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Evaluate the Efficacy and Safety of Various Treatment Schemes for Severe Fever With Thrombocytopenia Syndrome(SFTS)

Primary Purpose

Severe Fever With Thrombocytopenia Syndrome

Status
Recruiting
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Methylprednisolone
intravenous immunoglobulin
Tocilizumab
Low molecular weight heparin
conventional treatment
Sponsored by
Qin Ning
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Severe Fever With Thrombocytopenia Syndrome focused on measuring interleukin-6, D-D dimer, efficacy, safety, severe SFTS

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 1. Age ≥18 years. 2. SFTS Patients met the following diagnostic criteria:SFTS-virus (SFTSV) positive in peripheral blood detected by RT-PCR or Next Generation Sequencing (NGS) . 3. The intervention group shall meet the following conditions: Part A: Treatment can be initiated if the patient has two of the following conditions: (1) Persistent high fever for 7 days or more; (2) Platelets less than 50×10^9/L; (3) Multiple organ function impairment (MODS) including brain, heart, liver, kidney and blood coagulation; (4) Failure of more than 1 organ, such as brain, heart, liver, kidney and coagulation. Part B: Serum cytokine IL-6 quantification >2 times the upper limit of normal (ULN). Part C: Plasma D-D dimer ≥ 4×ULN. 4. Sign written informed consent and cooperate with follow-up. Exclusion Criteria: Patients with neoplastic diseases. Patients with severe chronic diseases, such as chronic kidney disease stage 3-5, chronic heart failure, decompensated cirrhosis, chronic diseases of the central nervous system, hematologic neoplastic diseases, uncontrolled solid tumors, etc. Patients who are or may be pregnant. Patients with a history of hypersensitivity reaction to the trial drug and its components. Patients with conditions that the investigator judged to affect short-term survival. Additional exclusion criteria for Part B: Patients with platelet < 50×10^9/L Additional exclusion criteria for Part C: Received vasopressor therapy for more than 36 hours before enrollment; Indications for anticoagulant therapy (such as ACS, acute VTE, mechanical valve, etc.); Significant bleeding risk as evidenced by one of the following conditions: Clinical: Surgery that requires general or spinal anesthesia within 24 hours prior to enrollment, or may require such surgery within the next 24 hours; Evidence of active bleeding; A history of severe head trauma requiring hospitalization; History of intracranial surgery or stroke or any cerebral arteriovenous malformation, cerebral aneurysm, or central nervous system mass within 3 months prior to the study; History of congenital hemorrhage; Gastrointestinal bleeding occurred within 6 weeks before the study unless corrective surgery was performed; Trauma that is thought to increase the risk of bleeding; The presence of an epidural catheter; Laboratory: INR > 2.0, or thrombelastogram results suggest significant hyperfibrinolysis. Present with other forms of shock that are clinically apparent, including cardiogenic, obstructive (massive pulmonary embolism, cardiac tamponade, tension pneumothorax), hemorrhagic, neurogenic, or anaphylactic shock.

Sites / Locations

  • Guangshui First Peoples HospitalRecruiting
  • Huanggang Central Hospital
  • Luotian County Peoples HospitalRecruiting
  • Macheng Peoples HospitalRecruiting
  • Qianjiang Central Hospital
  • Suizhou Central HospitalRecruiting
  • Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyRecruiting
  • Xianning Central Hospital
  • Yichang Third Peoples Hospital
  • Jiangsu Province Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

non-intervening group

intervention group

Arm Description

conventional treatment,including symptomatic and supportive treatment, antiviral treatment etc.

Part A group: Patients received methylprednisolone 1-2mg/kg/d(or other glucocorticoid equivalent to methylprednisolone 1-2mg/kg/d) + IVIG 0.2g-0.4g/kg/d for a total of 3-5 days. If the disease progressed after treatment, the patients were given the dose of rescue therapy (methylprednisolone > 2mg/kg/d or other glucocorticoid equivalent to methylprednisolone > 2mg/kg/d + IVIG 0.4g/kg/d) for another 3-5 days. Part B group: Patients received tocilizumab 4mg/kg once. Part C group: Patients received low molecular weight heparin 100U/kg, qd or q12h IH for 4-7 days. All patients received conventional treatment. All patients were followed up from the end of treatment to day 28 after completion of treatment.

Outcomes

Primary Outcome Measures

28-day survival rate
28-day survival rate was defined as the proportion of patients who were still alive 28 days after enrollment.

Secondary Outcome Measures

Incidence of complications
The complications include Respiratory system, gastrointestinal system, blood system, nervous system, liver and kidney, lymphatic system, multiple organ dysfunction syndrome may be related to Severe Fever With Thrombocytopenia Syndrome.Incidence of complications was defined as the proportion of complications occur after enrollment.
Incidence of AEs
Incidence of adverse events associated with trial drug treatment: blood glucose, electrolyte disturbances, osteoporosis, Cushing's syndrome, double infection, active bleeding, etc.

