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
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Szczegółowy opis
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Faza 2
- Faza 3
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Fang Liu, MD
- Numer telefonu: +86 021-64932800
- E-mail: liufang@fudan.edu.cn
Kopia zapasowa kontaktu do badania
- Nazwa: Lan He, MD
- Numer telefonu: +8602164932026
- E-mail: helan0361@163.com
Lokalizacje studiów
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Jiangxi
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Nanchang, Jiangxi, Chiny, 330006
- Jiangxi Provincial Children's Hospital
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Kontakt:
- Xiaohui Liu, MD
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Shanghai Municipality
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Shanghai, Shanghai Municipality, Chiny, 201102
- Children's Hospital of Fudan University
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Kontakt:
- Fang Liu, MD
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Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dziecko
Akceptuje zdrowych ochotników
Opis
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.
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Pojedynczy
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
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Aktywny komparator: 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.
Inne nazwy:
IVIG 2g/kg once, given over 8 to 12 hours, with the maximum dose of 60g.
Inne nazwy:
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Eksperymentalny: 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.
Inne nazwy:
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.
Inne nazwy:
IVIG 2g/kg once, given over 8 to 12 hours, with the maximum dose of 60g.
Inne nazwy:
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Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Occurrence of coronary artery lesions (CAL) at one month of illness
Ramy czasowe: from admission to 1 month of illness onset
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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.
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from admission to 1 month of illness onset
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Occurrence of the need for rescue therapy
Ramy czasowe: from admission to discharge (about 2 weeks of illness onset)
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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.
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from admission to discharge (about 2 weeks of illness onset)
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Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Duration of fever (hours) after initiation of initial IVIG infusion
Ramy czasowe: from initiation of the initial IVIG infusion to the first recorded afebrile status (up to 60 hours after the infusion of IVIG)
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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.
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from initiation of the initial IVIG infusion to the first recorded afebrile status (up to 60 hours after the infusion of IVIG)
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Occurrence of coronary artery lesions (CAL) at 2 weeks of illness
Ramy czasowe: 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.
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from admission to 2 weeks of illness onset
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Occurrence of coronary artery lesions (CAL) at 3 months of illness
Ramy czasowe: from admission to 3 months of illness onset
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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.
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from admission to 3 months of illness onset
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Occurrence of medium-to-giant coronary artery aneurysms (CAAs)
Ramy czasowe: from admission to 6 months of illness onset
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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.
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from admission to 6 months of illness onset
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Changes in z scores of LAD
Ramy czasowe: from admission to 6 months of illness onset
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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).).
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from admission to 6 months of illness onset
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Changes in z scores of LMCA
Ramy czasowe: 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).).
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from admission to 6 months of illness onset
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Changes in z scores of LCX
Ramy czasowe: 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).).
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from admission to 6 months of illness onset
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Changes in z scores of the proximal segment of RCA
Ramy czasowe: 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).).
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from admission to 6 months of illness onset
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Changes in z scores of the middle segment of RCA
Ramy czasowe: 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).).
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from admission to 6 months of illness onset
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Occurrence of CAL regression
Ramy czasowe: from admission to 6 months of illness onset
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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).).
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from admission to 6 months of illness onset
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Occurrence of CAL progression
Ramy czasowe: from admission to 6 months of illness onset
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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.
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from admission to 6 months of illness onset
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Occurrence of adverse events
Ramy czasowe: from admission to 6 months of illness onset
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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.
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from admission to 6 months of illness onset
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Change in serum C-reactive protein (CRP) concentration
Ramy czasowe: from admission to 1 month of illness onset
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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.
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from admission to 1 month of illness onset
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Change in Serum Amyloid A (SAA) concentration
Ramy czasowe: from admission to 1 month of illness onset
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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.
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from admission to 1 month of illness onset
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Change in serum interleukin (IL)-1β concentration
Ramy czasowe: from admission to 72 hours after completion of the initial IVIG infusion
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Serum IL-1β levels will be measured at two time points: at enrolment, 72 hours after completion of the initial IVIG infusion.
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from admission to 72 hours after completion of the initial IVIG infusion
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Współpracownicy i badacze
Sponsor
Sponsor
Współpracownicy
Współpracownicy
Śledczy
Śledczy
- Dyrektor Studium: Fang Liu, MD, Children's Hospital of Fudan University
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
- Choroby naczyniowe
- Choroby układu krążenia
- Choroby skórne
- Choroby limfatyczne
- Choroby skóry, naczyniowe
- Zapalenie naczyń
- Choroby skóry i tkanki łącznej
- Choroby hemowe i limfatyczne
- Zespół śluzówkowo-skórnych węzłów chłonnych
- Peptydy
- Aminokwasy, peptydy i białka
- Białka
- Organiczne chemikalia
- Węglowodory
- Węglowodory, cykliczne
- Czynniki biologiczne
- Węglowodory, aromatyczne
- Przeciwciała
- Immunoglobuliny
- Immunoproteiny
- Białka krwi
- Globuliny w surowicy
- Globuliny
- Fenole
- Pochodne benzenu
- Międzykomórkowe peptydy sygnalizacyjne i białka
- Izotypy immunoglobuliny
- Immunoglobulina g
- Salicylaty
- Hydroksybenzoates
- Cytokiny
- Aspiryna
- Immunoglobuliny, dożylnie
- Interleukins
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- 2026-244
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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