Ensayos clínicos

INCLUSION CRITERIA

1. Patients must be greater than or equal to 18-years-old.
2. All patients must have a pathologically confirmed diagnosis of refractory celiac disease(RCD) defined by internationally accepted criteria of persistent and recurrent symptoms(diarrhea, weight loss, and abdominal pain) associated with intestinal damage, characterized by partial to total villous atrophy with intraepithelial lymphocytes defined by > 25 intraepithelial lymphocytes per 100 epithelial cells.
3. Persistence of the above signs and symptoms despite strict adherence to a gluten-free diet for 6-12 months
4. Patients are to have had circulating antibodies to transglutaminase-1 or similar celiac specific serology
5. Patients must have a life expectancy of > 3 months
6. Patients must have a creatinine of less than 2.0 mg/dL or if the patient has an elevated creatinine measured creatinine clearance (Ccr) must be > 60 mL/min/1.73m(2)
7. Patients must have a serum alkaline phosphatase, ALT (SGPT) and AST (SGOT) less than 3x the upper limits of normal (ULN)
8. Patients must have a total bilirubin of less than 2.5 x ULN
9. Women of childbearing potential must have a negative beta HCG pregnancy test at initial screening and within 3 days prior to registration
10. Patients receiving a stable dose (> 4 weeks) of corticosteroid therapy equal to 20 mg of prednisone per day or less are eligible
11. Patients with a history of curatively treated basal cell carcinoma or intraepithelial neoplasia of the uterine surface will be allowed on the study
12. Patients must be able to understand and sign an informed consent

EXCLUSION CRITERIA

1. Patients enrolled in another therapeutic study
2. Patients with a history of venous thrombosis
3. Patients with antibodies to Hu-Mik-Beta-1
4. A contraindication to monoclonal antibody therapy including adverse events related to prior monoclonal antibody therapy. Patients who have received prior antibody therapy will have permanent medical records reviewed by the study investigator.
5. Any uncontrolled or chronic bacterial, mycobacterial or other viral (e.g., herpes virus), fungal, parasitic or protozoal infection
6. History of malignancy (active or within the previous 5 years)
7. Patients with HIV infection (antibody positive) with positive confirmatory molecular tests
8. Patients who have chronic hepatitis B or chronic hepatitis C
9. Pregnant or breastfeeding women. Women who not using an acceptable method of contraception. Acceptability of various methods of contraception will be determined by the investigator. Postmenopausal or surgically sterile women who have documentation of postmenopausal status or surgical sterility availability prior to enrollment.
10. Patients with significant co-morbidities including uncontrolled hypertension (diastolic B/P > 115 mm/Hg), unstable angina, congestive heart failure (> N.Y.H.A. Class II), poorly controlled diabetes, severe chronic pulmonary disease, coronary angioplasty or myocardial infarction within the last 6 months or uncontrolled atrial or ventricular cardiac arrhythmias.
11. Abnormal screening/baseline tests exceeding the limits outlined below:
    • Total white blood cell count (WBC) < 300/mm(3)
    • Platelet count < 85,000/mm(3)
    • INR greater than or equal to 1.5
    • Serum creatinine level > 1.5 mg/dL
    • Serum alanine transaminase, aspartate transaminase or creatinine kinase > 2 x the upper limits of normal
12. Patients with a history of a psychiatric disorder that may interfere with the understanding and compliance with this protocol, and the required follow-up
13. Exclusion at the discretion of the PI or delegate if participation in the study is deemed too risky (e.g., clinically significant pleural or pericardial effusion or ascites)
14. Inability to give informed consent