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Immunoadsorption Therapy in Managing NMDAR Antibodies Encephalitis

RECRUITINGPhase 2Sponsored by Assistance Publique - Hôpitaux de Paris
Actively Recruiting
PhasePhase 2
SponsorAssistance Publique - Hôpitaux de Paris
Started2021-06-23
Est. completion2024-07
Eligibility
Healthy vol.Accepted

Summary

The purpose of the study is to assess the efficacy of immunoadsorption therapy (IA) on improving the neurological status of severe pediatric anti-NMDAR encephalitis patients.

Eligibility

Healthy volunteers accepted
Inclusion Criteria:

* Age: 0-18 years inclusive
* Autoimmune encephalitis with positive anti-NMDAR antibodies in CSF (definite anti-NMDAR encephalitis according to Graus's criteria (Graus et al., 2016).
* PCPCS and mRS at 4 or over at the inclusion after first line therapy (steroids and/or IgIV) when Rituximab therapy is warranted
* Parents or legal guardians signed the Informed consent form
* Social insurance affiliation

Exclusion Criteria:

* Autoimmune encephalitis without NMDAR antibodies
* PCPCS and mRS scores under 4 after first-line therapy
* Contraindication to perform central vascular access
* Pregnancy, breastfeeding or absence of effective contraception (including abstinence) in a pubertal patient.
* Contraindication to perform IA therapy :

  * Clinical conditions that prohibit transitory volume changes
  * Indications that prohibit anticoagulation using Heparin and/or ACD-A solutions
  * History of hypercoagulability
  * Generalized viral, bacterial and/or mycotic infections
  * Severe immune deficiencies (e.g. AIDS)
  * Suspected allergies against sheep antibodies or agarose

Conditions2

Anti-NMDAR EncephalitisCancer

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