MedPath

A Phase 2 Efficacy and Safety Study of Dapirolizumab Pegol (DZP) in Systemic Lupus Erythematosus

Phase 2
Completed
Conditions
Systemic Lupus Erythematosus (SLE)
Interventions
Drug: Placebo
Drug: Dapirolizumab pegol (DZP)
Registration Number
NCT02804763
Lead Sponsor
UCB Biopharma S.P.R.L.
Brief Summary

The purpose is to evaluate the efficacy and safety of three different doses of Dapirolizumab Pegol (DZP) versus placebo in adult subjects with moderately to severely active systemic Lupus Erythematosus.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
182
Inclusion Criteria
  • Clinical diagnosis of Systemic Lupus Erythematosus (SLE) confirmed by Systemic Lupus International Collaborating Clinics (SLICC) classification criteria

  • Moderate to severe SLE disease activity

  • Evidence for at least 1 of the following SLE markers:

    • Anti-dsDNA antibodies confirmed by central laboratory or
    • Low complement confirmed by central laboratory or
    • Antinuclear antibody (ANA) titer of >= 1:80 in combination with at least 1 of the following: Historical positivity for anti-dsDNA or Positivity for extractable nuclear antigen (anti-ENA) confirmed by central laboratory
  • The subject is receiving stable SLE standard-of-care medication

Exclusion Criteria
  • Mixed connective tissue disease, scleroderma, and/or overlap syndromes of SLE
  • Subjects with severe neuropsychiatric SLE or other neurological symptoms that in the opinion of the Investigator, would prevent the subject from completing protocol required procedures and assessments.
  • New or worsening Class III or IV lupus nephritis
  • Chronic kidney failure stage 3b
  • Evidence of human immunodeficiency virus (HIV) infection, agammaglobulinemias, T-cell deficiencies, or human T-cell lymphotropic virus-1 infection at any time prior to or during the study
  • Clinically significant active or latent infection (eg. chronic viral hepatitis B or C)
  • Known tuberculosis (TB) infection, at high risk of acquiring TB infection, or latent TB (LTB) infection
  • Live/live attenuated vaccines within 6 weeks prior to the first study drug infusion (Visit 2) or who plan to receive these vaccines during the study or 12 weeks after the final dose of study drug
  • History of thromboembolic events within 12 months of screening
  • Subject has used protocol defined prohibited medications

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo in a specified sequence for a total of 24 weeks
DZP dose 1Dapirolizumab pegol (DZP)Dapirolizumab pegol (DZP) dose 1 in a specified sequence for a total of 24 weeks
DZP dose 3Dapirolizumab pegol (DZP)Dapirolizumab pegol (DZP) dose 3 in a specified sequence for a total of 24 weeks
DZP dose 2Dapirolizumab pegol (DZP)Dapirolizumab pegol (DZP) dose 2 in a specified sequence for a total of 24 weeks
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With British Isles Lupus Assessment Group Disease Activity Index 2004 (BILAG 2004)-Based Composite Lupus Assessment (BICLA) (mNRI) Response Across 3 Doses of Dapirolizumab Pegol (DZP) and Placebo (PBO) at Week 24Week 24

The primary efficacy variable was assessed by establishing if there was a dose response relationship between BICLA response at Week 24 and dose, using Multiple Comparison Procedure - Modelling (MCP-Mod). Four candidate dose-response models were evaluated: a linear model, a logistic model, and 2 Emax models, and the MCP-Mod methodology controlled for multiplicity.

BICLA response was defined as meeting all of the following criteria:

1. BILAG 2004 improvement: A scores at Baseline improved to B, C or D; B scores improved to C or D; no new A scores and ≤ 1 new B.

2. No worsening in Systemic Lupus Erythematosus Activity Index 2000 (SLEDAI-2K), defined as no increase in SLEDAI-2K total score.

3. No worsening in Physician's Global Assessment of Disease Activity (PGA), defined as \< 10 millimeter (mm) increase on a 100 mm visual analog scale (VAS).

4. No disallowed changes in concomitant medications, mainly including increases in corticosteroids, immunosuppressants, and antimalarials.

Secondary Outcome Measures
NameTimeMethod
Mean Change From Baseline in Diastolic Blood PressureFrom Baseline (Week 1) to Week 48

Blood pressure was measured in millimetre of mercury (mmHg).

Percentage of Participants Who Permanently Withdrew of Study Drug Due to an Adverse Event (AE)From Baseline (Week 1) until end of the study (Week 48)

An AE was any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product that did not necessarily have a causal relationship with this treatment. An adverse event (AE) was therefore any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. All AEs that occurred during the study were considered related unless clearly unrelated.

Mean Change From Baseline in ErythrocytesFrom Baseline (Week 1) to Week 48

Erythrocytes was measured in number of erythrocytes per liter (10\^12/L).

