

345 studies on the registry are indexed under Uveitis; 38 are open to participants now.

This study's enrollment of 13 is below the median of 30 across 214 interventional studies indexed under Uveitis.

Browse Uveitis studies →

Lead sponsor

This is the only study on the registry with Egla C. Rabinovich as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
4 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:.

  1. Ages 4 to 18 years old,
  2. Non-infectious uveitis
  3. Persistent uveitis uncontrolled by topical medications, or unacceptable side effects of topical medications.
  4. Failure of at least six weeks of treatment with a non-biological disease modifying agent such as methotrexate, cyclosporine, mycophenolate mofetil, or azathioprine.
  5. Ability to provide informed consent (subject or parent/guardian)
  6. Onset of uveitis \< 16 years of age.
  7. Topical ophthalmologic treatments allowed.
  8. Systemic corticosteroid use at entry may be allowed.
  9. Willingness to use acceptable contraception if sexually active for the duration of the study and for 6 months after receiving the last infliximab infusion.
  10. Concomitant methotrexate must be taken at time of initiation of infliximab
  11. Participant must be able to cooperate for a non-sedated slit lamp exam and visual acuity examination.
  12. Negative Purified Protein Derivative (PPD) placed and read within 1 month of initiation of infliximab
  13. The screening laboratory test results must meet the following criteria:

    • WBC (white blood cell count): within normal range for institution
    • ANC (absolute neutrophil count): within normal range for institution
    • Hemoglobin: greater than 10 grams/deciliter
    • Platelets: within normal range for institution
    • Serum Creatinine: within normal range for age
    • AST - aspartate aminotransferase - within normal range for institution
    • ALT - alanine aminotransferase- within normal range for institution

Exclusion Criteria:

  1. Previous use of biologic medications for uveitis.
  2. Intraocular steroid injection or ophthalmologic surgery within the preceding 3 months.
  3. Uveitis due to trauma or intraocular surgery
  4. Females who are pregnant, nursing, or planning pregnancy within 6 months after the last infliximab infusion.
  5. Males who plan on fathering a child within 6 months after their last infliximab infusion.
  6. A history of a known allergy to murine products.
  7. Documentation of seropositivity for human immunodeficiency virus (HIV).
  8. Documentation of a positive test for hepatitis B surface antigen or hepatitis C
  9. A known history of a serious infection (e.g., hepatitis, pneumonia, or pyelonephritis) in the previous 3 months.
  10. An opportunistic infection (e.g., herpes zoster [shingles], cytomegalovirus, Pneumocystis carinii, aspergillosis, histoplasmosis, or mycobacteria other than TB) within 6 months prior to screening.
  11. A concomitant diagnosis or history of congestive heart failure.
  12. A history of lymphoproliferative disease.
  13. Any known malignancy or a history of malignancy.
  14. Current signs or symptoms of severe, progressive or uncontrolled renal, hepatic, hematologic, gastrointestinal, endocrine, pulmonary, cardiac, neurologic, or cerebral disease.
  15. Use of any investigational drug within 30 days prior to screening or within five half-lives of the first dose of the investigational agent, whichever is longer.
  16. Presence of a transplanted solid organ.
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Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
13 participants (actual)

Study arms

  • Active comparator
    1

    5mg/kg/dose of infliximab IV every 4 weeks for 9 doses

    Drug: infliximab

  • Active comparator
    2

    10mg/kg/dose of infliximab IV every 4 weeks for 9 doses.

    Drug: infliximab

Interventions

  • 5mg/kg/dose IV at 4 week intervals

    Also known as: Remicade

  • 10mg/kg/dose IV at 4 week intervals

    Also known as: Remicade

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What researchers measure

Primary outcomes

  1. Effects of Infliximab on Uveitis Disease Activity.

    Number of subjects with improvement in uveitis, defined as a two step decrease in level of inflammation (as defined by SUN criteria, AC cells, vitreous haze) or decrease to grade 0. A grading scheme of 0 indicating (\<1 cell/ocular field) low levels of inflammation to 4+ indicating (\>50 cells/ocular field) indicating high levels of inflammation.

    Time frame: 9 months

07

Results

Posted Aug 26, 2013
Limitations and caveats
Study recruitment was difficult and slow. Optimal number not achieved in this descriptive study.

Participant flow

Participant flow — Overall Study
MilestoneInfliximab 5 mg/kgInfliximab 10 mg/kg
Started76
Completed75
Not completed01
Withdrew: Lost to follow-up01

Outcome measures

PrimaryEffects of Infliximab on Uveitis Disease Activity.

Number of subjects with improvement in uveitis, defined as a two step decrease in level of inflammation (as defined by SUN criteria, AC cells, vitreous haze) or decrease to grade 0. A grading scheme of 0 indicating (\<1 cell/ocular field) low levels of inflammation to 4+ indicating (\>50 cells/ocular field) indicating high levels of inflammation.

