ClinicalTrials.gg
CompletedNCT03864185RECIPEUpdated Aug 20, 2021

The Evaluation of Efficacy and Safety of Rituximab in Refractory CIDP Patients With IgG4 Autoantibodies

A Phase 2 interventional study of Rituximab (genetical recombination) and Placebo in Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP), sponsored by Nagoya University. Completed at 4 sites in Japan. Open to participants aged 12 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-08-20.

Sponsored by Nagoya University · Phase 2, Interventional, and Treatment

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Phase
Phase 2
Study type
Interventional
Enrollment
25
Allocation
Randomized
Ages
12 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 16 studies in Polyradiculoneuropathy, Chronic Inflammatory Demyelinating with a site in Japan — 7 open to participants now, 9 under way, 8 of them phase 3. Polyradiculoneuropathy, Chronic Inflammatory Demyelinating · Japan.

Enrollment
16th of 16
25 · median 160
Started
2019
the only one that year
Phase 2
3 of 16
none open now
Registered
5th of 16
by date
Lead sponsor
1 of 16
Nagoya University

Among the 16 studies in Polyradiculoneuropathy, Chronic Inflammatory Demyelinating with a site in Japan, this one is the 16th largest by enrollment, is the only one that started in 2019, is one of 3 in phase 2, and was the 5th registered.

Polyradiculoneuropathy, Chronic Inflammatory Demyelinating

137 studies on the registry are indexed under Polyradiculoneuropathy, Chronic Inflammatory Demyelinating; 51 are open to participants now.

Browse Polyradiculoneuropathy, Chronic Inflammatory Demyelinating studies →

Open to participants now

7 of the 16 studies in Polyradiculoneuropathy, Chronic Inflammatory Demyelinating with a site in Japan are open now. Recruiting first, the newest first:

2 more — sign in →

All 7 open studies →

A study can be open while its sites in Japan have not opened yet or have stopped. Only those recruiting at a site in Japan →

Who these studies take

Of the 36 Polyradiculoneuropathy, Chronic Inflammatory Demyelinating studies recruiting now, 24 (67%) set no upper age limit and 9 (25%) stop at 75 or younger; 4 take children under 18; 2 take healthy volunteers.

This study: 12 Years and older · all sexes · healthy volunteers too.

The full table on the hub →

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 16 studies in Polyradiculoneuropathy, Chronic Inflammatory Demyelinating with a site in Japan, or all of them as a file.
02

Study summary

To evaluate the efficacy and safety of rituximab (genetical recombination) intravenously administered to CIDP patients with positive or negative IgG4 autoantibody.

03

Conditions studied

  • Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP)

Keywords

  • IgG4 autoantibody
  • Neurofascin-155
  • Contactin-1
  • Rituximab
04

Who can participate

Ages eligible
12 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

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. Patients with definite CIDP diagnosed according to the modified diagnostic criteria of European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) (2010) by the time of enrollment in the study
  2. Patients meeting one of the following conditions:

    (i) Patients with positive serum IgG4 autoantibody (CNTN-1 or NF-155) confirmed by the time of enrollment in the study

    (ii) Patients with negative serum IgG4 autoantibody (CNTN-1 and NF-155) confirmed by the time of enrollment in the study

  3. Patients with CIDP not responding adequately to treatment with for 12 weeks, and intravenous immunoglobulin therapy (IVIg) for 8 weeks by the time of enrollment in the study, or those who are unable to administer or continue corticosteroid and IVIg
  4. Patients with total adjusted Inflammatory Neuropathy Cause and Treatment (INCAT) Disability Scale scores of 2 to 8 at both preliminary enrollment and enrollment, and with the total score at enrollment equal to or worse than that at preliminary enrollment
  5. Patients aged 12 years or older at
  6. Patients who give their voluntary written consent after having received adequate information on this study (legally acceptable representatives should also give consent for underage patients, and informed assent should be obtained from children aged 12 to 15)

Exclusion criteria

Exclusion Criteria:

  1. Patients with disease meeting one of the following exclusion criteria defined in the modified EFNS/PNS diagnostic criteria (2010).

    (i) Borrelia burgdorferi infection (Lyme disease), diphtheria, drug or toxin exposure probably to have caused the neuropathy Hereditary demyelinating neuropathy

    (ii) Prominent sphincter disturbance

    (iii) Diagnosis of multifocal motor neuropathy

    (iv) IgM monoclonal gammopathy with high titre antibodies to myelin-associated glycoprotein

    (v) Other causes for a demyelinating neuropathy including POEMS syndrome, osteosclerotic myeloma, diabetic and non-diabetic lumbosacral radiculoplexus neuropathy PNS lymphoma and amyloidosis may occasionally have demyelinating features

