The recognized manifestations of HHT are all due to abnormalities in vascular structure. Epistaxis are spontaneous, very variable, may occur as often as several times every day, and are recurrent in 90% of patients and associated with chronic and severe anemia in 2-10%. They also significantly reduce quality of life.
Blood transfusions are sometimes required in 10-30% of patients. Previous studies showed that antiangiogenic treatments such as anti-VEGF treatment (bevacizumab) administered intravenously was efficient on epistaxis and dramatically reduced nosebleeds.
Tyrosine kinase inhibitors are anti-angiogenic molecules which are available orally and could therefore overcome the difficulties encountered with bevacizumab. The investigator hypothesized that nintedanib, acting by indirect inhibition of the VEGF receptor should allow a reduction of epistaxis in HHT patient.
Nintedanib has been used in one HHT patient following the diagnosis of Insterstitial Pulmonary Fibrosis (published case report in 2017, Kovacs et al) with encouraging results.
The aim is to evaluate efficacy of nintedanib for the treatment of epistaxis in HHT patients
Condition or disease | Intervention/treatment | Phase |
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Hemorrhagic Hereditary Telangiectasia | Drug: Nintedanib 150 mg and 100 mg soft capsules Drug: Oral treatment of placebo soft capsule | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 60 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Triple (Participant, Care Provider, Investigator) |
Primary Purpose: | Treatment |
Official Title: | Efficacy of Nintedanib Per os as a Treatment for Epistaxis in HHT Disease. A National, Randomized, Multicentre Phase II Study |
Actual Study Start Date : | June 22, 2020 |
Estimated Primary Completion Date : | December 2022 |
Estimated Study Completion Date : | December 2022 |
Arm | Intervention/treatment |
---|---|
Experimental: Nintedanib
Oral treatment of Nintedanib 150 mg soft capsule
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Drug: Nintedanib 150 mg and 100 mg soft capsules
Nintedanib 150 mg soft capsules twice daily approximately 12 hours apart (i.e. 300 mg/day) for 12 weeks. In case of adverse reaction a dose reduction at 200 mg/day (100 mg twice daily) can be prescribe.
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Placebo Comparator: Placebo
Oral treatment of placebo soft capsule
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Drug: Oral treatment of placebo soft capsule
Placebo soft capsules (identical to 150 mg and 100 mg soft capsules)
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Sophie DUPUIS-GIROD, MD | 4 27 85 65 25 ext +33 | sophie.dupuis-girod@chu-lyon.fr |
France | |
CHU d'Angers | Not yet recruiting |
Angers, France | |
Contact: C LAVIGNE chlavigne@chu-angers.fr | |
Principal Investigator: C LAVIGNE | |
Hôpital Ambroise Paré | Not yet recruiting |
Boulogne Billancourt, France | |
Contact: Thierry CHINET thierry.chinet@aphp.fr | |
Principal Investigator: Thierry CHINET | |
Hôpital Femme-Mère-Enfant-Centre de Référence pour la maladie de Rendu-Osler | Recruiting |
Bron, France | |
Contact: Sophie DUPUIS-GIROD sophie.dupuis-girod@chu-lyon.fr | |
CHU Clermont Ferrand | Not yet recruiting |
Clermont-Ferrand, France | |
Contact: Vincent GROBOST vincent.grobost@gmail.com | |
Principal Investigator: Vincent GROBOST | |
Hôpital Jeanne de Flandre | Not yet recruiting |
Lille, France | |
Contact: Hélène MAILLARD helene.maillard@chru-lille.fr | |
Principal Investigator: Hélène MAILLARD | |
CHU de Marseille-Hôpital la conception | Recruiting |
Marseille, France | |
Contact: Julie SEGUIER julie.seguier@ap-hm.de | |
Principal Investigator: Julie SEGUIER | |
CHU de Montpellier-Hôpital St Eloi | Not yet recruiting |
Montpellier, France | |
Contact: Sophie RIVIERE s-riviere@chu-montpellier.fr | |
Principal Investigator: Sophie RIVIERE | |
Hôpital Tenon | Recruiting |
Paris, France | |
Contact: Antoine PARROT antoine-parrot@tnn.aphp.fr | |
Principal Investigator: Antoine PARROT | |
CHRU - Hôpital J.Bernard | Not yet recruiting |
Poitiers, France | |
Contact: Brigitte GILBERT-DUSSARDIER brigitte.gilbert-dussardier@chu-poitiers.fr | |
Principal Investigator: Brigitte GILBERT-DUSSARDIER | |
CHU de Rennes-Hôpital Pontchaillou | Recruiting |
Rennes, France | |
Contact: Mallorie KERJOUAN mallorie.kerjouan@chu-rennes.fr | |
Principal Investigator: Mallorie KERJOUAN |
Principal Investigator: | Sophie DUPUIS-GIROD | Hospices Civils de Lyon |
Tracking Information | |||||
---|---|---|---|---|---|
First Submitted Date ICMJE | May 15, 2019 | ||||
