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Lupus NephritisNCT06277427

Refractory ANCA Associated Vasculitis and Lupus Nephritis Treated With BCMA-targeting CAR-T Cells

A study testing PRG-1801 (CAR-T against BCMA) in people with Lupus Nephritis and ANCA Associated Vasculitis, run by Lingli Dong at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Lupus nephritis (LN) and ANCA-associated vasculitis are severe autoimmune diseases, which may lead to the death of patients, particularly when they are refractory to the conventional therapeutic agents. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Lupus Nephritis, ANCA Associated Vasculitis
What is being tested?
PRG-1801 (CAR-T against BCMA)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
1 siteChina
Study dates
5 Feb 2024to 31 Jan 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years old, not exceeding 70 years old (including 70 years old);
  • If the kidneys are involved, estimate the glomerular filtration rate (eGFR) to be ≥ 15 mL/minute/1.73 m2;
  • The following test values within 3 days before the collection of mononuclear cells meet the following standards:
  • Absolute lymphocyte count: ≥ 0.5 × 10 ^ 9/L [The use of granulocyte colony-stimulating factor (G CSF) is allowed, but subjects are not allowed to receive this supportive treatment within 7 days before the screening period laboratory examination];
  • Absolute neutrophil count: ≥ 1.0 × 10 ^ 9/L [The use of granulocyte colony-stimulating factor (G-CSF) is allowed, but subjects are not allowed to receive this supportive treatment within 7 days before the screening period laboratory examination];
  • Platelets: Subject platelet count ≥ 50 × 10 ^ 9/L (subjects are not allowed to receive blood transfusion support within 7 days before the screening period laboratory examination);
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  • Hemoglobin: ≥ 8.0 g/dL (allowing the use of recombinant human erythropoietin) [subjects have not received red blood cell (RBC) infusion within 7 days prior to the screening period laboratory examination];
  • Creatinine clearance rate: (CrCl) or glomerular filtration rate (GFR) (Cockcroft Gault formula) ≥ 30 mL/min;
  • Total bilirubin (serum): Total bilirubin (serum) ≤ 1.5 × ULN; Blood bilirubin>1.5 × Gilbert subjects from ULN can be enrolled with the consent of the sponsor
  • AST and ALT: ≤ 3.0 × ULN;
  • Plasma prothrombin time (PT), international standardized ratio (INR), partial prothrombin time (APTT): PT ≤ 1.5 × ULN, APTT ≤ 1.5 × ULN, INR ≤ 1.5 × ULN
  • Willing to sign an informed consent form.
  • - for refractory ANCA-associated vasculitis
  • ①According to the 2022ACR/EULAR criteria, diagnosed with AAV (GPA or MPA subtype), who has not achieved remission (BVAS score of 0) for ≥ 3 months after receiving standardized treatment. Severe patients who have previously undergone standardized treatment to induce remission and are now relapsing after maintenance therapy; ②The patient is currently or has a positive ANCA during the course of the disease; ③Severe illness (severe organ involvement or life-threatening) requiring treatment (BVAS score ≥ 3.0); The definition of severe illness is vasculitis with life-threatening or organ manifestations.
  • - for refractory LN
  • According to the 2019 American Society of Rheumatology (ACR) criteria, diagnosed with systemic lupus erythematosus, within 6 months prior to infusion, confirmed by renal tissue biopsy according to the 2003 International Society of Nephrology (ISN)/Society of Nephropathology (RPS) criteria as active, proliferative lupus nephritis (LN), type III or IV [excluding III (C), IV S (C), and IV G (C)], or type III/IV combined with type V, And have received standard treatment that is ineffective or relapses after disease remission. ②Positive anti-nuclear antibodies (ANA) and/or anti-dsDNA antibodies during the screening period. ③The SLE Disease Activity Index (SLEDAI-2000) score during the screening period is ≥ 8. SLEDAI-2000 clinical score ≥ 6 points, but low complement and/or anti ds-DNA positivity can be selected. ④The estimated survival period is at least 3 months.