Full Information

First Posted
October 31, 2022
Last Updated
July 19, 2023
Sponsor
Qin Ning
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1. Study Identification

Unique Protocol Identification Number
NCT05604859
Brief Title
Evaluate the Efficacy and Safety of Various Treatment Schemes for Severe Fever With Thrombocytopenia Syndrome(SFTS)
Official Title
Evaluate the Efficacy and Safety of Various Treatment Schemes for Severe Fever With Thrombocytopenia Syndrome:a Prospective, Multicenter, Non-randomized Controlled Intervention Study
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 19, 2022 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
June 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Qin Ning

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a prospective, multicenter, non-randomized, controlled intervention clinical study.Patients with severe fever with thrombocytopenia syndrome who have been clinically diagnosed and met the study inclusion criteria will be included in the study for analysis. All patients with SFTS will be assigned to different groups according to the ratio of 1:3, including the non-intervention group (conventional treatment group) and the related drug intervention group. Non-intervention group:patients received conventional treatment during hospitalization. Intervention group: Part A group: Patients received methylprednisolone 1-2mg/kg/d(or other glucocorticoid equivalent to methylprednisolone 1-2mg/kg/d) + intravenous immunoglobulin (IVIG) 0.2g-0.4g/kg/d for a total of 3-5 days. If the disease progressed after treatment, the patients was given the dose of rescue therapy (methylprednisolone > 2mg/kg/d or other glucocorticoid equivalent to methylprednisolone > 2mg/kg/d + IVIG 0.4g/kg/d) for another 3-5 days. Part B group: Patients received tocilizumab 4mg/kg once. Part C group: Patients received low molecular weight heparin 100U/kg, qd or q12h IH for 4-7 days. If the platelet count is less than 30 × 10^9/L, the low molecular weight heparin should be discontinued. All patients received conventional treatment. All patients were followed up from the end of treatment to day 28 after completion of treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Severe Fever With Thrombocytopenia Syndrome
Keywords
interleukin-6, D-D dimer, efficacy, safety, severe SFTS

