Efficacy and Safety of Immunoglobulin Plus Firsekibart in Patients With Kawasaki Disease
Efficacy and Safety of Immunoglobulin Plus Firsekibart in Patients With Kawasaki Disease: An Exploratory Randomized Controlled Study
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 2
- Fase 3
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Fang Liu, MD
- Numero di telefono: +86 021-64932800
- Email: liufang@fudan.edu.cn
Backup dei contatti dello studio
- Nome: Lan He, MD
- Numero di telefono: +8602164932026
- Email: helan0361@163.com
Luoghi di studio
-
-
Jiangxi
-
Nanchang, Jiangxi, Cina, 330006
- Jiangxi Provincial Children's Hospital
-
Contatto:
- Xiaohui Liu, MD
-
-
Shanghai Municipality
-
Shanghai, Shanghai Municipality, Cina, 201102
- Children's Hospital of Fudan University
-
Contatto:
- Fang Liu, MD
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Bambino
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Meeting diagnostic criteria for Kawasaki disease (KD) released by American Heart Association (AHA) in 2024
- Diagnosed before the tenth day of illness (with the first day of illness defined as the first day of fever)
- Not treated with IVIG yet
- Age >28 days,<18 years
Exclusion Criteria:
- Receiving steroids or other immunosuppressive agents in the previous 30 days;
- With a previous history of KD;
- Afebrile before enrolment;
- Contraindications for subcutaneous injection, including severe local skin infection, ulceration, etc;
- Known hypersensitivity to immunoglobulins, Firsekibart, or any of the excipients;
- With suspected infectious diseases including sepsis, septic meningitis, peritonitis, bacterial pneumonia, varicella and influenza, etc;
- With serious immune diseases, such as immunodeficiency, or chromosomal abnormalities;
- With severe hepatic dysfunction (ALT > 3 times the upper limit of normal) prior to treatment
- Unwillingness to provide written informed consent;
- Unlikely to complete at least 3 months of follow-up;
- Any other conditions deemed unsuitable for enrolment by investigators.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Comparatore attivo: standard treatment group
【Standard treatment follow the 2024 AHA Guidelines of Kawasaki Disease】
Participants with persistent or recurrent fever (temperature of ≥38°C ) 36 hours after completion of the first IVIG infusion are defined as having resistance to IVIG and will receive rescue therapy. The rescue therapy will be chosen on the basis of participant's condition and the physician's experience. Participants intolerant to aspirin may receive oral clopidogrel as an alternative. |
Aspirin 30 mg/kg in oral per day (given in 3 divided doses), then 3 to 5 mg/kg per day when fever subsides for 3 days and CRP is normal.
Aspirin will be continued for at least 6 weeks after onset of illness.
Altri nomi:
IVIG 2g/kg once, given over 8 to 12 hours, with the maximum dose of 60g.
Altri nomi:
|
|
Sperimentale: Firsekibart + standard treatment group
【Standard treatment also follow the 2024 AHA Guidelines of Kawasaki Disease】 Discomfort occurring during the observation period after Firsekibart will be treated symptomatically, and standard treatment will subsequently be provided as needed based on the participant's condition and the physician's experience. In the event of a Grade ≥3 allergic reaction, epinephrine will be administered as needed. Management of IVIG resistance, aspirin intolerance will be the same as in the control group. |
Aspirin 30 mg/kg in oral per day (given in 3 divided doses), then 3 to 5 mg/kg per day when fever subsides for 3 days and CRP is normal.
Aspirin will be continued for at least 6 weeks after onset of illness.
Altri nomi:
Firsekibart 3 mg/kg by a single subcutaneous injection prior to IVIG infusion.
After a 30-minute observation period confirming the absence of adverse reactions, the IVIG infusion is initiated.
Altri nomi:
IVIG 2g/kg once, given over 8 to 12 hours, with the maximum dose of 60g.
Altri nomi:
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Occurrence of coronary artery lesions (CAL) at one month of illness
Lasso di tempo: from admission to 1 month of illness onset
|
Two-dimensional echocardiography will be performed to evaluate CAL at 1 month of illness.
Measurements for each patient include the diameter of the left main coronary artery (LMCA), the left anterior descending artery (LAD), the left circumflex coronary artery (LCX), and the proximal and middle segments of the right coronary artery (RCA).
Z score of each coronary artery will be calculated (Journal of the American Society of Echocardiography, 2011, 24(1).).
CAL is defined as z≥2.5 of any coronary artery of LMCA, LAD, LCX, and the proximal and middle segment of the RCA.
|
from admission to 1 month of illness onset
|
|
Occurrence of the need for rescue therapy
Lasso di tempo: from admission to discharge (about 2 weeks of illness onset)
|
Temperature will be measured every 6 hours a day during hospitalization.
Participants who have recurrent or persistent fever (temperature ≥38°C) after 36 hours of completion of initial IVIG infusion will be given rescue therapy.
|
from admission to discharge (about 2 weeks of illness onset)
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Duration of fever (hours) after initiation of initial IVIG infusion
Lasso di tempo: from initiation of the initial IVIG infusion to the first recorded afebrile status (up to 60 hours after the infusion of IVIG)
|
Temperature will be measured every 6 hours a day during hospitalization.
Participants with temperature <37.5℃ for more than 24 hours are considered afebrile.
Record the time of the initiation of IVIG infusion and the time of the body temperature first becoming normal.
|
from initiation of the initial IVIG infusion to the first recorded afebrile status (up to 60 hours after the infusion of IVIG)
|
|
Occurrence of coronary artery lesions (CAL) at 2 weeks of illness
Lasso di tempo: from admission to 2 weeks of illness onset
|
Two-dimensional echocardiography will be performed to evaluate CAL at 2 weeks of illness.
The measurement of each patient included the diameter of the left main coronary artery (LMCA), the left anterior descending artery (LAD), the left circumflex coronary artery (LCX), and the proximal and middle segments of the right coronary artery (RCA).
Z score of each coronary artery will be calculated (Journal of the American Society of Echocardiography, 2011, 24(1).).
CAL is defined as z≥2.5 of any coronary artery of LMCA, LAD, LCX, and the proximal and middle segment of the RCA.
|
from admission to 2 weeks of illness onset
|
|
Occurrence of coronary artery lesions (CAL) at 3 months of illness
Lasso di tempo: from admission to 3 months of illness onset
|
Two-dimensional echocardiography will be performed to evaluate CAL at 3 months of illness.
Measurements for each patient include the diameter of the left main coronary artery (LMCA), the left anterior descending artery (LAD), the left circumflex coronary artery (LCX), and the proximal and middle segments of the right coronary artery (RCA).
Z score of each coronary artery will be calculated (Journal of the American Society of Echocardiography, 2011, 24(1).).
CAL is defined as z≥2.5 of any coronary artery of LMCA, LAD, LCX, and the proximal and middle segment of the RCA.
|
from admission to 3 months of illness onset
|
|
Occurrence of medium-to-giant coronary artery aneurysms (CAAs)
Lasso di tempo: from admission to 6 months of illness onset
|
This is a repeatedly measured binary variable.
CAL classification is based on the maximum Z score according to the 2024 American Heart Association guideline.
Medium CAAs is defined as a maximum Z score ≥5 to <10, and all internal diameters <8 mm; large or giant CAAs defined as a maximum Z score ≥10, or any internal diameter ≥8 mm.
|
from admission to 6 months of illness onset
|
|
Changes in z scores of LAD
Lasso di tempo: from admission to 6 months of illness onset
|
This is a repeated measurement.
The internal diameter of LAD will be measured by echocardiography at five time points: at enrolment, at 2 weeks, 1 month, 3 months and 6 months of illness.
Z score will be calculated based on the height, weight and coronary artery diameter (Journal of the American Society of Echocardiography, 2011, 24(1).).
|
from admission to 6 months of illness onset
|
|
Changes in z scores of LMCA
Lasso di tempo: from admission to 6 months of illness onset
|
This is a repeated measurement.
The internal diameter of LMCA will be measured by echocardiography at five time points: at enrolment, at 2 weeks, 1 month, 3 months and 6 months of illness.
Z score will be calculated based on the height, weight and coronary artery diameter (Journal of the American Society of Echocardiography, 2011, 24(1).).
|
from admission to 6 months of illness onset
|
|
Changes in z scores of LCX
Lasso di tempo: from admission to 6 months of illness onset
|
This is a repeated measurement.
The internal diameter of LCX will be measured by echocardiography at five time points: at enrolment, at 2 weeks, 1 month, 3 months and 6 months of illness.
Z score will be calculated based on the height, weight and coronary artery diameter (Journal of the American Society of Echocardiography, 2011, 24(1).).
|
from admission to 6 months of illness onset
|
|
Changes in z scores of the proximal segment of RCA
Lasso di tempo: from admission to 6 months of illness onset
|
This is a repeated measurement.
