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NCT ID: NCT05714670 Recruiting - Lupus Nephritis Clinical Trials

The Effect of Curcumin on the Clinical Outcome of Pediatric Patients With Active Lupus Nephritis

Start date: April 1, 2023
Phase: Phase 2
Study type: Interventional

Pediatric Lupus nephritis which is a sever and common complication to childhood onset systemic lupus erythematous is an aggressive inflammatory process triggered by the deposition of antigen-antibody complex in kidney tissue. The complex stimulates production of multiple immune cells, activating Inflammasome NLRP3 that plays massive role in stimulating various cytokines like IL-6. The inflammation also causes elevation in proteinuria and serum creatinine levels beside other inflammatory markers elevation (CRP )and (ESR). These children are treated with a standard regimen consists of an immunomodulator (mycophenolate mofetil) with strong steroid anti-inflammatory and also hydroxychloroquine is added to the regimen to decrease the intensity of the flares and management of arthritis symptoms. In our study we are introducing a powerful antioxidant and anti-inflammatory drug with nephroprotective benefits which is curcumin capsules. The drug showed success in managing different autoimmune and inflammatory diseases as rheumatoid arthritis and Crohn's disease, it also showed dramatic improvement in lupus nephritis models in previous experimental study. The study primary outcome is will be the composite of the effect of curcumin on Urine protein-to-creatinine ratio and NLPR3 Inflammasome levels in blood. Patients meeting the study inclusion criteria will be educated firmly about the disease details and all information about the drug, then will be randomly assigned to one of two groups, the first group receiving the standard therapy only while the second one receiving the standard therapy beside the curcumin 1000 mg capsules orally daily, a third small group of healthy children as a control for normal inflammasome levels. Patients in the first two groups will undergo baseline evaluation at the beginning of the study including Patients' demographic data, anthropometric measures and medication history. Moreover, collecting patients' medical history which includes Duration of systemic lupus, Duration of lupus nephritis, other organs involvement, past and current medical condition or prescribed and OTC medications. Laboratory Evaluation and renal function assessment will include Inflammasome levels in blood using ELISA technique using Human NLRP3 ELISA Kit, Serum creatinine levels, Protein in urine levels, estimated glomerular filtration rate (eGFR) using Original Schwartz Equations, Inflammatory biomarkers (ESR, CRP), anti-ds DNA, anti-ANA DNA and evaluating Hematuria. Baseline Clinical evaluation includes Blood pressure measurement and Kidney structural damage evaluation via biopsy. Then patients will be followed up monthly for three months for assessing Patient Compliance with the prescribed medication regimens and the study drug, Occurrence of side effect graded using monitoring of side effects scale (MOSES) and checking for Allergic reactions against the drug. After the three months, all patients will be reassessed for all laboratory and clinical evaluations. finally results will be statistically analyzed Statistical analysis will be done using SPSS statistical software package

NCT ID: NCT05704088 Active, not recruiting - Lupus Nephritis Clinical Trials

SGLT2 Inhibitors Between Reno Protective Effects and Impact on Bone and Mineral Disease Among Lupus Nephritis Patients

Start date: October 8, 2022
Phase: Phase 4
Study type: Interventional

The goal of this Randomized, controlled trial in 100 patients with LN with an estimated glomerular filtration rate (eGFR) of 25-75 ml/min/1.73m2. Diagnosis of LN was performed by renal biopsy, and all of the renal biopsies were carried out at urology and nephrology center. 1. The main questions it aims to answer are: - Assess the role of sodium glucose co transporter 2 inhibitors (SGLT2i) in regression of ongoing kidney and cardiac diseases among diabetic or non-diabetic patients with lupus nephritis (LN) under different immunosuppressive therapies. - Investigate the impact of SGLT2i on bone and mineral metabolism in these patients. Participants will be randomized into two groups : - Study group: will receive SGLT2i as add on drug or replace another drug according to the patient clinical situation, Dapagliflozin 10 mg will be used once daily with or without food. - Control group: will be maintained on their medication.

