Randomized Stepped Wedge Study of Emapalumab in APECED Enteritis

Conditions

• Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy Enteritis

Eligibility Criteria

Sex

ALL

Age

2 Years - 75 Years

Healthy Volunteers

Not accepted

Interventions

• Emapalumab — DRUG
  Emapalumab will be administered via IV infusion once a month. The initial dose of emapalumab is 3 mg/kg followed by a second dose of 3 mg/kg after 3 days. Subsequently, the dose is 3 mg/kg once a month for five additional doses.

Study Details

Background: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), also known as Autoimmune polyendocrine syndrome type-1 (APS-1), is a disease that causes the immune system to attack parts of a person s body. In some people, APECED attacks the small intestine; this causes an illness called enteritis. Objective: To test a drug (emapalumab) in people with enteritis caused by APECED. Eligibility: People aged 2 to 75 years with APECED and enteritis. They must also be enrolled in protocol 11-I-0187. Design: Participants will have 10-13 study visits in an 18-month period. Participants will be screened. They will have a physical exam with blood tests. These tests will be repeated at every study visit. They will have a test of their heart function. This will be at screening and prior to drug administration. Other tests are optional: Participants may have imaging exams and a test of lung function. They may have an endoscopy, which is an exam of their digestive tract. Participants may provide samples of urine, stool, nail clippings, saliva, vaginal fluid, or skin. Photos may be taken of their skin or scalp. These tests may be repeated at some visits. Emapalumab is given through a tube attached to a needle inserted into a vein. All participants will receive 7 doses: 2 on their first study visit; then 1 each at 30-day intervals. Some participants will have an observation period before they begin taking the drug; in those situations, they will either be seen in person or via video visit every 2 months before starting emapalumab to see how their symptoms change over time. Participants will have a follow-up visit 1 month after their last dose. Then they will have 2 telehealth visits at 30-day intervals. They will have a final clinic visit 1 year after their first dose. ...

Key Dates

Start date

Nov 12, 2025

Status verified

Dec 2025

Primary completion

Mar 31, 2031

Completion

Sep 1, 2031

Study Design

Enrollment

10 participants (estimated)

Allocation

NA

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Arms

• Experimental: Group 1
  No observation period prior to start of study drug.
• Experimental: Group 2
  2 month observation period prior to start of study drug.
• Experimental: Group 3
  4 month observation period prior to start of study drug.
• Experimental: Group 4
  6 month observation period prior to start of study drug.

Primary Outcome Measure

Averaged changes in APECED ES from baseline. [ Time Frame: Duration of study ]

Central Contacts

• Michail S Lionakis, M.D.
  (301) 443-5089
  [email protected]

Locations (1)

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