Time frame:
9 months
Reported as:
Number · participants
Effects of Infliximab on Uveitis Disease Activity.
participantsInfliximab 5mg/kgInfliximab 10mg/kg
Effects of Infliximab on Uveitis Disease Activity.3 (0 to 4)6 (0 to 4)

Adverse events

Non-serious events are listed at a 1% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
5 mg/kg of Infliximab—0/7 (0%)2/7 (28.6%)
10 mg/kg of Infliximab—1/6 (16.7%)2/6 (33.3%)
Most frequent serious events
Most frequent serious events
Event5 mg/kg of Infliximab10 mg/kg of Infliximab
FeverInfections and infestations0/71/6
Most frequent other events
Most frequent other events
Event5 mg/kg of Infliximab10 mg/kg of Infliximab
Upper respiratory infectionRespiratory, thoracic and mediastinal disorders1/71/6
otitis mediaEar and labyrinth disorders0/71/6
Fever blisterSkin and subcutaneous tissue disorders1/70/6

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)5 mg/kg of Infliximab10 mg/kg of InfliximabTotal
<=18 years7613
Between 18 and 65 years000
>=65 years000
Sex: Female, Male
Sex: Female, Male(Participants)5 mg/kg of Infliximab10 mg/kg of InfliximabTotal
Female538
Male235
Region of Enrollment
Region of Enrollment(participants)5 mg/kg of Infliximab10 mg/kg of InfliximabTotal
United States7613
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Study locations

1 site
  • Duke University Medical Center
    Durham, North Carolina 27710, United States
09

References and documents

Publications

  • Heiligenhaus A, Foeldvari I, Edelsten C, Smith JR, Saurenmann RK, Bodaghi B, de Boer J, Graham E, Anton J, Kotaniemi K, Mackensen F, Minden K, Nielsen S, Rabinovich EC, Ramanan AV, Strand V; Multinational Interdisciplinary Working Group for Uveitis in Childhood. Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis-associated uveitis: a consensus effort from the multinational interdisciplinary working group for uveitis in childhood. Arthritis Care Res (Hoboken). 2012 Sep;64(9):1365-72. doi: 10.1002/acr.21674. PubMed 22438273 ↗
  • Ardoin SP, Kredich D, Rabinovich E, Schanberg LE, Jaffe GJ. Infliximab to treat chronic noninfectious uveitis in children: retrospective case series with long-term follow-up. Am J Ophthalmol. 2007 Dec;144(6):844-849. doi: 10.1016/j.ajo.2007.08.018. Epub 2007 Oct 22. PubMed 17953940 ↗
  • Saurenmann RK, Levin AV, Rose JB, Parker S, Rabinovitch T, Tyrrell PN, Feldman BM, Laxer RM, Schneider R, Silverman ED. Tumour necrosis factor alpha inhibitors in the treatment of childhood uveitis. Rheumatology (Oxford). 2006 Aug;45(8):982-9. doi: 10.1093/rheumatology/kel030. Epub 2006 Feb 3. PubMed 16461435 ↗
  • Kahn P, Weiss M, Imundo LF, Levy DM. Favorable response to high-dose infliximab for refractory childhood uveitis. Ophthalmology. 2006 May;113(5):860-4.e2. doi: 10.1016/j.ophtha.2006.01.005. Epub 2006 Mar 20. PubMed 16545455 ↗
  • Rajaraman RT, Kimura Y, Li S, Haines K, Chu DS. Retrospective case review of pediatric patients with uveitis treated with infliximab. Ophthalmology. 2006 Feb;113(2):308-14. doi: 10.1016/j.ophtha.2005.09.037. Epub 2006 Jan 10. PubMed 16406545 ↗
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Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Sep 2007, a primary completion of Dec 2010 and a completion of Dec 2010. It does not say whether these dates are actual or estimated.

Results were first posted in Aug 2013, 2 years 8 months after primary completion.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 27, 2007
First posted
Jan 10, 2008
Start
Sep 2007
Primary completionActual
Dec 2010
CompletionActual
Dec 2010
Results first posted
Aug 26, 2013
Last update
Aug 26, 2013
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 26, 2013, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00589628
Lead sponsor
Egla C. Rabinovich
Collaborators
Childhood Arthritis and Rheumatology Research Alliance
Responsible party
Egla C. Rabinovich (Associate Professor of Pediatrics, Duke University) — Sponsor-investigator
First posted
Jan 10, 2008
Start date
Sep 2007
Primary completion
Dec 2010
Completion
Dec 2010
Results posted
Aug 26, 2013
Last update
Aug 26, 2013

Study contacts

Egla Rabinovich, MD. MPH
principal investigator · Duke University

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Aug 2013. You cannot join it, but the record below documents what was studied.

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