The internal diameter of the proximal segment of RCA will be measured by echocardiography at five time points: at enrolment, at 2 weeks, 1 month, 3 months and 6 months of illness.
Z score will be calculated based on the height, weight and coronary artery diameter (Journal of the American Society of Echocardiography, 2011, 24(1).).
|
from admission to 6 months of illness onset
|
|
Changes in z scores of the middle segment of RCA
Lasso di tempo: from admission to 6 months of illness onset
|
This is a repeated measurement.
The internal diameter of the middle segment of RCA will be measured by echocardiography at five time points: at enrolment, at 2 weeks, 1 month, 3 months and 6 months of illness.
Z score will be calculated based on the height, weight and coronary artery diameter (Journal of the American Society of Echocardiography, 2011, 24(1).).
|
from admission to 6 months of illness onset
|
|
Occurrence of CAL regression
Lasso di tempo: from admission to 6 months of illness onset
|
CAL regression is defined as Z score <2.5 in any coronary artery (LMCA, LAD, LCX, and the proximal and middle segments of the RCA), with no stenotic or occlusive lesions present.The internal diameter of the coronary artery will be measured by echocardiography at five time points: at enrolment, at 2 weeks, 1 month, 3 months and 6 months after illness onset.
Z score will be calculated based on the height, weight and coronary artery diameter (Journal of the American Society of Echocardiography, 2011, 24(1).).
|
from admission to 6 months of illness onset
|
|
Occurrence of CAL progression
Lasso di tempo: from admission to 6 months of illness onset
|
CAL progression is defined as an increment in the Z score >1 from admission in any coronary artery (LMCA, LAD, LCX, proximal and middle segments of RCA) at any given time point within 6 months of illness onset.
The outcome will be assessed in all participants and those with CAL at baseline.
|
from admission to 6 months of illness onset
|
|
Occurrence of adverse events
Lasso di tempo: from admission to 6 months of illness onset
|
This is a composite outcome, including (a) clinical adverse events (death, severe infection, allergic reactions, heart failure, and thrombosis); (b) laboratory abnormalities (neutropenia, defined as <1.5×10⁹/L; thrombocytopenia, defined as <100×10⁹/L; newly developed ALT abnormality after medication, or further elevation of abnormal baseline ALT); (c) infectious events (occurrence of bacterial/viral infections); and (d) injection-site allergic reactions (redness and swelling at the injection site, rash, and anaphylactic shock) , etc.
|
from admission to 6 months of illness onset
|
|
Change in serum C-reactive protein (CRP) concentration
Lasso di tempo: from admission to 1 month of illness onset
|
Serum CRP levels will be measured at three time points: at enrolment, 72 hours after completion of the initial IVIG infusion, and 1 month of illness onset.
|
from admission to 1 month of illness onset
|
|
Change in Serum Amyloid A (SAA) concentration
Lasso di tempo: from admission to 1 month of illness onset
|
SAA levels will be measured at three time points: at enrolment, 72 hours after completion of the initial IVIG infusion, and 1 month of illness onset.
|
from admission to 1 month of illness onset
|
|
Change in serum interleukin (IL)-1β concentration
Lasso di tempo: from admission to 72 hours after completion of the initial IVIG infusion
|
Serum IL-1β levels will be measured at two time points: at enrolment, 72 hours after completion of the initial IVIG infusion.
|
from admission to 72 hours after completion of the initial IVIG infusion
|
Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Investigatori
Investigatori
- Direttore dello studio: Fang Liu, MD, Children's Hospital of Fudan University
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Malattie vascolari
- Malattia cardiovascolare
- Malattie della pelle
- Malattie linfatiche
- Malattie della pelle, vascolari
- Vasculite
- Malattie della pelle e del tessuto connettivo
- Malattie emiche e linfatiche
- Sindrome dei linfonodi mucocutanei
- Peptidi
- Aminoacidi, peptidi e proteine
- Proteine
- Prodotti chimici organici
- Idrocarburi
- Idrocarburi, ciclici
- Fattori biologici
- Idrocarburi, aromatici
- Anticorpi
- Immunoglobuline
- Immunoproteine
- Proteine del sangue
- Globuline sieriche
- Globuline
- Fenoli
- Derivati di benzene
- Peptidi e proteine di segnalazione intercellulare
- Isotipi di immunoglobulina
- Immunoglobulina g
- Salicilati
- Idrossibenzoati
- Citochine
- Aspirina
- Immunoglobuline, per via endovenosa
- Interleukins
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- 2026-244
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .