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A Study to Evaluate the Efficacy and Safety of Obinutuzumab in Participants With Systemic Lupus Erythematosus

Phase 3
Active, not recruiting
Conditions
Systemic Lupus Erythematosus
Interventions
Registration Number
NCT04963296
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This parallel-group, double-blind, placebo-controlled study will evaluate the efficacy and safety of obinutuzumab versus placebo in participants with active, autoantibody-positive systemic lupus erythematosus (SLE) who are treated with standard-of-care therapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
300
Inclusion Criteria
  • Diagnosis of SLE according to the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) Classification Criteria >=12 weeks prior to screening
  • Anti-nuclear antibody (ANA) >=1:80, or anti-dsDNA and/or anti-Sm antibodies above the upper limit of normal (ULN), as determined by the central laboratory at screening
  • Low C3 or low C4 or low CH50 complement as determined by the central laboratory at screening
  • High disease activity at screening, based on; BILAG-2004 (Category A disease in >=1 organ system and/or Category B disease in >=2 organ systems), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) (score >=8) and Physician's Global Assessment (PGA) (score >=1.0 on a 0 to 3 visual analogue scale [VAS])
  • High disease activity on Day 1, based on; SLEDAI-2K (score >=8) and PGA (score >=1.0 on a 0 to 3 VAS)
  • Current receipt of >=1 of the following classes of standard therapies for the treatment of SLE at stable doses: oral corticosteroid (OCS), antimalarials, conventional immunosuppressants
  • Other inclusion criteria may apply
  • The Medical Monitor may be consulted if there are any questions related to eligibility criteria
Exclusion Criteria
  • Pregnancy or breastfeeding
  • Presence of significant lupus-associated renal disease and/or renal impairment
  • Receipt of an excluded therapy, including any anti-CD20, anti-CD19 therapy less than 9 months prior to screening or during screening; or cyclophosphamide, tacrolimus, ciclosporin, or voclosporin during the 2 months prior to screening or during screening
  • Significant or uncontrolled medical disease which, in the investigator's opinion, would preclude patient participation
  • Known active infection of any kind or recent major episode of infection
  • Intolerance or contraindication to study therapies
  • Other exclusion criteria may apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboDiphenhydramine hydrochloridePlacebo participants will receive obinutuzumab matched placebo on Day 1 and at Weeks 2, 24 and 26.
PlaceboPlaceboPlacebo participants will receive obinutuzumab matched placebo on Day 1 and at Weeks 2, 24 and 26.
PlaceboAcetaminophen/ParacetamolPlacebo participants will receive obinutuzumab matched placebo on Day 1 and at Weeks 2, 24 and 26.
ObinutuzumabAcetaminophen/ParacetamolParticipants will receive obinutuzumab 1000 milligrams (mg) intravenous (IV) infusions on Day 1 and at Weeks 2, 24 and 26.
ObinutuzumabDiphenhydramine hydrochlorideParticipants will receive obinutuzumab 1000 milligrams (mg) intravenous (IV) infusions on Day 1 and at Weeks 2, 24 and 26.
ObinutuzumabObinutuzumabParticipants will receive obinutuzumab 1000 milligrams (mg) intravenous (IV) infusions on Day 1 and at Weeks 2, 24 and 26.
ObinutuzumabMethylprednisoloneParticipants will receive obinutuzumab 1000 milligrams (mg) intravenous (IV) infusions on Day 1 and at Weeks 2, 24 and 26.
PlaceboMethylprednisolonePlacebo participants will receive obinutuzumab matched placebo on Day 1 and at Weeks 2, 24 and 26.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants who Achieve Systemic Lupus Erythematosus Responder Index (SRI[4]) at Week 52Week 52

SRI(4) requires reduction from baseline of \>=4 points in the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), no new systems or organs affected, as defined by \>=1 new British Isles Lupus Assessment Group (BILAG) A or \>=2 new BILAG B items compared with baseline using BILAG-2004, and no worsening from baseline of \>=0.30 points on a 3-point Physician's Global Assessment Visual Analogue Scale (PGA-VAS).

