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This study is designed as a single arm, open label, single center clinical trial to evaluate the safety, tolerability, efficacy, pharmacokinetic or pharmacodynamic characteristics of the investigational drug V001-BCMA in autoimmune disease.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| V001-BCMA injection | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| V001-BCMA | Drug | Targeted BCMA In-vivo LV Injection (Code: V001-BCMA) is a third-generation non-replicating self-inactivating lentiviral vector. Its envelope protein has been engineered to express targeting molecules on the lentiviral surface for specific recognition of T cells, while its nucleic acid contains a T cell-specific promoter and a CAR gene. After specifically targeting and binding to T cells, V001-BCMA enables the expression of CAR on the surface of T cells, forming CAR-T cells. These CAR-T cells can then specifically kill target cells. |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of adverse events of V001-BCMA single infusion. | For all participants | At Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Measure | Description | Time Frame |
|---|---|---|
| BILAG-2004 Scale Score | The BILAG-2004 index assesses disease activity in systemic lupus erythematosus (SLE) to guide treatment. It evaluates nine organ systems separately, grading each from A to E based on clinical features: A (severe, requiring aggressive therapy), B (moderate), C (mild), D (previous involvement), and E (no involvement). Its focus is on tracking changes per system for targeted management. |
| Measure | Description | Time Frame |
|---|---|---|
| Virus Leak Detection | For all subjects. Collect blood, saliva, urine, and fecal samples for cryogenic storage and detect any potential leaks. Collect blood, saliva, urine, and fecal samples to detect virus levels and determine if there is a carrier virus leak | baseline、Day2、Day4、Day6、Day8、Day10、Day14、Day21、Day28 |
Inclusion Criteria:
1. The age at the time of signing the informed consent form is ≥18 years old and ≤65 years old;
2. For cohort 1: recurrent or refractory systemic lupus erythematosus (all of the following four items must be met simultaneously)
3. For cohort 2: recurrent or refractory IgG4-related disease (all three of the following criteria must be met simultaneously)
4. For cohort 3: relapsed or refractory systemic sclerosis (all of the following 5 items must be met simultaneously)
5. For cohort 4: relapsed or refractory idiopathic inflammatory myopathies (all of the following 5 criteria must be met)
6. For cohort 5: relapsed or refractory AAV (all three of the following conditions must be met simultaneously)
7. Possess sufficient organ function
8. Men with fertility and women of childbearing age must agree to use effective contraception from the time they sign the informed consent form until 1 year after the study drug is administered. Blood pregnancy tests for women of childbearing age must be negative at screening and before infusion;
9. The subject or his/her guardian agrees to participate in this clinical study and signs the informed consent form (ICF), indicating that he/she understands the purpose and procedures of this clinical study and is willing to participate in the study.
Exclusion Criteria:
1. For cohort 1: relapsed or refractory systemic lupus erythematosus
2. For cohort 3: relapsed or refractory systemic sclerosis. High-risk pulmonary arterial hypertension, according to the "Risk Stratification of Arterial Pulmonary Arterial Hypertension (PAH)" in the "Guidelines for the Diagnosis and Treatment of Pulmonary Arterial Hypertension in China (2021 Edition)".
3. History of major organ transplantation (such as heart, lung, kidney, liver) or hematopoietic stem cell/bone marrow transplantation.
4. Subjects with a history of ≥ Grade 2 bleeding within 30 days prior to screening, as assessed by the investigator, were deemed unsuitable for enrollment.
5. Use of any live vaccines against infectious diseases within 8 weeks before infusion.
6. Received any treatment using vesicular stomatitis virus G (VSVG) pseudotype virus.
7. The subject has a history or evidence of suicidal thoughts within 6 months before signing the ICF, or any suicidal behavior within 12 months before signing the ICF, and the researcher believes that there is a significant risk of suicide.
8. Pregnant or lactating women;
9. The patient has a history of severe and/or uncontrolled liver, gastrointestinal, kidney, lung, cardiovascular, psychiatric, neurological, or musculoskeletal diseases, hypertension, or any other medical condition that, in the opinion of the investigator, may affect the integrity of the patient's participation in the study, or may endanger the safety of the subject or affect the validity of the study results.
10. Suffered from malignant tumor within 3 years before screening, except for the following conditions: received radical treatment for malignant tumor and had no known active disease within ≥3 years before enrollment; or had fully treated non-melanoma skin cancer and currently had no evidence of disease;
11. Received any B-cell depleting biologic therapy (e.g., rituximab, ocrelizumab, obinutuzumab, ofatumumab, inebilizumab, etc.) within 3 months prior to infusion, unless B-cell recovery is proven.
12. Received immunosuppressants and other small molecule drugs within 3 days before infusion.
13. Use of any other clinical research drugs within 4 weeks before infusion. However, if the study treatment is ineffective or the disease progresses during the study period, and at least 3 half-lives have elapsed before screening, enrollment is allowed.
