Neihulizumab (AbGn-168H) for Graft vs Host Disease
This study is evaluating whether a drug may help treat a type of graft-versus-host disease.
See full descriptionAbout the trial for Graft vs Host Disease
Treatment Groups
This trial involves 2 different treatments. Neihulizumab (AbGn-168H) is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are in Phase 1 and are in the first stage of evaluation with people.
Eligibility
This trial is for patients born any sex of any age. There are 6 eligibility criteria to participate in this trial as listed below.
Approximate Timelines
Measurement Requirements
This trial is evaluating whether Neihulizumab (AbGn-168H) will improve 7 primary outcomes and 8 secondary outcomes in patients with Graft vs Host Disease. Measurement will happen over the course of Day 28.
Patient Q & A Section
What are common treatments for graft vs host disease?
The recommended treatments for GVHD include: prophylactic treatment with corticosteroids, antilymphocyte globulin, cyclosporine, tacrolimus (FK506, Prograf), azathioprine, MMF, and mycophenolate mofetil. All of these medications have been shown to provide remission to a majority of patients with GVHD.
What is graft vs host disease?
Graft vs host disease occurs when an allogeneic bone marrow transplant fails to confer protective effect against the recipient's immune attack; it results in various clinical manifestations of the disease, including life-threatening complications (secondary) which require specific treatment. The most important signs are skin lesions and oral and gastrointestinal dysfunction. The immunological mechanism involved with GvHD and the cellular elements of the immune machinery responsible for its development have to be further elucidated. Currently the focus of clinicians' attention has to be on alloreactivity and on the regulation of an adaptive immune response in order to be able to prevent or delay allograft rejection.
How many people get graft vs host disease a year in the United States?
Around 10 million people will develop it. Many people become disoriented, lose weight, have difficulty in school, and may end up not seeing a doctor until it has got serious.
Can graft vs host disease be cured?
With a relatively poor prognosis after allogeneic stem cell transplantation (ASCT), the use of T cells to prevent graft vs host disease should be considered in carefully selected cases.
What are the signs of graft vs host disease?
Chronic illness of the gut and/or liver and a positive CBC and/or CRP may indicate a manifestation of GVHD. CXR alone or in combination with CT scans can assist in deciding what treatment to employ.
What causes graft vs host disease?
Graft-vs-host disease (GvHD) is the result of the transplantation of T-lymphocytes from a genetically-similar or identical donor into a genetically-distinct host. GvHD is the third most common cause of transplant rejection after the transplantation of T-lymphocytes and the rejection of allograft bone marrow. A more aggressive treatment regimen reduces the overall incidence and severity of GvHD. The incidence of GvHD depends on the age of the recipient, the type of allograft transplanted, the conditioning regimen used preceding transplantation, the overall health of the recipient following the transplantation, and the genetic diversity of the organ donor and recipient.
Who should consider clinical trials for graft vs host disease?
GVHD is a serious disease with devastating effects on quality of life. There are no reliable clinical markers for its development and treatment depends on symptoms, severity of disease and overall health status. In many patients with the disorder systemic treatment is indicated, particularly corticosteroids, cyclosporin and mycophenolate mofetil. However, only few patients require these agents. We consider the presence of positive progesterone markers or in women also of male origin to be predictive of the development of GVHD. We therefore strongly encourage clinical trials that involve GVHD.
Does graft vs host disease run in families?
The GvHD phenotype run in family. The clinical features in this large multiethnic study are consistent with those previously reported. The GvHD phenotype appears to be similar to other forms of AIE presenting in similar ways at different ages and in diverse geographic geographical loci and may represent a novel class of autoinflammatory diseases.
Is neihulizumab (abgn-168h) typically used in combination with any other treatments?
Neihulizumab can be used in combination with radiation therapy to treat metastatic or locally advanced non-[small cell lung cancer](https://www.withpower.com/clinical-trials/small-cell-lung-cancer) as well as pancreatic cancer. Neihulizumab can also be used together with chemotherapy to treat non- small cell lung cancer. Neihulizumab plus chemotherapy can also be effective in treating renal cell carcinoma. Neihulizumab plus chemotherapy is less frequently used to treat small cell lung carcinoma.
How serious can graft vs host disease be?
In solid organ transplantation the condition of the patient and the type of donor are of great importance. However, because one-fourth of all patients who receive bone marrow transplants develop GvHD, the seriousness of this disease can vary from mild to severe and has even caused death. GvHD can be divided into four grades of severity: 0 to I. Considering the severity, grade II (mild) GvHD is usually manageable and, in the majority of cases, the patient can be treated and go on living life normally. In grade III (moderate) GvHD is the most troublesome. In these patients there are often many chronic diseases.
What are the common side effects of neihulizumab (abgn-168h)?
In this multicenter, prospective study, the main observed side effects of abgn-168h were headache, nausea, diarrhea, and vomiting. There was a greater incidence of headache and nausea compared with placebo and abgn-168h, which showed promising efficacy and tolerability. Diarrhea was common in all patients regardless of treatment and was most prevalent in healthy adult male patients receiving abgn-168h at the higher dose. Data from a recent study was not designed to exclude the possibility of a drug-drug interaction in patients receiving abgn-168h with a concomitant treatment with oral contraceptives or other medications with the potential to prolong intestinal transit time.
What is the average age someone gets graft vs host disease?
G-GVHD has a mean age of onset at 10.6 years old. It occurs predominantly in adult males with an HLA-B13:Ile()150 homozygous genotype that is associated with an increased risk of GVHD. The pathophysiological underlying factors for this predisposition are not clear. It is evident that there is considerable variation in age of patients with GVHD. In the large GVHD registry of Canada we observed an overall median age of onset of 4.9 years, with a range of 6 months and 16 years of age. In the current clinical setting, the age of GVHD patients is reported to be around 10–12 years.