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A Phase 2 trial to evaluate the efficacy and safety of daxdilimab in participants with primary discoid lupus erythematosus.

Phase 1
Conditions
Discoid Lupus Erythematosus
MedDRA version: 25.0Level: LLTClassification code 10013072Term: Discoid lupus erythematosusSystem Organ Class: 10040785 - Skin and subcutaneous tissue disorders
Therapeutic area: Diseases [C] - Immune System Diseases [C20]
Registration Number
EUCTR2022-000831-21-PL
Lead Sponsor
Horizon Therapeutics Ireland DAC
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
99
Inclusion Criteria

Eligible participants must meet/provide all of the following criteria:
1. Written informed consent and any locally required authorization obtained from the participant/legal representative prior to performing any protocol-related procedures, including screening evaluations.
2. Willing and able to comply with the prescribed treatment protocol and evaluations for the duration of the trial.
3. Adult men or women = 18 and = 75 years of age
4. A diagnosis of DLE for = 6 months prior to screening supported by a history of:
a. A biopsy or
b. a clinical feature score of = 7 on the DLE Classification Criteria (DLECC) scale if a biopsy is not available.
5. Currently active discoid lupus with all the following:
a. Digital photography adjudicated with central reading to confirm a currently active discoid disease lesion.
b. CLASI-A score = 8 related to discoid lesions at Baseline
6. Treatment refractory DLE defined as active disease despite current or historical treatment with a systemic treatment including, but not limited to: antimalarial, methotrexate, mycophenolate, azathioprine, dapsone, corticosteroid, thalidomide, or lenalidomide, OR documented history of intolerance to antimalarials and/or immunosuppressive medications.
7. Participants with active disease who currently are on any of the following therapies must have been on a stable dosage prior to Screening and must remain on a stable dosage through Randomization and for the entire trial as described below:
-Antimalarials must be at a stable dosage for at least 8 weeks prior to Screening and through Randomization.
-Methotrexate = 20 mg/week (oral or SC) at stable dosage and route of administration for at least 4 weeks prior to Screening and through Randomization.
-Mycophenolate mofetil = 2 g/day or mycophenolic acid = 1.44 g/day at stable dosage for at least 4 weeks prior to Screening and through Randomization.
-Azathioprine must be stable for at least 4 weeks prior to Screening and through Randomization.
-Corticosteroid equivalent to prednisone = 10 mg/day at stable dosage for at least 4 weeks prior to Screening and through Randomization.
-Topical corticosteroids and calcineurin inhibitors at stable dosage for at least 1 week prior to Screening and through Randomization.
8. Vaccination status should be up to date per local standards.
9. Females are eligible to participate if they are not pregnant or breastfeeding, and one of the following conditions applies:
-Is a woman of non-childbearing potential (WONCBP) OR - Is a woman of childbearing potential (WOCBP) and using a contraceptive method that is highly effective (ie, has a failure rate of < 1%) , during the study intervention period and for at least 6 months after the last dose of IP and agrees not to donate eggs (ova, oocytes) for the purpose of reproduction during this period. A WOCBP must:
-have a negative serum pregnancy test at Screening and a negative urine pregnancy test at Day 1.
-Additional requirements for pregnancy testing during and after study intervention are located in Section 8.3.5 Pregnancy Testing of study protocol.
-The Investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy. The Investigator should also evaluate the potential for contraceptive method failure (eg, noncompliance, recently initiated) in relationship to the first dose of IP
10. Males are eligible to participate if t

Exclusion Criteria

Participants will be ineligible for this trial if they meet any of the following criteria:
1. Individuals involved in the conduct of the trial, their employees, or immediate family members
2. Participation in another clinical trial with an investigational IP within 4wks prior to Randomization or within 5published half-lives, whichever is longer
3. Any condition that, in the opinion of the Investigator, would interfere with evaluation of the IP or interpretation of participant safety or trial results.
4. Weight >160kg at Screening
5. History of allergy, hypersensitivity reaction, or anaphylaxis to any component of the IP or to a previous mAb or human Ig therapy
6. Breastfeeding/pregnant women/women who intend to become pregnant anytime from signing the ICF through 6months after receiving the last dose of IP
7. History of drug or alcohol abuse that, in the opinion of the Investigator, might affect participant safety or compliance with visits, or interfere with other trial assessments
8. Major surgery within 8wks prior to Screening or elective surgery planned from Screening through W48
9. Splenectomy
10. Spontaneous or induced abortion, still or live birth, or pregnancy= 4wks prior to Screening through Randomization
11. History of clinically significant cardiac disease including unstable angina, myocardial infarction, congestive heart failure within 6months prior to Randomization; arrhythmia requiring active therapy, except for clinically insignificant extra systoles, or minor conduction abnormalities; or presence of clinically significant abnormality on ECG
12. History of cancer within the past 5 years years, except as follows: In situ carcinoma of the cervix treated with apparent success with curative therapy>12months prior to Screening, or Cutaneous basal cell or squamous cell carcinoma treated with curative therapy.
13. Any underlying condition that in the opinion of the Investigator significantly predisposes the participant to infection
14. Participant who has given>499 ml of blood or plasma within 56 days of Screening (during a clinical trial or at a blood bank donation) or plans to give blood or plasma during their participation in the trial or up to
6months after the last IP administration, whichever is longer.
15. Transfusion with blood, packed red blood cells, platelets or treatment with plasmapheresis, or plasma exchange within 8wks prior to Randomization and for the total duration of the trial participation.
16. Known history of a primary immunodeficiency or an underlying condition, e.g.HIV infection, or a positive result for HIV infection.
17. At Screening, any of the following per central laboratory tests:
-Aspartate aminotransferase>2.5×upper limit of normal (ULN)
-Alanine aminotransferase>2.5×ULN
-Total bilirubin>1.5×ULN(unless due to Gilbert’s syndrome)
-Neutrophil count<1500/µL (or<1.5×109/L)
-Platelet count <135,000/µL (or<135×109/L)
-Hemoglobin<10g/dL(or<100g/L)
-Total lymphocyte count <800/µL(or<0.8×109/L)
-Antinuclear antibody titer>1:320
18. All participants will undergo testing for hepatitis B surface antigen
(HBsAg) and hepatitis B core antibody (HBcAb) during Screening.
19. All participants will undergo testing for hepatitis C antibody (HCVAb)
during Screening.
20. Active TB, or a positive IFN? release assay (IGRA) test at Screening, unless documented history of appropriate treatment for active or latent TB.
21. Any severe herpes virus family infection (including Epstein-Barr virus, cytomegalovirus [CMV]) at any

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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