Proof of Concept Study of SAR443122 in Patients With Cutaneous Lupus Erythematosus
- Registration Number
- NCT04781816
- Lead Sponsor
- Sanofi
- Brief Summary
Primary Objective:
* Assess the efficacy of SAR443122 in cutaneous lupus erythematosus (CLE)
Secondary Objectives:
* Assess the effect of SAR443122 on the physician's global assessment of disease activity (PhysGA - disease activity)
* Assess the effect of SAR443122 on CLE induced itch and overall pain
* Assess the effect of SAR443122 on the proportion of disease activity responders compared to placebo
* Assess the effect of SAR443122 on the CLASI components score
* Assess the effect of SAR443122 on the Investigator's global assessment for CLE (IGA-CLE)
* Assess oral cavities for patients with oral lesions
* Assess the disease specific quality of life (QoL)
* Assess the safety and tolerability of SAR443122 in patients with CLE
* Assess the pharmacokinetics (PK) exposure of SAR443122 in patients with CLE
- Detailed Description
Total study duration per participant was up 20 weeks including:
* A screening period of up to 4 weeks
* A treatment period of 12 weeks
* A post treatment follow-up period of 4 weeks
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 78
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description SAR443122 SAR443122 SAR443122 for 12 weeks Placebo Placebo Matching placebo
- Primary Outcome Measures
Name Time Method Percent Change From Baseline in Cutaneous Erythematosus Disease Area and Severity Index - Activity (CLASI-A) Sub-Score at Week 12 Baseline (Day 1) and Week 12 The CLASI is a clinician rated scale designed to assess the disease activity and damage in CLE in adults. It is composed of 56 items covering 2 dimensions: the disease activity (CLASI-A) and the disease damage (CLASI-D). CLASI-A disease activity covers the domains: erythema, scale/hypertrophy, recent hair loss/alopecia, and mucous membrane lesions. CLASI-A sub-score ranges for 0 to 70, where 0-9 indicates mild disease, 10-20 indicates moderate disease, and 21-70 indicates severe disease. Higher score indicates a more severe skin disease. Baseline was defined as the Day 1 assessment value.
- Secondary Outcome Measures
Name Time Method Percentage of Participants With Physician's Global Assessment of Disease Activity (PhysGA- Disease Activity) of 0 or 1 (Disease Free or Almost Disease Free) at Week 12 Week 12 The PhysGA- disease activity is a 5 point-Lickert scale instrument designed to assess physician-reported disease activity. The investigators were asked the following question "How active would you say your patient's cutaneous lupus erythematosus is currently?" The total score on scale ranges from 0 (not active at all) to 4 (extremely active). Higher score indicates a more severe skin disease.
Change From Baseline in Participants Reported Daily Worst Itch Using Peak Pruritus Numerical Rating Scale (Itch-NRS) at Week 12 Baseline (Day 1) and Week 12 The Peak Pruritus NRS (itch-NRS) is a single item patient reported outcomes (PRO) tool that participants used to report the intensity of their pruritus (itch) during a daily recall period. Participants were asked to rate their worst itch on a 0 (no itch) to 10 (worst itch imaginable) NRS by answering the following question: "On a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable', how would you rate your itch at the worst moment during the previous 24 hours?". The total score on scale ranges from 0 (no itch) to 10 (worst itch imaginable). Higher score indicates a more severe skin disease. Baseline was defined as the average of daily non-missing scores obtained during the week prior to Day 1.
Change From Baseline in Participants Reported Daily Worst Pain Using Peak Pain Numerical Rating Scale (Pain-NRS) at Week 12 Baseline (Day 1) and Week 12 The Peak Pain NRS (Pain-NRS) is a single item PRO tool that participants used to report the intensity of their CLE-related pain (skin, oral, genital) during a daily recall period. Participants were asked to rate their worst pain on a 0 (no pain) to 10 (worst pain imaginable) NRS by answering the following question: "On a scale of 0 to 10, with 0 being 'no pain' and 10 being the 'worst pain imaginable', how would you rate your pain at the worst moment due to your lupus during the previous 24 hours?". The total score on scale ranges from 0 (no pain) to 10 (worst pain imaginable). Higher score indicates a more severe skin disease. Baseline was defined as the average of daily non-missing scores obtained during the week prior to Day 1.
