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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2500107750 |
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最近更新日期: Date of Last Refreshed on: |
2025-08-18 11:51:02 |
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注册时间: Date of Registration: |
2025-08-18 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
托珠单抗治疗中国抗MDA5抗体阳性成人皮肌炎疗效及安全性的随机、双盲、安慰剂对照临床研究 |
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Public title: |
A Randomized, Double-Blind, Placebo-Controlled Clinical Study on the Efficacy and Safety of Tocilizumab in the Treatment of Anti-MDA5 Antibody-Positive Adult Dermatomyositis |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
托珠单抗治疗中国抗MDA5抗体阳性成人皮肌炎疗效及安全性的随机、双盲、安慰剂对照临床研究 |
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Scientific title: |
A Randomized, Double-Blind, Placebo-Controlled Clinical Study on the Efficacy and Safety of Tocilizumab in the Treatment of Anti-MDA5 Antibody-Positive Adult Dermatomyositis |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
王迁 |
研究负责人: |
王迁 |
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Applicant: |
Wang Qian |
Study leader: |
Wang Qian |
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申请注册联系人电话: Applicant telephone: |
+86 10 6915 9958 |
研究负责人电话:
Study leader's |
+86 10 6915 9958 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
zhengaqian@126.com |
研究负责人电子邮件: Study leader's E-mail: |
zhengaqian@126.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
北京市东城区帅府园1号 |
研究负责人通讯地址: |
北京市东城区王府井帅府园1号 |
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Applicant address: |
No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing |
Study leader's address: |
No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
北京协和医院 |
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Applicant's institution: |
Peking Union Medical College Hospital |
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研究负责人所在单位: |
中国医学科学院北京协和医院 |
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Affiliation of the Leader: |
Peking Union Medical College Hospital |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
I-25PJ1573 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
中国医学科学院北京协和医院伦理审查委员会 |
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Name of the ethic committee: |
PUMCH Institutional Review Board |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-07-15 00:00:00 | ||
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伦理委员会联系人: |
李佳月 |
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Contact Name of the ethic committee: |
Jiayue Li |
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伦理委员会联系地址: |
北京市东城区王府井帅府园1号 |
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Contact Address of the ethic committee: |
No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 10 69156874 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
dott1994@163.com |
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研究实施负责(组长)单位: |
中国医学科学院北京协和医院 |
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Primary sponsor: |
Peking Union Medical College Hospital |
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研究实施负责(组长)单位地址: |
北京市东城区王府井帅府园1号 |
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Primary sponsor's address: |
No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
常见多发病防治研究:难治性自身免疫病精准诊治与创新疗法研究,课题四:炎性肌病精准分型和优化治疗策略研究(2024YFC2510304) |
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Source(s) of funding: |
Study on Precision Classification and Optimized Treatment Strategies for Inflammatory Myopathies |
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研究疾病: |
抗MDA5抗体阳性成人皮肌炎 |
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Target disease: |
Anti-MDA5 Antibody-Positive Adult Dermatomyositis |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
上市后药物 | ||||||||||||||||||||||
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Study phase: |
4 |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
通过开展为期16周的多中心、前瞻性、随机、安慰剂对照的临床试验,系统评估托珠单抗在治疗中国成人抗MDA5-DM患者中的疗效和安全性。 |
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Objectives of Study: |
