Neuromyelitis optica spectrum disorder (NMOSD) is a chronic inflammatory demyelinating autoimmune disease of the central nervous system. NMOSD is a highly relapsing, severely disabling disease. AQP4-IgG positive NMOSD is related to a specific aquaporin 4 antibody (AQP4 IgG) produced by mature B cells. BTK is a key kinase in B cell receptor signal transduction pathway. Abnormal activation of BTK related signaling pathway can lead to autoantibody production and autoimmune diseases. Therefore, BTK can be developed as a new target for autoimmune diseases.
Approximately 23 subjects will be enrolled. Experimental drug treatment: Orelabrutinib, 50mg, orally, once a day. The subject will come to visit at week 0, 1, 2, 4, 8, 12, 16, 20, 24, 36, 48 and safety follow up visit which is planed 28 days after last administration. Baseline patient assessment: 1. Baseline examination: vital signs, physical examination, blood routine examination, urine routine examination, liver and kidney function, coagulation function, thyroid function, HIV, HCV, HBV virus test, tuberculosis test, chest X-ray, ECG and pregnancy test. 2. Functional disability assessment: Expanded Disability Status Scale (EDSS) score and low contrast vision (LCVA) score. 3. EQ5D scale evaluation. 4. Serum AQP4-IgG titer, neuro filament light chain, T/B/NK cell count, Immunoglobulin (IgG, IgA and IgM)
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
23
Orelabrutinib, orally, 50 mg QD
Peking Union Medical College Hospital, Chinese Academy of Medical Sciences
Beijing, Beijing Municipality, China
Annualized relapse rate at week 48 compared with that before baseline.
Annualized relapse rate at week 48 compared with that before baseline.
Time frame: week 48
Proportion of patients without relapse
Proportion of patients without relapse at weeks 24 and 48;
Time frame: weeks 24 and 48
Changes in the expanded disability status scale (EDSS) score from baseline
Changes in the expanded disability status scale (EDSS) score from baseline at weeks 4, 12, 24, 36 and 48;
Time frame: weeks 4, 12, 24, 36 and 48
Changes in low contrast visual acuity score (LCVA) from baseline
Changes in low contrast visual acuity score (LCVA) from baseline at weeks 4, 12, 24, 36 and 48;
Time frame: weeks 4, 12, 24, 36 and 48
Changes in EQ5D scores from baseline
Changes in EQ5D scores from baseline at weeks 12, 24, 36 and 48;
Time frame: weeks 12, 24, 36 and 48
Changes in serum AQP4-IgG titer and neurofilament light chain protein level from baseline
Changes in serum AQP4-IgG titer and neurofilament light chain protein level from baseline at weeks 4, 12, 24, 36 and 48;
Time frame: weeks 4, 12, 24, 36 and 48
Changes in absolute value of peripheral blood B cell count and immunoglobulin (IgA, IgM, IgG) from baseline
Changes in absolute value of peripheral blood B cell count and immunoglobulin (IgA, IgM, IgG) at weeks 4, 12, 24, 36 and 48 from baseline;
Time frame: weeks 4, 12, 24, 36 and 48
Percentage of patients who withdraw from the study due to adverse events.
Percentage of patients who withdraw from the study due to adverse events.
Time frame: weeks1, 2, 4, 8, 12, 16, 20, 24, 36 , 48
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