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Status unknownNCT05974683Updated Aug 3, 2023

Treatment Strategies in IgG4-RD Patients With Re-elevation of Serum IgG4 Level During Maintenance Remission Period

An interventional study of placebo and mycophenolate mofetil in Autoimmune Diseases, sponsored by Peking Union Medical College Hospital. Status unknown at 1 site in China. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2023-08-03.

Sponsored by Peking Union Medical College Hospital · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Jul 2023), so the status shown — last known as Not yet recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
108
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

This study has been designed as a 52-week, randomized double blind placebo controlled multicenter clinical trial. The study aims to compare the efficacy and safety of two treatment strategies in IgG4-RD patients with re-elevation of serum IgG4 level during maintenance remission period: basic maintenance treatment group (continue use of basic maintenance treatment of IgG4-RD) and enhanced treatment group (use low dose mycophenolate mofetil as an add-on therapy of basic maintenance treatment of IgG4-RD).

Read the detailed description

108 IgG4-RD patients with re-elevation of serum IgG4 level to ≥30% of baseline serum IgG4 level during maintenance remission period are to be enrolled in this study after screening period, and then double blind randomly in an 1:1 ratio into two groups: basic maintenance treatment group (continue use of basic maintenance treatment of IgG4-RD plus placebo) and enhanced treatment group (use low dose mycophenolate mofetil as an add-on therapy of basic maintenance treatment of IgG4-RD). The follow-up period will be 52 weeks. During the follow-up period, clinical evaluations, laboratory tests, image examinations and IgG4-RD responder index (RI) will be recorded. The primary endpoint is the difference of relapse rate between two groups at 52 weeks. Meanwhile, this study will also explore and study different biomarkers in IgG4-RD patients, to better understand the mechanisms, as well as prognostic factors of IgG4-RD.

02

Conditions studied

  • Autoimmune Diseases

Keywords

  • Immunoglobulin G4-Related Disease
  • Drug therapy
  • Relapse
03

In context

Autoimmune Diseases

672 studies on the registry are indexed under Autoimmune Diseases; 272 are open to participants now.

This study's planned enrollment of 108 is above the median of 44 across 433 interventional studies indexed under Autoimmune Diseases.

Browse Autoimmune Diseases studies →

Lead sponsor

Peking Union Medical College Hospital is the lead sponsor of 1,148 studies on the registry; 474 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

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

04

Who can participate

Ages eligible
18 Years to 70 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

  • 1. Fulfillment of the 2019 American College of Rheumatology/European League against Rheumatology (ACR/EULAR) IgG4-related disease classification criteria or the 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD.
  • 2. Age between 18 and 70 years.
  • 3. Elevation of baseline serum IgG4 level (>1400mg/L).
  • 4. Major organ involvement, including but not limited to autoimmune pancreatitis, retroperitoneal fibrosis, sclerosing cholangitis, IgG4-related Castleman disease, and involvement of the lungs, kidney, nasal sinus, and central nervous system.
  • 5. Re-elevation of serum IgG4 level to ≥30% of baseline serum IgG4 level during maintenance remission period, with no evidence of relapse.
  • 6. Written informed consent signed.
  • 7. Agreed to take highly effective contraceptive procedures from signing of informed consent till 6 months after the end of last visit.

Exclusion criteria

Exclusion Criteria:

  • 1. Patients with an IgG4-RD Responder Index ≥ 2 points of any organ system.
  • 2. IgG4-RD patients without major organ involvement.
  • 3. Patients with severe or active infections, including but not limited to HIV, HCV, HBV, TB.
  • 4. Patients with malignancies or a history of malignancies within 5 years, except:

    1. Patients with adenocarcinoma in situ (AIS) of the cervix who have received curative treatment for at least 12 months before screening.
    2. Patients with cutaneous basal or squamous cell carcinoma who have received curative treatment.
    3. Patients with prostate cancer, who have received radical prostatectomy or definitive radiotherapy for over 3 years, with no sign of relapse or ongoing treatment
  • 5. Patients with immunodeficiency diseases.
  • 6. Patients with severe cardiovascular, respiratory, endocrine, gastrointestinal, hematological, neuropsychological, or constitutional comorbidities; or at risk of unacceptable complications, or having confounding factors in safety and explanation of results according to the evaluations from investigators.
  • 7. Patients with other rheumatic diseases, including but not limited to rheumatoid arthritis, systemic lupus erythematosus, systemic vasculitis, sarcoidosis; or other mimickers of IgG4-RD, including but not limited to Rosai-Dorfman disease, Castleman disease.
  • 8. Participating in any other clinical trials with drug interventions.
  • 9. A history of alcohol or drug abuse, possibly harming patient's safety, compliance, or evaluation of study's safety or other necessary aspects according to the evaluations from investigators.
  • 10. Women during pregnancy, lactation, or planning of pregnancy within 6 months of the last visit of the study.
  • 11. Meeting any of the following blood test finding on screening:

