基于ARRS评分的ANCA相关性肾炎分层治疗疗效及不良反应的多中心前瞻性队列研究

注册号:

Registration number:

ChiCTR2000034214 

最近更新日期:

Date of Last Refreshed on:

2020-06-28 20:10:36 

注册时间:

Date of Registration:

2020-06-28 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于ARRS评分的ANCA相关性肾炎分层治疗疗效及不良反应的多中心前瞻性队列研究

Public title:

A multicenter, prospective, cohort study for the efficacy and adverse reactions of ANCA associated glomerulonephritis based on ARRS score

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于ARRS评分的ANCA相关性肾炎分层治疗疗效及不良反应的多中心前瞻性队列研究

Scientific title:

A multicenter, prospective, cohort study for the efficacy and adverse reactions of ANCA associated glomerulonephritis based on ARRS score

研究课题代号(代码):

Study subject ID:

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:

申请注册联系人:

王墨 

研究负责人:

王墨 

Applicant:

Mo Wang 

Study leader:

Mo Wang 

申请注册联系人电话:

Applicant telephone:

+86 13983649255

研究负责人电话:

Study leader's
telephone:

+86 13983649255

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

1010954275@qq.com

研究负责人电子邮件:

Study leader's E-mail:

1010954275@qq.com

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):

申请注册联系人通讯地址:

重庆市渝中区中山二路136号

研究负责人通讯地址:

重庆市渝中区中山二路136号

Applicant address:

136 Second Zhongshan Road, Yuzhong District, Chongqing, China

Study leader's address:

136 Second Zhongshan Road, Yuzhong District, Chongqing, China

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:

申请人所在单位:

重庆医科大学附属儿童医院

Applicant's institution:

Children's Hospital Affiliated to Chongqing Medical University

研究负责人所在单位:

重庆医科大学附属儿童医院

Affiliation of the Leader:

Children's Hospital Affiliated to Chongqing Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

(2020)年伦审(研)第(39)号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

重庆医科大学附属儿童医院伦理委员会

Name of the ethic committee:

The Institutional Review Board, Children's Hospital of Chongqing Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2020-04-29 00:00:00

伦理委员会联系人:

卢仲毅

Contact Name of the ethic committee:

Zhongyi Lu

伦理委员会联系地址:

重庆市渝中区中山二路136号

Contact Address of the ethic committee:

136 Second Zhongshan Road, Yuzhong District, Chongqing, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

重庆医科大学附属儿童医院

Primary sponsor:

Children's Hospital Affiliated to Chongqing Medical University

研究实施负责(组长)单位地址:

重庆市渝中区中山二路136号

Primary sponsor's address:

136 Second Zhongshan Road, Yuzhong District, Chongqing, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

重庆

市(区县):

重庆

Country:

China

Province:

Chongqing

City:

Chongqing

单位(医院):

重庆医科大学附属儿童医院

具体地址:

渝中区中山二路136号

Institution
hospital:

Children's Hospital Affiliated to Chongqing Medical University

Address:

136 Second Zhongshan Road, Yuzhong District

经费或物资来源:

自筹

Source(s) of funding:

self-financing

研究疾病:

ANCA相关性肾炎  

Target disease:

ANCA associated glomerulonephritis

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

析因分组(即根据危险因素或暴露因素分组) 

Study design:

Factorial 

研究目的:

本课题旨在为我国儿童ANCA相关性肾炎提供大样本流行病学资料,并开发出适用于儿童ANCA相关性肾炎患者的肾脏损伤风险评估体系,以在诊断早期进行肾脏结局预测;为未来的儿童ANCA相关性肾炎患者诊疗提供理论依据。  

Objectives of Study:

The purpose of this project is to provide large sample epidemiological data for ANCA related glomerulonephritis in children in China, and to develop a risk assessment system for renal injury in children with ANCA related glomerulonephritis, so as to predict the renal outcome in the early stage of diagnosis and provide theoretical basis for the diagnosis and treatment of children with ANCA related glomerulonephritis in the future.

