ClinicalTrials.gg
RecruitingNCT05843968Updated Apr 19, 2024

Efficacy and Safety of Rituximab Versus Mycophenolate Mofetil in Children With Steroid-dependent Nephrotic Syndrome

A Phase 2 interventional study of Rituximab and Mycophenolate Mofetil in Nephrotic Syndrome in Children, sponsored by Children's Hospital of Chongqing Medical University. Recruiting at 1 site in China. Open to participants aged 3 Years to 16 Years. Per ClinicalTrials.gov, last updated 2024-04-19.

Sponsored by Children's Hospital of Chongqing Medical University · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jul 2026, 4 months ago, but the record still lists the study as recruiting.
  • Started Jan 2023; still recruiting 3 years 9 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
46
Allocation
Randomized
Ages
3 Years to 16 Years
Sex
All
01

Study summary

The goal of this clinical trial is to evaluate the efficacy and safety of rituximab(RTX) and mycophenolate mofetile(MMF) in the treatment of children with low-dose steroid-dependent nephrotic syndrome(SDNS).

Read the detailed description

Idiopathic nephrotic syndrome(INS) is the most common glomerular disease in childhood. Currently, steroids are the primary treatment, but there are significant steroid-related toxicity, such as growth disorders, behavior changes, obesity, Cushing's syndrome, eye disease, osteoporosis, etc.

Both MMF and RTX have been shown to be effective in the treatment of SDNS, and there is a lack of prospective controlled studies to explore the optimal treatment regimen for low-dose SDNS. Therefore, the investigators will conduct a single-center, randomized controlled trial to evaluate the efficacy and safety of twice-daily rituximab(RTX) versus mycophenolate mofetil(MMF) in the treatment of children with low-dose steroid-dependent nephrotic syndrome(SDNS).

After the start of the study, all participants will be screened consecutively and eligible participants will be included in the study. Bias of potential influencing factors will be addressed by inclusion as covariates in the statistical analysis. Independent clinical site monitoring to ensure the safety and integrity of clinical data while patients adhere to the study protocol will focus on source data documentation, strict adherence to data correctness and study procedures, such as randomization and treatment.

02

Conditions studied

  • Nephrotic Syndrome in Children

Browse trials for

Keywords

  • Nephrotic Syndrome
  • Rituximab
  • Mycophenolate Mofetil
03

In context

Nephrotic Syndrome

191 studies on the registry are indexed under Nephrotic Syndrome; 65 are open to participants now.

This study's planned enrollment of 46 is close to the median of 46 across 122 interventional studies indexed under Nephrotic Syndrome.

Browse Nephrotic Syndrome studies →

Lead sponsor

Children's Hospital of Chongqing Medical University is the lead sponsor of 35 studies on the registry; 13 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
3 Years to 16 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Children with a definite diagnosis of SDNS are included in the study during relapse treatment.
  • Age 3-16 years.
  • dependent dose≤0.3mg/kg/day.
  • Cumulative steroid use for ≥6 months.
  • Ability to swallow tablet.
  • Guardians understand the characteristics and personal consequences of clinical trial.
  • Guardians willing to give informed written consent.

Exclusion criteria

Exclusion Criteria:

  • Diagnosis of secondary NS, such as secondary to lupus nephritis, -related nephritis, purpura nephritis, etc.
  • Anti-neutrophil cytoplasmic antibodies(ANCA) positive or complement C3 level decreased.
  • Diagnosis of hereditary nephrotic syndrome.
  • Full dose of prednisone (2mg/kg/day, maximum 60mg) are used for 14 days after relapse and urine protein don't turn negative.
  • Estimated (eGFR) \<90mL/min per 1.73m\^2 at study entry.
  • Those who with a known allergy to Mycophenolate Mofetil and their or to Rituximab and its excipients.
  • Those who refuse to participate in the trial.
  • Those who participate other clinical trials.
  • Those who with positive HBV serological markers (HBsAg or/and HBeAg or/and HBcAb), positive patients or patients with abnormal liver function (,AST,or >2 or more times the and persistently elevated for 2 weeks).
  • Severe leukopenia (white blood cells\<3.0×10\^9), severe anemia (\<90g/l), and thrombocytopenia (\<100×10\^9) at study entry.
  • History of pancreatitis or definite gastrointestinal ulcers and/or gastrointestinal bleeding within 6 months.
  • Those who with congenital or acquired immune deficiency, or with active tuberculosis, active CMV and other infections.
  • Those who with other serious physical or mental illnesses.
  • History of malignant tumor within 5 years.
  • Those who with congenital heart disease, arrhythmia, heart failure and other serious cardiovascular diseases.
  • Those who with serious infections requiring intravenous antibiotics.
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
46 participants (estimated)