The Percentage of Participants With BICLA (mNRI) Response in the Individual Dose Groups at Week 24Week 24

BICLA response was defined as meeting all of the following criteria:

1. BILAG 2004 improvement: A scores at Baseline improved to B, C or D; B scores improved to C or D; no new A scores and ≤ 1 new B.

2. No worsening in Systemic Lupus Erythematosus Activity Index 2000 (SLEDAI-2K), defined as no increase in SLEDAI-2K total score.

3. No worsening in Physician's Global Assessment of Disease Activity (PGA), defined as \< 10 millimeter (mm) increase on a 100 mm visual analog scale (VAS).

4. No disallowed changes in concomitant medications, mainly including increases in corticosteroids, immunosuppressants, and antimalarials.

Percentage of Participants With at Least One Adverse Events (AEs)From Baseline (Week 1) until end of the study (Week 48)

An AE was any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product that did not necessarily have a causal relationship with this treatment. An adverse event (AE) was therefore any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. All AEs that occurred during the study were considered related unless clearly unrelated.

Mean Change From Baseline in Systolic Blood PressureFrom Baseline (Week 1) to Week 48

Blood pressure was measured in millimetre of mercury (mmHg).

Mean Change From Baseline in Eosinophils/LeukocytesFrom Baseline (Week 1) to Week 48

Eosinophils/Leukocytes was measured in percentages (%).

Mean Change From Baseline in Basophils/LeukocytesFrom Baseline (Week 1) to Week 48

Basophils/Leukocytes was measured in percentages (%).

Mean Change From Baseline in BasophilsFrom Baseline (Week 1) to Week 48

Basophils was measured in number of basophils per liter (10\^9/L).

Mean Change From Baseline in Pulse RateFrom Baseline (Week 1) to Week 48

Pulse Rate was measured in beats per minute (beats/min).

Mean Change From Baseline in TemperatureFrom Baseline (Week 1) to Week 48

Temperature was measured in Grad Celsius (°C).

Mean Change From Baseline in WeightBaseline (Week 1), Week 4, Week 8, Week 12, Week 16, and Week 20

Weight was measured in kilograms (kg).

Mean Change From Baseline in HemoglobinFrom Baseline (Week 1) to Week 48

Hemoglobin was measured in grams per liter (g/L).

Mean Change From Baseline in HematocritFrom Baseline (Week 1) to Week 48

Hematocrit was measured in volume percentage (%) of red blood cells in blood.

Number of Participants With 12-Lead Electrocardiogram (ECG) Abnormal FindingsScreening, Week 4, Week 24, Week 28 and Week 48

Twelve-lead ECG assessments should have been performed prior to dosing (if applicable) and prior to obtaining pharmacokinetic (PK) or other laboratory samples. Electrocardiograms were recorded digitally and read by the Investigator for recording in the electronic Case Report Form (eCRF).

Percentage of Participants With a Serious Adverse Event (SAE)From Baseline (Week 1) until end of the study (Week 48)

A Serious Adverse Event (SAE) must have met 1 or more of the following criteria:

* Death

* Life threatening

* Significant or persistent disability/incapacity

* Congenital anomaly/birth defect (including that occurring in a fetus)

* Important medical event that, based upon appropriate medical judgment, may have jeopardized the study participant, and may have required medical or surgical intervention to prevent 1 of the other outcomes listed in the definition of serious

* Initial inpatient hospitalization or prolongation of hospitalization.

Percentage of Participants With at Least One Adverse Events (AEs) of InterestFrom Baseline (Week 1) until end of the study (Week 48)

Adverse events of interest (AEOI) were identified by the Investigator based on definitions per protocol, documented on the electronic Case Report Form (eCRF), adequately monitored, and source controlled.

AEOI (regardless of seriousness):

* Moderate to severe infections, including opportunistic infections and tuberculosis (TB)

* Infusion reactions (including hypersensitivity and anaphylaxis)

* Thromboembolic events (including but not limited to cardiovascular events, stroke, myocardial infarction, pulmonary embolism, and deep vein thrombosis)

* Prespecified neurological events: severe and/or serious headache, positional headache, cranial nerve dysfunction, or signs and symptoms of meningitis (photophobia, neck stiffness)

* Malignancies.

Mean Change From Baseline in HeightFrom Baseline (Week 1) to Week 48

Height was measured in centimeters (cm).

Mean Change From Baseline in Erythrocytes Mean Corpuscular Hemoglobin (HGB) ConcentrationFrom Baseline (Week 1) to Week 48

Erythrocytes Mean Corpuscular Hemoglobin (HGB) Concentration was measured in grams per liter (g/L).

Mean Change From Baseline in Alkaline PhosphataseFrom Baseline (Week 1) to Week 48

Alkaline Phosphatase was measured in units per liter (U/L).

