Study of the Efficacy and Safety of a Bispecific Antibody, Teclistamab in Severe Rapidly Progressive Interstitial Lung Disease Associated With Anti-MDA5 (TEAM MDA5)
Study of the Efficacy and Safety of a Bispecific Antibody, Teclistamab in Severe Rapidly Progressive Interstitial Lung Disease Associated With Anti-MDA5.
Patients with severe, rapidly progressive diffuse interstitial lung disease (RP ILD) with anti-MDA5 have an appalling prognosis and the lack of effective medical treatment leads to lung transplantation being proposed as salvage treatment. Currently, transplant-free survival at 90 days (D90) is approximately 25%, dropping to less to 10% among those requiring mechanical ventilation. Peripheral lymphopenia and elevated anti-MDA5 antibody levels are associated with greater disease severity, highlighting the involvement of mature T and B lymphocytes in disease pathogenesis.
Teclistamab, a bispecific antibody targeting the B-cell maturation antigen (BCMA) on plasma cells and engaging T cells - approved for the treatment of refractory multiple myeloma - has recently shown rapid and promising effects in patients with autoimmune conditions, including one MDA5-positive patient, while maintaining a favourable safety profile. We hypothesize that this bispecific antibody could represent a promising and safe therapeutic option for patients with severe MDA5-associated RP-ILD.
研究概览
地位
干预/治疗
研究类型
注册 (估计的)
阶段
- 阶段2
联系人和位置
学习联系方式
- 姓名：Yurdagül UZUNHAN, Pr
- 电话号码：+33148955280
- 邮箱：yurdagul.uzunhan@aphp.fr
参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
Inclusion Criteria:
- Patient ≥ 18 years old
- MDA5 antibody positivity
- ILD confirmed by chest HRCT
- Within less than 3 months after disease onset
- Refractory after more than 7 days to high dose steroids and two immunosuppressants drugs as first-line treatment.
- Confirmation of refractoriness by the national emergency multidisciplinary discussion (MDD),
- Worsening of respiratory symptoms with respiratory distress defined by increase in oxygen supply to reach SpO2>95% or requirement of mechanical ventilation
- Written informed consent obtained from the patient or the trusted support person designated in advance by the patient
- Patients covered by the French social security system
- Effective contraception for woman of childbearing age during treatment and for five months after the last dose of teclistamab.
- Effective contraception for men, having a partner of childbearing age, during treatment and for three months after the last dose of teclistamab.
Exclusion Criteria:
- Patient with known hypersensitivity to teclistamab, substance active or excipients, including sodium or polysorbate
- Patient or the trusted person designed by the patient not able to give their consent
- Known diagnosis of a serious comorbidity: active cancer, malignant blood disease, ongoing infection, stroke or seizure within 6 months
- Patient who received a live vaccine within 4 weeks prior to study inclusion.
- Patient under judicial protection, deprivation of liberty
- Patient participating in another clinical trial with an investigational medicinal product
- Pregnant or breastfeeding woman
- Patient on AME (state medical aid)
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：不适用
- 介入模型：单组作业
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的：Experimental
Dosage and subcutaneous administration of Teclistamab: Day 1: 0.06 mg/kg Day 3: 0.3 mg/kg Day 5: 1.5 mg/kg) |
Dosage and subcutaneous administration of Teclistamab: Day 1: 0.06 mg/kg Day 3: 0.3 mg/kg Day 5: 1.5 mg/kg)
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
The primary objective is to demonstrate the efficacy of teclistamab in improving transplant-free survival of patients with anti-Melanoma differentiation-associated protein 5 associated rapidly progressive diffuse interstitial lung disease.
大体时间：at 90 days
|
The primary endpoint is transplant-free survival at 90 days, defined as the time from inclusion to lung transplantation or death from any cause.
|
at 90 days
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
To assess the length of stay in hospital
大体时间：at 90 days
|
Total hospital length of stay, from admission to discharge
|
at 90 days
|
|
To evaluate disease severity
大体时间：at 90 days
|
Disease severity evaluated using the World Health Organization Clinical Progression Scale adapted for Interstitial Lung Disease-associated respiratory failure (11-point ordinal scale from 0 to 10).
|
at 90 days
|
|
To evaluate the response of Interstitial Lung Disease on imaging
大体时间：From enrollment to the end at week 24
|
Interstitial Lung Disease response will be based on evolution of Interstitial Lung Disease extent on centralized chest Computed Tomography at Day 0, Week 2, Week 4, Week 12 and Week 24
|
From enrollment to the end at week 24
|
|
To assess the tolerance profile of teclistamab
大体时间：to day 1 of treatment to the end of treatment (4 week )
|
Tolerance assessed by the occurrence and gradation of adverse events, including infections complications detected by microbiological monitoring protocolised in ICU units during the follow-up period.
|
to day 1 of treatment to the end of treatment (4 week )
|
|
To evaluate the response of extra-respiratory manifestations including muscular involvement
大体时间：From Day 0 at week 24
|
Dermatomyositis disease monitoring assessed at Day 0, Week 2, Week 4, Week 12 and Week 24 through: Manual Muscle Testing 8 score (set of 8 designated muscles tested unilaterally)
|
From Day 0 at week 24
|
|
To evaluate overall survival
大体时间：from inclusion to day 90
|
Overall Survial defined as the time from inclusion to death from any cause, with documentation of the causes of death.
|
from inclusion to day 90
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- APHP251597
- 2026-526467-38-00 (克蒂斯)
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