Phase 2
N=66
Efficacy of Methylprednisolone for Hantavirus Cardiopulmonary Syndrome
Hantavirus Infections
Bottom Line
View on ClinicalTrials.gov: NCT00128180 ↗Enrolled (actual)
66
Serious AEs
59.1%
Results posted
Jul 2012
Primary outcome: Primary: The Proportion of Subjects Who Develop Death, PaO2/FiO2 Ratio Less Than or Equal to 55, Cardiac Index Less Than or Equal to 2.2, Pulseless Electrical Activity, Ventricular Tachycardia or Fibrillation — 0.27; 0.47 proportion of paticipants — p=0.18
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Methylprednisolone (Drug); Placebo (Drug)
- Age
- Pediatric, Adult, Older Adult · 2+ yrs
- Sex
- All
- Sponsor
- University of New Mexico
- Primary completion
- Dec 2010
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY The Proportion of Subjects Who Develop Death, PaO2/FiO2 Ratio Less Than or Equal to 55, Cardiac Index Less Than or Equal to 2.2, Pulseless Electrical Activity, Ventricular Tachycardia or Fibrillation |
0.27; 0.47 | 0.18 |
| PRIMARY Number of Participants With SAEs |
14; 25 | — |
| SECONDARY Number of Participants on Extracorporeal Membrane Oxygenation (ECMO) |
0; 0 | — |
| SECONDARY Duration of ICU Stays |
4.48; 5.83 | — |
| SECONDARY Duration of Hospital Stay in Days |
8.90; 10.67 | — |
| SECONDARY Duration of Shock and/or Pressor/Inotropic Support |
2.67; 3.75 | — |
| SECONDARY Number of Participants Intubated and Placed on a Ventilator After Study Entry. |
6; 10 | — |
| SECONDARY Number of Participants Who Developed Refractory Shock Despite Fluid Resuscitation After Study Entry |
4; 6 | — |
| SECONDARY Length of Time on a Ventilator |
2.64; 4.95 | — |
| SECONDARY Development of Serum Creatinine Greater Than or Equal to 3.0 mg/dL After Study Entry |
1; 6 | — |
Summary
The purpose of this study is to see if a drug, called methylprednisolone, is safe and effective in people with Hantavirus infection. Individuals 2 years of age or older are invited to participate in this study if their doctor suspects or knows they have Hantavirus infection. Volunteers will either be given methylprednisolone or placebo (contains no medication) through a needle inserted in a vein for 3 days. During the first 7 days of hospitalization procedures may include blood tests, physical exams, chest x-rays, and urine tests. During study visits on days 14, 28, 84 and 180 after diagnosis, the doctors will ask about health, examine the body, take a chest X-ray, collect blood for safety testing and for measuring antibodies, and do breathing tests on volunteers. Participants will be involved in the study for about 6 months.
Eligibility Criteria
Inclusion Criteria
Informed consent is given by patient or guardian.
And one of the following:
- Confirmed diagnosis: Positive hantavirus IgM assay or detection of hantavirus in plasma or serum by RT-PCR in the presence of an acute febrile illness of less than 12 days duration, and
- Onset of hypoxia (oxygen saturation less than or equal to 92% or requiring supplemental oxygen) one or more days after onset of symptoms, and
- Development of pulmonary infiltrates on chest X-ray. OR
- Presumptive diagnosis: The presumptive diagnosis of acute hantavirus disease of less than 12 days duration with:
- Febrile illness (subjective or documented) in the judgment of the enrolling investigator; and
- Headache or myalgia or at least one digestive symptom (nausea, diarrhea, vomiting, abdominal pain) and
- A platelet count less than 150, 000 on peripheral smear; and
- Onset of hypoxia (oxygen saturation less than or equal to 92% or requiring supplemental oxygen) one or more days after onset of symptoms, and
- Development of bilateral pulmonary infiltrates on chest X-ray
Exclusion Criteria
- Age less than 2 years.
- If presumptive diagnosis is the inclusion criteria: subjects with a likely diagnosis other than hantavirus infection, including any positive culture or direct test for respiratory viruses (e.g., influenza, RSV, etc) or group A Streptococcus in a person with an illness compatible with streptococcal pharyngitis, a positive culture from a normally sterile site, or a presentation consistent with bacterial pneumonia.
- Immunocompromised patients at risk of opportunistic infection (e.g., patients with HIV infection, underlying malignancy, or who have received chemotherapy or immunosuppressive drugs within 30 days.)
- Patients who have or will receive any systemic antiviral medication (other than acyclovir, famciclovir, amantadine or rimantadine), systemic corticosteroids equivalent to approximately 0.5mg/kg prednisone, or any investigational drug within 30 days before enrollment or during treatment.
- Any period of extreme bradycardia, pulseless electric activity
- Active GI bleeding, with hematemesis, melena or hematochezia or documented by upper or lower endoscopy or by gastric aspiration.
Data sourced from ClinicalTrials.gov (NCT00128180). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.