药物成份或治疗方案详述:

观察组治疗方案及药物: 诱导缓解阶段:3-6月 1.低风险:糖皮质激素+环磷酰胺 强的松龙:30-60mg/m2/d(或1-2mg/kg/d),共4周,逐渐减量至0.5mg/kg/隔日给药(减量速度取决于对治疗的反应); 环磷酰胺:静脉冲击,每月0.5-1g/m2,6个月。或口服环磷酰胺给药(2-3mg/kg每日一次,持续2-3个月)。 2.中风险:甲泼尼龙+静脉注射环磷酰胺或利妥昔单抗 甲泼尼龙: 30mg/kg (最大1g),每日一次,连续三天,然后再转化为口服泼尼松龙(如上); 环磷酰胺(CTX):静脉冲击,每月0.5-1g/m2,6个月; 利妥昔单抗(RTX):750mg/m2(最大1000mg),分两次,间隔两周。 3.高风险:甲基强的松龙冲击+环磷酰胺冲击+利妥昔单抗+血浆置换 甲基强的松龙冲击,并序贯使用强的松(同上); 环磷酰胺(CTX):静脉冲击,每月0.5-1g/m2,6个月; 利妥昔单抗(RTX):750mg/m2(最大1000mg),分两次,间隔两周。 血浆交换(PE):必要时。5天或10天疗程2×体积PE。 IVIG静脉注射:必要时。2g/kg/次,或0.4g/kg/d, 5天。 维持缓解阶段:24月 1.低风险:激素+硫唑嘌呤/甲氨蝶呤/霉酚酸酯 激素逐渐减量,维持12-18月; 硫唑嘌呤(AZA):0.5-2.5mg/kg,每日一次,持续18月或以上,逐渐减量; 甲氨蝶呤(MTX):10-15mg/m2/w,持续18月或以上,逐渐减量; 霉酚酸酯(MMF):20mg//kg/d,持续18月或以上,逐渐减量。 2.中风险:激素+硫唑嘌呤/霉酚酸酯/利妥昔单抗 激素逐渐减量,维持12-18月; 硫唑嘌呤(AZA):0.5-2.5mg/kg,每日一次,持续18月或以上; 霉酚酸酯(MMF):20mg//kg/d,持续18月或以上,逐渐减量; 环磷酰胺(CTX):静脉或口服给药(同上); 利妥昔单抗(RTX):必要时,500-1000mg/次(最大1000mg)。 3.高风险:激素+硫唑嘌呤/霉酚酸酯/利妥昔单抗 激素逐渐减量,维持12-18月; 硫唑嘌呤(AZA):0.5-2.5mg/kg,每日一次,持续18月或以上; 霉酚酸酯(MMF):20mg//kg/d,持续18月或以上,逐渐减量; 环磷酰胺(CTX):静脉或口服给药(同上); 利妥昔单抗(RTX):500-1000mg/次(最大1000mg),半年一次; 对照组治疗方案: 诱导缓解阶段3-6月 甲泼尼龙+静脉注射环磷酰胺: 甲基强的松龙冲击,并序贯使用强的松,30-60mg/m2/d(或1-2mg/kg/d),共4周, 逐渐减量至0.5mg/kg/隔日给药(减量速度取决于对治疗的反应); 环磷酰胺(CTX):静脉冲击,每月0.5-1g/m2,6个月; 维持缓解阶段:24月 激素逐渐减量,维持12-18月; 硫唑嘌呤(AZA):0.5-2.5mg/kg,每日一次,持续18月或以上,逐渐减量; 甲氨蝶呤(MTX):10-15mg/m2/w,持续18月或以上,逐渐减量; 霉酚酸酯(MMF):20mg//kg/d,持续18月或以上,逐渐减量。 

Description for medicine or protocol of treatment in detail:

