Purpose

The purpose of this study is to determine whether ustekinumab is effective in the treatment of Giant Cell Arteritis (GCA)

Conditions

Eligibility

Eligible Ages
Over 50 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

Subjects must meet the following criteria 1. Able and willing to provide written informed consent and to comply with the study protocol 2. Diagnosis of GCA classified according to the following criteria: - Age 50 years or older - History of erythrosedimentation rate (ESR) ≥ 50 mm/hour or C-reactive protein (CRP) ≥ 10 mg/L AND at least one of the following: - Cranial symptoms of GCA - Symptoms of polymyalgia rheumatica (PMR) AND at least one of the following: - Temporal artery biopsy revealing features of GCA - Evidence of large-vessel vasculitis by angiography or cross-sectional imaging 3. Active new-onset or relapsing active disease

Exclusion Criteria

  1. Allergies: Subjects who have history of previous severe allergic or anaphylactic reaction associated with the administration of monoclonal antibodies or antibody fragments. 2. Systemic infection: Subjects who have an active systemic infection. 3. Serious infection: Subjects who have had serious infections, or any major episode of infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of enrollment. 4. Chronic or recurrent infection: Subjects who have chronic or recurrent bacterial, viral, fungal, mycobacterial, or protozoan infection. 5. Opportunistic infection: Subjects who have, or have had, an opportunistic infection within 6 months prior to enrollment. 6. Subjects who have active hepatitis B or active hepatitis C or a documented history of HIV 7. Latent tuberculosis infection 8. Malignancy 9. Subjects with evidence of serious uncontrolled concomitant cardiovascular, nervous system, pulmonary, renal, hepatic, endocrine, immunologic, psychiatric or gastrointestinal disease that could interfere with participation in the trial according to the protocol. 10. Subjects with transplanted organs (with the exception of a corneal transplant > 3 months prior to screening) 11. Major surgery within 8 weeks prior to Screening or planned major surgery within 12 months after Baseline 12. Pregnancy 13. The following laboratory abnormalities - Hemoglobin < 8 gr/dL - Platelets < 100/mm3 - White blood cell count (WBC) < 3000/mm3 - Absolute neutrophil count < 2000/mm3 - Absolute lymphocyte count < 500/mm3 - Serum creatinine > 1.4 mg/dL in female subjects and > 1.6 mg/dL in male subjects - Total bilirubin > 2 mg/dL - Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 1.5 X upper limit of normal - Positive hepatitis B surface antigen, hepatitis B core antibody or hepatitis C antibody 14. Prohibited medications: - Subjects who received methotrexate (MTX) > 30 mg weekly, azathioprine, mycophenolate mofetil, cyclophosphamide, chlorambucil, tacrolimus, leflunomide, canakinumab, belimumab, abatacept, tocilizumab, secukinumab, infliximab, etanercept, adalimumab, golimumab, or certolizumab within the 3-month period prior to enrollment. - Subjects who had treatment with any anti-cluster designation antigen (CD)20 agent (e.g., rituximab) within the 9-month period prior to enrolment - Subjects who used any investigational drug within 1 month prior to enrollment or within 5 half-lives of the investigational agent, whichever is longer. - Low dose MTX: Patients on < 30 mg of MTX weekly will be eligible for enrollment after a 2-week washout interval before receiving ustekinumab - Vaccines: Subjects who received any live virus or bacterial vaccinations other than bacille Calmette-Guerin (BCG) within the 3 months before the first administration of the study agent, or are expected to receive any live virus or live bacterial vaccinations during the study, or up to 3 month after the last administration of ustekinumab are not eligible. Subjects who received BCG vaccines within the 12 months before the first administration of the study agent, or are expected to receive BCG vaccines during the study, or up to 12 month after the last administration of ustekinumab are also not eligible.

Study Design

Phase
Phase 1/Phase 2
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Ustekinumab plus prednisone
Ustekinumab: 90 mg of ustekinumab will be administered subcutaneously at baseline, week 4, week 12, week 20, week 28, week 36 and week 44. Prednisone: All patients will receive a prednisone course tapered according to predefined schedules starting at either 60 mg, 40 mg or 20 mg. The initial dose of prednisone will be chosen by the investigators according to disease severity and comorbid medical conditions. The duration of the prednisone taper will be 6 months in all cases.
  • Drug: Ustekinumab
    Ustekinumab is a humanized monoclonal antibody that targets the p40 subunit of IL-12 and IL-23 and inhibits cytokine - cytokine receptor coupling and signaling
    Other names:
    • Stelara
  • Drug: Prednisone
    Prednisone is an anti-inflammatory medication

More Details

Status
Terminated
Sponsor
Massachusetts General Hospital

Study Contact

Detailed Description

The objective of this study is to evaluate the efficacy and safety of ustekinumab, an interleukin (IL)-12/23 inhibitor, in patients with GCA Hypothesis IL-12/23 pathway blockade may maintain disease remission in patients with GCA Specific Aims - To evaluate the safety and tolerability of ustekinumab administration in 20 patients with GCA - To evaluate the efficacy of ustekinumab for remission maintenance and glucocorticoid sparing in 20 patients with GCA

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.