  2. Patients who have started or have increased the dose of for CIDP within 12 weeks prior to the enrollment
  3. Patients who have started or have increased the dose of IVIg within 8 weeks prior to the enrollment
  4. Patients who have underwent plasmapheresis within 8 weeks prior to the enrollment or patients with disease not responding adequately to 8 weeks of plasmapheresis (plasma exchange or double-filtration plasmapheresis)
  5. Patients who have started or have increased the dose of an (azathioprine, cyclophosphamide, cyclosporine, mycophenolate mofetil, interferon alpha, interferon beta, etanercept, methotrexate, mitoxantrone, alemtuzumab, cladribine, tacrolimus, fingolimod) within 12 weeks prior to the enrollment
  6. Patients who have underwent hematopoietic stem cell transplant prior to the enrollment
  7. Patients who have used rituximab (genetical recombination) prior to the enrollment
  8. Patients who have participated in another clinical study within 3 months prior to the enrollment (enrollment is allowed for those participating in a clinical study in the range of Indications or Dosage and Administration in Japan) or patients who are participating in another study
  9. Patients with poorly controlled diabetes ( of 7 % or higher)
  10. Patients who have or are suspected to have active infection (infection requiring treatment with systemic antimicrobial, antifungal, or antiviral agents) at the time of the enrollment
  11. Patients tested positive for HBs antigen, HBs antibody, HBc antibody, and/or antibody (patients with positive HBs antibody or HBc antibody can be enrolled when a virus-DNA test is negative [below the limit of detection], and hepatitis B virus-DNA and aspartate/ levels are monitored at fixed intervals), or patients with positive antibody or HTLV-1 antibody at the time of the enrollment
  12. Patients with leukopenia (less than 2,000 /mm3), neutropenia (less than 1,000 /mm3), or lymphopenia (less than 500 /mm3) at the time of the enrollment
  13. Patients with history of serious or anaphylactic reaction to one of the ingredients in the drug or murine protein-containing products
  14. Patients with serious comorbidity (e.g., hepatic, renal, cardiac, lung, hematologic, or brain disease)
  15. Female patients who are pregnant, lactating, or potentially pregnant, or patients who are not willing to use measures during the study period
  16. Patients who are judged to be unsuitable by the investigator or a sub-investigator
Terms in these criteria, in plain language(12)

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.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

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.

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.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

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.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

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.

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.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

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.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
25 participants (actual)

Study arms

  • Active comparator
    Rituximab group (IgG4 autoantibody positive)

    Biological: Rituximab (genetical recombination)

  • Placebo comparator
    Placebo group (IgG4 autoantibody positive)

    Other: Placebo

  • Active comparator
    Rituximab group (IgG4 autoantibody negative)

    Biological: Rituximab (genetical recombination)

Interventions

  • Administer 375 mg/m2 of rituximab (genetical recombination) IV infusion once weekly for 4 doses.

  • OtherPlacebo

    Administer placebo IV infusion once weekly for 4 doses.

06

What researchers measure

Primary outcomes

  1. Rate of patients with improvement in adjusted Inflammatory Neuropathy Cause and Treatment (INCAT) disability scale

    Primary analysis will compare scores of adjusted INCAT Disability Scale evaluated prior to treatment (at the time of enrollment) and scores at each timepoint after week 26 to calculate the proportion of patients who achieve an improvement of one and more from the baseline. The INCAT Disability Scale is an index to evaluate disorders in lower (gait) and upper (elevation of the upper arms and fine movement of the fingertips) extremities. The INCAT score is a 10-point scale and ranges from 0 (normal) to 10 (worst). For the "adjusted" INCAT score, a change in upper extremity score from 0 to 1 or 1 to 0 will not be considered meaningful in this evaluation.

    Time frame: Up to 52 weeks

Secondary outcomes

  1. Change in grip strength (kPa)

    The differences of Grip strength (kPa) between prior to treatment and at each timepoint are summarized.

    Time frame: Up to 52 weeks

  2. Change in Rasch-built Overall Disability Scale (R-ODS) score

    The differences of R-ODS score between prior to treatment and at each timepoint are summarized. R-ODS is consist of a 24-item questionnaire about daily living task with 3 response options: (0) "impossible to perform," (1) "performed with difficulty," and (2) "easily performed. The R-ODS score is a 48-point scale (range: 0-48), and is converted into a centile metric score with values ranging from 0 (most severe activity and social participation limitations) to 100 (no activity and social participation limitations).

    Time frame: Up to 52 weeks

  3. Change in Medical Research Council (MRC) Sum Score

    The differences of MRC Sum Score between prior to treatment and at each timepoint are summarized. The MRC Sum Score is a scale to assess for 8 muscle groups (right and left side) as follow: Shoulder abduction, Elbow flexion, Wrist extension, Index finger abduction, Hip flexion, Knee extension, Foot dorsiflexion, Great toe dorsiflexion.The MRC Sum Score is a 80-point scale and ranges from 0 (paralysis) to 80 (normal strength).

