ClinicalTrials.gg
TerminatedNCT02556866ESBAMUpdated Mar 18, 2019

Rituximab Plus Corticosteroids in Non-infectious Active Mixed Cryoglobulinemia Vasculitis

A Phase 2 interventional study of rituximab and Prednisone in Cryoglobulinemia and Systemic Vasculitis, sponsored by Assistance Publique - Hôpitaux de Paris. Terminated at 1 site in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-03-18.

Sponsored by Assistance Publique - Hôpitaux de Paris · Phase 2, Interventional, and Treatment

Why this study was terminated
lack of recruitment
Phase
Phase 2
Study type
Interventional
Enrollment
14
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Multicenter randomized double-blind study comparing the efficacy and safety of rituximab in combination with corticosteroids to corticosteroids plus placebo in the treatment of non-infectious active mixed cryoglobulinemia vasculitis.

Read the detailed description

Cryoglobulinemia are responsible for systemic vasculitis, and the most frequently targeted organs are the skin, joints, kidneys and peripheral nervous system. Cryoglobulinemia vasculitis are associated with significant morbidity and mortality, and require therapeutic intervention. Management of non-infectious mixed cryoglobulinemia vasculitis is based on corticosteroids, plasma exchange, and/or immunosuppressants. These treatments are associated with frequent side effects. To date, no study has evaluated the efficacy and safety of these different therapeutic options, explaining the lack of recommendations.

Rituximab, a monoclonal antibody directed against CD20, has emerged as a novel therapeutic option in B-cell related disorders. Data from the French AutoImmunity and Rituximab (AIR) registry recently reported the positive effect of rituximab in non-infectious mixed cryoglobulinemia vasculitis. More recently, the multidisciplinary national French CryoVas survey also suggested a significant superiority of the combination corticosteroid plus rituximab compared to the corticosteroids alone in terms of complete clinical and immunological responses and corticosteroid sparing. However, no randomized controlled data addressing this issue has been published to date.

02

Conditions studied

  • Cryoglobulinemia
  • Systemic Vasculitis

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03

In context

Systemic Vasculitis

31 studies on the registry are indexed under Systemic Vasculitis; 7 are open to participants now.

This study's enrollment of 14 is below the median of 70 across 19 interventional studies indexed under Systemic Vasculitis.

Browse Systemic Vasculitis studies →

Lead sponsor

Assistance Publique - Hôpitaux de Paris is the lead sponsor of 3,592 studies on the registry; 1,033 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. The patient must be at least 18 years of age or older, without any upper age limit
  2. Patient informed and agreed to participate, and gave ,
  3. Patient with active cryoglobulinemia vasculitis define by positive cryoglobulinemia and a clinically active vasculitis with skin, joint, renal, peripheral nerve, central neurological, digestive, pulmonary and/or cardiac involvement (no histological evidence needed if presence of purpura demonstrated),
  4. Patient with primary Sjögren's syndrome, systemic lupus erythematosus, or another auto-immune disease, or B-cell non-Hodgkin lymphoma (with cryoglobulinemia as the only therapeutic indication), or essential mixed cryoglobulinemia,
  5. Naive or relapsing patients, without modification (initiation or increase) of therapy in the month prior the inclusion,
  6. For women of child bearing age: negative pregnancy test during the inclusion, and effective during the period of 12 months after the latest rituximab infusion or placebo,
  7. Patients with severe vasculitis must be treated in the 15 days prior inclusion by 3 bolus of methylprednisolone (15 mg/kg/d) AND 3 to 7 plasma exchanges (exchange volume of 60 ml/kg/session).

Exclusion criteria

Exclusion Criteria:

  1. Patient with a medium and small size vessels vasculitis unrelated to cryoglobulinemia (granulomatous with polyangiitis (Wegener's disease), microscopic polyangiitis, eosinophilic granulomatous with polyangiitis (Churg-Strauss syndrome), polyarteritis nodose, IgA vasculitis, vasculitis, infectious vasculitis, hypocomplementemic urticarial vasculitis),
  2. Patient with a large size vessels vasculitis,
  3. Patient with non active cryoglobulinemia vasculitis,
  4. Patient with therapy introduced or increased in the month prior to the inclusion,
  5. Patients receiving therapy > 0.5 mg/kg/d for more than one month before the inclusion or > 1 mg/kg/d for more than two weeks before the inclusion,
  6. Patient who had received rituximab therapy within the 12 months before the inclusion,
  7. Pregnancy in progress or needed , breast feeding,
  8. -positive status,
  9. Patient with active or C infection,
  10. HBs Ag-positive and/or HBV DNA detectable in the blood*,
  11. Patients with known hypersensitivity reaction to the active substance or any of the , or to murine proteins,
  12. to rituximab,
  13. Active infections at screening,
  14. Patient in guardianship,
  15. Patient already included in a biomedical research protocol,
  16. No social security scheme (Beneficiaries or eligible),
  17. History of cancer during the last 3 years before inclusion, including solid tumors, hematological (except lymphoproliferative disorder associated with the mixed cryoglobulinemia vasculitis), and carcinoma in situ (except basal cell and squamous cell carcinoma of the skin that have been treated or excized and cured)"

