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Trial registered on ANZCTR
Registration number
ACTRN12613001321730
Ethics application status
Approved
Date submitted
26/11/2013
Date registered
28/11/2013
Date last updated
28/11/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Sirolimus plus prednisone for the treatment of Erdheim-Chester Disease: a pilot study
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Scientific title
Prospective non randomized pilot study using Sirolimus and Prednisone to induce remission in patients with Erdheim-Chester Disease.
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Secondary ID [1]
283645
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Erdheim-Chester disease
290587
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Condition category
Condition code
Inflammatory and Immune System
290979
290979
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0
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Other inflammatory or immune system disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Prednisone is given orally at the initial dose of 0.75 mg/kg/day for 1 month, tapered to 2.5-5 mg/day over 6 months.
Rapamycin is given orally at a daily dose of 2-4 mg, with a target trough plasmatic level of 8-12 ng/mL.
The minimum duration of treatment to assess response to therapy is 6 months. If disease stabilisation or remission is achieved, we plan to continue treatment for an overall duration of 2 years. After the end of year 2, the decision as to whether treatment has to be continued or stopped is left at the discretion of the treating clinician and the patient.
The response to treatment and the monitoring for side effects is assessed by means of clinical examination and appropriate laboratory and imaging studies (CT, MRI, PET/CT, bone scintigraphy).
To monitor the adherence to sirolimus therapy and to modulate sirolimus dose, we evaluate plasma concentration of sirolimus (trough levels) which must be between 8 and 12 ng/mL.
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Intervention code [1]
288343
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Treatment: Drugs
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Comparator / control treatment
Non randomized study. No controls.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Mortality
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Assessment method [1]
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Timepoint [1]
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Three years follow-up
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Primary outcome [2]
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Evaluation of disease progression, regression or stabilization.
The response to treatment is assessed by means of clinical examination and appropriate laboratory (white blood cell count, hemoglobin, ESR, CRP, renal, hepatic, lipid and glucose profiles, urinalysis, etc.) and imaging studies (CT, MRI, PET/CT, bone scintigraphy).
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Assessment method [2]
290959
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Timepoint [2]
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One year follow-up
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Secondary outcome [1]
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Treatment related toxicity
This will be assessed regularly at the planned study visits by means of physical examination, laboratory and appropriate imaging studies. In particular, we will assess prednisone-and sirolimus-related side effects, such as dyslipidemia, diabetes, osteoporosis, drug-related pneumonia, effusions, edema.
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Assessment method [1]
305677
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Timepoint [1]
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At every year of follow-up for up to 5 years
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Eligibility
Key inclusion criteria
- Diagnosis of Erdheim-Chester with systemic involvement
- Active disease (newly diagnosed progressive disease in patients undergoing other treatments)
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Concurrent active malignancies or serious infections
- Hypersensitivity to sirolimus and/or prednisone and/or contraindications to their use (uncontrolled diabetes
mellitus, severe osteoporosis with previous fractures)
- Proteinuria > 1g/24h
- Recent major surgery and/or post-surgical complications
- Pregnancy
- Patients partecipating in other trials
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
1/12/2007
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Actual
1/12/2007
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Date of last participant enrolment
Anticipated
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Actual
14/06/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
5654
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Italy
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State/province [1]
5654
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Department of Clinical and Experimental Medicine, University of Parma
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Address [1]
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Department of Clinical and Experimental Medicine
University Hospital of Parma
via Gramsci 14
43126 Parma (PR)
Italy
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Country [1]
288330
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Italy
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Primary sponsor type
University
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Name
University of Parma, Department of Clinical and Experiment Medicine
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Address
Department of Clinical and Experimental Medicine
Universital Hospital of Parma
via Gramsci 14, 43126
Parma (PR)
Italy
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Country
Italy
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Secondary sponsor category [1]
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None
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Name [1]
287046
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Address [1]
287046
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Country [1]
287046
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290222
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Comitato Etico per la provincia di Parma
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Ethics committee address [1]
290222
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Ethics committee country [1]
290222
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Italy
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Date submitted for ethics approval [1]
290222
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Approval date [1]
290222
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12/11/2007
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Ethics approval number [1]
290222
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Summary
Brief summary
The main purpose of our study is to identify an effective and tolerable treatment for Erdheim-Chester disease. To date, various regimens have been used with variable results and often burdened by severe toxic effects. On the basis of rapamycin characteristics and of the information available about this disease, we think Sirolimus (one of the commercially available forms of rapamycin) associated with steroids, such as prednisone, could be an alternative therapeutic approach for this disease. Prednisone is given orally at the initial dose of 0.75 mg/kg/day for 1 month, tapered to 2.5-5 mg/day over 6 months. Rapamycin is given orally at a daily dose of 2-4 mg, with a target trough level of 8-12 ng/mL. The minimum duration of treatment to assess response to therapy is 6 months; if disease stabilisation or remission is achieved, the treatment is continued usually until the end of the second year; then, the treatment can be continued or stopped at the discretion of the treating clinician.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Augusto Vaglio
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Address
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Unit of Nephrology,
University Hospital of Parma,
Via Gramsci, 14
43126 Parma
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Country
44510
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Italy
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Phone
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+39 0521 033176
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Augusto Vaglio
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Address
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Unit of Nephrology,
University Hospital of Parma,
Via Gramsci, 14
43126 Parma
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Country
44511
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Italy
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Phone
44511
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+39 0521 033176
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Augusto Vaglio
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Address
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Unit of Nephrology,
University Hospital of Parma,
Via Gramsci, 14
43126 Parma
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Country
44512
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Italy
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Phone
44512
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+39 0521 033176
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Fax
44512
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Email
44512
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Recurrent RAS and PIK3CA mutations in Erdheim-Chester disease
2014
https://doi.org/10.1182/blood-2014-04-570937
Embase
Cardiovascular manifestations of Erdheim-Chester disease.
2015
Embase
Sirolimus plus prednisone for Erdheim-Chester disease: An open-label trial.
2015
https://dx.doi.org/10.1182/blood-2015-01-620377
N.B. These documents automatically identified may not have been verified by the study sponsor.
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