Percentage of CLASI-A50 and CLASI-A75 Responders at Week 12 Week 12 The CLASI is a clinician rated scale designed to assess the disease activity and damage in CLE in adults. It is composed of 56 items covering 2 dimensions: the disease activity (CLASI-A) and the disease damage (CLASI-D). CLASI-A disease activity covers the domains: erythema, scale/hypertrophy, recent hair loss/alopecia, and mucous membrane lesions. CLASI-A sub-score ranges for 0 to 70, where 0-9 indicates mild disease, 10-20 indicates moderate disease, and 21-70 indicates severe disease. Higher score indicates a more severe skin disease. The CLASI-A50/75 responder was defined as a participant who achieved a decrease by at least 50%/75% of CLASI-A sub-score from baseline.
Change From Baseline in CLASI Components' Score Over Time Baseline (Day 1) and Weeks 4, 8, 12, and 16 The CLASI is a clinician rated scale designed to assess the disease activity and damage in CLE in adults. It is composed of 56 items covering two dimensions: the disease activity (CLASI-A) and the disease damage (CLASI-D). CLASI-A disease activity covers the domains: erythema, scale/hypertrophy, recent hair loss/alopecia, and mucous membrane lesions. CLASI-A sub-score ranges 0 to 70, where 0-9 indicates mild disease, 10-20 indicates moderate disease, and 21-70 indicates severe disease. CLASI-D disease damage covers the domains: dyspigmentation, scarring/atrophy/panniculitis, and clinically judged scarring of the scalp (including scarring alopecia). Scale ranges 0 (absence of disease damage) to 56 (severe disease damage) using the parameters of dyspigmentation and scarring. For CLASI-A and CLASI-D, higher score indicates a more severe skin disease. Change from baseline in CLASI components' score are reported. Baseline was defined as the Day 1 assessment value.
Number of Participants With PCSA in Urinalysis From first dose of study treatment (Day 1) up to end of study (Week 16) PCSA values were defined as abnormal values considered medically important by the Sponsor, according to predefined criteria/thresholds based on literature reviews and defined by the Sponsor. Criteria for PCSA: pH ≤ 4.6 or ≥ 8.
Percentage of Participants With Investigator's Global Assessment of Cutaneous Lupus Erythematosus (IGA-CLE) Score of 0 or 1 (Clear Or Almost Clear) at Week 12 Week 12 The IGA-CLE is a clinician reported outcome (ClinRO) that allows for clinicians to assess the overall disease activity of CLE using a 5-point scale: 0 (clear), 1 (almost clear), 2 (mild), 3 (moderate), and 4 (severe). The severity of CLE is determined by descriptions of a combination of 3 plaque characteristics: erythema, scale, elevation. Erythema is the primary characteristic that influenced the rating, with other characteristics considered secondarily. Telangiectatic change is not considered in the rating. The assessment did not require the presence of all 4 characteristics, the severity was averaged over the observed characteristics. The total score on scale ranges from 0 to 4. Higher score indicates a more severe skin disease.
Change From Baseline to Week 12 in the Oral Health Impact Profile 14-Item Version (OHIP-14) for Participants With Oral Lesions at Baseline Baseline (Day 1) and Week 12 The OHIP-14 is a PRO questionnaire that is composed of 14 items that assess 7 different dimensions, considering the perception of the individual in relation to the impact of oral conditions in the physical, psychological and social well-being in the last month. Each of the 14 items has a set of possible answers distributed in a Likert scale (0 = never, 1 = hardly ever. 2 = occasionally 3 = fairly often, 4 = very often), which represents the frequency that the individual perceives the impact of oral health on 7 dimensions: functional limitation (2 items), physical pain (2 items), psychological discomfort (2 items), physical disability (2 items), psychological disability (2 items), social disability (2 items) and handicap (2 items). The OHIP-14 scores range from 0 to 56 and are calculated by summing the ordinal values for 14 items. Domain scores range from 0 to 8. Higher OHIP-14 scores indicate worse oral-health-related quality of life. Baseline was defined as Day 1 assessment value.
