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This is a prospective, randomized, open-label, parallel-controlled clinical trial to evaluate the efficacy and safety of targeted IL-17A inhibition with secukinumab on cardiovascular and renal endpoints in 100 patients with cardiorenal metabolic syndrome and atherosclerotic cardiovascular disease (ASCVD). Eligible subjects will be randomized 1:1 to receive either secukinumab 75 mg subcutaneous injection every 4 weeks for a total of 12 weeks plus standard guideline-directed medical therapy, or standard medical therapy alone. The primary endpoint is the time to first occurrence of 3-point major adverse cardiovascular events (MACE, including cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) over a 2-year follow-up period. Key indicators include estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) for renal outcome assessment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Secukinumab + Standard Guideline-Directed Therapy | Experimental |
| |
| Standard Guideline-Directed Therapy Alone | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Secukinumab (75 mg) | Biological | 75 mg, subcutaneous injection, once every 4 weeks for a total of 12 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to First Occurrence of 3-point Major Adverse Cardiovascular Events (MACE: cardiovascular death, non-fatal myocardial infarction, non-fatal stroke) | From randomization up to 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Time to first extended MACE composite endpoint | From randomization up to 2 years | |
| Total number of heart failure hospitalizations, urgent heart failure visits or cardiovascular death | From randomization up to 2 years |
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Inclusion Criteria:
Age ≥ 18 years at screening.
Meet at least one metabolic abnormality:
Meet at least one diagnostic criterion for chronic kidney disease:
Have documented atherosclerotic cardiovascular disease (at least one):
Able and willing to provide written informed consent.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wen Tang, MD, PhD | Contact | +86 13911292690 | tanggwen@126.com |
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| Standard Medical Therapy | Other | Standard guideline-directed cardiovascular and renal protective therapy per clinical practice guidelines |
|
| All-cause mortality | From randomization up to 2 years |
| Changes in carotid artery stenosis degree | Baseline, Month 6, Month 24 |
| Changes in carotid artery plaque size | Baseline, Month 6, Month 24 |
| Time to composite chronic kidney disease endpoint (sustained eGFR decline ≥30% or kidney failure) | From randomization up to 2 years |
| Incidence of kidney failure (death due to renal failure, sustained eGFR <15 mL/min/1.73 m², or long-term renal replacement therapy) | From randomization up to 2 years |
| Changes in UACR | Baseline, Month 6, Month 24 |
| Changes in eGFR | Baseline, Month 6, Month 24 |
| Annual slope of eGFR | Baseline, Month 6, Month 24 |
| Changes in high-sensitivity C-reactive protein (hs-CRP) | Baseline, Month 6, Month 24 |
| Changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) | Baseline, Month 6, Month 24 |
| Number of new-onset atrial fibrillation events | From randomization up to 2 years |
| Changes in hemoglobin levels | Baseline, Month 6, Month 24 |
| ID | Term |
|---|---|
| D050197 | Atherosclerosis |
| D051436 | Renal Insufficiency, Chronic |
| D003324 | Coronary Artery Disease |
| D006973 | Hypertension |
| D003924 | Diabetes Mellitus, Type 2 |
| D058729 | Peripheral Arterial Disease |
| D016893 | Carotid Stenosis |
| ID | Term |
|---|---|
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D016491 | Peripheral Vascular Diseases |
| D002340 | Carotid Artery Diseases |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| C555450 | secukinumab |
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