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Evaluation of the Benefit of Antiviral Treatment With Valganciclovir on Congenital CMV Infection-related Deafness on Hearing and Balance

Phase 2
Terminated
Conditions
Congenital Cytomegalovirus (CMV)
Interventions
Registration Number
NCT02606266
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

Congenital cytomegalovirus (CMV) infection is the leading cause of non-genetic neurosensory deafness and affects 0.5 to 1% of births. Twenty to thirty per cent of children will develop deafness, some of whom will progress gradually to profound bilateral deafness.

No curative treatment is currently offered for this deterioration in hearing and management involves the use of a hearing aid or cochlear implant. Many studies describe the utility of antiviral treatment on the course of the deafness. These mostly involve neonates with multi-system symptomatic forms of the infection who have been given 6 weeks of ganciclovir possibly switched to valganciclovir, which has shown benefit in stabilising auditory loss, or even improvement.

Detailed Description

Congenital cytomegalovirus (CMV) infection is the leading cause of non-genetic neurosensory deafness and affects 0.5 to 1% of births. Twenty to thirty per cent of children will develop deafness, some of whom will progress gradually to profound bilateral deafness.

No curative treatment is currently offered for this deterioration in hearing and management involves the use of a hearing aid or cochlear implant. Many studies describe the utility of antiviral treatment on the course of the deafness. These mostly involve neonates with multi-system symptomatic forms of the infection who have been given 6 weeks of ganciclovir possibly switched to valganciclovir, which has shown benefit in stabilising auditory loss, or even improvement.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
1
Inclusion Criteria
  • Children ≥ 6 months old and < 12 years old
  • Past history of proven congenital CMV infection
  • Auditory threshold of between 40 and 90 dB in at least 1 ear.
Exclusion Criteria
  • Bilateral deafness > 90 dB
  • Contraindication to valganciclovir, particularly: Neutropenia with a known neutrophil count of <500/mm3, Hb<8g/dl or platelets< 25,000/mm3 (FBC to be confirmed before randomisation)
  • Past history of neutropenia on valganciclovir or allergy to the compound
  • Renal impairment with creatinine clearance of < 10 ml/min/1.72m2 (confirmation of renal function before randomisation) according to the Schwartz equation
  • Patients on other antiviral treatment
  • Gastrointestinal absorption problems
  • Patients participating in a biomedical research project on a medicinal product or similar product

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ValganciclovirValganciclovirOral valganciclovir (Rovalcyte 50 mg/ml, powder for oral suspension), at a dose of 16 mg/kg 2 times/day (max 900 mg/d) for 6 weeks.
Primary Outcome Measures
NameTimeMethod
Auditory threshold in db6 months
Secondary Outcome Measures
NameTimeMethod
FBC (haemoglobin and leukocyte count)6 weeks
Serum valganciclovir concentrations6 weeks
Canal function6 months

Canal function will be assessed using 3 tests : caloric reflex tests; electronystamography \& HIT (Head Impulse Test)

Trial Locations

Locations (1)

Robert Debré Hospital

🇫🇷

Paris, France

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