Treatment plan and drug of observation group: Induced remission stage: March June 1. Low risk: glucocorticoid + cyclophosphamide Prednisolone: 30-60mg / m2 / D (or 1-2mg / kg / D), a total of 4 weeks, gradually reduced to 0.5mg/kg/day (the rate of reduction depends on the response to treatment); Cyclophosphamide: intravenous shock, 0.5-1g/m2 per month, 6 months. Or oral cyclophosphamide (2-3mg / kg once a day for 2-3 months). 2. Medium risk: methylprednisolone + intravenous cyclophosphamide or rituximab Methylprednisolone: 30mg / kg (1g maximum), once a day for three consecutive days, and then converted to oral prednisolone (as above); Cyclophosphamide (CTX): intravenous shock, 0.5-1g/m2 per month, 6 months; Rituximab (RTX): 750mg / m2 (maximum 1000mg), divided into two times, two weeks apart. 3. High risk: methylprednisolone shock + cyclophosphamide shock + rituximab + plasma exchange Methylprednisolone impact, and sequential use of prednisone (as above); Cyclophosphamide (CTX): intravenous shock, 0.5-1g/m2 per month, 6 months; Rituximab (RTX): 750mg / m2 (maximum 1000mg), divided into two times, two weeks apart. Plasma exchange (PE): if necessary. 5 days or 10 days course 2 x volume PE. IVIG: if necessary. 2G / kg / time, or 0.4g/kg/d, 5 days. Maintenance mitigation phase: 24 months 1. Low risk: hormone + azathioprine / methotrexate / mycophenolate mofetil The hormone decreased gradually and maintained for 12-18 months; Azathioprine (AZA): 0.5-2.5mg/kg, once a day, lasting for 18 months or more, gradually reduced; Methotrexate (MTX): 10-15mg / m2 / W, lasting for 18 months or more, gradually reduced; Mycophenolate mofetil (MMF): 20mg / / kg / D, lasting for 18 months or more, gradually reduced. 2. Medium risk: hormone + azathioprine / mycophenolate mofetil / rituximab The hormone decreased gradually and maintained for 12-18 months; Azathioprine (AZA): 0.5-2.5mg/kg, once a day, lasting for 18 months or more; Mycophenolate mofetil (MMF): 20mg / / kg / D, lasting for 18 months or more, gradually reduced; Cyclophosphamide (CTX): intravenous or oral administration (as above); Rituximab (RTX): 500-1000mg / time (1000mg maximum), if necessary. 3. High risk: hormone + azathioprine / mycophenolate mofetil / rituximab The hormone decreased gradually and maintained for 12-18 months; Azathioprine (AZA): 0.5-2.5mg/kg, once a day, lasting for 18 months or more; Mycophenolate mofetil (MMF): 20mg / / kg / D, lasting for 18 months or more, gradually reduced; Cyclophosphamide (CTX): intravenous or oral administration (as above); Rituximab (RTX): 500-1000mg / time (maximum 1000mg), once half a year; Treatment plan of control group: Induced remission phase 3-6 months Methylprednisolone + intravenous cyclophosphamide: Methylprednisolone was used for 4 weeks, Gradually reduce to 0.5mg/kg/day (the rate of reduction depends on the response to treatment); Cyclophosphamide (CTX): intravenous shock, 0.5-1g/m2 per month, 6 months; Maintenance mitigation phase: 24 months; The hormone decreased gradually and maintained for 12-18 months; Azathioprine (AZA): 0.5-2.5mg/kg, once a day, lasting for 18 months or more, gradually reduced; Methotrexate (MTX): 10-15mg/m2/w, lasting for 18 months or more, gradually reduced; Mycophenolate mofetil (MMF): 20mg/kg/d, lasting for 18 months or more, gradually reduced. 

纳入标准:

Inclusion criteria

排除标准:

(1)排除继发性血管炎(如系统性红斑狼疮、过敏性紫癜、药物、肿瘤、感染等);
(2)合并原发性肾脏疾病者(如IgA肾病、膜性肾病和抗肾小球基底膜肾炎等)。

Exclusion criteria:

1. Patients with secondary vasculitis (such as systemic lupus erythematosus, Henoch Schonlein purpura, drugs, tumors, infections, etc.);
2. Patients with primary renal diseases (such as IgA nephropathy, membranous nephropathy and anti glomerular basement membrane nephritis).

