Childhood onset idiopathic nephrotic syndrome showing frequent relapse or steroid dependence
Conditions
Sponsors
Kobe University Hospital
National Center for Child Medical Health and Development
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: (1) Diagnosed as idiopathic nephrotic syndrome (INS) according to the ISKDC criteria. (2) First onset of INS is under 18 years of age. (3) Subjects who are diagnosed as frequent recurrence or steroid dependency with recurrence just before registration and who can confirm the date of recurrence as the basis for diagnosis. (4) Subjects who have not been treated with immunosuppressive treatment for INS. (5) Diagnosed as steroid-sensitive relapse. (6) CD20 positive B-cells >/= 5/mcL in the peripheral blood. (7) Subjects can be hospitalized for treatments. (8) Subjects have ability to provide written informed consent form. The written informed consent form of legal representative is also required for subjects less than 20 years of age.
Exclusion criteria
Exclusion criteria: (1) Subjects who have been diagnosed with steroid resistance NS. (2) History of inflammatory nephritis such as IgA nephritis. (3) Subjects falling under any of the following infectious diseases. 1) Subjects who have had a history of severe infection (pneumonia, pyelonephritis, etc.) requiring hospitalization within the past 6 months before registration. 2) Subjects who have had a history of opportunistic infection (cytomegalovirus infection, systemic fungal infection, pneumocystis infection, nontuberculous mycobacterial infection etc.) within 6 months before registration. 3) Subjects with active tuberculosis. 4) Subjects with or having suspected tuberculosis infection. 5) Subjects complicated with active hepatitis B or active hepatitis C, or patients confirmed to be hepatitis B virus carriers. 6) Subjects with confirmed HIV infection. (4) Presence or history of angina pectoris, cardiac failure, myocardial infarction and/or serious arrhythmia grade 4 in "Common Terminology Criteria for Adverse Events (ver. 4.0)". (5) Having received a live vaccine within 4 weeks prior to screening. (6) Known hypertension which is uncontrollable with conventional anti-hypertensive. (7) Deteriorated kidney function, e.g. estimated GFR 2.5 x ULN 5) ALT(GPT) > 2.5 x ULN 6) Positive for HBs antigen, HBs antibody, HBc antibody and HCV antibody 7) Positive for HIV antibody (13) History of receiving any kinds of monoclonal antibody therapy. (14) Having received any investigational agent within 6 months prior to enrollment, or participating other clinical studies. (15) Subjects who do not agree with contraception during the study period (Negative HCG result is required at screening for female subjects after the first menstruation.). (16) A female patient who is pregnant, has a possibility of pregnancy, or is breastfeeding. (17) Judged inappropriate for this study by the physicians.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Efficacy outcome Relapse-free period 2. Safety endpoint Adverse event, Adverse drug reaction | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Efficacy outcomes (1) Time to treatment failure (2) Total steroid dose (3) Variation in B cell count during observational period 1) Measurement of B cell count 2) Duration of B-cell depletion 2. Other outcomes (1) Relapse-free period in open-label phase (2) Serum IDEC-C2B8 level (3) Anti-rituximab antibody (human anti-chimeric antibody, HACA) in subject serum | — |
Countries
Japan
Contacts
Public ContactNaoko Kashiwagi
Kobe University Hospital
Outcome results
None listed