    Time frame: Up to 52 weeks

  4. Change in motor nerve distal latency

    The differences of distal latency between prior to treatment and at each timepoint are summarized.

    Time frame: Up to 52 weeks

  5. Change in motor nerve proximal latency

    The differences of proximal latency between prior to treatment and at each timepoint are summarized.

    Time frame: Up to 52 weeks

  6. Change in motor nerve compound muscle action potential (CMAP)

    The differences of CMAP between prior to treatment and at each timepoint are summarized.

    Time frame: Up to 52 weeks

  7. Change in motor nerve conduction velocity

    The differences of motor nerve conduction velocity between prior to treatment and at each timepoint are summarized.

    Time frame: Up to 52 weeks

  8. Cerebrospinal fluid protein level

    Cerebrospinal fluid protein level at each timepoint are summarized.

    Time frame: Up to 52 weeks

  9. B cell counts (CD19 positive and CD20 positive cell counts) and T cell counts (CD3 positive, CD4 positive, and CD8 positive cell counts)

    B cell counts (CD19 positive and CD20 positive cell counts) and T cell counts (CD3 positive, CD4 positive, and CD8 positive cell counts) at each timepoint are summarized.

    Time frame: Up to 52 weeks

  10. Expression of HACA

    The number of patients expressing HACA, and the proportion and its 95% confidence interval of these patients at each timepoint are summarized.

    Time frame: Up to 52 weeks

  11. Serum rituximab (genetical recombination) level

    Serum rituximab (genetical recombination) level at each timepoint are summarized.

    Time frame: Up to 52 weeks

  12. Maximum serum concentration (Cmax) of rituximab (genetical recombination)

    Cmax of rituximab (genetical recombination) is summarized.

    Time frame: Up to 52 weeks

  13. Area under the curve (AUC) of blood concentration of rituximab (genetical recombination)

    AUC of blood concentration of rituximab (genetical recombination) is summarized.

    Time frame: Up to 52 weeks

  14. Half-life (t1/2) of rituximab (genetical recombination)

    t1/2 of rituximab (genetical recombination) is summarized.

    Time frame: Up to 52 weeks

  15. Clearance (CL) of rituximab (genetical recombination)

    CL of rituximab (genetical recombination) is summarized.

    Time frame: Up to 52 weeks

  16. Mean residence time (MRT) of rituximab (genetical recombination)

    MRT of rituximab (genetical recombination) is summarized.

    Time frame: Up to 52 weeks

  17. Volume of distribution (Vds) of rituximab (genetical recombination) level

    Vds of rituximab (genetical recombination) is summarized.

    Time frame: Up to 52 weeks

  18. Serum antibody titers of IgG4 (CNTN-1 and NF-155) and these IgG subclass

    Serum titers (CNTN-1 and NF-155, and these IgG subclasses 1 to 4) at each timepoint are summarized.

    Time frame: Up to 52 weeks

  19. Serum neurofilament

    Serum neurofilament level at each timepoint is summarized.

    Time frame: Up to 52 weeks

07

Study locations

4 sites
  • Nagoya University Hospital
    Nagoya, Aich 466-8560, Japan
  • Chiba University Hospital
    Chiba, Japan
  • Kyushu University Hospital
    Fukuoka, Japan
  • Yamaguchi University Hospital
    Ube, Japan
08

References and documents

Publications

  • Shimizu S, Iijima M, Fukami Y, Tamura N, Nakatochi M, Ando M, Nishi R, Koike H, Kaida K, Koga M, Kanda T, Ogata H, Kira JI, Mori M, Kuwabara S, Katsuno M. Efficacy and Safety of Rituximab in Refractory CIDP With or Without IgG4 Autoantibodies (RECIPE): Protocol for a Double-Blind, Randomized, Placebo-Controlled Clinical Trial. JMIR Res Protoc. 2020 Apr 1;9(4):e17117. doi: 10.2196/17117. PubMed 32234705 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Mar 2019 to primary completion in May 2021, 25 months.

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

Registered
Feb 19, 2019
First posted
Mar 6, 2019
StartActual
Mar 28, 2019
Primary completionActual
May 27, 2021
CompletionActual
May 27, 2021
Last update
Aug 20, 2021
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 20, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03864185
Lead sponsor
Nagoya University
Collaborators
Japan Agency for Medical Research and Development, Zenyaku Kogyo Co., Ltd.
Responsible party
Masahiro Iijima (Designated Associate Professor, Nagoya University) — Principal investigator
First posted
Mar 6, 2019
Start date
Mar 28, 2019
Primary completion
May 27, 2021
Completion
May 27, 2021
Last update
Aug 20, 2021

Study contacts

Masahiro Iijima, Ph. D
principal investigator · Nagoya University Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Aug 2021. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Studies of the drug tested here: Rituximab

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