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Safety and Efficacy Study of Sivelestat in Neuromyelitis Optica Spectrum Disorder (SIVAR-NMOSD)

2026년 7월 27일 업데이트: Mitsuru Watanabe, Kyushu University

A Phase I/IIa Investigator-Initiated Clinical Trial to Evaluate the Safety and Efficacy of Sivelestat in Patients With Acute Relapse of Neuromyelitis Optica Spectrum Disorder

The primary objective of this study is to evaluate the safety and tolerability of sivelestat sodium hydrate administered in combination with standard steroid pulse therapy in patients experiencing an acute NMOSD attack. Safety assessments will include adverse events, laboratory parameters, vital signs, and other clinically relevant findings. In addition, the study will explore whether the addition of sivelestat sodium hydrate to standard steroid pulse therapy improves neurological outcomes in patients with acute NMOSD.

Participants will receive intravenous sivelestat sodium hydrate at a dose of 4.8 mg/kg/day administered as a continuous infusion (0.2 mg/kg/hour) for 5 consecutive days, receive steroid pulse therapy according to the study protocol, and be followed for 28 days after treatment initiation for safety and efficacy evaluations.

연구 개요

상태

아직 모집하지 않음

정황

개입 / 치료

연구 유형

중재적

등록 (추정된)

7

단계

  • 2 단계
  • 1단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

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  • 고령자

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설명

Inclusion Criteria:

  1. Patients diagnosed with anti-AQP4 antibody-positive NMOSD according to the international diagnostic criteria for NMOSD (Wingerchuk, Neurology 2015).
  2. Patients experiencing a relapse including any of the following, with the relapse occurring within 14 days of obtaining consent:

    i. Unilateral or bilateral optic neuritis ii. Myelitis

  3. Patients whose FS domain has worsened by at least 1 point due to relapse.
  4. Patients with one or more relapse lesions identified on MRI (however, if the relapse is considered to have occurred in the same location as an existing MRI lesion neurologically, identification of a new relapse lesion is not required).
  5. Patients aged 18 years or older at the time of obtaining consent.
  6. Female patients of childbearing potential who agree to use appropriate contraception from the time of obtaining consent until 180 days after the end of investigational product administration.
  7. Male patients who agree to use appropriate contraception until 90 days after the end of investigational product administration.
  8. Patients who can provide written informed consent.

Exclusion Criteria:

  1. Patients with multi-organ dysfunction involving 4 or more organs.
  2. Patients with severe chronic respiratory disease.
  3. Patients with autoimmune diseases other than NMOSD that are expected to require additional treatment during the study period.
  4. Patients with active systemic bacterial, viral, or fungal infections.
  5. Patients who have received either or both of the following prior treatments after an NMOSD relapse:

    i. Two or more courses of steroid pulse therapy ii. Plasmapheresis iii. High-dose immunoglobulin therapy

  6. Patients with severe hepatic dysfunction.
  7. Patients with alcohol dependence, drug dependence, or psychiatric disorders that would interfere with study participation.
  8. Patients who have received other investigational drugs within 3 months prior to obtaining consent.
  9. Pregnant women, women suspected of being pregnant, or breastfeeding women.
  10. Patients with allergies to the investigational product or concomitant medications.
  11. Patients with severe allergies or a history of severe allergies.
  12. Patients with suicidal tendencies meeting any of the following criteria:

    i. Within 1 month prior to the screening assessment, there was suicidal behavior or ideation corresponding to "Yes" for Item 4 (Active suicidal ideation -some intent to act, but no specific plan) or Item 5 (Active suicidal ideation -specific plan and intent) of the Columbia-Suicide Severity Rating Scale (C-SSRS). (For subjects who only met Items 1-3, inclusion may be permitted at the discretion of the principal investigator or sub-investigator.) ii. Any suicidal behavior based on Item 6 of the C-SSRS occurred within the past 3 months.

