Abatacept for the Treatment of Common Variable Immunodeficiency With Interstitial Lung Disease

Overview

About this study

The purpose of this study is to determine the efficacy of abatacept compared to placebo for treatment of subjects with GLILD in the context of CVID.

There is no standard of care therapy for patients with granulomatous-lymphocytic interstitial lung disease (GLILD) seen in common variable immunodeficiency (CVID). Abatacept has recently looked promising for the treatment of patients with complex CVID.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Diagnosis of CVID according to the international consensus document (ICON):
    • Age 4 years or above;
    • Serum IgG at least 2 standard deviations below the age adjusted normal;
    • Decreased serum IgA and/or serum IgM;
    • Abnormal specific antibody response to immunization;
    • Exclusion of secondary immunodeficiency.
  • On replacement immunoglobulin for at least 6 months and willing to maintain throughout study.
  • Granulomatous-lymphocytic interstitial lung disease with a lymphocytic component diagnosed by lung biopsy prior to study entry, wedge biopsy preferred.
  • Persistence or worsening of interstitial lung disease measured on serial CT imaging of the lung at least 6 months apart, with the latest assessment within 2 months of study entry.
  • Signed written informed consent.
  • Willing to allow storage of biological specimens for future use in medical research.
  • Females of childbearing potential must use a highly effective form of birth control such as hormone-based contraceptive, intrauterine device, or double barrier method.

Exclusion Criteria:

  • History of hypersensitivity to abatacept or any of its components.
  • Has received any lymphocyte depleting agents including anti-CD20 monoclonal antibodies, alemtuzumab, ATG in the preceding 6 months.
  • Has received abatacept, cyclophosphamide, tumor necrosis factor inhibitors, or pulse steroids (defined as >15mg/kg/day of methylprednisone or corticosteroid equivalent) within the past 3 months.
  • History of HIV infection (positive PCR).
  • Chronic untreated hepatitis B or C (positive PCR).
  • Active tuberculosis (TB) by positive QuantiFERON gold. If history of latent TB, then must supply evidence of completing treatment.
  • Persistent Epstein-Barr Virus (EBV) load ≥ 1,000 units/mL blood checked twice at least 1 month apart.
  • Other uncontrolled infections.
  • Live vaccine given within 6 weeks of the start of the trial.
  • Malignancy or treated for malignancy within the past year.
  • Currently pregnant or breast feeding.
  • Life expectancy less than 1 month.
  • Subjects unwilling to self-administer or have a parent/caregiver self-administer subcutaneous injections at home.
  • Other conditions that the investigators feel contraindicate participation in the study.

Eligibility last updated 12/22/21. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Avni Joshi, M.D., M.S.

Open for enrollment

Contact information:

Dahir Sharif

(507) 255-1574

Sharif.Dahir@mayo.edu

More information

Publications

Publications are currently not available
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CLS-20542687

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