    1. Hemoglobin level \< 7.5g/dL.
    2. neutrophil count \< 1.0×10\^9/L.
    3. Platelet count \< 100×10\^9/L.
    4. Alanine aminotransferase (ALT) > 2 × upper limit number (ULN).
    5. Aspartate aminotransferase (AST) > 2 × ULN.
    6. Total Bilirubin (TBil) > 2 × ULN.
    7. Estimated glomerular filtration rate (eGFR) \< 30ml/(min·1.73m\^2), calculated using the Modification of Diet in Renal Disease (MDRD) study equation by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
108 participants (estimated)

Study arms

  • Placebo comparator
    Basic Maintenance Treatment

    Continue use of current basic maintenance treatment of IgG4-RD plus placebo, Follow-up intervals: week 4, week 12, week 24, week 36, week 52

    Drug: placebo

  • Active comparator
    Enhancement Treatment

    Use low dose mycophenolate mofetil (0.5g per day) as an add-on therapy of current basic maintenance treatment of IgG4-RD, Follow-up intervals: week 4, week 12, week 24, week 36, week 52

    Drug: mycophenolate mofetil

Interventions

  • Drugplacebo

    Continue use of current basic maintenance treatment of IgG4-RD plus placebo, Follow-up intervals: week 4, week 12, week 24, week 36, week 52

  • Use low dose mycophenolate mofetil (0.5g per day) as an add-on therapy of current basic maintenance treatment of IgG4-RD, Follow-up intervals: week 4, week 12, week 24, week 36, week 52

06

What researchers measure

Primary outcomes

  1. The difference of relapse rate of IgG4-RD between two groups in week 52.

    The primary endpoint is the difference of relapse rate between two groups at 52 weeks. The definition of relapse: elevation of IgG4-RD Responder Index ≥ 2 points; new organ involvement or recurrence, with or without elevation of serum IgG4 levels.

