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Not yet recruitingNCT07518277sirolimusUpdated Apr 8, 2026

A Multicenter, Prospective, Randomized Controlled Study Comparing Glucocorticoid Combined With Sirolimus With Monotherapy of Glucocorticoid in the Treatment of Newly Diagnosed Mild Autoimmune Hemolytic Anemia

An interventional study of Glucocorticoids in Autoimmune Hemolytic Anemia (AIHA), sponsored by Chen Miao. Not yet recruiting at 1 site in China. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-04-08.

Sponsored by Chen Miao · Not applicable, Interventional, and Treatment

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Phase
Not applicable
Study type
Interventional
Enrollment
216
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 39 studies in Anemia, Hemolytic, Autoimmune with a site in China — 22 open to participants now, 30 under way, 4 of them phase 3. Anemia, Hemolytic, Autoimmune · China.

Planned enrollment
Largest of 35
216 · median 18
Started
2026
with 8 others
No phase
2 of 39
2 open now
Primary completion
2028-04
later than 23 of 29 live
Registered
33rd of 39
by date
Lead sponsor
2 of 39
Chen Miao

Among the 39 studies in Anemia, Hemolytic, Autoimmune with a site in China, this one has the largest planned enrollment of the 35 interventional ones that give a count, is one of 9 that started in 2026, is one of 2 with no phase, reaches primary completion later than 23 of the 29 other live ones, and was the 33rd registered.

Anemia, Hemolytic, Autoimmune

103 studies on the registry are indexed under Anemia, Hemolytic, Autoimmune; 39 are open to participants now.

Browse Anemia, Hemolytic, Autoimmune studies →

Open to participants now

22 of the 39 studies in Anemia, Hemolytic, Autoimmune with a site in China are open now. Recruiting first, the newest first:

16 more — sign in →

All 22 open studies →

A study can be open while its sites in China have not opened yet or have stopped. Only those recruiting at a site in China →

Who these studies take

Of the 24 Anemia, Hemolytic, Autoimmune studies recruiting now, 12 (50%) set no upper age limit and 10 (42%) stop at 75 or younger; 5 take children under 18; none take healthy volunteers.

This study: 18 Years to 75 Years · all sexes · no healthy volunteers.

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02

Study summary

This study is a prospective, multicenter, randomized controlled trial. A total of 216 adult patients with newly diagnosed wAIHA were planned to be included and randomly assigned in a 1:1 ratio to the experimental group (glucocorticoid combined with sirolimus) or the control group (glucocorticoid monotherapy). The initial dose of sirolimus in the experimental group was 1mg/d, adjusted according to the blood drug concentration. The target concentration was 4-12ng/mL, and the treatment course was 6 months. Both groups of hormones were gradually reduced according to the standard protocol. All patients were followed up for 24 months, and the differences between the two groups at endpoints such as the hormone-free sustained response rate at the 12th month were compared.

Read the detailed description

This study was a randomized controlled study. Two groups of patients were randomly assigned in a 1:1 ratio to receive the following treatment regimens:

  1. Glucocorticoid monotherapy group Prednisone at a dose of 1-2 mg/kg/d (or an equivalent dose of methylprednisolone) is taken orally for 2-3 weeks, and then the dosage is reduced regularly. The total course of treatment is approximately 3-6 months. The reduction plan was formulated by the researchers based on clinical practice.
  2. Glucocorticoid combined with sirolimus group Glucocorticoids: The usage, dosage and reduction regimen are the same as those in the monotherapy group. \| Sirolimus: Starting dose 1 mg/d, orally, once a day. After reaching a steady state 7 to 14 days of medication, monitor the trough concentration. The target trough concentration range is 4 to 12 ng/mL. Adjust the dosage based on the results of blood drug concentration monitoring. The total course of treatment for sirolimus is 6 months. If grade ≥3 related adverse events or trough concentration \&gt occur; 12 ng/mL. Consider reducing the dosage or suspending the administration
03

Conditions studied

  • Autoimmune Hemolytic Anemia (AIHA)

Keywords

  • autoimmune hemolytic anemia
04

Who can participate

Ages eligible
18 Years to 75 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. Age ≥18 years old, gender not limited;
  2. Diagnosed as newly diagnosed wAIHA and requiring systemic therapy (those with short-term hormone exposure of ≤2 weeks before enrollment can be included)
  3. After a comprehensive rheumatology and immunology assessment, there is no evidence of clinical organ involvement in SLE or other connective tissue diseases (only serological abnormalities can be included).
  4. Positive Coombs test (IgG type, IgG+C3d type, or only C3d type with a condensed agglutinin titer of 1:64);
  5. Active hemolytic anemia, (HGB) ≤ 100 g/L;
  6. Liver and kidney function: (ALT) \< 3 times the value (ULN), isolated elevation of aspartate aminotransferase (AST) (normal ALT) is acceptable; Serum creatinine ≤2×ULN;
  7. (ECOG) Performance status score ≤2 points;
  8. Those with a history of malignant tumors must meet the following conditions:

    Radical treatment has been achieved; The disease-free survival period complies with the protocol provisions (such as ≥1 year for basal cell carcinoma, ≥5 years for early solid tumors, ≥5 years for curable lymphoma, etc.); There is currently no evidence of recurrence. Those who do not meet the above conditions (such as CLL, advanced solid tumors, and active tumors) are not included.