NCT ID: NCT05689580 Recruiting - Clinical trials for Systemic Lupus Erythematosus

The Influence of Ketogenic Diet on Lupus Nephritis Patients' Immunity

Start date: September 1, 2022
Phase: N/A
Study type: Interventional

The study investigates the dietary habits in relation to low doses of omega-3 fatty acids in subcutaneous adipose tissue, disease activity and atherosclerosis. The low intake of omega-3 and high intake of carbohydrate among patients with SLE appear to be associated with worse disease activity, adverse serum lipids and plaque presence.Three-month-old mice received an injection of pristane or saline solution and were fed with different experimental diets: sunflower oil diet or extra virgin olive oil (EVOO) diet. After 24 weeks, mice were sacrificed, spleens were collected and kidneys were removed for immunoinflammatory detections. The study have demonstrated that EVOO diet significantly reduced renal damage and decreased cytokine: TNF-α, IL-6, IL-10 and IL-17 production.The ketogenic diet utilizes a high fat, adequate protein, low carbohydrate diet that control type of food and exchange. The aim of the present study that ketogenic diet treated in SLE patients may decrease overactive immunity and associated inflammatory markers.

NCT ID: NCT05686746 Recruiting - Nephritis Clinical Trials

Use of Baricitenib to Maintain of Remission

Start date: June 1, 2022
Phase: Phase 2/Phase 3
Study type: Interventional

Baricitinib a selective Janus kinase (JAK) inhibitors 1&2 have been recognized as a potential therapeutic option in systemic lupus (SLE), also known Baricitinib, a JAK inhibitor, has demonstrated efficacy and safety in the treatment of dermatitis and arthritis 1 ; however, no JAK inhibitor studies have been conducted in lupus nephritis (LN) maintain remission to date.

NCT ID: NCT05680480 Recruiting - Lupus Nephritis Clinical Trials

A Study of Telitacicept in Lupus Nephritis

Start date: April 17, 2023
Phase: Phase 2
Study type: Interventional

The purpose of this study is to evaluate the safety and efficacy of Telitacicept in adult patients with active lupus nephritis.

NCT ID: NCT05631717 Recruiting - Clinical trials for Systemic Lupus Erythematosus

The Study of Comparing the Efficacy and Safety of Human Umbilical Cord MSCs and Low-dose IL-2 in the Treatment of LN

Start date: October 1, 2022
Phase: Phase 3
Study type: Interventional

The purpose of this study is to compare the efficacy and safety of human umbilical cord mesenchymal stem cells and low-dose IL-2 in the treatment of LN

NCT ID: NCT05609812 Suspended - Clinical trials for Lupus Nephritis (LN)

Atacicept in Subjects With Active Lupus Nephritis (COMPASS)

COMPASS
Start date: November 2, 2022
Phase: Phase 3
Study type: Interventional

The objective of the study is to evaluate the effect of atacicept compared to placebo on changes to renal response in adult subjects with LN.

NCT ID: NCT05588830 Not yet recruiting - Lupus Nephritis Clinical Trials

The Efficacy and Safety of Telitacicept and Belimumab in Active Lupus Nephritis in the Real World: a Prospective Cohort Study

Start date: October 20, 2022
Phase:
Study type: Observational

Lupus nephritis is an autoimmune disease. It is an inflammatory kidney damage caused by the deposition of immune complexes in the kidney. It is mainly characterized by the clinical manifestations of albuminuria, hematuria, tubular urine, pyuria, and creatinine elevation. At present, many drugs such as glucocorticoid, immunosuppressant and belimumab are used for clinical treatment, and patients still face difficulties such as complete remission, repeated relapse and so on. This study is a multicenter, prospective, cohort study. In the study, 60 patients with lupus nephritis were enrolled, and they were treated with Telitacicept (n=30) or belimumab (n=30) for 24 weeks on the basis of conventional treatment. To observe the effectiveness and safety of the two treatment schemes for patients. Study drug administration method: Telitacicept was injected subcutaneously, 160mg/time, once a week, for 24 weeks. Belimumab, 10mg/kg, was administered intravenously on the 0, 14 and 28 days, and then once every 28 days until the 24th week During the administration period of this study, the clinician fully evaluated the safety tolerance of patients using this product and decided whether to reduce the dose. The reason for adjusting the treatment plan needs to be recorded. Reference of routine treatment plan: High dose hormone plus cyclophosphamide was used for induction therapy, and then azathioprine or mycophenolate mofetil was used for maintenance therapy; Or high-dose hormone plus mycophenolate mofetil is used for induction therapy, and then mycophenolate mofetil is used for maintenance therapy.

