Primary objective of the study was to evaluate the safety and efficacy of canakinumab on the clinical and inflammatory findings of Behced Disease patients with neurologic and vascular involvement.
Primary endpoint: Resolution of acute exacerbation findings related to Behçet's Disease (BD) based on achievements in any of the following items without deterioration on day 30: For patients with parenchymal neurologic disease: Resolution of acute exacerbation of parenchymal neurologic findings based on improvements in any of the following items without deterioration on Day 30: * Improvement of muscle strength, ataxia, or other relevant neurologic findings depending on the involved region on neurological examination (by Neuro-Behçet's Disease Score, Modified Expanded Disability Status Scale, and Modified Rankin Scores) cerebrospinal fluid * Improvement in systemic inflammatory findings (CRP, Erythrocyte Sedimentation Rate , SAA) * Any decrease in the size of the MRI lesion, or disappearance of contrast enhancement * Improvement in patients' and physicians global assessment using a 10-cm visual analogue scale (VAS) Complete response was defined as full clinical recovery to the pre-attack state, disappearance of MRI lesion(s), and normalisation of Cerebrospinal Fluid findings. Partial response was defined as partial improvement in clinical findings, but with findings still worse than the pre-attack state, and MRI lesions, which become smaller with no or less enhancement, and a decrease in cerebrospinal fluid cell count. Non-response was defined as no improvement in clinical findings, no change on MRI, no change in cerebrospinal fluid parameters, or worsening in those findings. For patients with large vessel vascular disease: Resolution of acute vascular exacerbation findings related to Behçet's Disease based on achievements in any of the following items without deterioration at 1 month: * Improvement in relevant symptoms (localised pain, abdominal pain, calf thickness, haemoptysis) by using physician and patient's global assessment with VAS * Improvement in systemic inflammatory findings (CRP, ESR, SAA) * Any improvement in radiological findings depending on the involved vessels (MR, CT or Doppler findings) * Improvement in patients' and physicians global assessment using a 10-cm visual analogue scale (VAS) Complete response was defined as clinical and laboratory improvement based on ≥50% improvements in patient's and physician's global assessments by using VAS, and ≥50% reduction in CRP values; along with stable or ≥20% reduced aneurysm size in patients with arterial involvement, and stable or ≥20% reduced calf swelling in patients with lower extremity venous thrombosis. Partial response was defined as clinical and laboratory improvement based on observations of an improvement between 20-49% according to patient's and physician's global assessments by using VAS, 20-49% reduction in CRP values; along with stable or less than 20% reduced aneurysm size in patients with arterial involvement, and stable or less than 20% reduced calf swelling in patients with lower extremity thrombosis. Non-response will be defined as observing no or less than 20% clinical improvement by patient's and physician's global VAS or worsening of clinical findings, no change or increase in acute phase response, increase in aneurysm size for patients with arterial involvement or progression of venous thrombosis in patients with venous involvement.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
8
150 mg or 300 mg of canakinumab was administered monthly. IV (SC after month 6)
Novartis Investigative Site
Istanbul, Turkey (Türkiye)
Number of Participants With Attacks
Resolution of acute exacerbation findings related to Behçet's Disease (BD). The attacks were assessed by pyhsician global assesment. For patients with parenchymal neurologic disease: Resolution of acute exacerbation of parenchymal neurologic findings based on improvements in any of the following items without deterioration on Day 30 This was an exploratory trial that was not powered for a statistical analysis.
Time frame: 30 days
Modified Expanded Disability Status Scale (EDSS)
The Expanded Disability Status Scale (EDSS) is a method of quantifying disability in multiple sclerosis and monitoring changes in the level of disability over time. It is widely used in clinical trials and in the assessment of people with MS. Scale range is between 0-10 with 10 being most disability. Mean score of 3 participants who were evaluated in Neurology clinic. Other 5 participants were not evaluated for EDSS.
Time frame: 30 days
Neuro-Behçet's Disability Score (NBDS)
Neuro-Behçet's disability score (NBDS) has been proposed for parenchymal-NBD patients to quantify disabilities. This comprises scores for motor and cognitive status. NBDS is the arithmetic sum of both scores and ranges from 0 to 8, with 8 being death due to NBD. 3 neurologic participants were evaluated.
Time frame: 30 days
Modified Ranking Score (mRS)
Mean Modified Rankin Scale (mRS): mRS is a scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability. Scores range from 0-5 with 5 being the worst outcome. Only 3 participants from neurology clinic were evaluated with this scale.
Time frame: 30 days
Ataxia
Number of the partcipants with ataxia. 3 participants from neurology clinic were evaluated.
Time frame: 30 days
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Physical Examination Scores Indicating Change in Muscle Strength
All 4 extremties were evaluated for muscle strength (upper right, upper left, lower right and lower left) fro each patient. Score 0 is the worst outcome whereas 5 is the best outcome for muscle strength. 3 participants from neurology clinic were assessed.
Time frame: 30 days
C-reactive Protein (CRP) Values
Mean CRP (C-reactive protein) value (8 participants)
Time frame: 30 days
Erythrocyte Sedimentation Rate (ESR)
Mean erythrocyte sedimentation rate (ESR) value (8 participants)
Time frame: 30 days
SAA (Serum Amyloid A)
Mean Serum Amyloid A value (8 participants)
Time frame: 30 days
Hemoptysis
The number of the participants with hemoptysis
Time frame: 30 days
Visual Analogue Scores (VAS) for Headache
Headache intensity was measured by VAS where score 0 means "no pain," and score 10 means "the worst pain''. Physician and participant determined the VAS score separately.
Time frame: 30 days
Visual Analogue Scores (VAS) for Stomachache
Stomacheache intensity was measured by VAS where score 0 means "no pain," and score 10 means "the worst pain''. VAS is determined separately by physician and the participants.
Time frame: 30 days
Visual Analogue Scores (VAS) for Extremity Assessments
Extremity assessments were measured by VAS where score 0 means "no pain," and score 10 means "the worst possible pain''. The physicians and participants evaluated VAS separately.
Time frame: 30 days
Visual Analogue Scores (VAS) for Patients' General Assessments
Participants assessed their own well-being with VAS (visual analogue scale). Score 0 means the best outcome, score 10 is the worst outcome.
Time frame: 30 days
Physician's Global Assessment
Physician's General Assessments is VAS scale, ranging between 0-5, showing the disease status of participants. Score 0 is the worst outcome; 5 is the best outcome
Time frame: 30 days
Steroid Dose Regimen
Mean steroid treatment dose (8 participants)
Time frame: 30 days
BDCAF (Behçet's Disease Current Activity Form)
BDCAF is an assessment that is made by physician for evaluating the disease activity in last four weeks. Score range is 0 to 12, 0 is the best outcome, 12 is the worst outcome.
Time frame: 30 days
Extremity (Localized) Pain Assessment (VAS)
Localized pain in the extremities were assessed by visual analogue scale scores ranging between Scale; 0 is the best outcome; 10 is worst.
Time frame: 30 days