Who cannot join

  • -Subjects who meet any of the following criteria should be excluded from this study:
  • Pregnant or lactating women;
  • If combined with alveolar hemorrhage, invasive pulmonary ventilation is required;
  • Refractory GPA and MPA: Combined with other autoimmune diseases involving multiple organ systems, such as EGPA, SLE, IgA vasculitis (Henoch Schönlein), rheumatoid arthritis, inflammatory myositis, anti-glomerular basement membrane disease, or cryoglobulinemia vasculitis;
  • Difficult to treat LN: severe extrarenal clinical manifestations such as lupus encephalopathy, pulmonary hemorrhage, lupus myocarditis, lupus enteritis, and lupus crisis; Other autoimmune diseases other than combined SLE, including dermatomyositis/polymyositis, mixed connective tissue disease, systemic sclerosis, rheumatoid arthritis, etc;
  • Individuals who are known to have allergic reactions, hypersensitivity reactions, intolerance, or contraindications to any component of PRG-1801 or drugs that may be used in the study (including fludarabine, cyclophosphamide, tocilizumab, albumin), or have experienced severe allergic reactions in the past;
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  • A history of malignant tumors within 5 years (① subjects with cervical carcinoma in situ who have been completely removed and have not experienced recurrence or metastasis for at least 3 years may participate in this study. ② subjects with basal cell or squamous cell carcinoma who have been completely removed and have not experienced recurrence for at least 3 years may participate in this study);
  • Obvious evidence of cardiovascular disease as follows: a N-terminal B-type natriuretic peptide (NT proBNP)>8500ng/L; b. The New York Heart Association (NYHA) classifies heart failure as Grade IV; c. Patients who received hospitalization for unstable angina or myocardial infarction within 6 months prior to the first administration, or patients who received percutaneous cardiac intervention and received the most recent stent placement within 6 months or coronary artery bypass grafting within 6 months;
  • Received the following medication treatment within the prescribed time before single collection: ① Received B cell depletion therapy such as rituximab within 24 weeks; ② Received biological agents (such as TNF) within 4 weeks or 2 half-lives - Treatment with inhibitors, interleukin receptor inhibitors, belizumab, and tamoxifen; ③ Received treatment such as immunosuppressants within 2 weeks or 5 half-lives ; ④ If systemic glucocorticoids need to be used for a long time from 2 weeks before single collection to the study period, the dose of the hormone should not exceed 10mg/day; ⑤ Received plasma exchange or immunosorbent therapy within 24 weeks, and received intravenous immunoglobulin (IVIG) therapy within 4 weeks.
  • Vaccinate with live/attenuated vaccines within 4 weeks prior to single collection or during the study period;
  • Chronic and active hepatitis B ( the HBV DNA test is higher than 500IU/ml), hepatitis C (HCV), human immunodeficiency virus (HIV) infection, or syphilis infection;
  • There is an active infection that requires intravenous injection of antibiotics or hospitalization treatment;
  • Major surgery or surgical treatment caused by any reason within 4 weeks prior to enrollment;
  • Any serious and/or uncontrollable comorbidities that the researcher believes may interfere with the evaluation during the research process;
  • Participated in other intervention clinical trials within 3 months prior to enrollment or within 5 drug half-lives (whichever is longer);
  • Other conditions determined by the researcher as unsuitable for lymphocyte clearance or cell infusion, or other unsuitable patients for study.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Lingli Dong, MD contact

