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This is an open-label, investigator-initiated clinical trial (IIT) designed to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and efficacy of RD06-04 in patients with refractory IIM and AAV. The study plans to enroll a total of 12 participants, with 6 cases each for IIM and AAV. Enrollment for both diseases will proceed in parallel. The dose will be 6×10^6 CAR+T cells/kg (±30%), and patients will receive a single infusion of RD06-04.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| RD06-04 Cell Injection | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| RD06-04 Cell Injection Infusion | Drug | CAR T-cell therapy administered intravenously after a lymphodepleting therapy regimen consisting of fludarabine and cyclophosphamide. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Events (TEAE), Serious Adverse Events (SAE), Adverse Events of Special Interest (AESI) | Up to 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| The proportion of patients with kidney involvement achieving complete kidney remission (CRR) | At weeks 12, and months 6, 12, 18, and 24 following CAR-T infusion. | |
| The change in UPCR from baseline in patients with kidney involvement. | At weeks 2, 4, 8, 12, and at months 6, 9, 12, 18, and 24 following CAR-T infusion. |
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General Inclusion Criteria:
The subject voluntarily participates in this trial and has signed the informed consent form.
Age ≥18 years and ≤70 years, regardless of gender.
Organ Function and Laboratory Tests:
Female subjects of childbearing potential must have a negative serum or urine pregnancy test result during screening.
Females of childbearing potential must agree to use highly effective contraception from at least 28 days before the start of lymphodepletion until 12 months after the infusion of RD06-04. Males of reproductive potential must agree to use an effective barrier method of contraception from the start of lymphodepletion until 12 months after the infusion of RD06-04 and must not donate semen or sperm during the entire trial period.
For IIM participants:
1. Diagnosed with IIM (including probable or definite diagnosis, i.e., a probability of ≥55%) according to the 2017 ACR/EULAR classification criteria. Currently, the ENMC considers that the subtypes of IIM mainly include dermatomyositis (DM), antisynthetase syndrome (ASS), and immune-mediated necrotizing myopathy (IMNM).
For AAV participants:
1. Meets the diagnostic criteria for ANCA-associated vasculitis as established by the 2022 ACR/EULAR, including microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA).
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| ZhanGuo Li, Doctor | Contact | 010-88324073 | 1i99@bjmu.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University People's Hospital | Beijing | 100032 | China |
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| The change in eGFR (estimated glomerular filtration rate) from baseline in patients with kidney involvement. | At weeks 2, 4, 8, 12, and at months 6, 9, 12, 18, and 24 following CAR-T infusion. |
| The change in BVAS score from baseline in AAV patients | Birmingham Vasculitis Activity Score (BVAS) has a minimum score of 0 and a theoretical maximum score exceeding 100 (depending on the number and severity of affected organ systems). A higher score indicates stronger disease activity and a worse prognosis, while a decrease in score (especially to <5) typically suggests effective treatment. | At 6, 12, 18, and 24 months following CAR-T infusion. |
| IIM patients were assessed for major clinical remission (Total Improvement Score, TIS) according to the 2016 ACR /EULAR criteria for myocarditis remission. | Total Improvement Score (TIS) has a minimum score of 0 (indicating no improvement) and a maximum score of 100 (indicating maximal improvement). A higher score represents more significant disease improvement and better treatment efficacy. | At 6, 12, 18, and 24 months following CAR-T infusion. |
| The change in FACIT-Fatigue from baseline. | Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-Fatigue) has a minimum score of 0 and a maximum score of 52. A higher score indicates less severe fatigue and better quality of life. | At 6, 12, 18, and 24 months following CAR-T infusion. |
| Assessment of the peak amplification level (Cmax), area under the concentration-time curve (AUC0-28), and persistence profile of RD06-04. | Up to 2 years |
| The change in HAQ-DI from baseline. | Health Assessment Questionnaire-Disability Index (HAQ-DI) has a minimum score of 0 and a maximum score of 3. A higher score indicates more severe physical dysfunction and worse quality of life. | At 6, 12, 18, and 24 months following CAR-T infusion. |
| Assessment of the incidence and titer levels of anti-RD06-04 specific anti-drug antibodies (ADA). | Up to 2 years |
| ID | Term |
|---|---|
| D009220 | Myositis |
| D056648 | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis |
| ID | Term |
|---|---|
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D056647 | Systemic Vasculitis |
| D014657 | Vasculitis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D017445 | Skin Diseases, Vascular |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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