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
350 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
non-intervening group
Arm Type
Active Comparator
Arm Description
conventional treatment,including symptomatic and supportive treatment, antiviral treatment etc.
Arm Title
intervention group
Arm Type
Experimental
Arm Description
Part A group: Patients received methylprednisolone 1-2mg/kg/d(or other glucocorticoid equivalent to methylprednisolone 1-2mg/kg/d) + IVIG 0.2g-0.4g/kg/d for a total of 3-5 days. If the disease progressed after treatment, the patients were given the dose of rescue therapy (methylprednisolone > 2mg/kg/d or other glucocorticoid equivalent to methylprednisolone > 2mg/kg/d + IVIG 0.4g/kg/d) for another 3-5 days. Part B group: Patients received tocilizumab 4mg/kg once. Part C group: Patients received low molecular weight heparin 100U/kg, qd or q12h IH for 4-7 days. All patients received conventional treatment. All patients were followed up from the end of treatment to day 28 after completion of treatment.
Intervention Type
Drug
Intervention Name(s)
Methylprednisolone
Intervention Description
Methylprednisolone:1-2mg/kg/d(or other glucocorticoid equivalent to methylprednisolone 1-2mg/kg/d),ivgtt,3-5 days.If disease progression occurs after completion of treatment, the dose of salvage therapy (methylprednisolone > 2mg/kg/d or other glucocorticoid equivalent to methylprednisolone > 2mg/kg/d) was continued for another 3-5 days.
Intervention Type
Drug
Intervention Name(s)
intravenous immunoglobulin
Intervention Description
intravenous immunoglobulin:0.2g-0.4g/kg/d,ivgtt, 3-5 days.If disease progression occurs after completion of treatment, the dose of salvage therapy (IVIG 0.4g/kg/d) was continued for another 3-5 days.
Intervention Type
Drug
Intervention Name(s)
Tocilizumab
Intervention Description
Tocilizumab:4mg/kg, once
Intervention Type
Drug
Intervention Name(s)
Low molecular weight heparin
Intervention Description
Low molecular weight heparin:100U/kg, qd or q 12h,IH,4-7 days
Intervention Type
Other
Intervention Name(s)
conventional treatment
Intervention Description
conventional treatment,including symptomatic and supportive treatment, antiviral treatment etc.
Primary Outcome Measure Information:
Title
28-day survival rate
Description
28-day survival rate was defined as the proportion of patients who were still alive 28 days after enrollment.
Time Frame
From enrollment to 28 day
Secondary Outcome Measure Information:
Title
Incidence of complications
Description
The complications include Respiratory system, gastrointestinal system, blood system, nervous system, liver and kidney, lymphatic system, multiple organ dysfunction syndrome may be related to Severe Fever With Thrombocytopenia Syndrome.Incidence of complications was defined as the proportion of complications occur after enrollment.
Time Frame
From enrollment to 28 day
Title
Incidence of AEs
Description
Incidence of adverse events associated with trial drug treatment: blood glucose, electrolyte disturbances, osteoporosis, Cushing's syndrome, double infection, active bleeding, etc.
Time Frame
From enrollment to 28 day
Other Pre-specified Outcome Measures:
Title
Biomarkers associated with efficacy
Description
Blood, bone marrow, lymph node, urine and stool samples were collected to explore biomarkers associated with predicting the efficacy of methylprednisolone combined with IVIG, tocilizumab and low molecular weight heparin in the treatment of severe fever with thrombocytopenia syndrome.
Time Frame
From enrollment to 12 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Age ≥18 years. 2. SFTS Patients met the following diagnostic criteria:SFTS-virus (SFTSV) positive in peripheral blood detected by RT-PCR or Next Generation Sequencing (NGS) . 3. The intervention group shall meet the following conditions: Part A: Treatment can be initiated if the patient has two of the following conditions: (1) Persistent high fever for 7 days or more; (2) Platelets less than 50×10^9/L; (3) Multiple organ function impairment (MODS) including brain, heart, liver, kidney and blood coagulation; (4) Failure of more than 1 organ, such as brain, heart, liver, kidney and coagulation. Part B: Serum cytokine IL-6 quantification >2 times the upper limit of normal (ULN). Part C: Plasma D-D dimer ≥ 4×ULN. 4. Sign written informed consent and cooperate with follow-up. Exclusion Criteria: Patients with neoplastic diseases. Patients with severe chronic diseases, such as chronic kidney disease stage 3-5, chronic heart failure, decompensated cirrhosis, chronic diseases of the central nervous system, hematologic neoplastic diseases, uncontrolled solid tumors, etc. Patients who are or may be pregnant. Patients with a history of hypersensitivity reaction to the trial drug and its components. Patients with conditions that the investigator judged to affect short-term survival. Additional exclusion criteria for Part B: Patients with platelet < 50×10^9/L Additional exclusion criteria for Part C: Received vasopressor therapy for more than 36 hours before enrollment; Indications for anticoagulant therapy (such as ACS, acute VTE, mechanical valve, etc.); Significant bleeding risk as evidenced by one of the following conditions: Clinical: Surgery that requires general or spinal anesthesia within 24 hours prior to enrollment, or may require such surgery within the next 24 hours; Evidence of active bleeding; A history of severe head trauma requiring hospitalization; History of intracranial surgery or stroke or any cerebral arteriovenous malformation, cerebral aneurysm, or central nervous system mass within 3 months prior to the study; History of congenital hemorrhage; Gastrointestinal bleeding occurred within 6 weeks before the study unless corrective surgery was performed; Trauma that is thought to increase the risk of bleeding; The presence of an epidural catheter; Laboratory: INR > 2.0, or thrombelastogram results suggest significant hyperfibrinolysis. Present with other forms of shock that are clinically apparent, including cardiogenic, obstructive (massive pulmonary embolism, cardiac tamponade, tension pneumothorax), hemorrhagic, neurogenic, or anaphylactic shock.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Qin Ning, MD., PhD
Phone
+8602783662391
Email
qning@vip.sina.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Qin Qin, MD., PhD
Organizational Affiliation
Department of Infectious Disease, Tongji Hospital, Tongji Medical College, HUST
Official's Role
Study Chair
Facility Information:
Facility Name
Guangshui First Peoples Hospital
City
Guangshui
State/Province
Hubei
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
qian Liu
Facility Name
Huanggang Central Hospital
City
Huanggang
State/Province
Hubei
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
guoxiang Zhu
Facility Name
Luotian County Peoples Hospital
City
Huanggang
State/Province
Hubei
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
wei Wang
Facility Name
Macheng Peoples Hospital
City
Macheng
State/Province
Hubei
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
yi Zhou
Facility Name
Qianjiang Central Hospital
City
Qianjiang
State/Province
Hubei
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
jun Wang
Facility Name
Suizhou Central Hospital
City
Suizhou
State/Province
Hubei
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
tiantong Zhou
Facility Name
Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
City
Wuhan
State/Province
Hubei
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qin Ning, PHD,MD
Phone
+8602783662391
Email
qning@vip.sina.com
First Name & Middle Initial & Last Name & Degree
Qin Ning, PHD,MD
First Name & Middle Initial & Last Name & Degree
Tao Chen, PHD,MD
Facility Name
Xianning Central Hospital
City
Xianning
State/Province
Hubei
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
jun Zhu
Facility Name
Yichang Third Peoples Hospital
City
Yichang
State/Province
Hubei
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
quan Ming
Facility Name
Jiangsu Province Hospital
City
Nanjing
State/Province
Jiangsu
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
chuanlong Zhu

12. IPD Sharing Statement

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Evaluate the Efficacy and Safety of Various Treatment Schemes for Severe Fever With Thrombocytopenia Syndrome(SFTS)

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