Study arms

  • Experimental
    Rituximab

    2 doses of rituximab 375 mg/m\^2 (Maximum 500mg/day)at 6 months intervals

    Drug: Rituximab

  • Active comparator
    Mycophenolate Mofetil

    MMF 20\~30mg/kg/day,BID

    Drug: Mycophenolate Mofetil

Interventions

  • 2 doses of rituximab 375 mg/m\^2(maximum 500mg/day) at 6 months intervals. Half an hour before rituximab infusion: oral acetaminophen 15mg/kg, oral or intramuscular antihistamine, methylprednisolone 2mg/kg IV. Trimethoprim-sulfamethoxazole should be administered orally from the initiation of rituximab therapy until peripheral-blood B cell recovery to prevent pneumocystis infection.

    Also known as: Rituximab Injection

  • Mycophenolate Mofetil 20-30 mg/kg/day BID,then adjust the dosage of drugs(maximum 2g/day) to maintian the concentration for MPA-AUC is 30-50μg.h/ml. Total duration:1year. Steroids dose:1.5mg/kg(maximum 40mg) qod for 2 weeks and gradually taper by 0.3 mg/kg every 2 weeks

    Also known as: Mycophenolate Mofetil Dispersible tablets

06

What researchers measure

Primary outcomes

  1. 12-month relapse-free survival rate

    The rate of no relapse within 12 months.

    Time frame: 12 months

Secondary outcomes

  1. 6-month relapse-free survival

    Relapse-free survival within 6 months.

    Time frame: 6 months

  2. 6-month relapse-free survival rate

    The rate of no relapse within 6 months.

    Time frame: 6 months

  3. 12-month relapse-free survival

    Relapse-free survival within 12 months.

    Time frame: 12 months

  4. Proportion of frequent relapses

    The proportion of frequent relapses.Frequent relapsing NS:≥2 relapses per 6 months within 6 months of disease onset or ≥4 relapses per 12 months in any subsequent 12-month period.

    Time frame: Months 6,12

  5. Cumulative steroid dosage

    The total dosage of steroid from the beginning to the end of the trial.

    Time frame: 12 months

  6. Number of relapses within 0-12,0-6, and 7-12 months

    Number of relapses within 0-6 months,7-12 months, and total within 0-12 months.

    Time frame: 12 months

  7. Time of first relapse

    The first time to relapse after patients taking part in this study.

    Time frame: 12 months

  8. Adverse event

    It is a binary variable(1/0).The varibale would be setted as "1" if any adverse events occours including obesity, hypertrichosis, psychological disorders,glaucoma,neutropenia,hypogammaglobulinemia, rituximab-related lung injury, fatal hepatitis reactivation, multifocal leukoencephalopathy,severe diarrhea, severe infection. Adverse events graded according to Common Terminology Criteria For Adverse Events (CTCAE v4.0)

    Time frame: 12 months

  9. Proportion of participants who discontinued steroids

    Proportion of participants who discontinued steroids at 12 months

    Time frame: 12 months

  10. Height standard deviation score(SDS)

    SDS of height at 6 and 12 months, absolute and relative changes in SDS from baseline to 12 months.

    Time frame: months 0,6,12

  11. Body mass index(BMI)

    Weight and height will be combined to report BMI in kg/m\^2. BMI at 6 and 12 months, absolute and relative changes in BMI from baseline to 12 months.

    Time frame: Months 0,6,12

  12. Quality of life score

    The researchers assess the quality of life of the participants useing Pediatric Quality of Life Inventory (PedsQL).

    Time frame: Baseline to 12 months

  13. Cost of treatment

    The researchers calculate their cost during the study.

    Time frame: 12 months

07

Study locations

1 of 1 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 19, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05843968
Lead sponsor
Children's Hospital of Chongqing Medical University
Responsible party
Haiping Yang (Associate Director of Nephrology, Children's Hospital of Chongqing Medical University) — Principal investigator
First posted
May 6, 2023
Start date
Jan 29, 2023
Primary completion
Jul 1, 2026 (estimated)
Completion
Jul 1, 2026 (estimated)
Last update
Apr 19, 2024

Study contacts

Yang Haiping, Doctor
Contact
oyhp@hospital.cqmu.edu.cn
8618983703661

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Rituximab

Start the discussion