NMO Spectrum Disorder
Conditions
Brief summary
Neuromyelitis Optica Spectrum Disorders (NMOSD) is associated with a pathological humoral immune response against the aquaporin-4(AQP-4) water channel. Belimumab (Benlysta ®) is a human immunoglobulin G1λ monoclonal antibody that inhibits B-cell survival and differentiation by neutralizing soluble B lymphocyte stimulator. Belimumab may benefit some patients with NMOSD due to the important role of B cells in the pathogenesis of NMOSD. Clinical trials may be needed to observe its efficacy and safety.
Detailed description
The investigators primarily aim to observe the number of attacks from initiation of belimumab treatment. The secondary outcomes are to determine: The safety profile of belimumab in participants with NMO and whether belimumab improves Expanded Disability Status Scale (EDSS), et al.
Interventions
DRUGBelimumab
Belimumab will be intravenously administered with a dose of 10mg/kg on Days 0,14 and28, then every 28 days until week 48, with a final evaluation at week 52.
Sponsors
Tang-Du Hospital
Tianjin Medical University General Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Male or female patients ≥ 18 years old 2. Diagnosis of NMO or NMO spectrum disorder according to the 2015 International Panel for Neuromyelitis Optica Diagnosis criteria 3. Clinical evidence of either at least one attack requiring rescue therapy (intravenous corticosteroids, intravenous immunoglobulin, plasma exchange, or a combination of these therapies) in the year before screening or at least two attacks requiring rescue therapy in the 2 years before screening. 4. EDSS \<= 6.0 5. Patients were seropositive for AQP4-IgG 6. Able and willing to give written informed consent and comply with the requirements of the study protocol.
Exclusion criteria
1. Current evidence or known history of clinically significant infection (Herpes simplex virus, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, human immunodeficiency virus, Hepatitis viruses, Syphilis, etc) 2. Participation in another interventional trial within the last 3 months 3. Tumor disease currently or within last 5 years 4. Pregnant, breastfeeding, or child-bearing potential during the course of the study 5. Clinically relevant heart, liver, kidney or bone marrow function disorder
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The number of attacks | From baseline to one year after | An acute attack was defined as a new neurological worsening lasting for at least 24 hours and occurring more than 30 days after the previous attack. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Worsening in EDSS | Worsening from baseline in EDSS to 52 weeks | The Expanded Disability Status Scale (EDSS) is a rating system that is frequently used for classifying and standardizing the severity and progression. EDSS ranges from 0 to 10. |
| Number of New, and/or Enlarging T2 Hyperintense Lesions as Detected by Optic nerve,brain and spinal cord Magnetic Resonance Imaging (MRI) | From baseline to 52 weeks | The total number of new and/or enlarging T2 lesions for all participants was calculated as the sum of the individual number of lesions at Weeks 12, 24, and 52 |
| Counts of peripheral blood B cell subsets | From baseline to 52 weeks | Compare peripheral blood plasma cells before and one year after initial intervention |
| Determination of serum AQP4 antibodies | From baseline to 52 weeks | Compare serum AQP4-ab titers before and one year after initial intervention |
| Incidence of treatment-emergent adverse events [safety and tolerability] | From baseline to 52 weeks | Adverse events related to belimumab are recorded |
Countries
China
Outcome results
None listed