NCT ID: NCT05585671 Not yet recruiting - Clinical trials for Whether Belimumab Could Reduce 2-year Risk of New-onset Lupus Nephritis

Belimumab In Prevention of LN

Start date: June 1, 2023
Phase:
Study type: Observational

Systemic lupus erythematosus is a chronic autoimmune disease, which can involve multiple systems and largely impair patients' health. Kidney is the one of the most commonly affected organs. It was reported that more than about 70% SLE patients developed lupus nephritis, which was highly associated with the long-term prognosis1,2. It will be a great advantage if the high-risk groups could be predicated and prevented with pre-treatment, the renal prognosis and survival would be promisingly improved. The incidence of lupus nephritis within past 10 years in new-onset SLE patients was recorded in our retrospective study, which was highest in their first-year, about 17%, and about 5% per year in the following years3. The raising of risk prediction models and the recognition of high-risk patients are quite important. The prediction model depends on the collection of patient phenotypes, which are scattered in various forms and very cumbersome. In our previous study, a total of 14,439 SLE patients were collected from the rheumatology and immunology departments of 13 Chinese tertiary hospitals in this study, including 13 062 females (90.46%), with an average age of 33.4 years, and the time span of EMR (Electronic Medical Records) was from October 28, 2001 to March 31, 2017. It includes basic information about patients, physical examination, inspection and diagnostic information, etc. We designed a hybrid NLP system combined NLP technical and expert knowledge at the same time, which was named as Deep Phenotyping System (DPS), to extract all the phenotypic information recorded in EMR. The DPS efficiently processed EMR data, and its accuracy, precision, and recall were each greater than 93%. It extracted 73 794 entities from 14,439 SLE cases, each with time attributes, and produced 18,785,000,640 entities. Thus, a LN prediction model was raised, which the likelihood of lupus patients without nephritis will develop lupus nephritis within half and one year can be predicted.) More than 35 000 phenotypes were used in this model and it was verified with independent samples. The best accuracy (ACC) and area under the curve (AUC) predicting the 1-year and 2-year risk of developing lupus nephritis can be achieved 0.88 and 0.86 respectively. The comprehensive SLE phenotype database constructed by NLP greatly improves the research efficiency of lupus clinical phenotype. We first proposed a predictive model of lupus nephritis, which is high applicability and efficiency. The experimental results of good close and open testing fully demonstrate the authenticity and practicality of this database. The research process and method based on real world data are also applicable to predict other important complications of lupus3. Till now, there were no studies investigating secondary prevention tools of lupus nephritis. However, as we all known, disease flare is a high-risk factor of cruel organ damage, and our previous data showed that lupus nephritis was one of the important flare patterns4. Two phase III, randomized, placebo-controlled studies, BLISS-52 and BLISS-76 showed that belimumab, the only FDA-approved biologic in SLE, targeting B Lymphocyte Stimulator, can reduce disease flares compared to standard-of-care (SOC) therapy5,6. A propensity-score matching study further proved that belimumab add on reduces organ damage progression as measured by SDI7. A pooled post-hoc analysis of the BLISS trials took a deeper look at renal outcome, and suggest that belimumab may offer renal benefit in patients with SLE, indicated by less renal flares in belimumab group, that is 1.1% versus 3.0 in the placebo8. We hypothesized and tried to analyze that whether belimumab could act as a secondary prevention tool for SLE patients at high-risk.

NCT ID: NCT05566977 Not yet recruiting - Clinical trials for Type 1 Diabetes Mellitus

Autologous Adoptive T Regulatory Cell Transfer in Autoimmune Diseases.

Start date: December 2022
Phase: Phase 1
Study type: Interventional

Investigators aim to develop an effective and safe treatment of autoimmune diseases through adoptive T regulatory cells transfer. Our objectives are to evaluate the safety and efficacy of autologous adoptive Treg (CD4CD25FoxP3 CD127 low regulatory) cell transfer to patients with refractory autoimmune diseases: Refractory lupus Nephritis, and adults' type1 diabetes mellitus. Patients and Methods: This is Non randomized open label phase 1 pilot study including ten patients with refractory lupus nephritis and ten patients with Type 1 diabetic patients. All patients will be subjected to Full history taking, clinical examination and pretreatment investigations according to the type of autoimmune disease then regulatory T cells (Tregs) identification and count, Treg isolation and expansion and finally administration of T reg cells and follow-up of adverse events and outcomes.