Change From Baseline in SKINDEX-29+3 Total Score at Week 12 Baseline (Day 1) and Week 12 Skindex 29+3 is a PRO measure designed to assess the effects of skin disease on participants' health-related quality of life in adults. It contains the following domains: emotions (10 items), symptoms (7 items), functioning (12 items), lupus-specific issues (3 questions), and 1 item about treatment that is not part of the total score. Recall period is during the past week. Each item is rated on a 5-point Likert scale (never, rarely, sometimes, often, all the time). These responses are then transformed to a linear scale ranging from 0 to 100 in 25-point increments, with 100 representing maximal disability. The total score is the average of participants' responses to items in a given domain, ranging from 0 to 100, where higher scores indicate a greater impact on the health-related quality of life. Baseline was defined as the Day 1 assessment value.
Number of Participants With Treatment-emergent Adverse Events (TEAEs), Treatment-emergent Serious Adverse Events (TESAEs), and Adverse Events of Special Interest (AESIs) From first dose of study treatment (Day 1) up to end of study (Week 16) An adverse event (AE) was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. TEAEs were defined as the adverse events that occurred from the time of the first IMP administration up to the end of study visit. Serious adverse events (SAE): Any AE that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. An AESI: an AE (serious or nonserious) of scientific and medical concern specific to the Sponsor's product or program, for which ongoing monitoring and immediate notification by the Investigator to the Sponsor was required.
Number of Participants With Potentially Clinically Significant Abnormalities (PCSA) in Hematology Parameters From first dose of study treatment (Day 1) up to end of study (Week 16) PCSA values were defined as abnormal values considered medically important by the Sponsor, according to predefined criteria/thresholds based on literature reviews and defined by the Sponsor. Criteria for PCSA: Hemoglobin (Hb) ≤ 115 grams per liter (g/L) (Male \[M\]) or ≤ 95 g/L (Female \[F\]), ≥ 185 g/L (M) or ≥ 165 g/L (F), decrease from baseline ≥ 20 g/L; Platelets \<100 x 10\^9 per liter (/L) or ≥ 700 x 10\^9/L; Erythrocytes ≥ 6 x 10\^12/L; Leukocytes \< 3 x 10\^9/L (Non-Black \[NB\]); \< 2 x 10\^9/L (Black\[B\]); or ≥ 16 x 10\^9/L; Neutrophils \< 1.5 x 10\^9/L (NB); \< 1 x 10\^9/L (B); Lymphocytes \> 4 x 10\^9/L; Monocytes \> 0.7 x 10\^9/L; Basophils \> 0.1 x 10\^9/L; Eosinophils \> 0.5 x 10\^9/L or \> upper limit of normal range (ULN) (if ULN ≥ 0.5 x 10\^9/L).
Number of Participants With PCSA in Clinical Chemistry From first dose of study treatment (Day 1) up to end of study (Week 16) PCSA values were defined as abnormal values considered medically important by the Sponsor, according to predefined criteria/thresholds based on literature reviews and defined by the Sponsor. Criteria for PCSA: Glucose ≤ 3.9 millimoles per liter (mmol/L) and \< lower limit of normal range (LLN) or ≥ 11.1 mmol/L (unfasted); ≥ 7 mmol/L (fasted); Creatine Kinase \> 3 ULN; Sodium ≤ 129 mmol/L or ≥ 160 mmol/L; Potassium \< 3 mmol/L or ≥ 5.5 mmol/L; Creatinine ≥ 150 micromoles per liter (μmol/L) (Adults) or ≥ 30% change from baseline or ≥ 100% change from baseline; Creatinine Clearance ≥ 60 - \< 90 milliliters per minute (mL/min) (mild decrease in glomerular filtration rate \[GFR\]) or ≥ 30 - \< 60 mL/min (moderate decrease in GFR) or ≥ 15 - \< 30 mL/min (severe decrease in GFR) or \< 15 mL/min (end stage renal disease); Alanine Aminotransferase \> 3 ULN or \> 5 ULN; Aspartate Aminotransferase \> 3 ULN or \> 5 ULN; Alkaline Phosphatase \> 1.5 ULN; Total Bilirubin \> 1.5 ULN.
