Tonsillectomy and Immunosuppression in Caucasian Patients With High-risk IgA-nephropathy
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Immunosuppressive treatment, Tonsillectomy.
- Кому может быть актуально
- Состояния в реестре: Primary IgA-nephropathy, High-risk, Caucasians. Базовые параметры: 18 лет — 75 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Россия
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Effectiveness of Immunosuppression Combined With Tonsillectomy in Caucasian Patients With High-risk IgA-nephropathy (the Pragmatic Study)
Обзор
The open-label prospective non-randomised controlled aims to assess the efficacy of the combination of immunosupression (IST) and tonsillectomy (TE) in Caucasian patients at high risk of the IgA-nephropathy.
Вмешательства
- Препарат Immunosuppressive treatment
Patients will be able to receive the corticosteroid (CS) monotherapy or CS in combination with other immunosuppressive drugs (e.g. cyclophosphamide, mycophenolic acid) by a decision of treating physician. CS treatment will start with intravenous or oral induction. In the first case, methylprednisolone will be administered intravenously for 1-3 days at the dosage of 500-1000 mg. Oral prednisolone will be initiated at a dose of 0.5 to 1.0 mg/kg body weight, not exceeded 60 mg/day (week 1) with a - Процедура Tonsillectomy
Tonsillectomy will be done in accordance with local clinical practice. TE has to be performed no earlier than 12 months before and no later than 12 months after the initiation of IST.
Первичные конечные точки
- Progression [Срок оценки: From date of inclusion until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 120 months]
- Overall remission (partial or complete remission) [Срок оценки: From date of inclusion until the date of first documented overall remission, assessed up to 120 months]
- Time to clinical remission [Срок оценки: From date of inclusion until the date of first documented remission, assessed up to 120 months]
Вторичные конечные точки (6)
- Partial remission [Срок оценки: From date of inclusion until the date of first documented partial remission, assessed up to 120 months]
- Complete remission [Срок оценки: From date of inclusion until the date of first documented complete remission, assessed up to 120 months]
- Relapses [Срок оценки: From date of inclusion until the date of first documented relapse, assessed up to 120 months]
- The change in proteinuria [Срок оценки: Through study completion, an average of 120 months]
- The change in eGFR [Срок оценки: Through study completion, an average of 120 months]
- Adverse events per 100 patient-years [Срок оценки: From date of inclusion until the date of first documented AE, assessed up to 120 months]
Критерии участия
Критерии включения
Primary IgA-nephropathy (IgAN) patients with:
- DP >1 g with haematuria (>5 RBC/HPF)
- DP <1 g with haematuria AND probability of starting dialysis within 5 years >11% (estimated by the International risk-prediction tool in IgAN) AND at least one of the following histologic changes: at least one of the following histologic changes: mesangial proliferation, endocapillary hypercellularity, cellular crescents
Критерии исключения
- Age <18 or >75 years;
- eGFR ≤20 ml/min/1.73m2
- Patients with mild renal lesions (M0, E0, S0, T0, C0), minor urinary findings, DP <1.0 g
- Contraindications to IST or TE
- Patients with any co-existing kidney disease
- Patients with secondary IgAN (Schoenlein-Henoch purpura, liver cirrhosis, etc.)
- Patients with diabetes mellitus
- Any clinically significant acute illness within 60 days prior to kidney biopsy (including infection, aseptic necrosis of any bone, patients with myocardial infarction or cerebrovascular stroke, other conditions that can be exacerbated by corticosteroids
- Incomplete empiric IST administered prior to kidney biopsy
- Pregnancy
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Нерандомизированное
- Модель
- Параллельные группы
- Маскирование
- Открытое
- Основная цель
- Лечение
Центры проведения
Россия · 2 центра
- Research Institute of Nephrology (Pavlov Medical University) — Saint Petersburg
- St. Petersburg State Pavlov Medical University — Saint Petersburg
Публикации
- Barbour SJ, Coppo R, Zhang H, Liu ZH, Suzuki Y, Matsuzaki K, Katafuchi R, Er L, Espino-Hernandez G, Kim SJ, Reich HN, Feehally J, Cattran DC; International IgA Nephropathy Network. Evaluating a New International Risk-Prediction Tool in IgA Nephropathy. JAMA Intern Med. 2019 Jul 1;179(7):942-952. doi: 10.1001/jamainternmed.2019.0600. PMID 30980653
Идентификаторы
NCT: NCT07074951 · VD285/IgAN/TE+IST