    • If the hepatitis B core antibody (anti-HBc) is positive, the benefit/risk will be evaluated by an hepatologist before inclusion, and patient, if enrolled, will be monitored until the end of the study.
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
14 participants (actual)

Study arms

  • Experimental
    rituximab

    Prednisone treatment plus rituximab administered by slow intravenous infusion at 375 mg/m2 at D1, D8, D15 and D22.

    Drug: rituximab · Drug: Prednisone

  • Placebo comparator
    placebo

    Prednisone treatment plus placebo administered by slow intravenous infusion at day 1 (D1), D8, D15 and D22.

    Drug: Prednisone · Drug: Placebo

Interventions

  • Prednisone treatment plus rituximab administered by slow intravenous infusion at 375 mg/m2 at D1, D8, D15 and D22.

  • DrugPlacebo
06

What researchers measure

Primary outcomes

  1. Complete clinical response of vasculitis symptoms (yes-no, i.e. success-failure) with corticosteroid withdrawal (prednisone at 0 mg/day) at week (W) 24, with at least one clinical response at W4

    The complete clinical response is defined by the remission of all affected organs involved at baseline and the absence of clinical relapse.

    Time frame: Week 24

Secondary outcomes

  1. Partial clinical response

    Partial clinical response defined by an improvement of at least half of organ impairments present at baseline

    Time frame: Week 24

Other outcomes

  1. Evolution of cryoglobulinemia (positive or negative)

    Time frame: Week 24

  2. Evolution of C4 complement fraction (mg/L)

    Time frame: Week 24

  3. Rate of early failures

    Time frame: Week 4

  4. Occurrence of clinical relapse

    Clinical relapse is defined by de novo appearance or reappearance of a manifestation attributable to cryoglobulinemia vasculitis during 48 weeks of follow-up,

    Time frame: up to Week 48

  5. Cumulative dose of prednisone

    Time frame: Week 24

  6. quality of life

    evolution of quality of life will be assessed by the score SF36

    Time frame: Day 1

  7. quality of life

    evolution of quality of life will be assessed by the score SF36

    Time frame: Week 4

  8. quality of life

    evolution of quality of life will be assessed by the score SF36

    Time frame: Week 8

  9. quality of life

    evolution of quality of life will be assessed by the score SF36

    Time frame: Week 16

  10. quality of life

    evolution of quality of life will be assessed by the score SF36

    Time frame: Week 24

  11. quality of life

    evolution of quality of life will be assessed by the score SF36

    Time frame: Week 36

  12. quality of life

    evolution of quality of life will be assessed by the score SF36

    Time frame: Week 48

  13. quality of life at relapse

    quality of life at relapse will be assessed by the score SF36

    Time frame: up to Week 48

  14. Infusion related reactions

    hypersensitivity reaction rate such as fall in blood pressure, bronchospasm, ... due to rituximab or placebo infusions (included also reaction occurring after the end of infusion),

    Time frame: up to Week 4

  15. Rate of infections (severe or not) and other complications related to corticosteroids

    Time frame: up to Week 48

07

Study locations

1 site
  • Pitié Salpetriere Hospital
    Paris, 75013, France
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Jul 2015 to primary completion in May 2018, 34 months.

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

Registered
Jul 20, 2015
First posted
Sep 22, 2015
StartActual
Jul 17, 2015
Primary completionActual
May 31, 2018
CompletionActual
May 31, 2018
Last update
Mar 18, 2019
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 Mar 18, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT02556866
Responsible party
Sponsor
First posted
Sep 22, 2015
Start date
Jul 17, 2015
Primary completion
May 31, 2018
Completion
May 31, 2018
Last update
Mar 18, 2019

Study contacts

Patrice CACOUB, MD, PhD
principal investigator · Assistance Publique - Hôpitaux de Paris

Oversight

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

Not currently enrolling

This study is terminated, as verified in Mar 2019. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Rituximab

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