Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

Efficacy of Short Course of Intravenous Dexamethasone and Intravenous Immunoglobulin Therapy in Infection-Related Secondary Hemophagocytic Lymphohistiocytosis (isHLH) (isHLH-IVD/IVIg)

1. oktober 2026 opdateret af: Deba Prasad Dhibar, Post Graduate Institute of Medical Education and Research, Chandigarh

Randomized Controlled Trial to Evaluate and Compare the Efficacy of Short Course of Intravenous Dexamethasone and Intravenous Immunoglobulin Therapy in Infection-Related Secondary Hemophagocytic Lymphohistiocytosis (sHLH)

Rationale/Gaps in Existing Knowledge: Therapy of Infection-associated Secondary Hemophagocytic lymphohistiocytosis (sHLH) in adult lacks evidence from randomized trial guiding first-line immunomodulation and current therapeutic practice primarily extrapolated from decades old pediatric HLH protocols and retrospective studies. In presence of infection very expensive therapy with intravenous Immunoglobulin (IVIG) is preferred over Dexamethasone, however the comparative efficacy of IVIG and Dexamethasone alone remains undefined, especially in resource-constraints settings. (ii) Novelty: This will be among the first randomized controlled trials in adults with infection-associated sHLH, directly comparing efficacy of IVIG with Dexamethasone. The study uniquely integrates clinical outcomes with economic feasibility in a low-middle income setting. (iii) Objectives: Primary objectives will be to compare the efficacy of intravenous (IV) Dexamethasone and IVIG in achieving clinical remission and recovery of HLH-associated cytokines (IL-1, IL-6, TNF-α, IFN-γ, GM-CSF) and Ferritin level. Secondary objectives include assessment of hematologic recovery, adverse events, and short-term mortality. (iv)Method: In this Randomized controlled open-label, non-inferiority clinical trial participants with sHLH, will be allocated (1:1) to receive either short-course of IV Dexamethasone or IVIG along with infection-directed standard care and will be followed-up for 4 weeks to evaluate predefined clinical outcome and laboratory parameters. (v) Expected Outcome: The study aims to establish whether IV Dexamethasone is non-inferior to IVIG for achieving clinical remission, recovery of HLH-associated cytokines level and reduction of short-term mortality. Results are expected to reform evidence-based, cost-effective therapeutic strategies for infection-associated sHLH and improve access to care in resource-constraint healthcare systems.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

116

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Age ≥ 18 years
  • Gender: Male/female
  • h-Score probability ≥ 80%
  • Known microbiological etiology
  • Mild HLH not responding to infection specific targeted antimicrobial therapy (> 72 hours)
  • Mild HLH developing new organ dysfunction
  • Moderate to severe HLH with life threatening organ dysfunction

Exclusion Criteria:

  • Primary (familial) HLH
  • Malignancy associated HLH
  • HLH associated with autoimmune disease
  • EBV associated HLH
  • Pregnancy
  • Receiving immune modulator therapy within 2 moths
  • Participants with HIV
  • Consent not given
  • Known hypersensitivity to IVIG or Dexamethasone
  • Chronic liver disease
  • Chronic kidney disease

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: IVIg

Will receive intravenous Immunoglobulin (IVIg) therapy

Injection IVIg (400 mg/kg Body weight) over an hour IV infusion X 5 days (total cumulative dose 2g/kg).

Infection specific targeted antimicrobial therapy along with standard medical care

Eksperimentel: IVD

Will receive intravenous Dexamethasone (IVD)

Infection specific targeted antimicrobial therapy along with standard medical care

Injection Dexamethasone (10mg/m2) in 100 ml 0.9% normal saline (NS) over half an hour IV infusion X 3 days

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Clinical remission
Tidsramme: 4 weeks

Number of participants become persistently asymptomatic without fever for ≥72 hours with h-Score probability <80% and without any HLH-related new organ dysfunction at 1 week and 4 weeks of the IVIG/IVD intervention

4 weeks
The recovery of HLH-associated cytokines
Tidsramme: 4 weeks

Number of participants having reduction of HLH-associated cytokines (IL-1, IL-6, TNF-α, IFN-γ, GM-CSF) and Ferritin level from the pre-intervention baseline at 1 week and 4 weeks of the IVIG/IVD intervention

4 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Recovery of the hematological parameters
Tidsramme: 4 weeks

Number of participants with recovery or normalization of the hematological parameters (hemoglobin, total leukocyte count, and platelet count)

4 weeks
Adverse events/ adverse drug reactions
Tidsramme: 4 weeks

Number of incidence of any adverse events and adverse drug reactions

4 weeks
Duration of hospital stay
Tidsramme: 4 weeks

Number of days of hospital admission

4 weeks
Incidence of relapse of HLH: Recurrence of HLH after achieving clinical remission
Tidsramme: 4 weeks

Number of participants having recurrence of HLH after achieving clinical remission

4 weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Deba Prasad Dhibar, MD, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

15. oktober 2026

Primær færdiggørelse (Anslået)

30. september 2029

Studieafslutning (Anslået)

30. september 2029

Datoer for studieregistrering

Først indsendt

1. oktober 2026

Først indsendt, der opfyldte QC-kriterier

1. oktober 2026

Først opslået (Faktiske)

6. oktober 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. oktober 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

All the reasonable data requests should be submitted to the principal investigator (DPD) for consideration.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .