Status:

TERMINATED

Complement Regulation to Undo Systemic Harm in Preeclampsia

Lead Sponsor:

Cedars-Sinai Medical Center

Collaborating Sponsors:

Alexion Pharmaceuticals, Inc.

Conditions:

Preeclampsia

Severe Preeclampsia

Eligibility:

FEMALE

13+ years

Phase:

PHASE2

Brief Summary

This is a Phase II, single arm, open-label study to determine if treatment with eculizumab prolongs pregnancy compared to historical controls in women with preeclampsia between 23-30 weeks gestation.

Detailed Description

The purpose of this study is to determine if eculizumab is an effective treatment to prolong pregnancy in women with preeclampsia, compared to a historical control group of women that received standar...

Eligibility Criteria

Inclusion

  • Inclusion criteria:
  • Provision of signed and dated informed consent form
  • Stated willingness to comply with all study procedures \& availability for study duration
  • Biologically female, aged ≥13, body weight ≥40kg
  • Diagnosed with preeclampsia between 23-29+6/7 weeks gestation, by following criteria:
  • Blood pressure ≥160 mmHg systolic or ≥110 mmHg diastolic OR
  • Blood pressure ≥140 mmHg systolic or ≥90 mmHg diastolic and at least one of the following
  • i. Proteinuria (spot protein/creatinine ≥0.3mg/mg or 24Hr protein ≥300 mg) ii. Platelet count \<100,000/μl iii. Aspartate or alanine transaminase \>2x upper limit of normal iv. Creatinine \>1.1 mg/dl or oliguria v. Pulmonary edema
  • Ability to take intravenous medication and be willing to adhere to the eculizumab regimen
  • Ability to receive meningococcal vaccine and be willing to adhere to antibiotic regimen
  • Exclusion Criteria:
  • An individual who meets any of the following criteria prior to enrollment will be excluded from participation in this study:
  • Known allergic reactions eculizumab or meningococcal vaccine
  • Febrile illness within prior 2 weeks
  • Treatment with another investigational drug within previous 6 months
  • Inpatient expectant management for preeclampsia \>72 hours prior to enrollment
  • Fetal contraindication to expectant management of pregnancy
  • Platelet count \<50,000/μl
  • Diagnosis of hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome
  • Must meet all of the following criteria to be excluded: LDH \>600 U/L, platelet count \< 100,000/μl, AST \>2x upper limit of normal, ALT \>2x upper limit of normal
  • Diagnosis of Eclampsia
  • Diagnosis of Placental abruption
  • Intrauterine fetal demise
  • Coagulopathy (INR ≥ 1.5)
  • Fibrinogen \<200 mg/dl
  • Persistent, severe headache unresponsive to medications
  • Persistent, severe visual disturbances
  • Persistent, severe epigastric or RUQ pain unresponsive to medications
  • Diagnosis of Systemic lupus erythematosus
  • Diagnosis of Anti-phospholipid antibody syndrome
  • Diagnosis of Atypical hemolytic uremic syndrome
  • Diagnosis of Paroxysmal nocturnal hemoglobinuria
  • Known complement deficiency
  • Diagnosis of Venous thromboembolism active or within 6 months of enrollment
  • Diagnosis of Human immunodeficiency virus (HIV)
  • Diagnosis of Hepatitis C virus (active viremia)
  • Diagnosis of Cancer (not in remission)
  • History of Solid organ transplant
  • Systemic viral or bacterial infection (active, untreated)
  • Active use of eculizumab at time of enrollment
  • Contraindication to eculizumab treatment or complement system blockade
  • Contraindication to meningococcal vaccine
  • Body weight \<40kg
  • Age \<13
  • Neutropenia (\<1500/mm3)
  • Gonorrhea, chlamydia, or syphilis in current pregnancy
  • Illicit substance use in current pregnancy
  • Currently homeless or incarcerated
  • Alcoholism
  • Liver cirrhosis
  • Insulin dependent diabetes
  • Active use of immunosuppressive therapies, other than use of corticosteroids for fetal lung maturity
  • Use of prophylactic or therapeutic heparin, or low molecular weight heparin, in pregnancy for hypercoagulable condition

Exclusion

    Key Trial Info

    Start Date :

    September 13 2021

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    December 7 2021

    Estimated Enrollment :

    2 Patients enrolled

    Trial Details

    Trial ID

    NCT04725812

    Start Date

    September 13 2021

    End Date

    December 7 2021

    Last Update

    November 29 2023

    Active Locations (1)

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    Cedars-Sinai Medical Center

    Los Angeles, California, United States, 90048