Mean Change From Baseline in CreatinineFrom Baseline (Week 1) to Week 48

Creatinine was measured in micromols per liter (µmol/L).

Mean Change From Baseline in SodiumFrom Baseline (Week 1) to Week 48

Sodium was measured in millimoles per liter (mmol/L).

Mean Change From Baseline in AlbuminFrom Baseline (Week 1) to Week 48

Albumin was measured in grams per liter (g/L).

Mean Change From Baseline in TriglyceridesFrom Baseline (Week 1) to Week 48

Triglycerides was measured in millimoles per liter (mmol/L).

Mean Change From Baseline in Erythrocytes Mean Corpuscular VolumeFrom Baseline (Week 1) to Week 48

Erythrocytes Mean Corpuscular Volume was measured in femtolitres (fL).

Mean Change From Baseline in LeukocytesFrom Baseline (Week 1) to Week 48

Leukocytes was measured in number of leukocytes per liter (10\^9/L).

Mean Change From Baseline in NeutrophilsFrom Baseline (Week 1) to Week 48

Neutrophils was measured in number of neutrophils per liter (10\^9/L).

Mean Change From Baseline in Neutrophils/LeukocytesFrom Baseline (Week 1) to Week 48

Neutrophils/Leukocytes was measured in percentages (%).

Mean Change From Baseline in CD3/LymphocytesFrom Baseline (Week 1) to Week 48

CD3/Lymphocytes was measured in percentages (%).

Mean Change From Baseline in BilirubinFrom Baseline (Week 1) to Week 48

Bilirubin was measured in micromols per liter (µmol/L).

Mean Change From Baseline in Lactate DehydrogenaseFrom Baseline (Week 1) to Week 48

Lactate Dehydrogenase was measured in units per liter (U/L).

Mean Change From Baseline in Urea NitrogenFrom Baseline (Week 1) to Week 48

Urea Nitrogen was measured in millimoles per liter (mmol/L).

Mean Change From Baseline in CholesterolFrom Baseline (Week 1) to Week 48

Cholesterol was measured in millimoles per liter (mmol/L).

Mean Change From Baseline in ProteinFrom Baseline (Week 1) to Week 48

Protein was measured in grams per liter (g/L).

Mean Change From Baseline in Creatine KinaseFrom Baseline (Week 1) to Week 48

Creatine Kinase was measured in units per liter (U/L).

Mean Change From Baseline in Erythrocytes Mean Corpuscular HemoglobinFrom Baseline (Week 1) to Week 48

Erythrocytes Mean Corpuscular Hemoglobin was measured in picograms (pg).

Mean Change From Baseline in EosinophilsFrom Baseline (Week 1) to Week 48

Eosinophils was measured in number of eosinophils per liter (10\^9/L).

Mean Change From Baseline in LymphocytesFrom Baseline (Week 1) to Week 48

Lymphocytes was measured in number of lymphocytes per liter (10\^9/L).

Mean Change From Baseline in Cluster of Differentiation 19 (CD19)From Baseline (Week 1) to Week 48

Cluster of differentiation 19 (CD19) was measured in cells per microliter (cells/µL).

Mean Change From Baseline in Aspartate AminotransferaseFrom Baseline (Week 1) to Week 48

Aspartate Aminotransferase was measured in units per liter (U/L).

Mean Change From Baseline in Alanine AminotransferaseFrom Baseline (Week 1) to Week 48

Alanine Aminotransferase was measured in units per liter (U/L).

Mean Change From Baseline in Gamma Glutamyl TransferaseFrom Baseline (Week 1) to Week 48

Gamma Glutamyl Transferase was measured in units per liter (U/L).

Mean Change From Baseline in PotassiumFrom Baseline (Week 1) to Week 48

Potassium was measured in millimoles per liter (mmol/L).

Mean Change From Baseline in Lipase, PancreaticFrom Baseline (Week 1) to Week 48

Lipase, Pancreatic was measured in units per liter (U/L).

Mean Change From Baseline in pHFrom Baseline (Week 1) to Week 48
Mean Change From Baseline in Leukocytes (/HPF)From Baseline (Week 1) to Week 48
Mean Change From Baseline in Lymphocytes/LeukocytesFrom Baseline (Week 1) to Week 48

Lymphocytes/Leukocytes was measured in percentages (%).

Mean Change From Baseline in Monocytes/LeukocytesFrom Baseline (Week 1) to Week 48

Monocytes/Leukocytes was measured in percentages (%).

Mean Change From Baseline in PlateletsFrom Baseline (Week 1) to Week 48

Platelets was measured in number of platelets per liter (10\^9/L).

Mean Change From Baseline in Cluster of Differentiation 3 (CD3)From Baseline (Week 1) to Week 48

Cluster of differentiation 3 (CD3) was measured in cells per microliter (cells/µL).

