A Clinical Trial With KJ103 in Anti-GBM Disease
An Open-Label, Single-Arm Phase II Clinical Trial to Evaluate the Initial Efficacy, Safety, Pharmacokinetics, Pharmacodynamics and Immunogenicity of KJ103 for the Treatment of Patients With Anti-Glomerular Basement Membrane Disease
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Anti-glomerular basement membrane (GBM) disease is a severe, rare autoimmune disorder with an internationally reported incidence of 0.5-1/1 million. It is defined as a vasculitis in which anti-GBM antibodies affect glomerular capillaries, pulmonary capillaries or both. Pulmonary involvement leads to pulmonary haemorrhage and renal involvement can lead to glomerulonephritis with necrosis and crescents.
Anti-GBM disease is a severe autoimmune disorder characterised by rapidly progressive glomerulonephritis and positive anti-GBM antibodies. Antibodies can be found in the circulation and deposited in the lungs and kidneys, mediating renal injury through complement activation and recruitment of inflammatory cells. If left untreated, the vast majority of patients will progress to end-stage renal disease (ESRD) or die from pulmonary haemorrhage. Early detection and measures to reduce anti-GBM antibody levels have the potential to alter prognosis and protect renal function. Unfortunately, many patients with anti-GBM disease are diagnosed late and renal function is not restored even with an aggressive treatment regimen of plasma exchange (PE) combined with immunosuppression. Current KDIGO (Kidney Disease Improving Global Prognosis Organisation) guidelines state that the clinical treatment of anti-GBM disease is a combination of glucocorticoids, cyclophosphamide and PE. Despite treatment, patients continue to produce anti-GBM antibodies in their bodies. Rebound anti-GBM antibodies are usually indicative of adverse renal outcomes and PE must be initiated to remove the rebound antibodies.PE is an effective means of removing circulating anti-GBM antibodies, but only removes about 1/3 of the percentage per treatment, so multiple treatments are required to achieve complete removal.
This is a single-arm Phase II study designed to evaluate the preliminary efficacy, safety, pharmacokinetics, pharmacodynamics and immunogenicity of KJ103 in patients with anti-GBM disease. The trial is expected to enrol 9 to 12 subjects who will receive KJ103 treatment.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Beijing
-
Beijing, Beijing, China, 100000
- Peking University First Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion criteria:
- Patients aged ≥18 years, both sexes.
- Diagnosed with anti-GBM disease. Positive anti-GBM antibodies at screening, with or without ANCA antibody positivity.
- With or without symptoms of haematuria and proteinuria.
- Patients of childbearing potential who do not plan to have children during the study and for 6 months after the end of the study, or who are using effective contraception during sexual intercourse.
Exclusion criteria:
- Anuria for more than 24 hours prior to the first dose.
- Diagnosis of anti-GBM disease more than 14 days prior to first dose.
- Moderate to severe pulmonary haemorrhage requiring mechanical ventilation during the screening period, including those occurring within two weeks prior to signing the informed consent form.
- Severe renal disease not caused by anti-GBM disease, such as lupus nephritis, which, in the opinion of the investigator, makes them unsuitable for participation in this study.
- Pregnant or breastfeeding at the time of screening.
- Have a serious underlying medical condition other than anti-GBM disease, such as infection, autoimmune disease, respiratory disease, cardiovascular disease, central nervous system disease, etc., that the investigator deems unsuitable for participation in this trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Experimental Group
KJ103 +SOC(SoC consists of a standardized combination of PE, Cyclophosphamide, and glucocorticoids)
|
Glucocorticoids inhibit the inflammation process.
Subjects will administered KJ103 intravenously on D1 and adjunctively on D8
Hence treatment prevents formation of new anti-GBM antibodies.
PLEX removes the patient's pathogenic anti-GBM antibodies, by replacement of deficient plasma with a replacement fluid.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Renal function
Time Frame: day 90, day 180
|
Proportion of subjects with renal function after KJ103 administration.
|
day 90, day 180
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Adverse events
Time Frame: day 180
|
Assessing the incidence and severity of adverse events (AEs) and serious adverse events (SAEs) via the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.
|
day 180
|
|
Proportion and number of subjects requiring PE
Time Frame: day 180
|
Proportion and number of subjects requiring PE after KJ103 administration.
|
day 180
|
|
Anti-GBM antibodies
Time Frame: day 180
|
Number of days positive for anti-GBM antibodies after KJ103 administration.
|
day 180
|
|
Immunogenicity
Time Frame: day 180
|
Immunogenicity of KJ103 (Anti-KJ103 antibody) in patients with anti-GBM disease.
|
day 180
|
|
eGFR and change from baseline.
Time Frame: Day28, Day60, Day90, Day120, Day150, Day180
|
Estimated glomerular filtration rate (eGFR).
Glomerular filtration rate is an estimate of the amount of ultrafiltrate produced by each side of the kidney per unit of time and is an indicator of kidney function.
|
Day28, Day60, Day90, Day120, Day150, Day180
|
|
Pharmacokinetics of KJ103 (Cmax)
Time Frame: day 7
|
Maximum observed serum concentration of KJ103 following dosing (Cmax)
|
day 7
|
|
Pharmacokinetics of KJ103 (AUC)
Time Frame: day 7
|
Area under the serum concentration versustime curve (AUC)
|
day 7
|
|
Pharmacokinetics of KJ103 (t1/2)
Time Frame: day 7
|
Half-life of KJ103
|
day 7
|
|
Pharmacokinetics of KJ103 (CL)
Time Frame: day 7
|
Clearance(CL) is a measure of the ability of the body to clear KJ103
|
day 7
|
|
Pharmacokinetics of KJ103 (Vz)
Time Frame: day 7
|
Vz = Volume of distribution during the elimination phase
|
day 7
|
|
Pharmacodynamic profile (Serum IgG levels)
Time Frame: day 180
|
Serum IgG levels after KJ103 dosing
|
day 180
|
|
Pharmacodynamics-Anti neutrophil cytoplasmic antibodies (ANCA)
Time Frame: day 180
|
Serum Anti neutrophil cytoplasmic antibodies (ANCA) levels after KJ103 dosing
|
day 180
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Male Urogenital Diseases
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Autoimmune Diseases
- Immune System Diseases
- Respiratory Tract Diseases
- Lung Diseases
- Lung Diseases, Interstitial
- Glomerulonephritis
- Nephritis
- Anti-Glomerular Basement Membrane Disease
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antirheumatic Agents
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Cyclophosphamide
- Glucocorticoids
Other Study ID Numbers
Other Study ID Numbers
- SHBJ-KJ103-002
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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