RecruitingPhase 3NCT06867991

Safety and Efficacy of Combined B Cell Depleting theRapy And Daratumumab In Autoimmune Encephalitis


Sponsor

The First People's Hospital of Changzhou

Enrollment

200 participants

Start Date

Nov 8, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

Autoimmune encephalitis is an autoimmune disease of the central nervous system that targets neuronal autoantigens. Anti-neuronal autoantibodies are produced in patients, with anti-NMDAR antibody being the most common.Anti-NMDAR encephalitis can be severe and life-threatening. Anti-NMDAR autoantibodies against neurons are pathogenic and are mainly produced by autoreactive B cells and plasma cells. Therefore, early elimination of these abnormal immune cells is crucial for rapid improvement of the patient's condition. This study aims to explore the efficacy and safety of B cell depletion therapy (ofatumumab) followed by plasma cell depletion therapy (daratumumab) in the treatment of severe anti-NMDAR autoimmune encephalitis.


Eligibility

Min Age: 12 Years

Plain Language Summary

Simplified for easier understanding

This study tests a combination approach of B cell-depleting drugs (like rituximab) plus daratumumab — a drug normally used in blood cancers — for patients with autoimmune encephalitis (brain inflammation caused by the immune system attacking itself) that has not responded to standard treatments. **You may be eligible if...** - You are 12 years of age or older - You have been diagnosed with autoimmune encephalitis where antibodies are targeting the surface of brain cells - You have already received at least one round of first-line treatment (high-dose steroids plus IVIG, or plasma exchange, or efgartigimod) without adequate improvement - Your neurological disability score (mRS) is 3 or higher (meaning significant disability) **You may NOT be eligible if...** - You have a serious active infection that is not controlled - You have cancer-related autoimmune encephalitis that is still being treated - You have severe heart or lung disease - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGOfatumumab combined with daratumumab

All participants will begin acute first-line therapy prior to randomization, and participants who were receiving oral or intravenous corticosteroids at baseline will need to taper their doses according to a standard taper schedule starting 4 weeks after randomization (week 4). Patients will be randomly assigned to receive ofatumumab followed by daratumumab or ofatumumab followed by repeated intravenous globulin. The ofatumumab group will receive subcutaneous ofatumumab at weeks 0, 1, 2, 4, 8, 12, 16, 20, and 24, while the ofatumumab-daratumumab group will receive daratumumab intravenously (on the second day of ofatumumab) in addition to ofatumumab, with a dose of 8 mg/kg at weeks 0, 1, 2, and 4, and a dose of 4 mg/kg at weeks 8, 12, 16, 20, and 24. The study will investigate the effects of up to 24 cycles of daratumumab.

DRUGOfatumumab

All participants were started on acute first-line therapy before randomization, and participants who were receiving oral or intravenous glucocorticoids at baseline were required to taper their doses according to a standard taper schedule starting 4 weeks after randomization (week 4). Ofatumumab was administered subcutaneously at weeks 0, 1, 2, 4, 8, 12, 16, 20, and 24 in the ofatumumab group.

DRUGRepeated intravenous immunoglobulin/plasma exchange therapy

Repeated intravenous immunoglobulin/plasma exchange therapy


Locations(2)

The First Affiliated Hospital of Zhengzhou University

Zhengzhou, Henan, China

The First People's Hospital of Changzhou

Changzhou, Jiangsu, China

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NCT06867991


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