  9. Voluntarily sign a written form.

Exclusion criteria

Exclusion Criteria:

  1. Pregnant or lactating patients;
  2. Clinically confirmed SLE or other definite connective tissue diseases;
  3. Secondary AIHA secondary to lymphoproliferative diseases, other hematological , solid tumors, infections, and drugs;
  4. Cold-resistant type or hybrid type AIHA;
  5. Received before group enrollment:

    Other (such as rituximab, cyclosporine, etc., regardless of the duration); treatment for more than 2 weeks;

  6. Severe cardiac insufficiency ( grade III/IV, or \< 40%);
  7. Currently active malignant tumors, or previous tumors that do not meet the requirements of Article 8 of the inclusion criteria;
  8. Chronic active infections (active tuberculosis, active /C, etc.);
  9. Severe immunodeficiency diseases, infection (CD4⁺ \< 200/μL), currently using other potent immunosuppressants, and using targeted biological agents within the last 3 months;
  10. Have a history of severe allergy to sirolimus, glucocorticoids or related ;
  11. Other circumstances where the researcher deems it inappropriate to participate.
Terms in these criteria, in plain language(13)

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.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

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).

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.

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.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

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.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

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.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Excipients

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

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
216 participants (estimated)

Study arms

  • Active comparator
    Glucocorticoid

    Glucocorticoid monotherapy group Prednisone at a dose of 1-2 mg/kg/d (or an equivalent dose of methylprednisolone) is taken orally for 2-3 weeks, and then the dosage is reduced regularly. The total course of treatment is approximately 3-6 months. The reduction plan was formulated by the researchers based on clinical practice.

    Drug: Glucocorticoids

  • Experimental
    Glucocorticoids combined with Sirolimus

    Glucocorticoids: The usage, dosage and reduction regimen are the same as those in the monotherapy group. \| Sirolimus: Starting dose 1 mg/d, orally, once a day. After reaching a steady state 7 to 14 days of medication, monitor the trough concentration. The target trough concentration range is 4 to 12 ng/mL. Adjust the dosage based on the results of blood drug concentration monitoring. The total course of treatment for sirolimus is 6 months. If grade ≥3 related adverse events or trough concentration \&gt occur; 12 ng/mL. Consider reducing the dosage or suspending the administration.

    Drug: Glucocorticoids

Interventions

06

What researchers measure

Primary outcomes

  1. The 12-month sustained remission rate

    Defined as the proportion of patients who simultaneously met the following conditions at the 12th month after randomization: Discontinue glucocorticoids (or only use prednisone ≤5 mg/d or an equivalent dose for maintenance); * Has not received any follow-up treatment for wAIHA; * Still in complete remission (CR) or partial remission (PR) status.

    Time frame: 12 months

Secondary outcomes

  1. Safety

    1. The incidence of adverse events (AE), serious adverse events (SAE), and grade ≥3 AE; 2. Adverse events of particular concern: infections (especially opportunistic infections), metabolic disorders (new-onset diabetes, dyslipidemia), bleeding events, hormone-related adverse events (Cushing's syndrome, hypertension, osteoporosis, etc.); 3. The proportion of patients who discontinued medication, reduced dosage or interrupted treatment due to adverse events

    Time frame: 1,3,6,12 months

07

Study locations

1 site
08

References and documents

Publications

  • 1.Birgens H, Frederiksen H, Hasselbalch HC, et al. A phase III randomized trial comparing glucocorticoid monotherapy versus glucocorticoid and rituximab in patients with autoimmune haemolytic anaemia. Br J Haematol. 2013;163(2):244-252.https://doi.org/10.1111/bjh.12541. 2.Kuter DJ. Warm autoimmune hemolytic anemia and the best treatment strategies. Hematology Am Soc Hematol Educ Program. 2022;2022(1):393-402.https://doi.org/10.1182/hematology.2022000405. 3.Murakhovskaya I, Crivera C, Leon A,et al. Healthcare resource utilization of patients with warm autoimmune hemolytic anemia initiating first line therapy of oral corticosteroids with or without rituximab. Ann Hematol. 2024;103(2):521-533.https://doi.org/10.1007/s00277-023-05613-8. 4.Berentsen S. Treatment of autoimmune hemolytic anemia: novel and investigational approaches. Minerva Med. 2025;116(2):145-158.https://doi.org/10.23736/S0026-4806.25.09617-X. 5.Ciudad M, Ouandji S, Lamarthée B, et al. Regulatory T-cell dysfunctions are associated with increase in tumor necrosis factor α in autoimmune hemolytic anemia and participate in polarization. Haematologica. 2023;108(11):3012-3025. https://doi.org/10.3324/haematol.2023.282859. 6.中华医学会血液学分会红细胞疾病(贫血)学组. 中国成人自身免疫性溶血性贫血诊疗指南(2023年版)[J]. 中华血液学杂志,2023,44(01):12-18. DOI:10.3760/cma.j.issn.0253-2727.2023.01.003

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Apr 2026; primary completion for Apr 2028, 24 months later.

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

Registered
Mar 30, 2026
First posted
Apr 8, 2026
StartEst.
Apr 1, 2026
Primary completionEst.
Apr 1, 2028
CompletionEst.
Apr 1, 2028
Last update
Apr 8, 2026
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 Apr 8, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07518277
Lead sponsor
Chen Miao
Responsible party
Chen Miao (Peking Union Medical College Hospital, Peking Union Medical College Hospital) — Sponsor-investigator
First posted
Apr 8, 2026
Start date
Apr 1, 2026 (estimated)
Primary completion
Apr 1, 2028 (estimated)
Completion
Apr 1, 2028 (estimated)
Last update
Apr 8, 2026

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Corticosteroids

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