Number of Participants With PCSA in Electrocardiogram (ECG) From first dose of study treatment (Day 1) up to end of study (Week 16) PCSA values were defined as abnormal values considered medically important by the Sponsor, according to predefined criteria/thresholds based on literature reviews and defined by the Sponsor. Criteria for PCSA: Heart Rate (HR) \< 50 beats/min (bpm) or \< 50 bpm and decrease from baseline ≥ 20 bpm or \< 40 bpm or \> 90 bpm; PR Interval \> 200 milliseconds (msec) or \> 200 msec and increase from baseline ≥ 25% or \> 220 msec; QRS Interval \> 110 msec or 110 msec and increase from baseline ≥ 25% or \> 120 msec; QT Interval \> 500 msec; corrected QT (QTc) Interval \> 450 msec or \> 480 msec or increase from baseline \[30-60\] msec or increase from baseline \> 60 msec.
Number of Participants With PCSA in Vital Signs From first dose of study treatment (Day 1) up to end of study (Week 16) PCSA values were defined as abnormal values considered medically important by the Sponsor, according to predefined criteria/thresholds based on literature reviews and defined by the Sponsor. Criteria for PCSA: Diastolic Blood Pressure (DBP) ≤ 45 millimeters of mercury (mmHg) and decrease from baseline ≥ 10 mmHg or ≥ 110 mmHg and increase from baseline ≥ 10 mmHg; Pulse Rate (PR) ≤ 50 bpm and decrease from baseline ≥ 20 bpm or ≥ 120 bpm and increase from baseline ≥ 20 bpm; Systolic Blood Pressure (SBP) ≤ 95 mmHg and decrease from baseline ≥ 20 mmHg or ≥ 160 mmHg and increase from baseline ≥ 20 mmHg; Weight ≥ 5% decrease from baseline or ≥ 5% increase from baseline.
Maximum Plasma Concentration (Cmax) of SAR443122 2-5 hours post first morning dose on Days 1, 57, and 85; 1 hour before morning dose on Days 57 and 85; 7-10 hours after morning dose on Day 57 Blood samples were collected at the specified timepoints. Cmax was assessed by a Bayesian analysis using the population PK model.
Time to Reach Maximum Plasma Concentration (Tmax) of SAR443122 2-5 hours post first morning dose on Days 1, 57, and 85; 1 hour before morning dose on Days 57 and 85; 7-10 hours after morning dose on Day 57 Blood samples were collected at the specified timepoints. tmax was assessed by a Bayesian analysis using the population PK model.
Area Under the Curve From Time 0 to 12 Hours (AUC0-12) of SAR443122 2-5 hours post first morning dose on Days 1, 57, and 85; 1 hour before morning dose on Days 57 and 85; 7-10 hours after morning dose on Day 57 Blood samples were collected at the specified timepoints. AUC0-12 was assessed by a Bayesian analysis using the population PK model.
Terminal Elimination Half-Life (t1/2z) of SAR443122 1 hour before morning dose and 2-5 hours post first morning dose on Day 85 Blood samples were collected at the specified timepoints. t1/2z was assessed by a Bayesian analysis using the population PK model.