    Time frame: 52 weeks

Secondary outcomes

  1. The difference of relapse rate of IgG4-RD between two groups in the week 12.

    Time frame: 12 weeks

  2. The difference of relapse rate of IgG4-RD between two groups in the week 24

    Time frame: 24 weeks

  3. The difference of relapse rate of IgG4-RD between two groups in the week 36.

    Time frame: 36 weeks

  4. The time and duration of relapse

    Time frame: 52 weeks

  5. The changes of IgG4-RD Responder Index at week 52

    Time frame: 52 weeks

  6. The changes of serum IgG level at week 52

    Time frame: 52 weeks

  7. The changes of serum IgG4 level at week 52

    Time frame: 52 weeks

  8. The changes of erythrocyte sedimentation rate at week 52

    Time frame: 52 weeks

  9. The changes of serum C-reactive protein level at week 52

    Time frame: 52 weeks

  10. Adverse effect events

    Time frame: 52 weeks

  11. The changes of Physician Global Assessment score at week 52

    Time frame: 52 weeks

07

Study locations

1 site
  • Peking Union Medical College Hospital
    Beijing, China
08

References and documents

Publications

  • Zhang W, Stone JH. Management of IgG4-related disease. Lancet Rheumatol. 2019 Sep;1(1):e55-e65. doi: 10.1016/S2665-9913(19)30017-7. Epub 2019 Aug 28. PubMed 38229361 ↗
  • Wallace ZS, Naden RP, Chari S, Choi HK, Della-Torre E, Dicaire JF, Hart PA, Inoue D, Kawano M, Khosroshahi A, Lanzillotta M, Okazaki K, Perugino CA, Sharma A, Saeki T, Schleinitz N, Takahashi N, Umehara H, Zen Y, Stone JH; Members of the ACR/EULAR IgG4-RD Classification Criteria Working Group. The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease. Ann Rheum Dis. 2020 Jan;79(1):77-87. doi: 10.1136/annrheumdis-2019-216561. Epub 2019 Dec 3. PubMed 31796497 ↗
  • Lin W, Lu S, Chen H, Wu Q, Fei Y, Li M, Zhang X, Tian X, Zheng W, Leng X, Xu D, Wang Q, Shen M, Wang L, Li J, Wu D, Zhao L, Wu C, Yang Y, Peng L, Zhou J, Wang Y, Sha Y, Huang X, Jiao Y, Zeng X, Shi Q, Li P, Zhang S, Hu C, Deng C, Li Y, Zhang S, Liu J, Su J, Hou Y, Jiang Y, You X, Zhang H, Yan L, Zhang W, Zhao Y, Zeng X, Zhang F, Lipsky PE. Clinical characteristics of immunoglobulin G4-related disease: a prospective study of 118 Chinese patients. Rheumatology (Oxford). 2015 Nov;54(11):1982-90. doi: 10.1093/rheumatology/kev203. Epub 2015 Jun 22. PubMed 26106212 ↗
  • Umehara H, Okazaki K, Kawa S, Takahashi H, Goto H, Matsui S, Ishizaka N, Akamizu T, Sato Y, Kawano M; Research Program for Intractable Disease by the Ministry of Health, Labor and Welfare (MHLW) Japan.. The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD. Mod Rheumatol. 2021 May;31(3):529-533. doi: 10.1080/14397595.2020.1859710. Epub 2021 Jan 28. PubMed 33274670 ↗
  • Khosroshahi A, Wallace ZS, Crowe JL, Akamizu T, Azumi A, Carruthers MN, Chari ST, Della-Torre E, Frulloni L, Goto H, Hart PA, Kamisawa T, Kawa S, Kawano M, Kim MH, Kodama Y, Kubota K, Lerch MM, Lohr M, Masaki Y, Matsui S, Mimori T, Nakamura S, Nakazawa T, Ohara H, Okazaki K, Ryu JH, Saeki T, Schleinitz N, Shimatsu A, Shimosegawa T, Takahashi H, Takahira M, Tanaka A, Topazian M, Umehara H, Webster GJ, Witzig TE, Yamamoto M, Zhang W, Chiba T, Stone JH; Second International Symposium on IgG4-Related Disease. International Consensus Guidance Statement on the Management and Treatment of IgG4-Related Disease. Arthritis Rheumatol. 2015 Jul;67(7):1688-99. doi: 10.1002/art.39132. No abstract available. PubMed 25809420 ↗
  • Yunyun F, Yu P, Panpan Z, Xia Z, Linyi P, Jiaxin Z, Li Z, Shangzhu Z, Jinjing L, Di W, Yamin L, Xiaowei L, Huadan X, Xuan Z, Xiaofeng Z, Fengchun Z, Yan Z, Wen Z. Efficacy and safety of low dose Mycophenolate mofetil treatment for immunoglobulin G4-related disease: a randomized clinical trial. Rheumatology (Oxford). 2019 Jan 1;58(1):52-60. doi: 10.1093/rheumatology/key227. PubMed 30124952 ↗
  • Peng Y, Li JQ, Zhang PP, Zhang X, Peng LY, Chen H, Zhou JX, Zhang SZ, Yang HX, Liu JJ, Guo HF, Li J, Zhang X, Zhao Y, Zeng XF, Zhang FC, Fei YY, Zhang W. Clinical outcomes and predictive relapse factors of IgG4-related disease following treatment: a long-term cohort study. J Intern Med. 2019 Nov;286(5):542-552. doi: 10.1111/joim.12942. Epub 2019 Jun 17. PubMed 31121062 ↗
  • Liu Z, Peng Y, Li J, Lu H, Peng L, Zhou J, Zhou S, Huang C, Wang M, Zhu L, Chen H, Wang L, Fei Y, Zhao Y, Zeng X, Zhang W. Prediction of new organ onset in recurrent immunoglobulin G4-related disease during 10 years of follow-up. J Intern Med. 2022 Jul;292(1):91-102. doi: 10.1111/joim.13477. Epub 2022 Apr 13. PubMed 35419810 ↗
  • Zhang J, Nie Y, Peng L, Fei Y, Liu Y, Dong L, Kong X, Fu M, Zhang X, Liu C, Chen Y, Li M, Zhou J, Zhang W. Efficacy and safety of mycophenolate mofetil in preventing relapse of IgG4-related disease with re-elevation of serum IgG4 level during maintenance therapy: a protocol for a multicentre, randomised, double-blind, placebo-controlled study in China. BMJ Open. 2026 Sep 11;16(9):e113850. doi: 10.1136/bmjopen-2025-113850. PubMed 42731845 ↗

Individual participant data

Plan to share: Yes

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Aug 2023; primary completion for Dec 2025, 28 months later.

Of 75 non-industry interventional studies with no phase under Autoimmune Diseases, half reached primary completion within 35 months of starting (the median), counting those still running; a quarter within 14 and three quarters within 58. This study's planned 28 months is below that.

Counting every sponsor, half of 86 studies reached it within 35 months; a quarter within 14 and three quarters within 58.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 5, 2023
First posted
Aug 3, 2023
StartEst.
Aug 1, 2023
Primary completionEst.
Dec 2025
CompletionEst.
Dec 2025
Last update
Aug 3, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 3, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05974683
Responsible party
Wen Zhang (Professor, Peking Union Medical College Hospital) — Principal investigator
First posted
Aug 3, 2023
Start date
Aug 1, 2023 (estimated)
Primary completion
Dec 2025 (estimated)
Completion
Dec 2025 (estimated)
Last update
Aug 3, 2023

Study contacts

Jiaxin Zhou, MD
Contact
pumczhou@sina.com
86-10-69155647
Linyi Peng, MD
Contact
pumczhou@sina.com
86-10-69155647
Wen Zhang, MD
principal investigator · Peking Union Medical College Hospital

Oversight

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

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Studies of the drug tested here: Mycophenolic Acid

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