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Trial registered on ANZCTR
Registration number
ACTRN12618000922279
Ethics application status
Approved
Date submitted
17/03/2018
Date registered
31/05/2018
Date last updated
31/05/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Tocilizumab for the treatment of retroperitoneal fibrosis
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Scientific title
Tocilizumab treatment for induction of remission in patients with idiopathic retroperitoneal fibrosis (TOCIRET)
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Secondary ID [1]
294373
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EUDRACT No. 2017-001429-41
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Universal Trial Number (UTN)
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Trial acronym
TOCIRET
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
retroperitoneal fibrosis
307106
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Condition category
Condition code
Inflammatory and Immune System
306214
306214
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0
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Autoimmune diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment with the monoclonal antibody Tocilizumab, given intravenously at a dose of 8 mk/kg every month for 6 consecutive months. This therapeutic regimen will apply to all enrolled patients. The drug will be administered in a hospital setting (day hospital), which will allow evaluation of patient's adherence.
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Intervention code [1]
300677
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
305230
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Remission is a composite endpoint, defined as absence of disease-related symptoms and hydronephrosis, in the presence of normal acute-phase reactants, and a prednisone dose max 5 mg/day.
This outcome will be assessed on the basis of: i) patient-reported symptoms; 2)measurement of acute-phase reactants (Erythrocyte sedimentation rate and C-reactive protein level); 3)imaging evaluation of hydronephrosis, assessed by ultrasound, computed tomography or magnetic resonance.
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Assessment method [1]
305230
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Timepoint [1]
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6 months (end of treatment)
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Secondary outcome [1]
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Percentage of patients in remission. This will be assessed on the basis of patient reported symptoms and medical records reporting the results of laboratory tests (Erythrocyte sedimentation rate and C reactive protein) and imaging studies (ultrasound of the kidney and urinary tract, abdominal computed tomography or magnetic resonance)
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Assessment method [1]
344543
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Timepoint [1]
344543
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Month 12 (6 months after the end of treatment)
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Secondary outcome [2]
344544
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Change in retroperitoneal fibrosis thickness (assessed by CT or MRI)
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Assessment method [2]
344544
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Timepoint [2]
344544
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Months 6 and 12 after the start of treatment
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Secondary outcome [3]
347507
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Change in FDG uptake (assessed by PET) versus baseline
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Assessment method [3]
347507
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Timepoint [3]
347507
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Months 6 and 12 after the start of treatment
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Secondary outcome [4]
347528
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Treatment-related toxicity (frequency, type and severity of adverse events)
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Assessment method [4]
347528
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Timepoint [4]
347528
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This will be monitored monthly during treatment (months 1,2,3,4,5,6 after the start of treatment) and bi-monthly during the post-treatment follow-up (months 8, 10, 12 after the start of treatment)
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Eligibility
Key inclusion criteria
- Clinically active idiopathic retroperitoneal fibrosis
- Absence of potential causes of retroperitoneal fibrosis
- Written informed consent
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Minimum age
18
Years
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Maximum age
80
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
- Secondary forms of retroperitoneal fibrosis (infectious, neoplastic, post-radiation therapy, drug-related)
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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)
Not applicable
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not applicable
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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
None
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Data will be presented as median (range) or mean (SD), where appropriate.
Survival will be analyzed using the Kaplan-Meier method
Paired t-tests or the corresponding non-parametric tests will be used to analyze changes in measurable parameters such as mass thickness, FDG uptake, ESR or CRP levels. P values <0.05 will be considered statistically significant.
All patients will be analyzed following an intention-to-treat analysis provided that they received at least 2 months of therapy
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
10/07/2018
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
18
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
10226
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Italy
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State/province [1]
10226
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Parma, Firenze, Reggio Emilia
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Funding & Sponsors
Funding source category [1]
299014
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Commercial sector/Industry
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Name [1]
299014
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Roche
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Address [1]
299014
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Viale Gian Battista Stucchi, 110, 20900 Monza
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Country [1]
299014
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Italy
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Primary sponsor type
Hospital
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Name
Azienda Ospedaliero Universitaria di Parma
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Address
Via Gramsci 14, 43126 Parma
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Country
Italy
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Secondary sponsor category [1]
298240
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None
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Name [1]
298240
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None
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Address [1]
298240
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None
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Country [1]
298240
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299952
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Comitato Etico per Parma
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Ethics committee address [1]
299952
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Via Gramsci 14, 43126 Parma
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Ethics committee country [1]
299952
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Italy
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Date submitted for ethics approval [1]
299952
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18/12/2017
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Approval date [1]
299952
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22/12/2017
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Ethics approval number [1]
299952
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Protocol number 46706
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Summary
Brief summary
In this prospective, open-label trial we will analyse the efficacy and safety of TCZ in a series of 18 patients with IRF who either experienced frequent relapses under adequate immunosuppressive therapy or had a clearly refractory disease and/or contraindications to glucocorticoid therapy. Patients will receive a monthly TCZ dose of 8 mg/kg for six months. a follow-up period of at least an additional 6 months will follow. The assessment of treatment efficacy will be evaluated as the rate of remission at months 6 and 12. Remission will be defined as absence of disease-related symptoms (abdominal or lumbar pain, testicular pain, constipation, systemic symptoms), resolution or improvement of hydronephrosis (without indwelling stents), near-normalization (i.e. normalization or reduction to <30% of basal values) of erythrocyte sedimentation rate and C-reactive protein levels, as previously described; remission will require a dose of prednisone equal to or lower than 5 mg/day. Secondary outcomes will include the assessment of the percentage of reduction in IRF thickness at CT or MRI scans and the reduction of FDG uptake (measured as SUVmax) at PET-CT. Patients will be evaluated monthly during the treatment course and every 3 months after remission. Adverse events will be assessed at each scheduled visit by physical examination and routine exams. Eventual adverse events will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.
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Trial website
None
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Trial related presentations / publications
None
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Public notes
None
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Contacts
Principal investigator
Name
82062
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Dr Augusto Vaglio
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Address
82062
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Azienda Ospedaliero-Universitaria di Parma,
Nephrology Unit,
Via Gramsci 14
43126 Parma
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Country
82062
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Italy
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Phone
82062
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+39 0521 702013
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Fax
82062
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+39 0521 704701
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Email
82062
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[email protected]
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Contact person for public queries
Name
82063
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Augusto Vaglio
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Address
82063
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Azienda Ospedaliero-Universitaria di Parma,
Nephrology Unit,
Via Gramsci 14
43126 Parma
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Country
82063
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Italy
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Phone
82063
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+39 0521 702013
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Fax
82063
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+39 0521 704701
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Email
82063
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[email protected]
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Contact person for scientific queries
Name
82064
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Augusto Vaglio
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Address
82064
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Azienda Ospedaliero-Universitaria di Parma,
Nephrology Unit,
Via Gramsci 14
43126 Parma
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Country
82064
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Italy
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Phone
82064
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+39 0521 702013
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Fax
82064
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+39 0521 704701
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Email
82064
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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
No additional documents have been identified.
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