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This study aims to explore the clinical and immunological efficacy of low-dose Interleukin-2 (IL-2) on idiopathic inflammatory myopathy (IIM).
The investigators designed a single center, open-label, prospective study. Adults with active IIM will be enrolled. IIM is defined as Dermatomyositis (DM) or Polymyositis (PM), meeting the Bohan & Peter (1975) diagnostic criteria for definite or probable DM or PM. One million units of Recombinant Human Interleukin-2 (rhIL-2) was administered subcutaneously every other day for 3 months. All patients were followed up for 3 months after withdraw of IL-2.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| interleukin-2 | Experimental | low dose interleukin-2 injected subcutaneously, at a dose of 1 x 10~6 IU/m2 once every other day, for 3 months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Interleukin-2 | Drug | low dose interleukin-2 injected subcutaneously, at a dose of 1 x 10~6 IU/m2 once every other day, for 3 months. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Foxp3+Treg cells: change in percentage of total lymphocytes | Treg refers to regulatory T cells | week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| MMT-8 | MMT-8; a set of 8 designated muscles tested bilaterally [potential score 0 - 150] | week12 and 24 |
| CDASI activity score | The CDASI is a clinician-scored single page instrument that separately measures activity and damage in the skin of DM patients for use in clinical practice or clinical/therapeutic studies. Disease involvement in 15 different anatomical locations is rated using three activity (erythema, scale, erosion/ulceration) and two damage (poikiloderma, calcinosis) measures. The presence and severity of Gottron's papules, periungual changes and alopecia are also captured. Disease activity is scored from 0 to 100; higher scores indicate greater disease severity. |
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Inclusion Criteria:
Male or female >18 years of age at screening visits
Diagnostics meet the 1975 Bohan recommendations
Applying of glucocorticoids (≤0.5 mg/kg/d prednisone or equivalent doses of other hormones), DMARDs (eg methotrexate, hydroxychloroquine, azathioprine, morphine, Ester, leflunomide, cyclosporine, etc.) must be stable for 4 weeks and do not increase hormone doses or other immunosuppressive agents throughout the study. If the enrolled doctor plans to stop using the current immunosuppressant or glucocorticoid, the elution period needs to be followed before enrollment. Each drug needs to meet the following elution period
The patient must be informed in writing of the consent to participate in the trial and the patient is expected to be able to comply with the requirements of the study follow-up plan and other protocols.
Active Disease means active skin disease or active muscle myositis. Active skin disease as defined by a CDASI score of at least 5. The active muscle myositis defined by the baseline hand muscle strength test (MMT-8) does not exceed 142/150, wtih at least 2 additional CSMs meet the criteria specified below:
Exclusion Criteria:
Any subject meeting any of the following criteria should be excluded:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Miao MIAO | Contact | +86 18810024336 | miao18734897489@126.com | |
| Jing He | Contact | 8618611707347 | hejing1105@126.com |
| Name | Affiliation | Role |
|---|---|---|
| Zhanguo Li | Peking University Institute of Rheuamotology and Immunology | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 327194 | Background | Bohan A, Peter JB, Bowman RL, Pearson CM. Computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore). 1977 Jul;56(4):255-86. doi: 10.1097/00005792-197707000-00001. No abstract available. | |
| 33852146 | Derived | Miao M, Li Y, Huang B, Chen J, Jin Y, Shao M, Zhang X, Sun X, He J, Li Z. Treatment of Active Idiopathic Inflammatory Myopathies by Low-Dose Interleukin-2: A Prospective Cohort Pilot Study. Rheumatol Ther. 2021 Jun;8(2):835-847. doi: 10.1007/s40744-021-00301-3. Epub 2021 Apr 14. |
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| ID | Term |
|---|---|
| D009220 | Myositis |
| ID | Term |
|---|---|
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D007376 | Interleukin-2 |
| C082598 | aldesleukin |
| ID | Term |
|---|---|
| D007378 | Interleukins |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
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| week12 and 24 |
| Physician's Global Disease Activity VAS | Physician's Global Disease Activity (10 cm VAS assessing global disease activity from "No evidence of disease activity" to "Extremely active or severe disease activity"; Disease Activity being defined as potentially reversible pathology or physiology resulting from the myositis). | week 12 and 24 |
| Safety and tolerability of interleukin-2 as assessed by incidence of adverse events reported and observed | we will report frequency of adverse events | up tp 24 weeks |
| Patient's Global Disease Activity VAS | Patient's Global Disease Activity (10 cm VAS assessing global disease activity from "No evidence of disease activity" to "Extremely active or severe disease activity"; Disease Activity being defined as potentially reversible pathology or physiology resulting from the myositis). | week 12 and 24 |
| Proportion of subjects meeting the definition of improvement (DOI) | The primary outcome will be to compare the proportion of subjects meeting the definition of improvement (DOI) at visits 3 after the 3-month treatment period. The DOI for this trial is a composite utilizing the six core set measures (CSM): 3 of 6 CSM improved by ≥ 20%, with no more than 2 CSM worsening by ≥25% (a worsening measure cannot be the MMT). | week12 and 24 |
| D000602 |
| Amino Acids, Peptides, and Proteins |
| D008222 | Lymphokines |
| D011506 | Proteins |
| D001685 | Biological Factors |