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants with Adverse EventsFrom baseline to approximately 6 years
Time to First BILAG Flare over 52 WeeksFrom baseline to Week 52

Flare is defined as the occurrence of \>=1 new BILAG A or \>=2 new BILAG B manifestations from the previous visit

Percentage of Participants who Achieve SRI(4) at Week 52 on Low-dose CorticosteroidsWeek 52
Change in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) ScaleFrom baseline to Week 24 and from baseline to Week 52
Percentage of Participants who Achieve SRI(6) at Week 52Week 52

SRI(6) requires reduction from baseline of \>=6 points in the SLEDAI-2K, no new systems or organs affected, as defined by \>=1 new BILAG A or \>=2 new BILAG B items compared with baseline using BILAG-2004, and no worsening from baseline of \>=0.30 points on a 3-point PGA-VAS.

Percentage of Participants who Achieve British Isles Lupus Assessment Group-based Composite Lupus Assessment (BICLA) at Week 52Week 52

Reduction of all baseline BILAG-2004 A items to B/C/D and baseline BILAG-2004 B items to C/D; no new systems or organs affected, as defined by \>=1 new BILAG A or \>=2 new BILAG B items compared with baseline; no net increase in SLEDAI-2K score from baseline; and no worsening from baseline of \>=0.30 points on a 3-point PGA-VAS.

Percentage of Participants who Achieve Lupus Low Disease Activity State (LLDAS) at Week 52Week 52
Percentage of Participants who Achieve Definition of Remission in SLE (DORIS) at Week 52Week 52
Percentage of Participants who Achieve a >= 50% Reduction in Active Joint Counts (Swollen plus Tender) at Each Study VisitFrom baseline to Week 52
Percentage of Participants who Achieve a >= 50% Reduction in Cutaneous Lupus Erythematosus Disease Area and Severity (CLASI) Total Activity Score at each Study Visit, among Participants with CLASI Total Activity Score >=10 at BaselineFrom baseline to Week 52
Percentage of Participants who Achieve Sustained Corticosteroid ControlFrom Week 40 through Week 52
Cumulative Corticosteroid use (in Equivalent Milligrams of Prednisone)From baseline to Week 52
Percentage of Participants Entering the Study on Prednisone >= 10 mg/day (or equivalent) who Achieve Sustained Corticosteroid ControlFrom Week 40 to Week 52

No treatment with prednisone \>=7.5 mg/day (or equivalent) and no receipt of intravenous, intramuscular, or intra-articular corticosteroids.

Percentage of Participants who Achieve SRI(8) at Week 52Week 52
Percentage of Participants who Achieve SRI(4) at Week 24Week 24
Percentage of Participants who Achieve Clinical SRI(4) at Week 52Week 52
Change in 36-Item Short Form Survey, Version 2 (SF-36 v2) Bodily Pain Domain ScaleFrom baseline to Week 24 and from baseline to Week 52
Change in SF-36 v2 Physical Component Summary ScaleFrom baseline to Week 24 and from baseline to Week 52
Percentage of Participants with Anti-drug Antibodies (ADAs) at BaselineBaseline
Change in Active Joint Count (Swollen plus Tender)From baseline to Week 24 and from baseline to Week 52
Annualized flare rate through Week 52At Week 52
Percentage of Participants with Adverse Events of Special Interest (AESIs)From baseline to approximately 6 years
Serum Concentration of ObinutuzumabDouble blind period: At Weeks 2, 4, 12, 24, 26, 36, 52 and at early study discontinuation visit; Open label period: At Weeks 54, 56, 58, 66, 78, 90, 104 and at early study discontinuation visit
Percentage of Participants with ADAs During the StudyUp to approximately 6 years
Percentage of Participants who Achieve a Sustained SRI(4) ResponseFrom Week 40 to Week 52

Achievement of SRI(4) at all study visits from Week 40 through Week 52.

Trial Locations

Locations (66)

Mediclinic Vergelegen

🇿🇦

Somerset West, South Africa

Dr Asokan Naidoo

🇿🇦

Umhlanga, South Africa

Pinnacle Research Group

🇺🇸

Anniston, Alabama, United States

Unity Health - White County Medical Center- Rheumatology

🇺🇸

Searcy, Arkansas, United States

Providence Medical Foundation

🇺🇸

Fullerton, California, United States

University of Colorado Denver, Barbara Davis Center, Center For Clinical Research

🇺🇸

Aurora, Colorado, United States

Arthritis & Rheumatism

🇺🇸

Aventura, Florida, United States

Great Lakes Center of Rheumatology

🇺🇸

Lansing, Michigan, United States

Clinical Research Institute of Michigan, LLC

🇺🇸

Troy, Michigan, United States

Northwell Health Division of Rheumatology

🇺🇸

Great Neck, New York, United States

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Mediclinic Vergelegen
🇿🇦Somerset West, South Africa

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