First Posted Date ICMJE | May 17, 2019 | ||||
Last Update Posted Date | January 7, 2021 | ||||
Actual Study Start Date ICMJE | June 22, 2020 | ||||
Estimated Primary Completion Date | December 2022 (Final data collection date for primary outcome measure) | ||||
Current Primary Outcome Measures ICMJE |
Epistaxis duration assessed on epistaxis grids completed by the patients. [ Time Frame: 12 weeks ] | ||||
Original Primary Outcome Measures ICMJE | Same as current | ||||
Change History | |||||
Current Secondary Outcome Measures ICMJE |
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Original Secondary Outcome Measures ICMJE |
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Current Other Pre-specified Outcome Measures | Not Provided | ||||
Original Other Pre-specified Outcome Measures | Not Provided | ||||
Descriptive Information | |||||
Brief Title ICMJE | Efficacy of Nintedanib Per os as a Treatment for Epistaxis in HHT Disease. | ||||
Official Title ICMJE | Efficacy of Nintedanib Per os as a Treatment for Epistaxis in HHT Disease. A National, Randomized, Multicentre Phase II Study | ||||
Brief Summary |
The recognized manifestations of HHT are all due to abnormalities in vascular structure. Epistaxis are spontaneous, very variable, may occur as often as several times every day, and are recurrent in 90% of patients and associated with chronic and severe anemia in 2-10%. They also significantly reduce quality of life. Blood transfusions are sometimes required in 10-30% of patients. Previous studies showed that antiangiogenic treatments such as anti-VEGF treatment (bevacizumab) administered intravenously was efficient on epistaxis and dramatically reduced nosebleeds. Tyrosine kinase inhibitors are anti-angiogenic molecules which are available orally and could therefore overcome the difficulties encountered with bevacizumab. The investigator hypothesized that nintedanib, acting by indirect inhibition of the VEGF receptor should allow a reduction of epistaxis in HHT patient. Nintedanib has been used in one HHT patient following the diagnosis of Insterstitial Pulmonary Fibrosis (published case report in 2017, Kovacs et al) with encouraging results. The aim is to evaluate efficacy of nintedanib for the treatment of epistaxis in HHT patients |
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Detailed Description | Not Provided | ||||
Study Type ICMJE | Interventional | ||||
Study Phase ICMJE | Phase 2 | ||||
Study Design ICMJE | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Triple (Participant, Care Provider, Investigator) Primary Purpose: Treatment |
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Condition ICMJE | Hemorrhagic Hereditary Telangiectasia | ||||
Intervention ICMJE |
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Study Arms ICMJE |
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Publications * | Not Provided | ||||
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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Recruitment Information | |||||
Recruitment Status ICMJE | Recruiting | ||||
Estimated Enrollment ICMJE |
60 | ||||
Original Estimated Enrollment ICMJE | Same as current | ||||
Estimated Study Completion Date ICMJE | December 2022 | ||||
Estimated Primary Completion Date | December 2022 (Final data collection date for primary outcome measure) | ||||
Eligibility Criteria ICMJE |
Inclusion Criteria:
Exclusion Criteria:
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Sex/Gender ICMJE |
|
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Ages ICMJE | 18 Years and older (Adult, Older Adult) | ||||
Accepts Healthy Volunteers ICMJE | No | ||||
Contacts ICMJE |
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Listed Location Countries ICMJE | France | ||||
Removed Location Countries | |||||
Administrative Information | |||||
NCT Number ICMJE | NCT03954782 | ||||
Other Study ID Numbers ICMJE | 69HCL19_0003 2019-002593-31 ( EudraCT Number ) |
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Has Data Monitoring Committee | Yes | ||||
U.S. FDA-regulated Product |
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IPD Sharing Statement ICMJE |
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Responsible Party | Hospices Civils de Lyon | ||||
Study Sponsor ICMJE | Hospices Civils de Lyon | ||||
Collaborators ICMJE | Not Provided | ||||
Investigators ICMJE |
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PRS Account | Hospices Civils de Lyon | ||||
Verification Date | January 2021 | ||||
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |