Immunoglobulin G

Clinical trials are investigating Immunoglobulin G in serious infections and acute leukemia. These studies look at whether treatment can improve survival and other outcomes in patients with peritonitis, septic shock, or leukemia-related infection risk.

Table of contents

Overview of the clinical research

The available studies of Immunoglobulin G are focused on very serious illnesses, mainly severe abdominal infection, septic shock, and infection risk in acute myeloid leukemia. In these trials, researchers are testing whether the treatment may improve survival or reduce organ damage in selected patient groups.[1][2][3]

All three trials are interventional, which means the research team gives a treatment and then measures the results. The studies are in Phase 2 or Phase 3, so they are focused on checking benefit in patients and comparing approaches in larger groups.[1][2][3]

Peritonitis and sepsis after source control

NCT03334006 is a Phase 2 study in patients with secondary or quaternary peritonitis and sepsis. The trial is described as a prospective, randomized study of personalized medicine with Pentaglobin after interventional infectious source control in peritonitis patients.[1]

The main endpoint is the change in multiple organ failure (MOF) score from the start of treatment to day 7 after source control. This score looks at how the lungs, heart, kidneys, liver, and blood are working, so the study is checking whether the treatment may help prevent worsening organ failure.[1]

The study plans to enroll 200 patients and is listed as Authorised.[1]

Acute leukemia and transplant-related infection risk

The trial 2024-518940-19-02, called PENTALLO, is a Phase 2 study in Acute Myeloid Leukemia (AML). It focuses on neutropenic febrile patients with acute leukemia or allogeneic hematopoietic stem cell transplantation (HSCT) patients who are colonized by carbapenem-resistant Enterobacteriaceae (CRE) or Pseudomonas aeruginosa (PA).[2]

The study brief says the goal is to test whether early addition of Pentaglobin to the best available antimicrobial therapy can reduce mortality and improve survival in these high-risk patients. The trial has two co-primary endpoints: a 50% reduction in 30-day mortality for patients who develop a pre-engraftment bloodstream infection caused by CRE or PA, and a 20% increase in overall survival at 4 months compared with historical controls.[2]

This trial plans to enroll 120 participants and is also listed as Authorised.[2]

Septic shock and personalized dosing

The third study, 2024-518096-57-00, is a multicenter, randomized, single-blinded, two-arm, adaptive Phase 3 trial in patients with septic shock. It is testing adjunctive IgM-enriched immunoglobulin therapy with a personalized dose based on serum IgM titers versus a standard dose.[3]

The primary endpoint is all-cause mortality at day 28. In simple terms, the researchers want to know whether fewer patients die within 28 days when the personalized approach is used.[3]

The study plans to enroll 356 patients and is listed as Authorised.[3]

Main endpoints and what they mean

Across these studies, the main endpoints are focused on outcomes that matter to patients: survival, organ function, and recovery after severe infection. The peritonitis study measures MOF score, the leukemia study measures short-term death and longer-term survival, and the septic shock study measures death at 28 days.[1][2][3]

  • MOF score: a way to track whether several organs are failing or improving. In the peritonitis study, it is checked from baseline to day 7 after source control.[1]
  • 30-day mortality: the number of patients who die within 30 days. In the leukemia study, this is used for patients with bloodstream infection caused by CRE or PA.[2]
  • Overall survival: how long patients stay alive after treatment begins. The leukemia study checks survival at 4 months from the start of intensive treatment.[2]
  • All-cause mortality at day 28: death from any cause within 28 days. This is the main measure in the septic shock study.[3]

Who the studies are designed for

These trials are not for the general population. They are designed for patients with very serious conditions: people with peritonitis after infection source control, people with septic shock, and people with acute leukemia or transplant-related infection risk.[1][2][3]

The leukemia study gives a clearer example of a selected high-risk group: patients with neutropenic fever, patients colonized by CRE or PA, and patients undergoing allogeneic HSCT. This shows that the trial is aiming at patients whose immune system is already very weak and who may be more likely to develop severe infections.[2]

Trial designs, phases, and status

All three studies are interventional, meaning the researchers actively assign the treatment being tested. Two studies are in Phase 2, and one is in Phase 3, which suggests the research is moving from earlier testing toward larger confirmatory evaluation.[1][2][3]

The peritonitis and leukemia studies are randomized, and the septic shock study is randomized, single-blinded, and adaptive. “Randomized” means patients are assigned by chance to different treatment groups, while “single-blinded” means one side of the study does not know which treatment was given. “Adaptive” means the study design can allow planned changes based on the data collected during the trial.[1][3]

All three trials are listed as Authorised, and their planned enrollment ranges from 120 to 356 participants.[1][2][3]

Trial IDPhaseCondition studiedStatusEnrollment
NCT03334006Phase 2Secondary or quaternary peritonitis, sepsisAuthorised200
2024-518940-19-02Phase 2Acute Myeloid Leukemia (AML)Authorised120
2024-518096-57-00Phase 3Septic shockAuthorised356

Sperimentazioni cliniche in corso su Immunoglobulin G

  • Studio sull’efficacia e sicurezza della terapia con immunoglobuline arricchite di IgM in pazienti con shock settico

    In arruolamento

    1 1 1 1
    Farmaci in studio:
    Italia
  • Studio sull’uso di immunoglobuline A, G e M in pazienti con sepsi e peritonite secondaria o quaternaria

    In arruolamento

    1 1 1
    Malattie in studio:
    Farmaci in studio:
    Austria Germania
  • Studio sull’uso di Pentaglobin per la febbre neutropenica in pazienti con leucemia acuta o trapianto di cellule staminali ematopoietiche

    Arruolamento concluso

    1 1 1
    Malattie in studio:
    Farmaci in studio:
    Italia

Glossario

  • Clinical trial: A research study in people that tests whether a treatment works and is safe for a specific condition.
  • Phase 2: A study stage that looks more closely at whether a treatment helps patients and continues to check safety.
  • Phase 3: A larger study stage used to compare a treatment with standard care and confirm its benefit.
  • Interventional study: A trial where researchers give a treatment and then measure the results.
  • Sepsis: A serious body-wide response to infection that can damage organs.
  • Septic shock: A very severe form of sepsis with dangerously low blood pressure and organ risk.
  • Peritonitis: Inflammation or infection of the lining inside the abdomen.
  • Source control: Treatment to remove or control the source of infection, such as surgery or drainage.
  • Multiple organ failure (MOF) score: A score that shows how many organs are affected and how badly they are working.
  • All-cause mortality: Death from any cause during the study period.

Riferimenti

  1. https://studi-clinici.it/studio/studio-sulluso-di-immunoglobuline-a-g-e-m-in-pazienti-con-sepsi-e-peritonite-secondaria-o-quaternaria/
  2. https://clinicaltrials.gov/study/2024-518940-19-02
  3. https://clinicaltrials.gov/study/2024-518096-57-00