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Prevent Allergic Reactions to Aphexda With Dexamethasone (PARADE)
This phase IV trial compares the effect of premedication regimens with methylprednisolone versus dexamethasone for the prevention of allergic reaction to motixafortide in patients with multiple myeloma (MM) undergoing stem cell mobilization. MM patients that receive an autologous stem cell transplantation (ASCT) have better outcomes. However, not all MM patients are able to have a successful stem cell mobilization and collection which is needed to proceed to ASCT. The addition of motixafortide prior to stem cell mobilization has allowed more MM patients to collect the needed number of stem cells to proceed to ASCT. However, motixafortide does produce systemic and injection site reactions in many patients. The optimal medication regimen to prevent reactions remains unknown. A premedication regimen with dexamethasone prior to motixafortide decreases the incidence of reactions in many patients and is considered the standard of care regimen for the prevention of systemic and injection site reactions to motixafortide in patients with MM undergoing stem cell mobilization. Dexamethasone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen side effects/allergic reactions. However, dexamethasone is associated with other side effects like headache, difficulty sleeping, high blood glucose, high blood pressure, mood changes, fluid retention, and infection, among others. A premedication regimen with methylprednisolone prior to motixafortide may work better to decrease the incidence of reactions to motixafortide in patients with MM undergoing stem cell mobilization. Methylprednisolone is in a class of medications called corticosteroids. It works to decrease side effects/allergic reactions by changing the way the immune system works. Giving methylprednisolone may be safe, tolerable and/or more effective than dexamethasone as part of a premedication regimen for the prevention of allergic reaction to motixafortide in patients with MM undergoing stem cell mobilization.
Eligibility Criteria
Inclusion Criteria
- 1Patients must be aged 18 years or older.
- 2Patient must understand and voluntarily signed an informed consent form.
- 3Patient must be willing and able to adhere to the study schedule and other protocol requirements.
- 4Histologically confirmed multiple myeloma prior to enrollment and randomization.
- 5Eligible for hematopoietic stem cell mobilization and autologous hematopoietic stem cell transplantation as per institutional guidelines.
- 6Females of reproductive potential must use effective contraception during treatment with motixafortide and for 8 days after the final dose.
Exclusion Criteria
- 1Previous history of autologous or allogeneic hematopoietic cell transplantation.
- 2History of hemoglobin SS disease or hemoglobin S trait precluding the patient's ability to use G-CSF.
- 3History of steroid-induced psychosis or encephalopathy requiring medical intervention.
- 4History of type I or II diabetes mellitus that is poorly controlled or with high glucose variability precluding safe administration of dexamethasone 12mg IV as premedication in the opinion of the investigator.
- 5History of serious systemic reaction to motixafortide.
Locations
1 site participating in this study
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia 30322
Joseph Rimando, MD