A Single Dose, Dose Escalation Clinical Trial on the Safety, Tolerability and Efficacy of Lyophilized Powder for Inhalation of Recombinant Human Keratinocyte Growth Factor-2 (Rh-KGF-2) in The Treatment of Patients With Acute Respiratory Distress Syndrome

Overview

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

• Drug Recombinant 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.

Primary outcome measures

• Incidence of adverse events (AE) and incidence of adverse drug reactions (ADR); [Time frame: At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28.]
• Incidence of serious adverse events (SAE) [Time frame: 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 [Time frame: At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28.]
• Various Laboratory test parameters: Serum creatinine (Cr) level [Time frame: At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28.]
• Various laboratory test parameters: Total Bilirubin [Time frame: At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28.]
• Incidence of airway spasm (increased airway resistance) caused by local drug stimulation [Time frame: At Baseline, Day 1, Day 2, Day 3, Day 5, Day 7, Day 14 and Day 28.]

Secondary outcome measures (11)

• Improvement rate of oxygenation indexPaO₂/FiO₂ ratio (PFR) [Time frame: at Day 3 and Day 7]
• PaO₂/FiO₂ ratio (PFR) and its change from baseline [Time frame: 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 [Time frame: 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). [Time frame: at Day 7]
• Change from baseline in Radiographic Assessment of Lung Edema (RALE) score; [Time frame: at Day 3, Day 7, Day 14, and Day 28]
• Proportion of patients with improvement in ARDS severity grade [Time frame: at Day 7 and Day 14]
• Proportion of patients with progression in ARDS severity grade [Time frame: at Day 7 and Day 14]
• All-cause mortality [Time frame: at Day 28]
• Systemic evaluation measures: Ventilator-free days at Day 28 [Time frame: at Day 28]
• Systemic evaluation measures: Non-ICU hospital stay days at Day 28 [Time frame: at Day 28.]
• Systemic evaluation measures: Non-hospitalization days at Day 28 [Time frame: at Day 28]

Eligibility criteria

Inclusion criteria

• Aged ≥18 years and <80 years, male or female.
• Definite diagnosis of acute respiratory distress syndrome (ARDS) according to the Berlin Definition.
• Patients with PaO₂/FiO₂ < 200 mmHg and receiving invasive mechanical ventilation via endotracheal intubation.
• Diagnosis of ARDS confirmed no more than 72 hours prior to enrollment.
• 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.
• 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

• Use of inhaled pulmonary vasodilators (e.g., nitric oxide or prostaglandins).
• Current receipt or planned receipt of extracorporeal membrane oxygenation (ECMO) during the study period.
• Expected survival < 3 months due to causes other than respiratory failure.
• 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.
• 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.
• History of severe allergic reaction, or known allergy or hypersensitivity to any component of the investigational product.
• Breastfeeding or pregnant women.
• Participation in any drug clinical trial within 3 months prior to enrollment.
• Any other condition that, in the opinion of the investigator, makes the subject unsuitable for participation in this study.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Treatment

Study locations

China · 1 center

• ShanghaiZhongshan — Shanghai

Identifiers

NCT: NCT07558538 · B2026-113R

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