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Nephrotic Syndrome in ChildrenPhase 4NCT05772871

The Efficacy and Safety of Prednisone Combined With Huaiqihuang Granule for Primary Nephrotic Syndrome in Children

A Phase 4 study testing Huaiqihuang granule, Prednisone and Levamisole in people with Nephrotic Syndrome in Children, run by Jianhua Zhou at 26 sites in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This non-inferiority study aims to compare the efficacy of Prednisone combined with Huaiqihuang Granule against Prednisone combined with Levamisole in the treatment of primary nephrotic syndrome (PNS) in children. Read more about this study

Who is it for?
Ages 18 months to 18 years
Conditions the study is for
Nephrotic Syndrome in Children
What is being tested?
Huaiqihuang granule, Prednisone and Levamisole
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
402 participants
Where
26 sitesChina
Study dates
26 Apr 2023to 30 Oct 2025
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 months to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Age from 1.5 to 18 years;
  • According to the Evidence-based Guideline for Diagnosis and Treatment of Hormone-sensitive, Relapsed/dependent Nephrotic Syndrome in Children (2016), children diagnosed with PNS;
  • At enrollment, estimated glomerular filtration rate (eGFR)≥90ml/min/1.73m2;
  • At enrollment, serum albumin level below 30g/L, and morning urine protein is 4+ or urinary albumin/creatinine ratio (ACR)≥2.0g/g;
  • Volunteered to participate in this study and signed informed consent. For children less than 8 years, legal guardians need to sign the informed consent.

Who cannot join

  • Children who were diagnosed as steroid-resistant NS;
  • Patients who received Prednisone, other corticosteroids (like Prednisolone, Methylprednisolone), or immunosuppressants (Tacrolimus, Mycophenolate Mofetil, Cyclosporine A, Rituximab, Cyclophosphamide) within 3 months before enrollment;
  • Secondary NS caused by lupus nephritis, hepatitis B associated nephritis, purpura nephritis, and EB virus, cytomegalovirus (CMV), etc;
  • With combined diseases of autoimmune disorder or primary immunodeficiency or malignancy;
  • With combined diseases of the cardiovascular, liver, hematopoietic system, mental disorders, and other serious diseases;
  • With serious infectious diseases (like tuberculosis) in the past or at present;
Show all 11Show fewer
  • With combined diseases of Human immunodeficiency virus (HIV), hepatitis B and /or C virus (HBV, HCV), and other active virus infections;
  • History of diabetes;
  • Abnormal liver function: alanine aminotransferase and aspartate aminotransferase levels exceed twice the upper limit of the normal range;
  • Participation in other ongoing clinical trials;
  • Other reasons that the researcher considers unsuitable to participate in this study.

Trial locations and contacts

26 sites in 1 country.

