There is no confirmed drug therapy for RP-ILD. Prognosis is poor of regular treatment. The study is designed to compare efficacy and safety of tocilizumab versus regular treatment in participants with severe RP-ILD secondary to systemic diseases.
RP-ILD, also known as the acute exacerbation of interstitial lung disease, was defined as an acute, clinically significant respiratory deterioration characterized by evidence of new widespread alveolar abnormality on chest imaging or histopathology. It is rapidly progressive and life-threatening. Despite aggressive regular treatments with high-dose glucocorticoids in combination with immunosuppressant drugs such as cyclosporine, tacrolimus, or cyclophosphamide, the post-exacerbation mortality rates remain high. There is no confirmed drug therapy for RP-ILD. Recently, the exacerbation of interstitial lung diseases secondary to systemic diseases was proved to involve many inflammatory responses, so patients are more likely to benefit from immune regulation therapy. Tocilizumab is a monoclonal antibody that inhibits the binding of interleukin-6 (IL-6), a multifunctional cytokine that regulates the immune response and inflammation, to its receptor (IL-6R). The study is designed to compare efficacy and safety of tocilizumab versus regular treatment in participants with severe RP-ILD secondary to systemic diseases.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
68
Participants in tocilizumab group will receive intravenous 8mg/kg tocilizumab.
Peking Union Medical College Hospital
Beijing, China
RECRUITINGThe differences of oxygenation index changes between the two groups on day 7, 14, 28 and month 3 after the first dose*
first dose: The tocilizumab group: the tocilizumab administered for the first time; The control group: the maximum dose of glucocorticoid administered for the first time
Time frame: 3 months
Time to clinical stability
clinical stability was defined as on the first day that all of the following criteria are simultaneously achieved: (1) Participants can tolerate walking with or without oxygen therapy; (2) no wheeze; and (3) oxygen saturation \>88% on room air.
Time frame: 3 months
Survival rate after 3 months
Time frame: 3 months
Length of stay in hospital
Time frame: 3 months
Length of stay in ICU
Time frame: 3 months
Changes of dyspnea index
Time frame: 3 months
The occurrence of adverse events within 1, 3, 7, 14, 28 days and 3 months after the first dose
adverse events: sepsis, treatment-related hyperglycemia, gastrointestinal bleeding, hospital infection
Time frame: 3 months
Changes of erythrocyte sedimentation rate, c-reactive protein or ferritin at baseline and on day 3, 7, 14, 28, month 3 after the first dose
Time frame: 3 months
Computed tomography score
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Time frame: 3 months
Hospitalization cost
Time frame: 3 months
Re-admission rate
Time frame: 3 months