Mean Change From Baseline in Direct BilirubinFrom Baseline (Week 1) to Week 48

Direct Bilirubin was measured in micromols per liter (µmol/L).

Mean Change From Baseline in CalciumFrom Baseline (Week 1) to Week 48

Calcium was measured in millimoles per liter (mmol/L).

Mean Change From Baseline in PhosphateFrom Baseline (Week 1) to Week 48

Phosphate was measured in millimoles per liter (mmol/L).

Mean Change From Baseline in MonocytesFrom Baseline (Week 1) to Week 48

Monocytes was measured in number of monocytes per liter (10\^9/L).

Mean Change From Baseline in CD19/LymphocytesFrom Baseline (Week 1) to Week 48

CD19/Lymphocytes was measured in percentages (%).

Mean Change From Baseline in GlucoseFrom Baseline (Week 1) to Week 48

Glucose was measured in millimoles per liter (mmol/L).

Mean Change From Baseline in Erythrocytes (/HPF)From Baseline (Week 1) to Week 48

Trial Locations

Locations (71)

Sl0023 135

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Warszawa, Poland

Sl0023 310

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Tampa, Florida, United States

Sl0023 312

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Birmingham, Alabama, United States

Sl0023 304

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Clearwater, Florida, United States

Sl0023 301

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Miami Lakes, Florida, United States

Sl0023 321

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Miami, Florida, United States

Sl0023 320

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Idaho Falls, Idaho, United States

Sl0023 305

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Oklahoma City, Oklahoma, United States

Sl0023 303

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Houston, Texas, United States

Sl0023 102

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Plovdiv, Bulgaria

Sl0023 311

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Los Angeles, California, United States

Sl0023 307

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El Cajon, California, United States

Sl0023 309

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El Cajon, California, United States

Sl0023 323

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Huntington Beach, California, United States

Sl0023 326

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New Haven, Connecticut, United States

Sl0023 314

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Thousand Oaks, California, United States

Sl0023 302

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Upland, California, United States

Sl0023 322

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DeBary, Florida, United States

Sl0023 319

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Palm Harbor, Florida, United States

Sl0023 327

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Stockbridge, Georgia, United States

Sl0023 324

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Atlanta, Georgia, United States

Sl0023 313

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Lake Success, New York, United States

Sl0023 306

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Albuquerque, New Mexico, United States

Sl0023 315

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Jackson, Tennessee, United States

Sl0023 308

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Memphis, Tennessee, United States

Sl0023 317

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Amarillo, Texas, United States

Sl0023 101

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Plovdiv, Bulgaria

Sl0023 328

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Spokane, Washington, United States

Sl0023 202

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Providencia, Chile

Sl0023 203

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Providencia, Chile

Sl0023 201

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Puerto Varas, Chile

Sl0023 204

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Vina del Mar, Chile

Sl0023 213

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Barranquilla, Colombia

Sl0023 212

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Bogotá, Colombia

Sl0023 216

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Bucaramanga, Colombia

Sl0023 211

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Chía, Colombia

Sl0023 214

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Bogotá, Colombia

Sl0023 215

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Medellín, Colombia

Sl0023 341

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Hannover, Germany

Sl0023 113

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Leipzig, Germany

Sl0023 225

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Guadalajara, Mexico

Sl0023 124

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Debrecen, Hungary

Sl0023 224

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León, Mexico

Sl0023 222

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San Luis Potosí, Mexico

Sl0023 221

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Mexico, Mexico

Sl0023 231

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Lima, Peru

Sl0023 232

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Arequipa, Peru

Sl0023 234

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Lima, Peru

Sl0023 235

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Lima, Peru

Sl0023 131

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Poznan, Poland

Sl0023 133

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Bytom, Poland

Sl0023 136

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Lublin, Poland

Sl0023 134

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Sosnowiec, Poland

Sl0023 138

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Łódź, Poland

Sl0023 146

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Brasov, Romania

Sl0023 144

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Cluj-Napoca, Romania

Sl0023 142

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Bucuresti, Romania

Sl0023 141

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Galati, Romania

Sl0023 157

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Kazan, Russian Federation

Sl0023 151

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Yaroslavl', Russian Federation

Sl0023 153

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Yekaterinburg, Russian Federation

Sl0023 156

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Kemerovo, Russian Federation

Sl0023 155

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Voronezh, Russian Federation

Sl0023 152

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Saint Petersburg, Russian Federation

Sl0023 161

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Barcelona, Spain

Sl0023 172

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Kyiv, Ukraine

Sl0023 162

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Madrid, Spain

Sl0023 166

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Tenerife, Spain

Sl0023 175

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Kyiv, Ukraine

Sl0023 171

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Odessa, Ukraine

Sl0023 173

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Vinnytsya, Ukraine

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