研究实施时间:

Study execute time:

From 2020-09-01 00:00:00 To 2025-06-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2020-09-01 00:00:00 To 2023-06-01 00:00:00

干预措施:

Interventions:

组别:

低风险组

样本量:

18

Group:

Low risk group

Sample size:

干预措施:

诱导缓解阶段:糖皮质激素+环磷酰胺;维持缓解阶段:激素+硫唑嘌呤/甲氨蝶呤/霉酚酸酯

干预措施代码:

Intervention:

Induction remission stage: Glucocorticoid + cyclophosphamide; Maintain remission stage: Hormone + azathioprine / methotrexate / mycophenolate mofetil

Intervention code:

组别:

中风险组

样本量:

18

Group:

Medium risk group

Sample size:

干预措施:

诱导缓解阶段:甲泼尼龙+静脉注射环磷酰胺或利妥昔单抗;维持缓解阶段:激素+硫唑嘌呤/霉酚酸酯/利妥昔单抗

干预措施代码:

Intervention:

Induction remission stage: Methylprednisolone + intravenous cyclophosphamide or rituximab; Maintain remission stage: Hormone + azathioprine / mycophenolate mofetil / rituximab

Intervention code:

组别:

高风险组

样本量:

18

Group:

High risk group

Sample size:

干预措施:

诱导缓解阶段:甲基强的松龙冲击+环磷酰胺冲击+利妥昔单抗+血浆置换;维持缓解阶段:激素+硫唑嘌呤/霉酚酸酯/利妥昔单抗

干预措施代码:

Intervention:

Induction: Methylprednisolone + cyclophosphamide + rituximab + plasma exchange; Maintain: Hormone + azathioprine / mycophenolate mofetil / rituximab

Intervention code:

组别:

对照组

样本量:

52

Group:

control group

Sample size:

干预措施:

诱导缓解阶段:甲泼尼龙+静脉注射环磷酰胺;维持缓解阶段:激素+硫唑嘌呤/甲氨蝶呤/霉酚酸酯

干预措施代码:

Intervention:

Induction: Methylprednisolone + intravenous cyclophosphamide; Maintain: Hormone + azathioprine / methotrexate / mycophenolate mofetil

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

重庆 

市(区县):

重庆 

Country:

China

Province:

Chongqing

City:

Chongqing

单位(医院):

重庆医科大学附属儿童医院 

单位级别:

三甲 

Institution
hospital:

Children's Hospital Affiliated to Chongqing Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

南京 

Country:

China

Province:

Jiangsu

City:

Nanjing

单位(医院):

南京儿童医院 

单位级别:

三甲 

Institution
hospital:

Children's Hospital of Nanjing Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

上海 

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

复旦大学附属儿科医院 

单位级别:

三甲 

Institution
hospital:

Children's Hospital of Fudan University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

北京 

市(区县):

北京 

Country:

China

Province:

Beijing

City:

Beijing

单位(医院):

北京儿童医院 

单位级别:

三甲 

Institution
hospital:

Beijing Children Hosptal

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖北 

市(区县):

武汉 

Country:

China

Province:

Hubei

City:

Wuhan

单位(医院):

武汉儿童医院 

单位级别:

三甲 

Institution
hospital:

Wuhan Children Hosptal

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

上海 

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海市儿童医院 

单位级别:

三甲 

Institution
hospital:

Shanghai Children Hosptal

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

深圳 

Country:

China

Province:

Guangdong

City:

Shenzhen

单位(医院):

深圳市儿童医院 

单位级别:

三甲 

Institution
hospital:

Shenzhen Children's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

苏州 

Country:

China

Province:

Jiangsu

City:

Suzhou

单位(医院):

苏州大学附属儿童医院 

单位级别:

三甲 

Institution
hospital:

Children's Hospital of Suzhou University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

辽宁 

市(区县):

沈阳 

Country:

China

Province:

Liaoning

City:

Shenyang

单位(医院):

中国医科大学附属盛京医院 

单位级别:

三甲 

Institution
hospital:

Shengjing Hospital Affiliated to China Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

安徽 

市(区县):

合肥 

Country:

China

Province:

Anhui

City:

Hefei

单位(医院):

安徽省儿童医院 

单位级别:

三甲 

Institution
hospital:

