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Immunomodulatory Agent

Leflunomide for Chronic Graft Versus Host Disease

Phase 1
Waitlist Available
Led By Amandeep Salhotra
Research Sponsored by City of Hope Medical Center
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Able to swallow pills
Participants must have steroid-dependent cGVHD. Steroid dependent cGVHD is defined as having persistent signs and symptoms of cGVHD despite the use of prednisone for 2 months without complete resolution of signs and symptoms. Both classic cGVHD and overlap syndromes will be allowed to participate
Timeline
Screening 3 weeks
Treatment Varies
Follow Up up to 48 weeks
Awards & highlights

Study Summary

This trial is studying leflunomide to see if it can help patients with cGVHD who have not responded to steroids.

Who is the study for?
This trial is for patients with chronic graft versus host disease (cGVHD) after a bone marrow transplant, who are dependent on steroids without full relief of symptoms. Participants must have stable organ function and blood counts, be able to swallow pills, and not be pregnant or breastfeeding. They should agree to use birth control and have no active infections or other serious health issues that could interfere with the study.Check my eligibility
What is being tested?
The trial is testing Leflunomide's effectiveness in treating cGVHD symptoms when steroids alone aren't enough. It aims to see if this drug can reduce the immune response causing inflammation without the complications linked to prolonged steroid use.See study design
What are the potential side effects?
Leflunomide may cause side effects such as diarrhea, liver enzyme changes, blood pressure variations, potential harm to an unborn child (hence contraception requirement), and possibly others related to weakening of the immune system.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I can swallow pills.
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I have chronic GVHD that hasn't improved with 2 months of prednisone treatment.
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I have received a stem cell transplant from another person.
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My white blood cell count is healthy without needing medication in the past week.
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I am able to care for myself but may not be able to do active work.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~up to 48 weeks
This trial's timeline: 3 weeks for screening, Varies for treatment, and up to 48 weeks for reporting.

Treatment Details

Study Objectives

Outcome measures can provide a clearer picture of what you can expect from a treatment.
Primary outcome measures
Dose limiting toxicity
Secondary outcome measures
Changes in cGVHD severity
Changes in steroid doses while on therapy
Changes in symptom activity
+4 more
Other outcome measures
Effect of leflunomide consumption of the presence and levels of GVHD inflammatory biomarkers
Pharmacokinetics concentration of teriflunomide in patients with chronic GVHD
Presence and levels of immune cells (i.e., T and B cells, regulatory T cells [T regs], T cell receptor excision circles [TRECs]) after leflunomide consumption

Side effects data

From 2015 Phase 4 trial • 400 Patients • NCT01172639
33%
Upper respiratory tract infection
26%
Abdominal pain
23%
Nausea
19%
Gastroenteritis
16%
Hairloss
14%
Liver function disturbance
12%
Tendinopathy
12%
Arthralgia
9%
Vertigo
9%
Hypertension
9%
Eczema
7%
Increased transpiration
7%
Arthrosis
7%
Back pain
7%
Agitation
7%
Tooth extraction
7%
Paresthesia
7%
Pruritus
5%
Anaemia
5%
Venous insufficiency
5%
Palpitations
5%
Sjogren's disease
5%
Muscle cramps
5%
Influenza infection
5%
Fatigue
5%
Headache
5%
Bronchitis
5%
General malaise
5%
Arthritis
5%
Flushes
2%
Intervertebral disc disorder
2%
Pyrosis
2%
Endometrioid adenocarcinoma
2%
Rotator cuff lesion
2%
Bladder infection
2%
Eye infection
2%
Insomnia
2%
Diarrhoea
2%
Angina
2%
Kidney cancer malignant
2%
Pneumonia
2%
Cough
2%
Genital infection
100%
80%
60%
40%
20%
0%
Study treatment Arm
CoBRA Slim Low Risk Group
Tight Step Up Low Risk Group
CoBRA Classic High Risk Group
CoBRA Slim High Risk Group
CoBRA Avant-garde High Risk Group

Trial Design

1Treatment groups
Experimental Treatment
Group I: Treatment (leflunomide)Experimental Treatment1 Intervention
Patients receive leflunomide PO QD for days 1-28. Treatment repeats every 28 days for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients may optionally continue leflunomide for an additional 6 cycles as long as response or stable disease is maintained.
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Leflunomide
FDA approved

Find a Location

Who is running the clinical trial?

City of Hope Medical CenterLead Sponsor
565 Previous Clinical Trials
1,921,442 Total Patients Enrolled
National Cancer Institute (NCI)NIH
13,657 Previous Clinical Trials
40,933,649 Total Patients Enrolled
1 Trials studying Graft-versus-Host Disease
236 Patients Enrolled for Graft-versus-Host Disease
Amandeep SalhotraPrincipal InvestigatorCity of Hope Medical Center
3 Previous Clinical Trials
75 Total Patients Enrolled

Frequently Asked Questions

These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

How many participants are invited to join this medical examination?

"Indeed, records on clinicaltrials.gov show that this medical investigation is presently recruiting for 24 volunteers across a single hospital. The trial was first posted in May 12th 2020 and its most recent update took place September 14th 2022."

Answered by AI

Can you tell me what prior investigations have been conducted with Leflunomide?

"As of now, 15 experiments related to leflunomide are active with 2 trials in the advanced stage 3. Most research is conducted in Duarte, California; however, 22 clinical trial sites participate across the nation."

Answered by AI

Does this trial have availability for new participants?

"According to clinicaltrials.gov, this trial is currently welcoming participants and was first made public on the 12th of May 2020 with its most recent revision on September 14th 2022."

Answered by AI

How secure is the utilization of leflunomide for therapeutic purposes?

"As this is an early stage trial with limited evidence for safety and efficacy, leflunomide was rated a 1 on our scale at Power."

Answered by AI
~1 spots leftby Aug 2024