Jianhua Zhou, Dr. contact

86+13367266559

jhzhou@tjh.tjmu.edu.cn

26 sites in 1 country

China26 sites, 26 recruiting
  • Baiqiu'en First Hospital of Jilin University

    Changchun, Jilin

    Kaishu Zhao

    Recruiting
  • Hunan Children's Hospital

    Changsha, Hunan

    Zhihui Li

    Recruiting
  • West China Second Hospital of Sichuan University

    Chengde, Sichuan

    Yuhong Tao

    Recruiting
  • Chengdu Women's and Children's Central Hospital

    Chengdu, Sichuan

    Shipin Feng

    Recruiting
  • Children's Hospital of Chongqing Medical University

    Chongqing, Chongqing Municipality

    Mo Wang

    Recruiting
  • Dalian Women and Children's Medical Centre

    Dalian, Liaoning

    Mei Han

    Recruiting
  • Fujian Children's Hospital

    Fuzhou, Fujian

    Zihua Yu

    Recruiting
  • People's Liberation Army Joint Logistics Force No. 900 Hospital

    Fuzhou, Fujian

    Xiaojing Nie

    Recruiting
  • The First Affiliated Hospital, Sun Yat-sen University

    Guangzhou, Guangdong

    Xiaoyun Jiang

    Recruiting
  • Children's Hospital of Zhejiang University School of Medicine

    Hangzhou, Zhejiang

    Jianhua Mao

    Recruiting
  • Harbin Children's Hospital

    Harbin, Heilongjiang

    Fang Ning

    Recruiting
  • Anhui Children's Hospital

    Hefei, Anhui

    Fang Deng

    Recruiting
  • Shandong Provincial Hospital

    Jinan, Shandong

    Shunzhen Sun

    Recruiting
  • Ningbo Women's and Children's Hospital

    Ningbo, Zhejiang

    Xiaohui Qiao

    Recruiting
  • Shanghai Children's Hospital

    Shanghai, Shanghai Municipality

    Wenyan Huang

    Recruiting
  • Shengjing Hospital of China Medical University

    Shenyang, Liaoning

    Yue Du

    Recruiting
  • Hebei Children's Hospital

    Shijiazhuang, Hebei

    Dongfeng Zhang

    Recruiting
  • Children's Hospital of Soochow University

    Suzhou, Jiangsu

    Xiaozhong Li

    Recruiting
  • Shanxi Children's Hospital

    Taiyuan, Shanxi

    Lijun Zhao

    Recruiting
  • Tianjin Children's Hospital

    Tianjin, Tianjin Municipality

    Wenhong Wang

    Recruiting
  • Xinjiang Uiger Municipal People's Hospital

    Ürümqi, Xinjiang

    Feiyan Wang

    Recruiting
  • Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology

    Wuhan, Hubei

    Jianhua Zhou

    Recruiting
  • Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology

    Wuhan, Hubei

    Xiaowen Wang

    Recruiting
  • The First Affiliated Hospital of Xinxiang Medical University

    Xinxiang, Henan

    Ziming Han

    Recruiting
  • Henan Children's Hospital

    Zhengzhou, Henan

    Cuihua Liu

    Recruiting
  • The First Affliated Hospital of Zhengzhou University

    Zhengzhou, Henan

    Jianhua Zhang

    Recruiting

Other trials in China

About this study

Official title: Compare the Efficacy and Safety of Prednisone Combined With Huaiqihuang Granule Versus Combined With Levamisole for Primary Nephrotic Syndrome in Children: A Prospective, Multi-center, Randomized, Double-blind, Non-inferiority Study

This non-inferiority study aims to compare the efficacy of Prednisone combined with Huaiqihuang Granule against Prednisone combined with Levamisole in the treatment of primary nephrotic syndrome (PNS) in children.

Read the detailed description

Nephrotic syndrome (NS) is the most frequent glomerular disease in children, with an incidence of 1.15-16.9 per 100,000 children. Children present with the disease at a median age of 2-3 years, and it is twice as common in boys. More than 90% of children who present with NS respond to corticosteroid treatment, and current practice is to treat most patients empirically with prednisone. However, after initial successful treatment, around 80% of children with steroid sensitive NS have disease relapses requiring further courses of prednisone. About 50% of patients develop frequent relapsing or steroid dependent. Further, the long-term use of corticosteroids is associated with numerous side effects, like obesity, diabetes and hypertension.

Traditional Chinese medicine plays a unique role in the enhancement of immune function and kidney function. Huaiqihuang granule is composed of Trametes robiniophila Murr, Fructus Lycii, and Polygonatum sibiricum. It has been used for the treatment of primary nephrotic syndrome (PNS) in China. Previous studies showed Huaiqihuang granule combined with corticosteroids could significantly decrease relapse and infection rates of PNS and were well tolerated by children. This non-inferiority study aims to compare the efficacy of Prednisone combined with Huaiqihuang Granule against Prednisone combined with Levamisole in the treatment of PNS in children.

In this study, about 20 research centers will participate. A total of 402 participants will be divided into two groups (the intervention group and control group) at a ratio of 1:1. The intervention group will receive Prednisone, Huaiqihuang granule and Levamisole placebo, and the control group will receive Prednisone, Levamisole and Huaiqihuang granule placebo. The planned length of patient recruitment enrolment will be 2 years and the total length of visits be 6 months. After enrollment, participants will be followed up until the end of the study (6 months), second relapse, develop as steroid-resistant, lost to follow-up, withdrawal from the study for any reason, or die, whichever occurs first.

Being tested
Huaiqihuang granule, Prednisone, Levamisole placebo, Levamisole, Huaiqihuang Granule placebo
Keywords
Huaiqihuang granule, Children, Nephrotic syndrome
Medical subject headings
Nephrotic Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Huaiqihuang granuleDrug

    Huaiqihuang Granule, oral administration, recommended daily dose: for body weight <10 kg, 5g, twice a day; for 10 kg ≤ body weight <20 kg, 10g, twice a day; for 20 kg≤body weight <30 kg, 15g, twice a day; for 30 kg≤body weight <50 kg, 20g, twice a day; for body weight>50 kg, 30g, twice a day. Continuous medication until the end of the study (6 months), second relapse, development as steroid-resistant, lost to follow-up, withdrawal from the study for any reason, or death, whichever occurs first.

  • PrednisoneDrug

    Prednisone, oral administration, recommended dose: 2mg/kg/d (maximum 60 mg/d) for 4 weeks followed by 2 mg/kg (maximum 60mg) on alternate days for the other 4 weeks. If patients have relapsed during reducing dosage or withdrawal, the patients will receive Prednisone for 8 weeks again [2mg/kg/d (maximum 60 mg/d) for 4 weeks followed by 2 mg/kg (maximum 60mg) on alternate days for the other 4 weeks]. If a second relapse is observed, patients will receive immunosuppressants and then withdraw from the trial.