+862783665519

tjhdongll@163.com

Cong Ye, MD contact

+862783665518

Yecong@163.com

China1 site, 1 recruiting
  • Tongji Hospital

    Wuhan, Hubei, 430030

    Lingli Dong, MD, 86-27-83665519, tjhdongll@163.com

    Cong Ye, MD, 86-27-83665518, Yecong@163.com

    Recruiting

Other trials in China

About this study

Lupus nephritis (LN) and ANCA-associated vasculitis are severe autoimmune diseases, which may lead to the death of patients, particularly when they are refractory to the conventional therapeutic agents. Based on the current knowledge, the autoantibodies against self-antigens may exert important pathological roles in the pathogenesis of both LN and ANCA-associated vasculitis, of which the origins are primarily plasmablasts and plasma cells. BCMA is the molecule expressed on memory B cells, plasmablasts and plasma cells, and therefore is an ideal target for the elimination of potential pathogenic antibody secreting cells. Chimeric antigen receptor (CAR) T cells against BCMA may provide a novel therapeutic way for the refractory LN and ANCA-associated vasculitis patients to eliminate the pathogenic autoantibody-secreting cells. In this study, the safety and efficacy of a novel CAR-T cell therapy using PRG-1801 cells, are evaluated in patients with refractory LN and ANCA-associated vasculitis.

Being tested
PRG-1801 (CAR-T against BCMA)
Keywords
CAR-T, Lupus nephritis, ANCA associated vasculitis, BCMA
Medical subject headings
Lupus Nephritis, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis

What participants receive

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

  • PRG-1801 (CAR-T against BCMA)Drug

    Patients with refractory LN and ANCA-associated vasculitis will be treated with PRG-1801

Study groups in NCT06277427
Study groupRoleWhat they receive
CAR-T treatmentExperimentalLymphocyte clearance before PRG-1801 cells' infusion; Plan to design two dose levels (2.5x10^6 CAR-T/kg and 5.0x10^6 CAR-T/kg), with 3-6 AAV and LN subjects included in each dose group, totaling 12-24 subjects. Within each dose group, the next subject can be administered after the previous subject has completed at least 14 days of safety observation. Dose group 1: with a dosage of 2.5x10^6 (cells/kg) per dose Dose group 2: with a dosage of 5.0x10^6 (cells/kg) per dose
Receives: Drug: PRG-1801 (CAR-T against BCMA)

What is being measured

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

  1. AE Incidence of PRG-1801 Single Infusion

    AE Incidence of PRG-1801 Single Infusion

    Measured: 24 months after PRG-1801 infusion

  2. Types and incidence of dose-limiting toxicity(DLT) after PRG-1801 cells infusion in subjects with refractory ANCA-associated vasculitis and refractory LN.

    To evaluate the DLT occurred within 28 days and 3 months after PRG-1801 infusion

    Measured: 28 days and 3 months after PRG-1801 infusion

Secondary outcomes (24)
  1. Therapeutic effects-For refractory ANCA-associated vasculitis(The proportion of subjects who maintained remission after cell infusion)

    The proportion of subjects who maintained remission after cell infusion

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  2. Therapeutic effects-For refractory ANCA-associated vasculitis(Changes in VDI (Vasculitis Damage Index) scores from baseline after cell infusion)

    Changes in VDI (Vasculitis Damage Index) scores from baseline after cell infusion

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  3. Therapeutic effects-For refractory ANCA-associated vasculitis (Changes in glomerular filtration rate compared to baseline after cell infusion in subjects with renal involvement.)

    Changes in glomerular filtration rate compared to baseline after cell infusion in subjects with renal involvement.

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  4. Therapeutic effects-For refractory LN (Changes in SLEDAI-2000 score from baseline after cell infusion)

    Changes in SLEDAI-2000 score from baseline after cell infusion

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  5. Therapeutic effects-For refractory LN (Changes in FACIT fatigue score from baseline after cell infusion )

    Changes in FACIT fatigue score from baseline after cell infusion

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  6. Therapeutic effects-For refractory LN (Changes in PGA score (0-10) from baseline after cell infusion)

    Changes in PGA score (0-10) from baseline after cell infusion

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  7. Therapeutic effects-For refractory LN (Changes in eGFR(mL/min/1.73 m2) relative to baseline after cell infusion)

    Changes in eGFR(mL/min/1.73 m2) relative to baseline after cell infusion

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  8. Therapeutic effects-For refractory LN (Changes in UPCR (g/24h)relative to baseline after cell infusion)

    Changes in UPCR (g/24h)relative to baseline after cell infusion

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  9. Therapeutic effects-For refractory LN (The proportion of subjects who achieved overall response rate after cell infusion.)