14. The patient has received live vaccines or live therapeutic infectious pathogens within 2 weeks before infusion.
15. The presence of chronic and active hepatitis B (excluding HBV-DNA levels below 500IU/ml), hepatitis C (HCV), human immunodeficiency virus (HIV) infection, or syphilis infection;
16. Active infection exists, requiring intravenous antibiotic therapy or hospitalization;
17. Patients who have undergone major surgery other than diagnosis or biopsy within 4 weeks before infusion, or are expected to undergo major surgery during the study period; note: patients who plan to undergo surgical procedures under local anesthesia can participate in the study.
Kyphoplasty or vertebroplasty are not considered major surgery;
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| lingli Dong, professor | Contact | 83665519 | tjhdongll@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tongji Hospital, Affiliated to Tongji Medical College of Huazhong University of Science and Technology | Recruiting | Wuhan | Hubei | 430000 | China |
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| At baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| PGA | Physician Global Assessment. PGA score is used to assess the disease activity status of patient by physician. PGA min-max(0-3, the higher score represents the worse result) | At baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| SF-36 | The 36-Item Short Form Health Survey. For SLE and AAV. SF-36 score min-max(0-100,the higher score represents the better result) | At baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| DORIS score | The DORIS score defines remission criteria in systemic lupus erythematosus (SLE), guiding treatment goals and trial endpoints. Its core assessment includes: 1) clinical SLEDAI=0; 2) Physician Global Assessment (PGA)<0.5; 3) prednisone ≤5mg/day; 4) stable immunosuppressive/biologic therapy. It also requires stable/improved serology and sustained duration of remission. | At Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| LLDAS | The LLDAS defines a "low disease activity state" in SLE, a key treatment target linked to better long-term outcomes. Core criteria include: 1) SLEDAI-2K ≤4; 2) no new disease activity; 3) Physician Global Assessment (PGA) ≤1.0; 4) prednisone ≤7.5mg/day; 5) stable immunosuppressive/biologic doses. | At Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Renal function response | Only for LN patients | At Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Cmax | For all subjects. Parameters of CAR copy number | Baseline, Day 2, Day 6, Day 10, Day 14, Day 21, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 |
| Tmax | For all subjects | Baseline, Day 2, Day 6, Day 10, Day 14, Day 21, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 |
| AUC0-28d | For all subjects | Baseline, Day 2, Day 6, Day 10, Day 14, Day 21, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 |
| AUC0-90d | For all subjects | Baseline, Day 2, Day 6, Day 10, Day 14, Day 21, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 |
| Tlast | For all subjects | Baseline, Day 2, Day 6, Day 10, Day 14, Day 21, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 |
| 24-hour urine protein | Only for LN | Baseline, Day 2, Day 6, Day 10, Day 14, Day 21, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 |
| UPCR | UPCR (Urine Protein-to-Creatinine Ratio) is a key index to measure assessing treatment response in lupus nephritis. | Baseline, Day 2, Day 6, Day 10, Day 14, Day 21, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, Month 24 |
| Proportion of CAR-T cells in T cells | For all subjects | baseline、Day 2、Day 6、Day 10、Day 14、Day 21、Day 28 after infusion |
| serum sBCMA level | BCMA expression levels of memory B cells and plasma blast cells in peripheral blood | Screening period, baseline, Day 14, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 post-infusion. |
| Time to disease recurrence | For IgG4-RD. Defined as the number of days between the day of infusion and the date of first treatment for IgG4-RD recurrence, as determined by a clinical professional, during the follow-up period | through study completion (at most 52 weeks) |
| Changes in lymphocyte subpopulations | For all subjects | Screening period, Day 14, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion, and at recurrence |
| Proportion of patients with improved disease activity (IgG4-RD RI) | For IgG4-RD. Improvement is defined as a decrease of ≥2 from the baseline disease activity score | Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| annualized recurrence rate | For IgG4-RD | through study completion, an average of 1 year |
| The proportion of subjects who achieved complete remission without relapse at week 52 | For IgG4-RD | at week 52 |
| Change in CRISS-25 score from baseline | For systemic sclerosis. The score of CRISS-25 min-max(0-1.0, the higher score represents the better result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Change in forced vital capacity (FVC) (mL) from baseline | For systemic sclerosis | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Change in mRSS from baseline | For systemic sclerosis. The score of mRSS min-max(0-51, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Change from baseline in Quantitative Interstitial Lung Disease (QILD) imaging score | For systemic sclerosis. The min-max score (0-100%, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Change from baseline in Quantitative Lung Fibrosis (QLF) imaging score | For systemic sclerosis. The min-max score (0-100%, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Scleroderma Patient Skin Report (SSPRO) compared to baseline | For systemic sclerosis.The min-max score (0-108, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Scleroderma Clinical Trial Consortium Damage Index (SCTC-DI) compared to baseline | For systemic sclerosis. The min-max score (0-55, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in EUSTAR activity index scores compared to baseline | For systemic sclerosis The min-max score (0-10, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Capillaroscopic skin ulcer risk index (CSURI) compared to baseline | For systemic sclerosis. CSURI is a continuous variable; the higher the score, the greater the ulcer