Trial Locations
- Locations (50)
Investigational Site Number : 3560002
🇮🇳Chandigarh, India
Investigational Site Number : 4840002
🇲🇽Veracruz, Mexico
ClinOhio Research Services Site Number : 8400007
🇺🇸Columbus, Ohio, United States
Investigational Site Number : 1240005
🇨🇦Toronto, Ontario, Canada
Prolato Clinical Research Center Site Number : 8400010
🇺🇸Houston, Texas, United States
Investigational Site Number : 1240002
🇨🇦Sherbrooke, Quebec, Canada
Investigational Site Number : 1240001
🇨🇦London, Ontario, Canada
GNP Research Site Number : 8400008
🇺🇸Cooper City, Florida, United States
Investigational Site Number : 1520006
🇨🇱Osorno, Reg Metropolitana De Santiago, Chile
Investigational Site Number : 2030002
🇨🇿Brno, Czechia
Investigational Site Number : 2030004
🇨🇿Nachod, Czechia
Investigational Site Number : 3560003
🇮🇳Nagpur, India
Investigational Site Number : 3480001
🇭🇺Budapest, Hungary
Investigational Site Number : 6430005
🇷🇺Moscow, Russian Federation
Investigational Site Number : 6430003
🇷🇺Stavropol, Russian Federation
Investigational Site Number : 6160004
🇵🇱Lublin, Lubelskie, Poland
Investigational Site Number : 8040001
🇺🇦Ivano-Frankivsk, Ukraine
Investigational Site Number : 6430002
🇷🇺Moscow, Russian Federation
Investigational Site Number : 7240002
🇪🇸Barcelona, Barcelona [Barcelona], Spain
Investigational Site Number : 6430001
🇷🇺St-Petersburg, Russian Federation
Investigational Site Number : 7240001
🇪🇸Hospitalet de Llobregat, Barcelona [Barcelona], Spain
Investigational Site Number : 6430004
🇷🇺Krasnodar, Russian Federation
Investigational Site Number : 8260003
🇬🇧London, London, City Of, United Kingdom
Investigational Site Number : 7240007
🇪🇸Barcelona, Barcelona [Barcelona], Spain
Investigational Site Number : 7240004
🇪🇸Madrid, Madrid, Comunidad De, Spain
Investigational Site Number : 2030006
🇨🇿Pardubice, Czechia
Investigational Site Number : 0320005
🇦🇷Mendoza, Argentina
Investigational Site Number : 0320001
🇦🇷Caba, Buenos Aires, Argentina
DJL Clinical Research, PLLC Site Number : 8400003
🇺🇸Charlotte, North Carolina, United States
Investigational Site Number : 0320004
🇦🇷Rosario, Santa Fe, Argentina
Investigational Site Number : 0320002
🇦🇷Caba, Buenos Aires, Argentina
Investigational Site Number : 0320003
🇦🇷Caba, Buenos Aires, Argentina
Investigational Site Number : 0360001
🇦🇺Camberwell, Victoria, Australia
Investigational Site Number : 0360002
🇦🇺East Melbourne, Victoria, Australia
Investigational Site Number : 1520009
🇨🇱Valdivia, Los Ríos, Chile
Investigational Site Number : 1520007
🇨🇱Santiago, Reg Metropolitana De Santiago, Chile
Investigational Site Number : 1520001
🇨🇱Santiago, Reg Metropolitana De Santiago, Chile
Investigational Site Number : 1520002
🇨🇱Santiago, Reg Metropolitana De Santiago, Chile
Investigational Site Number : 2030005
🇨🇿Praha 6, Czechia
Investigational Site Number : 3480002
🇭🇺Szeged, Hungary
Investigational Site Number : 3560004
🇮🇳Nashik, India
Investigational Site Number : 3800001
🇮🇹Genova, Italy
Investigational Site Number : 3800002
🇮🇹Milano, Italy
Investigational Site Number : 4840004
🇲🇽Chihuahua, Mexico
Investigational Site Number : 4840001
🇲🇽Monterrey, Nuevo León, Mexico
Investigational Site Number : 4840003
🇲🇽Benito Juarez, Mexico
Investigational Site Number : 6160007
🇵🇱Katowice, Slaskie, Poland
Investigational Site Number : 6160006
🇵🇱Krakow, Malopolskie, Poland
Investigational Site Number : 1520003
🇨🇱Santiago, Reg Metropolitana De Santiago, Chile
Investigational Site Number : 8040002
🇺🇦Kyiv, Ukraine