Combination of Rituximab and Cyclosporine in the Treatment of Primary Membranous Nephropathy
Efficacy and Safety of Rituximab Combined With Cyclosporine for Primary Membranous Nephropathy
High-grade proteinuria is one of the key determinants of adverse renal prognosis in patients with primary membranous nephropathy (PMN).The main purpose of this study is to determine whether Rituximab combined with Cyclosporine is superior to Rituximab monotherapy in inducing remission of proteinuria in patients with PMN.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Primary membranous nephropathy (PMN) is one of the most common causes of nephrotic syndrome among Chinese adults. For patients with high-grade proteinuria , immunosuppressive therapy is needed. B cell-depleting agent Rituximab is a recommended treatment Regimen in maintaining remission but the response to Rituximab is relatively slow. Calcineurin inhibitors lead to earlier reductions in proteinuria but presenting higher relapse rates in the long follow-up period.Combination therapy may provide both earlier proteinuria remission and durable effect. This is a multi-center, randomized, open-label study conducted in adult patients with biopsy-proven PMN. The main purpose of this study is to determine whether Rituximab combined with Cyclosporine is superior to Rituximab monotherapy in inducing remission of proteinuria in patients with PMN.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
- Fase 3
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Fang Wang, Doctor
- Telefonnummer: 01083572388
- E-mail: wangfang@bjmu.edu.cn
Studiesteder
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-
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Beijing, Kina
- Rekruttering
- Peking University First Hospital
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Kontakt:
- Fang Wang
- Telefonnummer: 86-10-83572388
- E-mail: wangfang@bjmu.edu.cn
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Age 18-80 years.
- Primary membranous nephropathy confirmed by renal biopsy.
- 24-hour urinary protein quantification > 5.0 g/24h and serum albumin < 30 g/L after at least 3 months of treatment with RAAS blockers.
- eGFR ≥ 40 mL/min/1.73 m².
- Well-controlled blood pressure (≤140/90 mmHg) in the recent 3 months.
- Signed informed consent form.
Exclusion Criteria:
- Secondary causes of membranous nephropathy, such as that secondary to systemic lupus erythematosus, malignant tumors, hepatitis B virus infection, heavy metal poisoning;
- Coexistence of other types of kidney diseases;
- Use of rituximab within the past 12 months;
- Use of corticosteroids, cyclophosphamide, cyclosporine, mycophenolate mofetil, or leflunomide within the past 3 months;
- Active infection: active tuberculosis, HBsAg positivity or HBV-DNA indicating viral replication, positive HCV antibody, HIV infection;
- New-onset cardiovascular or cerebrovascular diseases within the past 3
- Severe liver disease: AST and ALT > 3 times range upper limit ;
- Uncontrolled severe hypertension;
- Newly diagnosed or recurrent malignant tumors within the past 5 years;
- Coexistent autoimmune diseases;
- Pregnancy, lactation, or recent plans for pregnancy;
- Life expectancy less than 12 months;
- Participation in other clinical trials within the past 3 months;
- Unwillingness to sign the informed consent form;
- Any other condition deemed unsuitable for the study by the investigator.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Aktiv komparator: combination therapy
Rituximab combined with cyclosporine |
The first cycle of rituximab was given at a dose of 1000 mg i.v. on day 1 and day 15.Patients were retreated with rituximab (1000mg ) when CD20 B-cell count was more than 5 cells/ml.Oral cyclosporine will be started at 3 mg/kg/day and continued for 6 months, followed by a 2-month tapering period. |
|
Aktiv komparator: monotherapy
Rituximab |
The first cycle of rituximab was given at a dose of 1000 mg i.v. on day 1 and day 15.Patients were retreated with rituximab (1000mg ) when CD20 B-cell count was more than 5 cells/ml. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Remission Status
Tidsramme: At 3 months after randomization
|
the proportion of subjects to reach the composite of maintaining complete remission or partial remission at 3 months after randomization |
At 3 months after randomization
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Remission at 6 months and 12 months
Tidsramme: From enrollment to the end of follow-up at 12 months
|
The proportions of patients achieving complete remission or partial remission at 6 and 12 months of treatment. |
From enrollment to the end of follow-up at 12 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Urogenitale sygdomme
- Mandlige urogenitale sygdomme
- Nyresygdomme
- Urologiske sygdomme
- Urogenitale sygdomme hos kvinder
- Kvinders urogenitale sygdomme og graviditetskomplikationer
- Autoimmune sygdomme
- Sygdomme i immunsystemet
- Glomerulonefritis
- Nefritis
- Glomerulonephritis, Membranøs
- Peptider
- Aminosyrer, peptider og proteiner
- Proteiner
- Polycykliske forbindelser
- Antistoffer, monoklonal
- Antistoffer
- Immunoglobuliner
- Immunoproteiner
- Blodproteiner
- Serum globuliner
- Globuliner
- Makrocykliske forbindelser
- Antistoffer, monoklonal, murint afledt
- Peptider, cyklisk
- Cyclosporiner
- Rituximab
- Cyclosporin
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- Ricyclo-pMN
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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