  13. Other patients judged inappropriate by the principal investigator or sub-investigator.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 해당 없음
  • 중재 모델: 단일 그룹 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: 시벨레스타트
Sivelestat sodium hydrate is administered intravenously at a dose of 4.8 mg/kg/day as a continuous infusion (0.2 mg/kg/hour) for 5 consecutive days in combination with steroid pulse therapy in patients with acute NMOSD attacks.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
기간
이상반응의 발생
기간: 4 주
4 주

2차 결과 측정

결과 측정
측정값 설명
기간
Change from baseline in body temperature at 3 hours, Day 2, Day 3, Day 4, Day 5, and Day 6 after the start of investigational product administration.
기간: 6 days
6 days
Change from baseline in blood pressure at 3 hours, Day 2, Day 3, Day 4, Day 5, and Day 6 after the start of investigational product administration.
기간: 6 days
6 days
Change from baseline in pulse rate at 3 hours, Day 2, Day 3, Day 4, Day 5, and Day 6 after the start of investigational product administration.
기간: 6 days
6 days
Change from baseline in percutaneous arterial oxygen saturation at 3 hours, Day 2, Day 3, Day 4, Day 5, and Day 6 after the start of investigational product administration.
기간: 6 days
6 days
Change from baseline in Expanded Disability Status Scale (EDSS) score at 4 weeks (Day 28).
기간: 4 weeks
The Expanded Disability Status Scale (EDSS) ranges from 0 to 10. Higher scores indicate greater neurological disability and worse clinical status.
4 weeks
Proportion of cases where Expanded Disability Status Scale (EDSS) score improved by 1 point or more from baseline at 4 weeks (Day 28).
기간: 4 weeks
The Expanded Disability Status Scale (EDSS) ranges from 0 to 10. Higher scores indicate greater neurological disability and worse clinical status.
4 weeks
Change from baseline in Functional System (FS) domain scores at 4 weeks
기간: 4 weeks
Functional System (FS) scores are neurological disability scores that contribute to the Expanded Disability Status Scale (EDSS). Functional systems assessed include visual, brainstem, pyramidal, cerebellar, sensory, bowel and bladder, and cerebral functions. Individual FS scores generally range from 0 (normal function) to 5 or 6 (maximal impairment), depending on the functional system assessed. Higher scores indicate greater neurological impairment and worse clinical status.
4 weeks
Change from baseline in Opticospinal Impairment Scale (OSIS) score at 4 weeks (Day 28).
기간: 4 weeks
The Opticospinal Impairment Scale (OSIS) is a disability scale for neuromyelitis optica spectrum disorder that assesses visual acuity, motor function, sensory function, and sphincter function. Total scores range from 0 to 25, with higher scores indicating greater neurological impairment and worse clinical status.
4 weeks
Proportion of participants with recovery to pre-relapse neurological disability status at 4 weeks (Day 28).
기간: 4 weeks
Recovery to pre-relapse neurological disability status is defined as a return of the Expanded Disability Status Scale (EDSS; range 0-10, higher scores indicate greater disability) and the Opticospinal Impairment Scale (OSIS; range 0-25, higher scores indicate greater neurological impairment) to their respective pre-relapse scores.
4 weeks
Change from baseline in best-corrected visual acuity at 4 weeks (Day 28)
기간: 4 weeks
4 weeks
Change from baseline in critical flicker fusion frequency at 4 weeks (Day 28).
기간: 4 weeks
4 weeks
Change from baseline in retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness measured by optical coherence tomography (OCT) at 4 weeks (Day 28).
기간: 4 weeks
4 weeks
Proportion of cases with gadolinium-enhancing lesions on MRI at 4 weeks.
기간: 4 weeks
4 weeks
Proportion of cases requiring a second course of steroid pulse therapy, plasmapheresis, or high-dose immunoglobulin therapy.
기간: 4 weeks
4 weeks

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 8월 17일

기본 완료 (추정된)

2028년 1월 31일

연구 완료 (추정된)

2028년 5월 31일

연구 등록 날짜

최초 제출

2026년 7월 17일

QC 기준을 충족하는 최초 제출

2026년 7월 27일

처음 게시됨 (실제)

2026년 7월 31일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 7월 31일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 7월 27일

마지막으로 확인됨

2026년 7월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • CTR542-01

개별 참가자 데이터(IPD) 계획

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