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West Nile Neuroinvasive DiseasePhase 2PARADIGMNCT00927953

Treatment of West Nile Virus With MGAWN1

A Phase 2 study testing MGAWN1 in people with West Nile Neuroinvasive Disease and West Nile Virus Infection, run by MacroGenics.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This study will test a drug called MGAWN1 for the treatment of West Nile infections. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
MGAWN1
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
13 participants
Where
No sites listed yet
Study dates
May 2009to May 2011
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Provide written informed consent
  • Be >=18 years of age at the time of enrollment
  • Have West Nile Fever defined as:
  • temperature >38°C, headache, AND
  • positive diagnostic test for WNV Ribonucleic acid or Immunoglobulin M with serum or cerebrospinal fluid (CSF)
  • OR have West Nile Neuroinvasive Disease (includes neurological signs and/or symptoms of West Nile meningitis, encephalitis, and/or acute flaccid paralysis), defined as:
Show all 33Show fewer
  • West Nile encephalitis (must meet criteria a and b below)
  • Encephalopathy (depressed or altered level of consciousness, lethargy, or personality change lasting 24 hours)
  • CSF pleocytosis >=5 cells/mm^3
  • AND/OR
  • West Nile meningitis (must meet criteria c and d)
  • Clinical signs of meningeal inflammation, including nuchal rigidity, Kernig or Brudzinski sign, photophobia, or phonophobia
  • CSF pleocytosis >=5 cells/mm^3
  • AND/OR
  • Acute flaccid paralysis (must meet criteria e and f)
  • Acute onset of limb weakness with marked progression over 48 hours
  • Two or more of the following conditions:
  • asymmetry to weakness
  • areflexia or hyporeflexia of affected limb(s)
  • absence of pain, paresthesia, or numbness in affected limb(s)
  • CSF pleocytosis >=5 cells/mm^3
  • CSF elevated protein levels (4.5 g/L)
  • electrodiagnostic studies consistent with an anterior horn cell process
  • or abnormal increased signal in the anterior gray matter as documented by spinal cord magnetic resonance imaging
  • Have epidemiological factors consistent with West Nile Virus infection (must meet criterion a or b below):
  • Appropriate time of year for West Nile Virus transmission in region
  • Travel history to a region where West Nile Virus is active
  • Develop signs and/or symptoms within 14 days before study enrollment.
  • If female of childbearing potential or male and in a sexual relationship with a female of childbearing potential, agree (or have partner agree) to practice abstinence or use 2 of the following methods of contraception for 120 days (approximately 4 months) after study drug administration:
  • Oral contraceptives, or other form of hormonal birth control including hormonal vaginal rings or transdermal patches
  • An intrauterine device
  • Barrier contraception (condom) with a spermicide (i.e., female subject ensures use by male partner[s])
  • Any other equivalent method of contraception (as judged by the investigator)

Who cannot join

None listed.

About this study

Official title: Phase 2, Stratified, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate Safety and Efficacy of MGAWN1 in Subjects With Laboratory-documented West Nile Fever or Suspected Central Nervous System Infection Due to West Nile Virus

This study will test a drug called MGAWN1 for the treatment of West Nile infections.

Read the detailed description

The objective of this study is to evaluate the safety, efficacy, and pharmacokinetics of MGAWN1 in subjects with West Nile Fever or a syndrome compatible with West Nile Neuroinvasive Disease (WNND) [encephalitis, meningitis, or acute flaccid paralysis]. Subjects can be enrolled based on a syndrome compatible with WNND, and do not need documented West Nile virus infection.

Being tested
MGAWN1, Placebo - normal saline
Keywords
West Nile virus, WNV, Encephalitis, Meningitis, Acute Flaccid Paralysis, Monoclonal Antibody, WNND, West Nile Fever, WNF
Medical subject headings
West Nile Fever, Encephalitis, Meningitis, acute flaccid myelitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MGAWN1Biological

    Humanized monoclonal to West Nile virus. Dose = 30 mg/kg actual body weight intravenous, one dose at Day 0.

  • Placebo - normal salineBiological

    Normal Saline intravenous, volume same as active comparator, one dose at Day 0

Study groups in NCT00927953
Study groupRoleWhat they receive
MGAWN1Experimental30 mg/kg single intravenous infusion of MGAWN1
Receives: Biological: MGAWN1
Placebo - Normal SalinePlacebo comparatorsingle intravenous infusion of saline placebo
Receives: Biological: Placebo - normal saline

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The Number of West Nile Neuroinvasive Disease (WNND) Participants Who Show Improvement in the Modified Rankin Scale (MRS) (>=1 Improvement in Score)

    The MRS is a 7-point disability scale that assesses the degree of disability in subjects with neurological impairment. Possible scores range from 0 (perfect health) up to 5 (severe disability). The scale is as follows:

    • 0 = No symptoms at all
    • 1 = No significant disability despite symptoms;
    • 2 = Slight disability;
    • 3 = Moderate disability;
    • 4 = Moderately severe disability;
    • 5 = Severe disability; bedridden, incontinent and requiring constant nursing care and attention;
    • 6 = Dead

    Measured: Study Day 2, 7, 14, 28, and 120

  2. The Number of Participants Who Had At Least 1 Treatment-Related Adverse Event

    Includes adverse events considered possibly, probably, or definitely related to study drug

    Measured: 120 days

Secondary outcomes (3)
  1. The Number of Participants With a Favorable Neurologic Outcome

    Favorable neurologic outcome responders are defined as subjects whose Modified Rankin Score is <=2. The MRS is a 7-point disability scale that assesses the degree of disability in subjects with neurological impairment. Possible scores range from 0 (perfect health) up to 5 (severe disability). The scale is as follows:

    • 0 = No symptoms at all
    • 1 = No significant disability despite symptoms;
    • 2 = Slight disability;
    • 3 = Moderate disability;
    • 4 = Moderately severe disability;
    • 5 = Severe disability; bedridden, incontinent and requiring constant nursing care and attention;
    • 6 = Dead.

    Measured: Study Day 2, 7, 14, 28, and 120

  2. Mean Modified Rankin Scale Scores

    The MRS is a 7-point disability scale that assesses the degree of disability in subjects with neurological impairment. Possible scores range from 0 (perfect health) up to 5 (severe disability). The scale is as follows:

    • 0 = No symptoms at all
    • 1 = No significant disability despite symptoms;
    • 2 = Slight disability;
    • 3 = Moderate disability;
    • 4 = Moderately severe disability;
    • 5 = Severe disability; bedridden, incontinent and requiring constant nursing care and attention;
    • 6 = Dead.

    Measured: Study Day 0, 2, 7, 14, 28, and 120

  3. Time to a >= 1 Point Reduction in the Modified Rankin Scale Score

    Measured: Study Day 2, 7, 14, 28, and 120

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jun 2009 (estimated)
  2. Study startMay 2009
  3. Primary completionFeb 2011
  4. Study completionMay 2011

Why it stopped: Early termination due to the inability to enroll (13 of 120 subjects enrolled)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
13 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00927953
Sponsor's protocol ID
CP-MGAWN1-02
Acronym
PARADIGM
Status last verified
Jan 2022
First submitted
24 Jun 2009
Last updated
10 Feb 2022
Data monitoring committee
Yes
Expanded access
Available

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing MGAWN1 in people with West Nile Neuroinvasive Disease and West Nile Virus Infection, run by MacroGenics.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 33 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 10 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 7 Nov 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Number of West Nile Neuroinvasive Disease (WNND) Participants Who Show Improvement in the Modified Rankin Scale (MRS) (>=1 Improvement in Score) (time frame: Study Day 2, 7, 14, 28, and 120). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Feb 2022.

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