To systematically evaluate the efficacy and safety of tocilizumab in the treatment of Chinese adults with Anti-MDA5 Antibody-Positive Adult Dermatomyositis, by a 16-week multicenter, prospective, randomized, placebo-controlled clinical trial. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1. 年龄≥18岁且<65岁,男女性别不限;总体重 ≥ 45 kg; |
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Inclusion criteria |
1. Between 18 and 65 years of age, with no gender restrictions, with a body weight of at least 45 kg. 2. Diagnosis of anti-MDA5-DM based on the "2023 Chinese Expert Consensus on the Diagnosis and Treatment of Dermatomyositis Positive for Anti-Melanoma Differentiation-Associated Gene 5 Antibody": a dermatomyositis patient can be diagnosed with anti-MDA5-DM if presenting with Gottron's sign, Gottron's papules, or heliotrope rash, and positive for serum anti-MDA5 antibody. 3. If patients have associated ILD, they must also meet the following conditions: i) SpO2 >= 90% or PaO2 >= 60mmHg, ii) In pulmonary function tests, a forced vital capacity (FVC%) ≥>=60% of predicted value, and a carbon monoxide diffusion capacity (DLco%) >=40% of predicted value; iii) Chest HRCT showing an extent of interstitial lung disease less than 50% of the lung field. 4. Patients must have been on a stable oral dose of prednisone (< 1mg/kg/day, or an equivalent dose of another type of glucocorticoid) for at least 4 weeks before randomization. 5. Patients must have been on a stable dose of one calcineurin inhibitor (tacrolimus 1mg bid, or cyclosporine 3-5mg/kg) for at least 4 weeks before randomization; if immunosuppressive drugs were discontinued before the screening visit, they must have been discontinued for at least 4 weeks. 6. Patients must use trimethoprim-sulfamethoxazole (TMP-SMZ) for infection prophylaxis during the treatment period, 1-2 tablets/day. 7. Female subjects of childbearing age must have a negative pregnancy test at the start of the trial, must not intend to become pregnant during the study, and must agree to use effective contraceptive measures throughout the study if they are sexually active. 8. Patients must voluntarily participate in this study and sign an informed consent form. |
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排除标准: |
1. 多发性肌炎、抗合成酶综合征、免疫介导的坏死性肌炎或合并其他结缔组织病的重叠性肌炎; 2. 患者存在危及生命的并发症,包括但不限于筛选前 24 周内有急性冠脉综合征(例如心肌梗死、不稳定型心绞痛)或任何重要的脑血管疾病病史; 3. 筛选时存在以下任何一项实验室异常:白细胞<3.0×10^9/L,中性粒细胞<1.0×10^9/L,淋巴细胞计数<0.5×10^9/L,血红蛋白<90g/L,血小板计数<50×10^9/L;严重的肝功能不全(ALT或AST ≥3倍ULN,总胆红素 ≥1.5 倍ULN,不包括由皮肌炎引起的血清ALT或AST升高);严重的肾功能不全(肌酐清除率≤45 ml/min); 4. 筛选前60天内因严重感染而接受住院治疗,或静脉输注抗生素(使用静脉抗生素的患者需完成五个半衰期的洗脱,并确认无活动性感染后方可入组),可接受经验性口服抗生素、或局部外用抗生素的患者; 5. 未经治疗或未经充分治疗的活动性结核感染;潜伏性结核(LTBI)需要在随机前至少接受2周以上的预防性抗结核治疗(至少包括2种抗结核药)并延续至研究结束。LTBI定义如下:IGRA 结果呈阳性(可接受的 IGRA 分析包括:QFT-GIT和QFT-G以及T-spot? TB 检测); 6. 筛选时存在活动性病毒性肝炎:患者血清HBsAg阳性、HBeAg阳性或HBV-DNA>103拷贝/L,如患者HBcAb阳性需加测HBV-DNA;HCVAb阳性; 7. 有文件记录的HIV感染,表现为血清学试验结果呈阳性或筛选时的 HIV血清学试验结果呈阳性; 8. 若患者4周内出现ILD相关临床表现、影像学的进行性加重,则应考虑RP-lLD,RP-ILD 定义为在呼吸道症状出现后 1 个月内存在以下 4 种情况中的任何一种:①急性和进行性呼吸困难加剧,需要住院治疗或额外氧气供应;②肺功能受损,表现为FVC%下降>10%伴或不伴DLco%下降>15%;③胸部 HRCT扫描显示间质异常程度增加>20%;④动脉血气分析或氧分压降低>10 mmHg,提示呼吸衰竭;且PaO2/FiO2≥200mmHg。 9. 对托珠单抗活性成分及其其他任何辅料过敏; 10. 对磺胺过敏的患者; 11. 基线期无法完成肺功能检查的患者; 12. 筛选前接受剂量大于2mg/kg/d的泼尼松治疗的患者; 13. 若患者在筛选前使用静脉注射免疫球蛋白(IVIG),必须停止用药至少30天; 14. 筛选前相应时间窗内使用如下一种或多种药物者: a) 筛选前6个月内使用利妥昔单抗; b) 筛选前2周内使用JAK抑制剂; c) 筛选前4周内使用其他生物制剂(包括但不限于阿那白滞素、阿达木单抗、英夫利昔单抗)及其他免疫抑制剂药物(包括但不限于甲氨蝶呤、硫唑嘌呤、吗替麦考酚酯); 15. 既往使用过研究药物、其他 IL-6 抑制剂或类似物的患者; 16. 孕妇或哺乳期妇女,或计划怀孕或开始哺乳的妇女; 17. 5年内有恶性肿瘤病史(不包括充分治疗后的皮肤基底细胞癌、皮肤鳞状细胞癌或前5年内无复发证据的宫颈原位癌); 18. 经研究者判断不适合纳入研究的其他情况。 |
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Exclusion criteria: |
1. Polymyositis, antisynthetase syndrome, immune-mediated necrotizing myopathy, or overlap myositis with other connective tissue diseases. 2. Patients with life-threatening complications, including but not limited to a history of acute coronary syndrome (e.g., myocardial infarction, unstable angina) or any significant cerebrovascular disease within 24 weeks prior to screening. 3. Any of the following laboratory abnormalities at screening: white blood cell count <3.0×10^9/L, neutrophil count <1.0×10^9/L, lymphocyte count <0.5×10^9/L, hemoglobin <90g/L, platelet count <50×10^9/L; severe liver dysfunction (ALT or AST ≥3 times the upper limit of normal (ULN), total bilirubin ≥1.5 times ULN, excluding serum ALT or AST elevation caused by dermatomyositis); severe renal dysfunction (creatinine clearance <=45 ml/min). 