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| Name | Class |
|---|---|
| The First Affiliated Hospital of Anhui Medical University | OTHER |
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This is an investigator-initiated trial designed to evaluate the safety, tolerability and primary efficacy of AFN50 injection for the treatment of autoimmune diseases.
This study is a prospective exploratory clinical trial in subjects with autoimmune diseases, mainly relapsing and refractory systemic lupus erythematosus. The objective is to evaluate the safety, tolerability, and primary efficacy of AFN50 injection in relapsing and refractory systemic lupus erythematosus.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Participant Group | Experimental | AFN50 Injection |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AFN50 injection | Biological | Intravenous infusion therapy. AFN50 was developed using novel T-cell-targeted lipid nanoparticles (T-LNP) encapsulating mRNA encoding Chimeric Antigen Receptor. |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse events | Incidence and severity of AEs associated with AFN50 as assessed by CTCAE v5.0 | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| in vivo CAR T cell production | The counts, proportions and sustained days of CAR-T cells in the peripheral blood | Day-28 to 28 days |
| B cell ratios and counts in peripheral blood | Assessment of the change of B cell ratios and counts in peripheral blood after AFN50 treatment |
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Inclusion Criteria:
Be able to understand and voluntarily sign the written informed consent form;
Patients aged between 18 and 69 (inclusive), of any gender, diagnosed with SLE according to the 2019 EULAR/ACR SLE diagnostic criteria;
A history of SLE for at least 6 months, having used a stable standard treatment regimen for at least 8 weeks, with the dosage stable for 2 weeks, yet the disease remains active or has relapsed; Standard treatment refers to the stable use of the following drugs alone or in combination: non-steroidal anti-inflammatory drugs (NSAIDs), antimalarials, corticosteroids; immunosuppressants (including but not limited to cyclophosphamide, methotrexate, azathioprine, mycophenolate mofetil, leflunomide, tacrolimus, cyclosporine); targeted drugs (including but not limited to belimumab, telitacicept, eculizumab, rituximab);
Oral corticosteroids are prednisone (or equivalent drug) ≥7.5mg/day and ≤30mg/day. If used in combination with immunosuppressants, there is no minimum daily dose requirement;
Standardized treatment failure with hydroxychloroquine or at least two immunosuppressants;
Screening period tests meet: positive blood antinuclear antibody (ANA), and/or positive anti-double-stranded DNA (anti-dsDNA) antibodies, and/or hypocomplementemia (low C3 and/or C4);
Screening period SLEDAI-2K score ≥6 points. If scoring includes low complement and/or anti-ds-DNA antibodies, the score for SLEDAI-2K clinical symptoms (excluding low complement and/or anti-ds-DNA antibodies) should be ≥4 points;
Appropriate bone marrow, coagulation, cardiopulmonary, liver, and kidney functions.
Bone marrow function: Absolute Neutrophil Count (ANC) ≥1.5×10⁹/L (no granulocyte colony-stimulating factor (G-CSF) administered within 7 days prior to screening; a 14-day interval required for long-acting G-CSF); Hemoglobin (Hb) ≥80 g/L (no red blood cell transfusion within 14 days prior to screening; recombinant human erythropoietin is permitted. For patients meeting the Hb ≥80 g/L inclusion criterion, red blood cell transfusion is allowed during treatment to maintain hemoglobin level at ≥80 g/L); Platelet Count (PLT) ≥50×10⁹/L, Absolute Lymphocyte Count (ALC) ≥0.8×10⁹/L.
Coagulation function: International Normalized Ratio (INR) or Activated Partial Thromboplastin Time (APTT) ≤1.5 times the upper limit of normal (ULN).
Cardiac function: Left Ventricular Ejection Fraction (LVEF) ≥40% as measured by echocardiography (ECHO).
Pulmonary function: Dyspnea of ≤CTCAE Grade 1; pulse oxygen saturation (SpO2) >92% under room air.
Hepatic function: Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) ≤2.5×ULN; total bilirubin ≤1.5×ULN.
Renal function: Creatinine clearance rate (calculated by the Cockcroft-Gault formula) ≥50 mL/min, without the need for fluid support;
Baseline oxygen saturation >92% without oxygen supplementation;
Non-pregnant/non-lactating participants. Women of childbearing potential must have a negative serum or urine pregnancy test result (women who have undergone surgical sterilization or postmenopausal women for at least 2 years are not considered women of childbearing potential) and be willing to adopt contraceptive measures within 12 months after drug infusion.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Beicheng SUN, Dr | Contact | +86 551 6292 2800 | sunbc0207@163.com | |
| Huan ZHOU, Dr | Contact | +8613665527160 | zhouhuanbest@vip.163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| First Affiliated Hospital of Anhui Medical University | Recruiting | Hefei | Anhui | 230001 | China |
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| ID | Term |
|---|---|
| D001327 | Autoimmune Diseases |
| ID | Term |
|---|---|
| D007154 | Immune System Diseases |
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| Day-28 to 12 months |
| Changes in the 2000 Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2000) relative to baseline in participants | Assessment of Systemic Lupus Erythematosus Disease Activity Index 2000 from baseline to the month 12 follow-up visit. A total score can fall between 0 and 105, which determines changes in the disease activity of patients. | Day-28 to12 months |
| SLE Responder Index-4 (SRI-4) | Achievement of SRI-4 response at one or more scheduled study visits between baseline and the Month 12 follow-up. | Day-28 to12 months |
| Changes in the Physician's Global Assessment (PGA) relative to baseline | A total score can range from 0.0 to 3.0, with higher scores indicating more severe disease activity. | Day-28 to12 months |
| Proportion of participants achieving DORIS remission | Proportion of participants achieving DORIS (Definition Of Remission In SLE) remission after AFN50 administration. | Day-28 to12 months |
| Proportion of participants achieving complete renal response (CRR) | Proportion of participants achieving complete renal response (CRR) after AFN50 administration | Day-28 to12 months |
| Proportion of participants achieving low disease activity status (LLDAS) | Maintenance of LLDAS: The proportion of participants with SLE who remain in Lupus Low Disease Activity State at predefined study visits through the 12-month follow-up period. | Day-28 to12 months |