ARDS (Acute Respiratory Distress Syndrome), ARDS (Moderate or Severe)
Conditions
Keywords
ARDS (Acute Respiratory Distress Syndrome), rh-KGF2
Brief summary
This study is a randomized, blank-controlled, open-label, single-dose, dose-escalation clinical study of rhKGF-2 in patients with ARDS. The trial is designed with three dose groups (5 mg, 10 mg, and 15 mg), which will be escalated sequentially from the lowest dose group to the highest dose group. Each dose group will enroll 8 subjects, randomized in a 6:2 ratio according to the order of enrollment, to receive either the corresponding dose of rhKGF-2 (6 subjects) or serve as a blank control (2 subjects). Each subject will receive a single dose, administered once via a disposable bronchoscopic catheter. All subjects will receive the trial intervention on top of standard ARDS treatment (see Concomitant Medications for details). Following the completion of drug administration, subjects will enter a 28-day follow-up period. Outcome measures include adverse events (AE), vital signs, laboratory parameters, oxygenation index (PFR), chest imaging changes, etc., to evaluate the safety, tolerability, and efficacy of the treatment.
Interventions
DRUGRecombinant Human Keratinocyte Growth Factor-2 for Inhalation (Lyophilized Powder)
The investigational drug will be reconstituted with water for injection to a concentration of 1 mg/mL, and then administered via a single-use bronchoscopic imaging catheter.
Sponsors
Shanghai Zhongshan Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Aged ≥18 years and \<80 years, male or female. 2. Definite diagnosis of acute respiratory distress syndrome (ARDS) according to the Berlin Definition. 3. Patients with PaO₂/FiO₂ \< 200 mmHg and receiving invasive mechanical ventilation via endotracheal intubation. 4. Diagnosis of ARDS confirmed no more than 72 hours prior to enrollment. 5. No plan for parenthood within 1 year and agree to take effective contraceptive measures during the study period. Female participants of childbearing potential must have a negative serum pregnancy test. 6. The subject fully understands the purpose of the study, as well as the nature, methods, and potential reactions of the investigational drug. The subject voluntarily signs the informed consent form to participate in the study and agrees to comply with the requirements of the study protocol. If the subject is unable to provide consent or has limited capacity to consent, consent must be obtained from the subject's legal guardian. \-
Exclusion criteria
1. Use of inhaled pulmonary vasodilators (e.g., nitric oxide or prostaglandins). 2. Current receipt or planned receipt of extracorporeal membrane oxygenation (ECMO) during the study period. 3. Expected survival \< 3 months due to causes other than respiratory failure. 4. Cerebrovascular or cardiovascular events within 3 months prior to study drug administration, including unstable angina, congestive heart failure, myocardial infarction within the past 12 months, hemodynamic instability, known left ventricular ejection fraction (LVEF) \< 40%, or clinically significant arrhythmia or conduction abnormality. 5. Inability to tolerate single-use bronchoscopic imaging catheter examination, including but not limited to the following: active massive hemoptysis; severe hypertension and arrhythmia; myocardial infarction or unstable angina within 4-6 weeks prior to screening; severe cardiac dysfunction; uncorrectable bleeding tendency (platelet count \< 60 × 10⁹/L), such as severe coagulation disorders, uremia, or severe pulmonary hypertension; severe superior vena cava syndrome; suspected aortic aneurysm; multiple pulmonary bullae. 6. History of severe allergic reaction, or known allergy or hypersensitivity to any component of the investigational product. 7. Breastfeeding or pregnant women. 8. Participation in any drug clinical trial within 3 months prior to enrollment. 9. Any other condition that, in the opinion of the investigator, makes the subject unsuitable for participation in this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of adverse events (AE) and incidence of adverse drug reactions (ADR); | At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28. | — |
| Incidence of serious adverse events (SAE) | At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28. | — |
| Various laboratory test parameters：White blood cell (WBC) count | At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28. | Unit of measure: 3.5 - 9.5 × 10\^9/L |
| Various Laboratory test parameters: Serum creatinine (Cr) level | At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28. | Unit of measure: 44 -115 μmol/L |
| Various laboratory test parameters: Total Bilirubin | At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28. | Unit of measure: 3.4-20.4 umol /L |
| Incidence of airway spasm (increased airway resistance) caused by local drug stimulation | At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28. | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Improvement rate of oxygenation indexPaO₂/FiO₂ ratio (PFR) | at Day 3 and Day 7 | — |
| PaO₂/FiO₂ ratio (PFR) and its change from baseline | at Day 3, Day 5, and Day 7 | — |
| Number of days from baseline to first PaO₂/FiO₂ ratio (PFR) > 300 mmHg or liberation from mechanical ventilation for at least 12 consecutive hours | From baseline to first PFR > 300 mmHg or liberation from mechanical ventilation for at least 12 consecutive hours | — |
| Change from baseline in the Murray Lung Injury Score(LIS). | at Day 7 | Score (scale range: 0-4; higher scores indicate more severe lung injury) |
| Change from baseline in Radiographic Assessment of Lung Edema (RALE) score; | at Day 3, Day 7, Day 14, and Day 28 | Score (scale range: 0-48; higher scores indicate a worse outcome); |
| Proportion of patients with improvement in ARDS severity grade | at Day 7 and Day 14 | — |
| Proportion of patients with progression in ARDS severity grade | at Day 7 and Day 14 | — |
| All-cause mortality | at Day 28 | — |
| Systemic evaluation measures: Ventilator-free days at Day 28 | at Day 28 | Ventilator-free days at Day 28 (unit: days; higher scores indicate a better outcome). |
| Systemic evaluation measures: Non-ICU hospital stay days at Day 28 | at Day 28. | Non-ICU hospital stay days at Day 28 (unit: days; higher scores indicate a better outcome as applicable). |
| Systemic evaluation measures: Non-hospitalization days at Day 28 | at Day 28 | Non-hospitalization days at Day 28 (unit: days; higher scores indicate a better outcome). |
Countries
China
Contacts
CONTACTYi Wei
STUDY_DIRECTORYuanlin Song
Shanghai Zhongshan Hospital
PRINCIPAL_INVESTIGATORJing Bi
Shanghai Zhongshan Hospital
Outcome results
None listed