risk. | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Gastrointestinal questionnaire scores of the University of California, Los Angeles Scleroderma Clinical Trial Alliance compared to baseline | For systemic sclerosis.The min-max score (0-3, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in serum SSc-related antibodies compared to baseline | For systemic sclerosis | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Muscle Strength Score (MRC) compared to baseline | For idiopathic inflammatory myopathies. The min-max score (0-60, the higher score represents the better result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| The changes in total improvement score (TIS) compared to baseline | For idiopathic inflammatory myopathies. The min-max score (0-100, the higher score represents the better result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in lesion size and severity index (CDASI) compared to baseline | For idiopathic inflammatory myopathies. The CDASI is a core instrument for assessing the severity of cutaneous dermatomyositis. It consists of two independent subscales: Activity (scored 0-100, with higher scores indicating worse status) and Damage (scored 0-32, with higher scores indicating worse status). | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Physician's overall disease activity score | For idiopathic inflammatory myopathies. The min-max score (0-10, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Manual Muscle Testing 8 (MMT8) compared to baseline | For idiopathic inflammatory myopathies. The min-max score (0-150, the higher score represents the better result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Expanded Myositis Disease Activity Index (EMDA) compared to baseline | For idiopathic inflammatory myopathies. The min-max score (0-10, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in MDAAT score compared to baseline | For idiopathic inflammatory myopathies. the overall score of extramuscular disease activity was assessed using the MDAAT scoring tool. The min-max score (0-60, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Myositis Core Set Measures | For idiopathic inflammatory myopathies | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| the remission rate of myositis (defined as an increase in TIS of ≥20, ≥40, and ≥60 points) was assessed according to the 2016 ACR/EULAR criteria for myositis remission | For idiopathic inflammatory myopathies | Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Time to improvement (TIS≥20, ≥40 and ≥60) | For idiopathic inflammatory myopathies | up to 52 weeks |
| Duration of remission (time from clinical remission to deterioration/time from remission to first recurrence) | For idiopathic inflammatory myopathies | up to 52 weeks |
| Changes in myositis specific antibodies and myositis associated antibodies in serum compared to baseline after injection | For idiopathic inflammatory myopathies | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in ILD on CT imaging compared to baseline (only for patients with ILD at baseline) | For idiopathic inflammatory myopathy patients with ILD in the baseline period | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Pulmonary function examination evaluates changes in ventilation and diffusion function compared to baseline | For idiopathic inflammatory myopathies. Pulmonary function examination can comprehensively evaluate the ventilation function, air exchange function, and airway responsiveness of the lungs, which is of great significance for the diagnosis, condition evaluation, and efficacy judgment of respiratory diseases | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Myositis specific antibody levels | For idiopathic inflammatory myopathies | Screening period, baseline, Day 14, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 post-infusion. |
| Myositis related antibody levels | For idiopathic inflammatory myopathies | Screening period, baseline, Day 14, Day 28, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 post-infusion. |
| The proportion of subjects who maintained remission | For AAV | Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| duration of response | For AAV | Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Vasculitis Damage Index (VDI) scores compared to baseline | For AAV | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in quality of life (SF-36 V2 scale) scores compared to baseline | For AAV. The min-max score (0-100, the higher score represents the better result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Disease Scope Index (DEI) compared to baseline | For AAV. The min-max score (0-21, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| Changes in Five Factor Score (FFS) compared to baseline | For AAV. The min-max score (0-5, the higher score represents the worse result) | At Baseline, Month 1, Month 2, Month 3, Month 6, Month 9, Month 12, Month 18, and Month 24 after infusion |
| immunogenicity |
For all subjects. Detecting anti CAR antibodies in patient serum using bridging ELISA or flow cytometry |
| baseline、Day28、Month3,Month6,Month9,Month12,Month18,Month24 post infusion |
| Single-cell sequencing | For all subjects. Collect peripheral blood from patients and perform single-cell sequencing. Droplet platforms (such as 10 × Genomics) are the most commonly used scRNA seq platforms. The platform places single cells into water in oil droplets containing gel beads through the microfluidic chamber. gel beads have mRNA capture primers, unique molecular barcodes, and enzyme/reagent mixtures required for cell lysis and reverse transcription. After reverse transcription of transcription information to obtain cDNA, high-throughput sequencing can be performed through PCR amplification and library preparation. | During the screening period, at either 3 months or 6 months, the specific timing of the test will be determined by the researcher |
| ID | Term |
|---|---|
| D012008 | Recurrence |
| D008180 | Lupus Erythematosus, Systemic |
| D000077733 | Immunoglobulin G4-Related Disease |
| D012595 | Scleroderma, Systemic |
| D009220 | Myositis |
| D056648 | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D012871 | Skin Diseases |
| 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 |
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