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This is an investigator-initiated trial to evaluate the safety and efficacy of universal allogeneic anti-CD19/BCMA CAR T-cells in With Relapse/Refractory Autoimmune Diseases.
This is an investigator-initiated trial to evaluate the safety and efficacy ofuniversal allogeneic anti-CD19/BCMA CAR T-cells in Patients With Relapse/Refractory Autoimmune Diseases.
Study intervention consists of a single infusion of universal allogeneic CART-cells administered intravenously after a lymphodepleting therapy regimen consisting of fludarabine and cyclophosphamide.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| UCAR T-cell group | Experimental | A single injection of UCAR T-cells, referred to as universal allogeneic anti-CD19/BCMA CAR T-cells |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| universal allogeneic anti-CD19/BCMA CAR T-cells | Biological | A single injection of UCAR T-cells, referred to as universal allogeneic anti-CD19/BCMA CAR T-cells |
|
| Measure | Description | Time Frame |
|---|---|---|
| The number and severity of dose-limiting toxicity (DLT) events | DLT will be graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0, and the ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. | Within 28 Days After UCAR T-cell Infusion |
| The total number, incidence, and severity of AEs | Up to 90 days After UCAR T-cell Infusion |
| Measure | Description | Time Frame |
|---|---|---|
| AIHA:Rates of CR, CRi, PR, ORR | CR: complete response CRi: Complete Remission with incomplete and compensated hemolysis PR: Partial response ORR: Overall response rate | Up to 24 Months After UCAR T-cell Infusion |
| SLE:SLE Response Index 4 (SRI-4) |
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Inclusion Criteria:
1.Age ≥ 18 years old (inclusive), regardless of gender.
2.Positive expression of CD19 on peripheral blood B cells confirmed by flow cytometry.
3.Functional requirements for major organs are as follows:
4.ECOG score 0-1.
5.Female subjects of childbearing potential and male subjects with partners of childbearing potential must use medically approved contraception or abstinence during the study treatment period and for at least 6 months after the end of the study treatment; Female subjects of childbearing potential must have a negative Human chorionic gonadotropin (HCG) test within 7 days before study enrollment and not be lactating.
6.Willing to participate in this clinical study, sign an informed consent form, have good compliance, and cooperate with follow-up.
7.Subjects with relapsed or refractory autoimmune diseases, Including relapsed or refractory Autoimmune Hemolytic Anemia, relapsed or refractory Systemic Lupus Erythematosus, relapsed or refractory or Progressive Systemic Sclerosis, relapsed or refractory or Progressive Inflammatory Myopathy, relapsed or refractory ANCA-Associated Vasculitis, relapsed or refractory Immunoglobulin-G4 related disease and relapsed or refractory Myasthenia Gravis.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Xuzhang Lu, Doctor | Contact | +86-15295189493 | Luxuzhang2008@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Changzhou No.2 People's Hospital | Changzhou | China |
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The SRI-4 (SLE Responder Index-4) response was defined as a reduction of at least 4 points in SLEDAI score compared with the baseline level, no new British Isles Lupus Assessment Group (BILAG) A organ domain score or no more than one new BILAG B organ domain score, and no worsening in the Physician's Global Assessment (PGA) (<0.3 points worsening from the baseline level).
