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This study has been designed as a 12-month, open-label randomized controlled clinical trial. The study aims to compare the efficacy and safety of two treatment strategies in IgG4-RD patients with superficial organ involvement: prednisone plus iguratimod and prednisone plus leflunomide.
60 IgG4-RD patients with superficial organ involvement are enrolled in this study and randomly divided into two groups at a 1:1 ratio: Patients in Group I are treated with prednisone (≤20 mg qd, or equivalent glucocorticoid, taper to ≤5mg in 3 months) and iguratimod (25 mg bid). Patients in Group II are treated with prednisone (≤20 mg qd, or equivalent glucocorticoid, taper to ≤5mg in 3 months ) and leflunomide (10-20 mg qd).All patients will be followed up for 12 months, and clinical evaluations, laboratory tests, image examinations and IgG4-RD responder index (RI) will be recorded during follow up. The primary endpoint is the difference of relapse rate between two groups at 12 months. The secondary endpoints are relapse time, response rate and side effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I | Experimental | Patients are treated with prednisone (≤20 mg qd, or equivalent glucocorticoid, taper to ≦ 5mg in 3 months) and iguratimod (25 mg bid). |
|
| Group II | Experimental | Patients are treated with prednisone (≤20 mg qd, or equivalent glucocorticoid, taper to ≦ 5mg in 3 months ) and leflunomide (10-20 mg qd). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| glucocorticoid plus iguratimod | Drug | Patients in Group I are treated with prednisone (≤20 mg qd, or equivalent glucocorticoid, taper to ≦ 5mg in 3 months) and iguratimod (25 mg bid). |
| Measure | Description | Time Frame |
|---|---|---|
| The difference of relapse rate of IgG4-RD among 2 groups in 12 months. | The definition of relapse: elevation of IgG4-RD Responder Index ≥ 2 points; new organ involvement or recurrence, with or without elevation of serum IgG4 levels. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| The difference of the time at baseline to first relapse among 2 groups | The difference of relapse time in 2 groups | 12 months |
| The difference of the response rate of the treatment among the 2 groups. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yunyun Fei, MD | Contact | 01069159953 | feiyunyun@pumch.cn |
| Name | Affiliation | Role |
|---|---|---|
| Wen Zhang, MD | Peking Union Medical College Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking Union Medical College Hospital | Recruiting | Beijing | China |
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| ID | Term |
|---|---|
| D001327 | Autoimmune Diseases |
| D000077733 | Immunoglobulin G4-Related Disease |
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D007154 | Immune System Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D005938 | Glucocorticoids |
| C519076 | iguratimod |
| D000077339 | Leflunomide |
| ID | Term |
|---|---|
| D000305 | Adrenal Cortex Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D045505 | Physiological Effects of Drugs |
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| glucocorticoid plus leflunomide | Drug | Patients in Group II are treated with prednisone (≤20 mg qd, or equivalent glucocorticoid, taper to ≦ 5mg in 3 months ) and leflunomide (10-20 mg qd). |
|
Complete response rate; Partial response rate; No response
| 12 months |
| Side effects | Any side effects caused by treatments for IgG4-RD. | 12 months |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D007555 | Isoxazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |