Nephrotic Syndrome
Conditions
Brief summary
To demonstrate that the treatment effect in refractory nephrotic syndrome of MZR is non-inferior to that of standard therapy CTX through analyzing overall remission rate after treatment.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients who have medical history with clear documentation of diagnosis of nephrotic syndrome * Patient who received renal biopsy within 1 year prior to screening and confirmed the pathologic classification: Minimal Change Disease (MCD), IgA nephropathy, Mesangioproliferative Glomerulonephritis (MsPGN), Membranous Nephropathy (MN), Focal Segmental Glomerulosclerosis (FSGS) * Patient with the above different pathologic classification who received adequate hormone therapy more than 8 weeks (including FSGS more than 12 weeks)prior to screening and have 24hr-urine protein≥2.0g/day at screening Adequate hormone dose is defined as prednisone (prednisolone) equivalent dose of 0.8 to 1.0 mg/kg/day (inclusive) * Male or female patient between 18 and 70 years (inclusive) at informed consent obtained date * Patient with body weight between 40kg and 80kg (inclusive) at screening * Patients who sign the informed consent form
Exclusion criteria
* Other primary nephrotic syndrome, e.g. membrano-proliferative glomerulonephritis (MPGN) * Secondary nephrotic syndrome (e.g. diabetic nephropathy, anaphylactic purpura nephritis, lupus nephritis, type B hepatitis-related nephritis, renal amyloidosis) * Patient who had history of allergy to any investigational product (MZR, CTX) or hormone * Patient who had received accumulated dosage of CTX \>3g within one year prior to screening * Patient who had received immunosuppressant or Chinese traditional medicine with immunosuppressive effect within 30 days prior to screening * Patient who received other investigational drugs within 30 days prior to screening * Patient who have received plasma exchange therapy or immunoadsorption therapy within 30 days prior to screening * Patient who require pentostatin or live vaccine (not including flu vaccine) * Patient who is undergoing renal replacement therapy * Patient who received kidney transplantation * Patient with malignancy * Patient with severe hypertension (SBP \> 160mmHg or DBP \> 100mmHg) which has not been effectively controlled * Patient with white blood cell count \<3×109/L /L(=3.0 GI/L) * Patient with SCr \> 176.8μmol/L * Patient who has a value that is \> 3 times of the upper limit of normal range for AST or ALT * Patient with hepatitis B, hepatitis C or HIV infection * Patient with other serious infections * Patient who is unsuitable for participating in this study in the opinion of investigators ( e.g. uncontrolled diabetes, central nervous system lupus , lupus encephalopathy, active psychosis,osteonecrosis of the femoral head, fulminant hepatitis, peptic ulcer, etc.) * Female patient who is pregnant, currently breast feeding or willing to become pregnant * Patient with any other diseases that would affect the evaluation of efficacy or safety
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total Remission rate | 52 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Partial Remission rate | 52 weeks |
| Changes of Overall Remission rate | 8 weeks, 20 weeks, 32 weeks, 44 weeks and 52 weeks |
| Changes of Complete Remission rate | 8 weeks, 20 weeks, 32 weeks, 44 weeks and 52 weeks |
| Changes of Partial Remission rate | 8 weeks, 20 weeks, 32 weeks, 44 weeks and 52 weeks |
| Complete Remission rate | 52 weeks |
| Changes and percentage change of 24 hours urine protein and serum albumin from the baseline | 8 weeks, 20 weeks, 32 weeks, 44 weeks and 52 weeks |
| Changes of and percentage change of SCr, eGFR and BUN from the baseline | 8 weeks, 20 weeks, 32 weeks, 44 weeks and 52 weeks |
| Progression to End-Stage Renal Disease or Doubling of SCr through the study | 52 weeks |
| Treatment failure rate | 52 weeks |
Countries
China