    The proportion of subjects who achieved overall response rate after cell infusion.

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  10. Therapeutic effects-For refractory LN(The proportion of subjects who achieved complete renal response after cell infusion.)

    The proportion of subjects who achieved complete renal response after cell infusion.

    Measured: Month1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  11. PK feature evaluation (PK parameters related to CAR copy number)

    PK parameters related to CAR copy number

    Measured: baseline, Day2, Day6, Day10, Day21, Day28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 after cell infusion

  12. Serum sBCMA level

    Serum sBCMA level (count/uL)

    Measured: baseline, Day14, Day28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 month after cell infusion

  13. Serum ANCA titer level (AAV)

    Serum ANCA titer level (AAV)

    Measured: baseline, Day14, Day28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 month after cell infusion

  14. Serum dsDNA level (LN)

    Serum dsDNA level (IU/mL)

    Measured: baseline, Day14, Day28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 month after cell infusion

  15. Serum ANA titer level (LN)

    Serum ANA titer level (IU/mL)

    Measured: baseline, Day14, Day28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 month after cell infusion

  16. Serum complement C3 levels

    Serum complement C3 levels (g/L)

    Measured: baseline, Day14, Day28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 month after cell infusion

  17. Serum complement C4 levels

    Serum complement C4 levels (g/L)

    Measured: baseline, Day14, Day28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 month after cell infusion

  18. Serum immunoglobulin quantification

    Serum immunoglobulin quantification (g/L)

    Measured: baseline, Day14, Day28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 month after cell infusion

  19. Levels of CRP levels

    Levels of CRP levels (mg/L)

    Measured: baseline, Day2, Day6, Day10, Day14, Day21, Day28 after cell infusion

  20. Levels of ferritin levels

    Levels of ferritin levels (ug/L)

    Measured: baseline, Day2, Day6, Day10, Day14, Day21, Day28 after cell infusion

  21. Levels of cytokine levels

    Levels of cytokine levels (pg/mL)

    Measured: baseline, Day2, Day6, Day10, Day14, Day21, Day28 after cell infusion

  22. Changes of peripheral blood lymphocyte subsets

    Changes of peripheral blood lymphocyte subsets (count/uL)

    Measured: baseline, Day2, Day6, Day10, Day14, Day21, Day28, Month 2, Month 3, Month 6 after cell infusion

  23. Expression levels of BCMA on peripheral blood B cell subsets surface

    Expression levels of BCMA on peripheral blood B cell subsets surface (%), using flow cytometer method.

    Measured: baseline, through study completion, an average of 2 years

  24. The level of anti drug antibody (ADA)

    The level of anti drug antibody (ADA)

    Measured: baseline, through study completion, an average of 2 years

Timeline

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

  1. First posted26 Feb 2024
  2. Study start5 Feb 2024
  3. Primary completion1 Feb 2026 (estimated)
  4. Study completion31 Jan 2027 (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 N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
24 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06277427
Sponsor's protocol ID
[2023]S208
Status last verified
Feb 2024
First submitted
1 Feb 2024
Last updated
26 Feb 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 study testing PRG-1801 (CAR-T against BCMA) in people with Lupus Nephritis and ANCA Associated Vasculitis, run by Lingli Dong at 1 site 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 16 inclusion and 16 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: looking for participants now, as of the sponsor's last update on 26 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Lingli Dong, MD (+862783665519, tjhdongll@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

AE Incidence of PRG-1801 Single Infusion (time frame: 24 months after PRG-1801 infusion). The study lists 2 primary outcomes in all. 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 26 Feb 2024.

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