4. Hospitalization for severe infection or intravenous antibiotic administration within 60 days prior to screening (patients on intravenous antibiotics must complete a washout period of five half-lives and are confirm to have no active infection before enrollment), patients on empirical oral antibiotics or topical antibiotics are acceptable. 5. Untreated or inadequately treated active tuberculosis infection; latent tuberculosis infection (LTBI) requires at least 2 weeks of preventive anti-tuberculosis treatment (including at least two anti-tuberculosis drugs) before randomization and continuation until the end of the study. LTBI is defined as positive IGRA results (acceptable IGRA analyses include: QFT-GIT and QFT-G as well as T-spot? TB test). 6. Active viral hepatitis at screening: patients who are serum HBsAg positive, HBeAg positive, or HBV-DNA >10^3 copies/L, if the patient is HBcAb positive, additional HBV-DNA testing is required; HCV-Ab positive. 7. Documented HIV infection, characterized by positive serological test results or positive HIV serological test results at screening. 8. Patients with rapidly progressive interstitial lung disease (RP-ILD): RP-ILD is defined as the presence of any one of the following four conditions within 1 month after the onset of respiratory symptoms: i) acute and progressive exacerbation of dyspnea requiring hospitalization or additional oxygen supply; ii) lung function impairment presenting as a decrease in FVC% from baseline of >10%, with or without a decrease in DLCO% of >15%; iii) chest HRCT scan showing an increase in the extent of interstitial abnormalities of >20%; iv) arterial blood gas analysis showing a PaO2 decrease from baseline of >10 mmHg, indicating respiratory failure, And PaO2/FiO2 >=200mmHg. 9. Allergy to the active ingredient of tocilizumab or any other excipients. 10. Allergy to sulfonamides. 11. Patients who are unable to complete pulmonary function tests at baseline. 12. Patients who have received prednisone treatment at a dose greater than 2mg/kg/day within the screening period. 13. Patients who have used intravenous immunoglobulin (IVIG) within 30 days before screening. 14. Use of one or more of the following medications within the specified time frames prior to screening: Rituximab within 6 months before screening. JAK inhibitors within 2 weeks before screening. Other biologic agents (including but not limited to adalimumab, infliximab, anakinra) and other immunosuppressive drugs (including but not limited to methotrexate, azathioprine, mycophenolate mofetil) within 4 weeks before screening. 15. History of intolerance to study medication, other IL-6 inhibitors, or similar agents. 16. Patients who are pregnant or breastfeeding, or planning to become pregnant or start breastfeeding. 17. History of malignancy within the last 5 years (excluding adequately treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or cervical carcinoma in situ with no evidence of recurrence in the last 5 years). 18. Any other conditions deemed by the investigator as unsuitable for inclusion in the study. |
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研究实施时间: Study execute time: |
从 From 2025-05-20 00:00:00至 To 2027-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2025-08-31 00:00:00 至 To 2026-12-31 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
由中央随机系统提供及随机非盲管理单位采用SAS 9.4的PLAN过程产生受试者随机表和药物随机表,采用随机系统实现受试者的入组管理和药物的随机分发。 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
The central randomization system provided and the randomized non-blind management unit used the PLAN procedure in SAS 9.4 to generate the subject randomization list and drug randomization list. |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
双盲 |
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Blinding: |
Double blind |
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是否共享原始数据: IPD sharing |
否No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
向主要研究者发送申请邮件 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
Send an application email to the principal investigator |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
电子采集和管理系统 (Electronic Data Capture,EDC) |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Electronic Data Capture |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |