A Randomized Double Blind Placebo Controlled Study of Intravenous Immunoglobulin (IVIG) Patients With Voltage Gated Potassium Channel Complex (VGKC) Antibody Associated Autoimmune Epilepsy
Overview
- Phase
- Phase 3
- Intervention
- Intravenous Immunoglobulin
- Conditions
- Autoimmune Epilepsy
- Sponsor
- Mayo Clinic
- Enrollment
- 17
- Locations
- 1
- Primary Endpoint
- Change in Seizure Frequency From Baseline to 5 Weeks
- Status
- Terminated
- Last Updated
- 6 years ago
Overview
Brief Summary
The purpose of this study is to determine whether intravenous immunoglobulin (IVIG) treatment reduces significantly the number of epileptic seizures in cases of autoimmune epileptic seizures.
Detailed Description
The purpose of this study is to determine if intravenous immunoglobulin (IVIG) treatment significantly reduces the number of epileptic seizures in cases of autoimmune epilepsy. Potential participants will be screened at an outpatient neurology clinic visit appointment. Interested qualified potential participants will be consented and offered participation in this trial. Once consent has been obtained, and it is determined that the participant meets all inclusion criteria, the participant will be randomized to either IVIG or placebo treatment for the next 5 weeks. Participants will return to Mayo Clinic for an evaluation. Those participants that received the placebo for 5 weeks will be given IVIG in an open label fashion for 5 weeks (week 7-11) then return to Mayo Clinic for evaluation. All participants will receive monthly phone calls after they complete the IVIG treatment for a period of 1 year from the end of IVIG 5 week course.
Investigators
Sean Pittock
Principal Investigator
Mayo Clinic
Eligibility Criteria
Inclusion Criteria
- •Seropositivity for Voltage Gated Potassium Channel Complex (VGKC) complex antibodies or positive for Leucine-Rich, Glioma Inactivated 1 (LGI1)/contactin-associated protein-like 2 (CASPR2) Antibody by cell based assay.
- •And ≥ 2 seizures per week (mean of total over 1 week)
- •And duration of epilepsy \<3 years
- •Male or female between the ages of 18 and 80 years of age
- •Women and men of child bearing potential must agree to use a reliable form of contraception throughout the course of the study.
- •Homecare treatment agency available at place of residence.
Exclusion Criteria
- •History of thrombotic episodes within the 2 years prior to enrollment
- •Known allergic or other severe reactions to blood products including intolerability to previous IVIG
- •Immunoglobulin A (IgA) deficiency
- •Prior failed trial of high dose steroid (prednisone \>60mg daily or methylprednisolone \>1g weekly for \>2 weeks)
- •Reproductive status:
- •Women who are pregnant,
- •Women who are breastfeeding,
- •Women and men of childbearing potential who are unwilling or unable to use an acceptable method of birth control to avoid pregnancy for the entire study period, as evaluated by the investigator. (Women of non-childbearing potential are those that have a history of hysterectomy, bilateral oophorectomy, or are postmenopausal with no history of menstrual flow for \> 12 months prior to screen visit.)
- •Any surgical procedure (except for minor surgeries) within 4 weeks prior to baseline.
- •Evidence of serious uncontrolled concomitant diseases that may preclude patient participation (physician determined), as described; Other nervous system disease, cardiovascular disease, hematologic/hematopoiesis disease, respiratory disease, muscular disease, endocrine disease, renal/urologic disease, digestive system disease, congenital or acquired severe immunodeficiency
Arms & Interventions
Placebo/Normal Saline Group
Subjects will receive placebo for 4 infusions. After completion of the blinded phase, subjects will receive IVIG for 4 infusions. Subjects will maintain their stable dose of antiepileptic meds.
Intervention: Intravenous Immunoglobulin
Placebo/Normal Saline Group
Subjects will receive placebo for 4 infusions. After completion of the blinded phase, subjects will receive IVIG for 4 infusions. Subjects will maintain their stable dose of antiepileptic meds.
Intervention: Placebos
Placebo/Normal Saline Group
Subjects will receive placebo for 4 infusions. After completion of the blinded phase, subjects will receive IVIG for 4 infusions. Subjects will maintain their stable dose of antiepileptic meds.
Intervention: Normal Saline
Intravenous Immunoglobulin (IVIG) (Gamunex-C) Group
Subjects will receive IVIG for 4 infusions. Subjects will maintain their stable dose of antiepileptic meds.
Intervention: Intravenous Immunoglobulin
Intravenous Immunoglobulin (IVIG) (Gamunex-C) Group
Subjects will receive IVIG for 4 infusions. Subjects will maintain their stable dose of antiepileptic meds.
Intervention: Normal Saline
Outcomes
Primary Outcomes
Change in Seizure Frequency From Baseline to 5 Weeks
Time Frame: baseline, 5 weeks
The number of subjects who experience a ≥ 50% reduction in seizure frequency
Secondary Outcomes
- Change in Cognitive Assessment(baseline, 5 weeks)