| Up to 24 Months After UCAR T-cell Infusion |
| SLE: Change in the Systemic Lupus Erythematosus Disease Activity Index(SLEDAI) from baseline | SLEDAI stands for Systemic Lupus Erythematosus Disease Activity Index, with a score of 0-6 representing mild disease activity, 7-12 representing moderate disease activity, and 12-16 representing severe disease activity | Up to 24 Months After UCAR T-cell Infusion |
| SSc:Change in the modified Rodnan Skin Score (mRSS) from baseline | The modified Rodnan Skin Score (mRSS) describes the thickness of skin in 17 anatomic areas rated from 0 to 3, where 3 indicates the most severe thickening. | Up to 24 Months After UCAR T-cell Infusion |
| IIM:The ACR-EULAR Myositis Response Criteria [Total Improvement Score (TIS)] | Total Improvement Score (TIS) contains Physician Global Activity(PGA),Patient/Parent Global Activity(PtGA),Manual Muscle Testing(MMT) and Health Assessment Questionnaire(HAQ). PGA:This partially validated tool measures the global evaluation by the treating physician of the overall disease activity of the patient at the time of assessment using a 10 cm. visual analogue scale and a 5 point Likert scale. PtGA:This partially validated tool measures the global evaluation by the patient, or by the parent if the patient is a minor, of the patient's overall disease activity at the time of assessment using a 10 cm. visual analogue scale. MMT:This partially validated tool assesses muscle strength using manual muscle testing (MMT). A 0 - 10 point scale is proposed for use. An abbreviated group of 8 proximal, distal, and axial muscles performs similarly to a total of 24 muscle groups, and is also proposed for use for research studies. HAQ:Define the health assessement questionnaire. | Up to 24 Months After UCAR T-cell Infusion |
| AAV: Change in disease activity as measured by Birmingham Vasculitis Activity Score (BVAS) | The Birmingham Vasculitis Activity (BVAS) form is divided into 9 organ-based systems, with each section including symptoms/signs that are typical of that particular organ involvement in systemic vasculitis. The clinician only scores features believed to be due to active vasculitis. Completion of the form provides a numerical score, which ranges from 0 (best health) to 63 (worst health). A negative percentage change indicated improvement in health. | Up to 24 Months After UCAR T-cell Infusion |
| IgG4-RD:IgG4-Related Disease Responder Index (IgG4-RD RI) | The IgG4-RD RI detects change in disease activity and identifies improvements/worsening in the same or different organ systems. It encompasses more than 25 organs/sites and records the following for each organ/site: (i) activity trend (through a 0-3 [normal/resolved - worsening] organ/site score); (ii) presence of symptoms due to active disease; (iii) need for urgent care; (iv) presence of damage; and (v) presence of symptoms due to damage. The final activity score at each visit is obtained by summing all organ/site scores (i) and by doubling items needing urgent care (iii). Higher scores represent greater (i.e. worse) disease activity. | Up to 24 Months After UCAR T-cell Infusion |
| MG:Changes of Myasthenia Gravis Activities of Daily Living (MG-ADL) Score | MG-ADL scale assesses the impact of gMG on daily functions by measuring 8 signs or symptoms that are commonly affected in MG. Each item is measured on a 4-point scale, where a score of 0 represents normal function and a score of 3 represents the loss of ability to perform that function. Total scores range from 0 to 24 points, with a higher score showing more severe MG. | Up to 24 Months After UCAR T-cell Infusion |
| MG:Quantitative Myasthenia Gravis Score (QMG) | The QMG score is a 13-item scale used to quantify disease severity in myasthenia gravis. The scale measures ocular, bulbar, respiratory, and limb function, grading each finding, and ranges from 0 (no myasthenic findings) to 39 (maximal myasthenic deficits). | Up to 24 Months After UCAR T-cell Infusion |
| ID | Term |
|---|---|
| D008180 | Lupus Erythematosus, Systemic |
| D000744 | Anemia, Hemolytic, Autoimmune |
| D009157 | Myasthenia Gravis |
| D012595 | Scleroderma, Systemic |
| D056648 | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis |
| D009220 | Myositis |
| D000077733 | Immunoglobulin G4-Related Disease |
| ID | Term |
|---|---|
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D000743 | Anemia, Hemolytic |
| D000740 | Anemia |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D020361 | Paraneoplastic Syndromes, Nervous System |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D010257 | Paraneoplastic Syndromes |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D019636 | Neurodegenerative Diseases |
| D020511 | Neuromuscular Junction Diseases |
| D009468 | Neuromuscular Diseases |
| D012871 | Skin Diseases |
| D056647 | Systemic Vasculitis |
| D014657 | Vasculitis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D017445 | Skin Diseases, Vascular |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
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