  • Levamisole placeboDrug

    Levamisole placebo, 1.25 mg/kg. once daily. Continuous medication until the end of the study (6 months), second relapse, development as steroid-resistant, lost to follow-up, withdrawal from the study for any reason, or death, whichever occurs first.

  • LevamisoleDrug

    Levamisole, 1.25 mg/kg. once daily. Continuous medication until the end of the study (6 months), second relapse, development as steroid-resistant, lost to follow-up, withdrawal from the study for any reason, or death, whichever occurs first.

  • Huaiqihuang Granule placeboDrug

    Huaiqihuang Granule placebo, oral administration, recommended daily dose: for body weight <10 kg, 5g, twice a day; for 10 kg ≤ body weight <20 kg, 10g, twice a day; for 20 kg≤body weight <30 kg, 15g, twice a day; for 30 kg≤body weight <50 kg, 20g, twice a day; for body weight>50 kg, 30g, twice a day. Continuous medication until the end of the study (6 months), second relapse, development as steroid-resistant, lost to follow-up, withdrawal from the study for any reason, or death, whichever occurs first.

Study groups in NCT05772871
Study groupRoleWhat they receive
Prednisone, Huaiqihuang granule, and Levamisole placeboExperimentalIn this group, patients will take Prednisone, Huaiqihuang granule, and Levamisole placebo.
Receives: Drug: Huaiqihuang granule; Drug: Prednisone; Drug: Levamisole placebo
Prednisone, Levamisole, and Huaiqihuang granule placeboPlacebo comparatorIn this group, patients will take Prednisone, Levamisole, and Huaiqihuang granule placebo.
Receives: Drug: Prednisone; Drug: Levamisole; Drug: Huaiqihuang Granule placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maintaining remission rate

    At the end of the study, the proportion of patients who maintained urine protein negative without relapse (removed the patients who developed steroid resistance at the first 4 weeks of treatment of Prednisone).

    Measured: Start of randomization until 6-month follow-up

Secondary outcomes (12)
  1. Remission time to first relapse

    Among patients who get remission after treatment, time from the onset of remission to the first relapse

    Measured: Start of onset of remission after treatment until first relapse, assessed up to 6-month

  2. Number of relapses

    Among patients who get remission after treatment, number of relapse per patient

    Measured: Start of randomization until 6-month follow-up

  3. Relapse rate

    Among patients who get remission after treatment, proportion of patients with relapse

    Measured: Start of randomization until 6-month follow-up

  4. Incidence of frequently relapse

    Among patients who get remission after treatment, proportion of patients with more than two times of relapses within 6-month follow-up

    Measured: Start of randomization until 6-month follow-up

  5. Infection rate

    Proportion of patients experiencing infection during the treatment. Infections include respiratory tract infections, urinary tract infections, skin infections, gastrointestinal infections, and others.

    Measured: Start of medication until 6-month follow-up

  6. Cumulative corticosteroids dosage adjusted by body weight

    Total amount of per patient per kilogram cumulative corticosteroids dosage

    Measured: Start of receiving corticosteroids until 6-month follow-up

  7. Change in serum creatinine and estimated glomerular filtration rate (eGFR) before and after treatment

    The level change of serum creatinine, eGFR between baseline and the last testing result during follow-up

    Measured: Start of randomization until 6-month follow-up

  8. Change in serum albumin before and after treatment

    The level change of serum albumin between baseline and the last testing result during follow-up

    Measured: Start of randomization until 6-month follow-up

  9. Change in urinary albumin/creatinine ratio (ACR) before and after treatment

    The level change of urinary albumin/creatinine ratio (ACR) between baseline and the last testing result during follow-up

    Measured: Start of randomization until 6-month follow-up

  10. Change in 24h urinary protein (applying to more than 3 years patients) before and after treatment

    The level change of 24h urinary protein (applying to more than 3 years patients) between baseline and the last testing result during follow-up

    Measured: Start of randomization until 6-month follow-up

  11. Incidence and severity of adverse events (AE) and serious adverse events (SAE)

    Measured: Start of randomization until 6-month follow-up

  12. Incidence and severity of adverse reactions (ADR), serious adverse reactions (SADR), suspicious and unexpected serious adverse reactions (SUSAR)

    Measured: Start of randomization until 6-month follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Mar 2023
  2. Study start26 Apr 2023
  3. Primary completion15 Sep 2025 (estimated)
  4. Study completion30 Oct 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
402 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05772871
Sponsor's protocol ID
HQH-202205
Status last verified
Jun 2024
First submitted
24 Feb 2023
Last updated
21 Jun 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Huaiqihuang granule, Prednisone and Levamisole in people with Nephrotic Syndrome in Children, run by Jianhua Zhou at 26 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 21 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 26 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Jianhua Zhou, Dr. (86+13367266559, jhzhou@tjh.tjmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maintaining remission rate (time frame: Start of randomization until 6-month follow-up). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Jun 2024.

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