A Controlled Study of Steroids Therapy for Patients of IgA Nephropathy With Active Pathological Changes.

NCT ID: NCT02160132

Last Updated: 2015-03-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-06-30

Study Completion Date

2016-12-31

Brief Summary

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This prospective, randomized, controlled, multi-center clinical trial will evaluate the effect and security of steroids therapy for patients of IgA nephropathy with active pathological changes,including crescents,necrosis and microthrombus.

Detailed Description

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It has been reported that for urinary protein excretion that is persistently more than 1g/24h and eGFR\>50ml/min/1.73m2 in IgA nephropathy(IgAN), the KDIGO guidelines suggest a 6-month course of glucocorticoids. The famous study by Pozzi C has proved that for patients of IgAN with proteinuria of 1.0-3.5g/24h and serum creatinine concentrations of 133 umol/L or less, a 6-month course of steroid treatment(1g/d methylprednisolone intravenously for 3 consecutive days,with the course repeated 2 months and 4 months later,then oral prednisone 0.5mg/kg/d on alternate days for 6 months) could significantly reduce proteinuria and protect against renal function deterioration in IgAN. Furthermore, as we know, active pathological changes in IgAN,including crescents,necrosis and microthrombus,which may turn fibrosis after three months would effect the prognosis.This will be a prospective, randomized, controlled, multi-center study. Patients in treatment group will receive 0.5g/d methylprednisolone intravenously for 3 consecutive days in the 1st-2nd-3rd month ,then oral methylprednisolone 0.4mg/kg/d on consecutive days Patients in control group will receive 0.5g/d methylprednisolone intravenously for 3 consecutive days in the 1st-3rd-5th month ,then oral methylprednisolone 0.4mg/kg/d on consecutive days. After followed-up for 6 months, the curative effect of steroid therapy on proteinuria and the progression of IgAN will be evaluated.

Conditions

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Glomerulonephritis, IGA Peripapillary Crescent Necrosis Steroid Nephropathy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A 1-2-3Group

Methylprednisolone 0.5g/d intravenously for 3 consecutive days in the 1st-2nd-3rd month ,and oral methylprednisolone 0.4mg/kg/d on consecutive days for 6 months.

Group Type EXPERIMENTAL

Methylprednisolone(intravenously in the 1st-2nd-3rd month )

Intervention Type DRUG

Methylprednisolone 0.5g/d intravenously for 3 consecutive days in the 1st-2nd-3rd month ,and oral methylprednisolone 0.4mg/kg/d on consecutive days for 6 months.

B 1-3-5Group

Methylprednisolone 0.5g/d intravenously for 3 consecutive days in the 1st-3rd-5th month ,and oral methylprednisolone 0.4mg/kg/d on consecutive days for 6 months.

Group Type ACTIVE_COMPARATOR

Methylprednisolone(intravenously in the 1st-3rd-5th month)

Intervention Type DRUG

Methylprednisolone 0.5g/d intravenously for 3 consecutive days in the 1st-3rd-5th month ,and oral methylprednisolone 0.4mg/kg/d on consecutive days for 6 months.

Interventions

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Methylprednisolone(intravenously in the 1st-2nd-3rd month )

Methylprednisolone 0.5g/d intravenously for 3 consecutive days in the 1st-2nd-3rd month ,and oral methylprednisolone 0.4mg/kg/d on consecutive days for 6 months.

Intervention Type DRUG

Methylprednisolone(intravenously in the 1st-3rd-5th month)

Methylprednisolone 0.5g/d intravenously for 3 consecutive days in the 1st-3rd-5th month ,and oral methylprednisolone 0.4mg/kg/d on consecutive days for 6 months.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age 14\~65 years, regardless of gender
* Clinical evaluation and renal biopsy diagnostic for IgA nephropathy, presenting with active pathological changes,including cellular crescents,necrosis and microthrombus.
* Average urinary protein excretion of 0.5\~3.5g/24h on two successive examinations.
* eGFR ≥ 50 ml/min/1.73 m2
* Willingness to sign an informed consent.

Exclusion Criteria

* Secondary IgAN such as systemic lupus erythematosus, Henoch-Schonlein purpuric nephritis and hepatitis B -associated nephritis.
* Rapidly progressive nephritic syndrome (crescent formation≥50%).
* Acute renal failure, including rapidly progressive IgAN.
* Current or recent (within 30 days) exposure to high-dose of steroids or immunosuppressive therapy (CTX、MMF、CsA、FK506).
* Date of renal biopsy exceeds more than 30 days.
* Cirrhosis, chronic active liver disease.
* History of significant gastrointestinal disorders (e.g. severe chronic diarrhea or active peptic ulcer disease).
* Any Active systemic infection or history of serious infection within one month.
* Other major organ system disease (e.g. serious cardiovascular diseases including congestive heart failure , chronic obstructive pulmonary disease, asthma requiring oral steroid treatment or central nervous system diseases).
* Active tuberculosis
* Malignant hypertension that is difficult to be controlled by oral drugs.
* Known allergy, contraindication or intolerance to the steroids.
* Pregnancy or breast feeding at the time of entry or unwillingness to comply with measures for contraception.
* Malignant tumors
* Excessive drinking or drug abuse
* Mental aberrations
* Current or recent (within 30 days) exposure to any other investigational drugs.
Minimum Eligible Age

14 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sun Yat-sen University

OTHER

Sponsor Role lead

Responsible Party

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Yanhong Deng

The Sixth Affiliated Hospital of Sun Yat-Sen University

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Zongpei Jiang, M.D. & Ph.D.

Role: PRINCIPAL_INVESTIGATOR

The Sixth Affiliated Hospital, Sun Yat-sen University

Locations

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Department of Nephrology,Dongguan People's Hospital

Dongguan, Guangdong, China

Site Status RECRUITING

Department of Nephrology, 2nd Affiliated Hospital,Guangzhou Medical University

Guangzhou, Guangdong, China

Site Status RECRUITING

Department of Nephrology, 6th Affiliated Hospital, Sun Yat-Sen University

Guangzhou, Guangdong, China

Site Status RECRUITING

Department of Nephrology,Huizhou Municipal Central Hospital

Huizhou, Guangdong, China

Site Status RECRUITING

Department of Nephrology,1st Affiliated Hospital,Shenzhen University

Shenzhen, Guangdong, China

Site Status RECRUITING

Department of Nephrology,1st People's Hospital of Zhaoqing

Zhaoqing, Guangdong, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Zongpei Jiang, M.D. & Ph.D.

Role: CONTACT

8620-38379727

Facility Contacts

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Guohui Liu, MD

Role: primary

86769-28637333

Jianbo Liang, MD

Role: primary

8620-34152282

Zongpei Jiang, M.D. & Ph.D.

Role: primary

8620-38379727

Weiqiang Zhong, MD

Role: primary

86752-2288288

Yongcheng He, MD

Role: primary

86755-83366388

Jinquan Wu, MD

Role: primary

86758-2832139

References

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Liang M, Xiong L, Li A, Zhou J, Huang Y, Huang M, Zhang X, Shi H, Su N, Wei Y, Jiang Z. The effectiveness and safety of corticosteroid therapy for IgA nephropathy with crescents: a prospective, randomized, controlled study. BMC Nephrol. 2022 Jan 21;23(1):40. doi: 10.1186/s12882-022-02661-6.

Reference Type DERIVED
PMID: 35062886 (View on PubMed)

Other Identifiers

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Usix-IgAN-001

Identifier Type: -

Identifier Source: org_study_id

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