E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10025140 |
E.1.2 | Term | Lupus nephritis |
E.1.2 | System Organ Class | 10038359 - Renal and urinary disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of the study is to assess the efficacy of BIIB023 as an add-on treatment to background therapy compared with placebo in combination with background therapy in the treatment of subjects with active, biopsy-proven LN. |
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E.2.2 | Secondary objectives of the trial |
Secondary objectives of this study are to assess the safety and tolerability of BIIB023 compared with placebo in this study population. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
•Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (PHI) in accordance with national and local subject privacy regulations.
•Aged 18 to 75 years old, inclusive, at the time of informed consent.
•Must have a documented diagnosis of SLE according to current ACR criteria. At least 4 ACR criteria must be documented, 1 of which must be a positive antinuclear antibody (ANA), anti-Sm, or anti-dsDNA antibody.
•Must have a diagnosis of ISN/RPS 2003 Class III or IV LN with either active or active/chronic disease, confirmed by biopsy within 3 months prior to Screening. Subjects are permitted to have co-existing Class V LN. If a renal biopsy has not been performed within 3 months of the Screening Visit, one can be performed during the Screening Period after all other eligibility criteria have been confirmed. The local histological diagnosis must be confirmed by the central study pathologist.
•Must have proteinuria at Screening (from a 24-hour urine sample collection) defined as: uPCR >1.0 mg/mg
•Subjects of childbearing potential must practice effective contraception during the study and be willing and able to continue contraception for 6 months after their last dose of study treatment.. |
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E.4 | Principal exclusion criteria |
•Retinitis, poorly-controlled seizure disorder, acute confusional state, myelitis, stroke or stroke syndrome, cerebellar ataxia, or dementia that is currently active and resulting from SLE at Screening
•Estimated GFR <30 mL/min per 1.73 m2 (calculated using the abbreviated MDRD equation) or the presence of oliguria or ESRD requiring dialysis or transplantation
•Subjects requiring dialysis within 12 months prior to Screening
•History of renal transplant
•History of opportunistic infection within 3 years of Screening.
•Subjects with any abnormal laboratory test result at Screening considered clinically significant and that would preclude the subject from participating in the study (as determined by the Investigator) or:
• aspartate aminotransferase/serum glutamate oxaloacetate transaminase (AST/SGOT) or alanine aminotransferase/serum glutamate pyruvate transaminase (ALT/SGPT) >2 x ULN established by the central laboratory
• platelet count <20,000/μL; subjects with platelet count >20,000/μL and <150,000 who are experiencing, or at high risk for developing, clinically significant bleeding or organ dysfunction requiring therapy (as determined by the Investigator) should be excluded from the study
• hemoglobin <8.5 g/dL
• neutrophils <1.5 x 1000/μL
•Treatment with any biologic B-cell-depleting therapy (e.g., anti-CD20 [rituximab], anti-CD22 [epratuzumab], anti-BLyS/BAFF [e.g., briobacept, belimumab] therapy), or TACI-Ig within 12 months prior to Run-in Day 1. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of subjects who achieve a renal response (complete or partial renal response) at Week 52.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
1. Proportion of subjects who achieve complete renal response at Week 52.
2. Duration of response in subjects who achieve complete renal response at Week 52.
3. Proportion of subjects with uPCR >3.0 at Day 1 (Baseline) who achieve uPCR <1.0 at Week 52.
4. Time to partial or complete renal response in subjects who achieve renal response at Week 52.
5. Proportion of subjects with active urinary sediment at Day 1 (Baseline) who have inactive urinary sediment at Week 52.
Active urinary sediment is defined by 1 of the following (in the absence of a urinary tract infection or menses):
->5 red blood cell/high power field (RBC/HPF) or above the reference range for the laboratory, and >5 white blood cell/high power field (WBC/HPF) or above the reference range for the laboratory
-Presence of cellular casts (RBC or WBC)
Inactive urinary sediment defined as:
-<5 RBC/HPF and <5 WBC/HPF, or within the laboratory reference range, and
-no cellular casts (no RBC or WBC casts).
6. Incidence of AEs, SAEs, and AEs leading to study discontinuation.
7. Duration of renal response.
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
At week 52 or throughout the duration of the study |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 42 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Argentina |
Australia |
Belgium |
Brazil |
Canada |
Colombia |
France |
Germany |
Hong Kong |
Hungary |
Israel |
Italy |
Korea, Republic of |
Malaysia |
Mexico |
Peru |
Philippines |
Poland |
Portugal |
Russian Federation |
Serbia |
South Africa |
Spain |
Thailand |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 5 |
E.8.9.2 | In all countries concerned by the trial days | 0 |