Vasculitis Clinical Trial
Official title:
A Randomised Clinical Trial of Mycophenolate Mofetil Versus Cyclophosphamide for Remission Induction in ANCA Associated Vasculitis.
The purpose of this study is to investigate whether mycophenolate mofetil is effective as treatment for new cases of ANCA associated vasculitis.
There is a clear need for improved therapy in ANCA associated vasculitis where current
treatments are toxic and contribute to poor outcomes. Conventional therapy combines
cyclophosphamide with prednisolone but is associated with severe adverse events in 35%,
early mortality, malignancy and infertility. Mycophenolate mofetil (MMF) is a newer
immunosuppressive drug which has superior efficacy to azathioprine in solid organ
transplantation. MMF is an effective alternative to cyclophosphamide in lupus nephritis.
Open label studies and retrospective surveys point to the efficacy and low toxicity of MMF
in vasculitis.
We hypothesise that MMF not be less effective than cyclophosphamide for remission induction
in AASV. 140 new patients will be randomised to MMF 3g/day or a European consensus
intravenous cyclophosphamide regimen, with the same prednisolone dosing. Following a six
month induction course all patients will receive consensus remission maintenance treatment
with azathioprine and prednisolone. The primary end-point will be remission rate by six
months, secondary end-points include relapse rate at 18 months and safety. The trial will be
conducted in 10 countries by members of the European Vasculitis Study Group (EUVAS). The
trial duration will be 42 months (24 months recruitment, 18 months follow up).
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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