Anhui Children's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

四川 

市(区县):

成都 

Country:

China

Province:

Sichuan

City:

Chengdu

单位(医院):

成都市妇女儿童中心医院 

单位级别:

三甲 

Institution
hospital:

Chengdu Women's and Children's Central Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

甘肃 

市(区县):

兰州 

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

甘肃省妇幼保健院 

单位级别:

二甲 

Institution
hospital:

Gansu Provincial maternity and Child-care Hospital

Level of the institution:

Second A

国家:

中国

省(直辖市):

湖南 

市(区县):

长沙 

Country:

China

Province:

Hu'nan

City:

Changsha

单位(医院):

中南大学湘雅二医院 

单位级别:

三甲 

Institution
hospital:

Xiangya Second Hospital of Central South University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

四川 

市(区县):

成都 

Country:

China

Province:

Sichuan

City:

Chengdu

单位(医院):

四川大学华西第二医院 

单位级别:

三甲 

Institution
hospital:

West China Second Hospital of Sichuan University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

贵州 

市(区县):

贵阳 

Country:

China

Province:

Guizhou

City:

Guiyang

单位(医院):

贵阳市妇幼保健院 

单位级别:

三甲 

Institution
hospital:

Guiyang Maternal and Child Health Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江 

市(区县):

杭州 

Country:

China

Province:

Zhejiang

City:

Hangzhou

单位(医院):

浙江大学附属儿童医院 

单位级别:

三甲 

Institution
hospital:

Children's Hospital Zhejiang University School of Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

广州 

Country:

China

Province:

Guangdong

City:

Guangzhou

单位(医院):

中山大学附属第一医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital, Sun Yat-Sen University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

北京 

市(区县):

北京 

Country:

China

Province:

Beijing

City:

Beijing

单位(医院):

北京大学第一医院 

单位级别:

三甲 

Institution
hospital:

Peking University first hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

甘肃 

市(区县):

兰州 

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

甘肃省第二人民医院 

单位级别:

三甲 

Institution
hospital:

Second Provincial People's Hospital of Gansu

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

南京 

Country:

China

Province:

Jiangsu

City:

Nanjing

单位(医院):

东部战区总医院儿科 

单位级别:

三甲 

Institution
hospital:

Eastern Theater General Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

ARRS评分

指标类型:

主要指标

Outcome:

ARRS score

Type:

Primary indicator

测量时间点:

测量方法:

肾脏组织病理中正常肾小球的比例、诊断时估计的肾小球滤过率(eGFR)、肾小管萎缩和间质纤维化比例

Measure time point of outcome:

Measure method:

Proportion of normal glomeruli in renal histopathology, estimated glomerular filtration rate (EGFR) at diagnosis, tubular atrophy and interstitial fibrosis

指标中文名:

有效性

指标类型:

主要指标

Outcome:

Effectiveness

Type:

Primary indicator

测量时间点:

测量方法:

尿常规、24小时尿蛋白定量、血尿素氮、肌酐、eGFR;生存率

Measure time point of outcome:

Measure method:

Urine routine, 24-hour urine protein quantitative, blood urea nitrogen, creatinine, eGFR;survival rate

指标中文名:

不良事件

指标类型:

主要指标

Outcome:

adverse event

Type:

Primary indicator

测量时间点:

测量方法:

眼压升高、青光眼、白内障、骨质疏松;消化道症状、出血性膀胱炎、骨髓抑制;感染

Measure time point of outcome:

Measure method:

Ocular hypertension, glaucoma, cataract, osteoporosis; gastrointestinal symptoms, hemorrhagic cystitis, myelosuppression; infection

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液、尿液

组织:

Sample Name:

blood and urine

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 0 years
最大 Max age 18 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

N/A

Randomization Procedure (please state who generates the random number sequence and by what method):

N/A

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

N/A

Blinding:

N/A

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

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):

ResMan临床试验公共管理平台, http://www.medresman.org.cn.

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Clincal trial management public platorm, http://www.medresman.org.cn.

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:

病例记录表、电子采集和管理系统

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CRFand an electronic data capture

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2020-06-28 18:44:11