Rilonacept for Deficiency of the Interleukin-1 Receptor Antagonist (DIRA)

Completed · Phase 2

Conditions studied: DIRA

In brief

Background: \- Deficiency of the IL-1 receptor antagonist (DIRA) is a condition that causes repeated episodes of inflammation. People with DIRA can have rashes, fever, and joint pain. Most treatments for DIRA are intended to control the immune system to stop these inflammations. There are drugs that can treat DIRA, but they have to be given daily as injections. Researchers want to try another drug, rilonacept, as a treatment for DIRA. It needs to be given only once a week. Rilonacept will be given to individuals who are at least 3 months old and who have DIRA. Objectives: \- To test the safety and effectiveness of rilonacept for children and adults with DIRA. Eligibility: \- Individuals at least 3 months old who have DIRA. Design: * Participants will be screened with a physical exam and medical history. Blood and urine samples will be collected. Other tests to study pain and movement will be given. Imaging studies such as bone density scans and x-rays may also be taken. * Participants will have a minimum of four to five study visits over 12 months. Those who are on different anti-inflammatory drugs (such as anakinra) will stop taking them before beginning the study visits. * Participants will have rilonacept injections weekly while on this study. The dose will be adjusted as needed to help treat the DIRA symptoms. Participants will keep a diary to monitor their symptoms and any side effects. * Treatment with rilonacept will be given for 1 year. Participants will have study visits to monitor the treatment. They will provide blood samples and have other tests at these study visits.

Key facts

Study ID

NCT01801449

Run by

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

People needed

6

Starts

2013-02-12

Expected to finish

2016-04-28

Last updated by the study team

2017-10-16

Who can join

Age: 0 and older. Sex: any. Healthy volunteers: not accepted.

You may not qualify if…

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• Treatment receiving a live virus vaccine (such as the measles, mumps, and rubella vaccine) during the 3 months prior to baseline visit. No live vaccines will be allowed throughout the course of this study.
• Presence of active infections or a history of pulmonary TB infection without documented adequate therapy. Subjects with current active TB, or recent close exposure to an individual with active TB, are excluded from the study. Exceptions include patients with latent TB treated with adequate therapy for at least one month prior to the first dose of study medication, and patients with history of TB with documentation of adequate treatment.
• Positive test for, or prior history of, HIV, or Hepatitis B or C.
• History of malignancy. Subjects deemed cured of superficial malignancies such as cutaneous basal or squamous cell carcinomas, or in situ cervical cancer may be enrolled.
• Known hypersensitivity to Chinese Hamster Ovary cell-derived biological or any components of rilonacept.
• Presence of any additional rheumatic disease or significant systemic disease. For example, major chronic infectious/ inflammatory/ immunologic disease (such as inflammatory bowel disease, psoriatic arthritis, spondyloarthropathy, SLE in addition to autoinflammatory disease).
• Presence of any of the following laboratory abnormalities at enrollment visit:
• creatinine greater than 1.5xULN
• WBC less than 3.0x103/mm3
• ANC less than 800 cells/mL
• platelet count less than 150,000 mm3
• ALT or AST greater than 2.0x ULN.
• Lactating, breastfeeding or pregnant females.
• Enrollment in any other investigational treatment study or use of an investigational agent, or has not yet completed at least 4 weeks or 5 half-lives, whichever is longer, since ending another investigational device or drug trial.
• Subjects for whom there is concern about compliance with the protocol procedures.
• Presence of other severe acute or chronic medical or psychiatric condition, or significant laboratory abnormality requiring further investigation that may cause undue risk for the subject s safety, inhibit protocol participation, or interfere with interpretation of study results, and in the judgment of the Investigator would make the subject inappropriate for entry into this study.
• Subjects who have received a DMARDs (except methotrexate) and or TNFblocking agent within 4 half-lives prior to study entry.
• Men able to father a child and who are sexually active, who do not agree to use 2 form of effective birth control, including abstinence during the duration of the study an for at least 28 days following the last dose of rilonacept.
• Females of childbearing potential (woman greater than 12 or who have had at least 1 menstrual period regardless of age) who are sexually active and who do not agree to use 2 effective methods of birth control, including abstinence during the duration of the study an for at least 28 days following the last dose of rilonacept.

Where it is running

• National Institutes of Health Clinical Center, 9000 Rockville Pike — Bethesda, Maryland, United States

Full record on ClinicalTrials.gov

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