背景:多发性硬化(MS)是中枢神经系统的自身免疫性炎性疾病,可引起髓鞘损伤和轴突变性。糖脂(2S,3S,4R)-1-O-(α-d-半乳糖基)-2-四烷酰氨基-1,3,4-壬三醇(OCH-NCNP1或OCH)发挥免疫调节作用,通过自然杀伤T细胞激活抑制T辅助(Th)1细胞介导的免疫反应,选择性白细胞介素-4的产生,和人CD4阳性自然杀伤T细胞中的Th2偏向诱导。
目的:本试验旨在通过24周的重复给药研究免疫调节剂OCH在复发MS患者中的疗效和安全性。
方法:该协议描述了双盲,多中心,安慰剂对照,随机II期临床试验于2019年9月启动。参与者被随机分配到安慰剂对照组或OCH-NCNP1组,研究药物(3.0mg)每周一次口服给药,持续24周。主要纳入标准如下:根据修订的McDonald标准,患者已被诊断为复发性MS(复发缓解型和/或继发性进展型MS),或根据其病历中的记录由主治医师诊断为MS;在同意前24个月内至少有两次医学证实的临床恶化或在同意前12个月内有一次恶化的患者;在磁共振成像(MRI)筛查中至少有一个病变被怀疑为MS的患者;以及在7个主要排除标准如下:诊断为视神经脊髓炎和视神经炎之一,急性脊髓炎,并满足以下三项中的至少两项:(1)延伸穿过至少三个椎体的脊髓MRI病变,(2)发病时无脑MRI病变(至少4个脑白质病变或3个病变,其中一个在侧脑室周围),和(3)视神经脊髓炎-免疫球蛋白G或抗水通道蛋白-4抗体阳性。结果指标包括MRI变化的主要结果(T2加权MRI在24周时出现新的或新扩大的病变的受试者的百分比)和次要结果年复发率(每年的复发次数)。无复发期(复发时间),残疾(SRD)发生率持续降低,直到SRD(SRD发生的时间)的期间,没有疾病活动的证据,和来自第一阶段试验的探索性生物标志物(如基因表达,小区频率,和肠道和口腔微生物组)。
结果:我们计划在整个分析集中招募30名患者。报名于2021年6月结束,研究分析于2023年3月完成。
结论:这项随机对照试验将确定OCH-NCNP1对MS患者是否有效和安全,并为OCH-NCNP1作为MS治疗剂的潜力提供证据。
背景:ClinicalTrials.govNCT04211740;https://clinicaltrials.gov/study/NCT04211740。
■DERR1-10.2196/46709。
BACKGROUND: Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system that causes myelin sheath damage and axonal
degeneration. The glycolipid (2S, 3S, 4R)-1-O-(α-d-galactosyl)-2-tetracosanoylamino-1,3,4-nonaetriol (OCH-NCNP1 or OCH) exerts an immunoregulatory action that suppresses T helper (Th)1 cell-mediated immune responses through natural killer T cell activation, selective interleukin-4 production, and Th2 bias induction in human CD4-positive natural killer T cells.
OBJECTIVE: This
trial aims to investigate the efficacy and safety of the immunomodulator OCH in patients with relapsing MS through 24-week repeated administration.
METHODS: This protocol describes a double-blind, multicenter, placebo-controlled, randomized phase II clinical trial that was initiated in September 2019. The participants were randomly assigned to either a placebo control group or an OCH-NCNP1 group and the investigational drug (3.0 mg) was orally administered once weekly for the 24-week duration. Major inclusion criteria are as follows: patients had been diagnosed with relapsing MS (relapsing-remitting and/or secondary progressive MS) based on the revised McDonald criteria or were diagnosed with MS by an attending physician as noted in their medical records; patients with at least two medically confirmed clinical exacerbations within 24 months prior to consent or one exacerbation within 12 months prior to consent; patients with at least one lesion suspected to be MS on screening magnetic resonance imaging (MRI); and patients with 7 points or less in the Expanded Disability Status Scale during screening. Major exclusion criteria are as follows: diagnosis of neuromyelitis optica and one of optic neuritis, acute myelitis, and satisfying at least two of the following three items: (1) spinal cord MRI lesion extending across at least three vertebral bodies, (2) no brain MRI lesions during onset (at least four cerebral white matter lesions or three lesions, one of which is around the lateral ventricle), and (3) neuromyelitis optica-immunoglobulin G or antiaquaporin-4 antibody-positive. Outcome measures include the primary outcome of MRI changes (the percentage of subjects with new or newly expanded lesions at 24 weeks on T2-weighted MRI) and the secondary outcomes annual relapse rate (number of recurrences per year), relapse-free period (time to recurrence), sustained reduction in disability (SRD) occurrence rate, period until SRD (time to SRD occurrence), no evidence of disease activity, and exploratory biomarkers from phase I trials (such as gene expression, cell frequency, and intestinal and oral microbiome).
RESULTS: We plan to enroll 30 patients in the full analysis set. Enrollment was closed in June 2021 and the
study analysis was completed in March 2023.
CONCLUSIONS: This randomized controlled
trial will determine whether OCH-NCNP1 is effective and safe in patients with MS as well as provide evidence for the potential of OCH-NCNP1 as a therapeutic agent for MS.
BACKGROUND: ClinicalTrials.gov NCT04211740; https://clinicaltrials.gov/
study/NCT04211740.
UNASSIGNED: DERR1-10.2196/46709.