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    Summary
    EudraCT Number:2015-000372-95
    Sponsor's Protocol Code Number:ALX0061-C204
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2015-07-10
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2015-000372-95
    A.3Full title of the trial
    A Phase II Multicenter, Randomized, Double-blind, Placebo controlled, Dose-range Finding Study to Evaluate the Safety and Efficacy of ALX 0061 Administered Subcutaneously in Subjects with Moderate to Severe Active Systemic Lupus Erythematosus
    Estudio de fase II, multicéntrico, aleatorizado, doble ciego, controlado con
    placebo, de búsqueda de dosis para evaluar la seguridad y la eficacia de
    ALX-0061 administrado por vía subcutánea en sujetos con lupus
    eritematoso sistémico activo moderado a grave
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study Evaluating ALX-0061 Administered Subcutaneously in Patients with Systemic Lupus Erythematosus
    Estudio para evaluar ALX-0061 administrado por vía subcutánea en sujetos
    con lupus eritematoso sistémico
    A.3.2Name or abbreviated title of the trial where available
    STEADY
    STEADY
    A.4.1Sponsor's protocol code numberALX0061-C204
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02437890
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorAblynx N.V.
    B.1.3.4CountryBelgium
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportAblynx N.V.
    B.4.2CountryBelgium
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAblynx N.V.
    B.5.2Functional name of contact pointClinical trials
    B.5.3 Address:
    B.5.3.1Street AddressTechnologiepark 21
    B.5.3.2Town/ cityZwijnaarde
    B.5.3.3Post code9052
    B.5.3.4CountryBelgium
    B.5.4Telephone number+34900834223
    B.5.6E-mailRegistroEspanolDeEstudiosClinicos@druginfo.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameALX-0061 150 mg/mL
    D.3.4Pharmaceutical form Solution for injection in pre-filled syringe
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNN/A
    D.3.9.1CAS number 1628814-88-9
    D.3.9.2Current sponsor codeALX-0061
    D.3.9.3Other descriptive nameIL-6R nanobody
    D.3.9.4EV Substance CodeSUB126826
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for injection
    D.8.4Route of administration of the placeboSubcutaneous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Moderate to Severe Active Systemic Lupus Erythematosus
    Lupus eritematoso sistémico activo moderado a grave
    E.1.1.1Medical condition in easily understood language
    Systemic Lupus Erythematosus
    Lupus eritematoso sistémico
    E.1.1.2Therapeutic area Diseases [C] - Immune System Diseases [C20]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 18.0
    E.1.2Level LLT
    E.1.2Classification code 10025139
    E.1.2Term Lupus erythematosus systemic
    E.1.2System Organ Class 100000004859
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To assess the efficacy and safety of different dose regimens of ALX-0061 administered subcutaneously (s.c.) to subjects with moderate to severe active, seropositive SLE compared to placebo.
    Evaluar la eficacia y la seguridad de diferentes pautas posológicas de
    ALX-0061 administrado por vía subcutánea (SC) a sujetos con LES
    seropositivo activo moderado a grave en comparación con un placebo.
    E.2.2Secondary objectives of the trial
    To assess the pharmacokinetics (PK), pharmacodynamics (PD), immunogenicity, flare rate, steroid reduction and health-related quality of life, with different dose regimens of ALX-0061.
    Evaluar la farmacocinética (FC), la farmacodinámica (FD), la
    inmunogenicidad, la tasa de exacerbaciones, la reducción de los
    esteroides y la calidad de vida relacionada con la salud con diferentes
    pautas posológicas de ALX-0061.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Male or female adults >=18 years and < 65 years of age at the time of signing the informed consent form (ICF). The minimum age for adults will depend on local regulations.
    2. Have a diagnosis of SLE and fulfill the 1997 ACR (see Appendix 9.1) or 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for at least 6 months prior to screening.
    3. Have moderate to severe active SLE, for the purpose of this study defined by a SLEDAI 2K score >=6 at screening.
    4. Have at least one A or one B score on the revised BILAG 2004 criteria for the mucocutaneous and/or musculoskeletal system.
    5. Have seropositive disease at screening for ANA (>=1:80) and/or anti-dsDNA (>=30 IU/mL) measured at the central laboratory.
    6. Subject at least must be on one or more of the following treatments for SLE:
    a. If subject is on oral corticosteroids, the dose should be equivalent to a maximum dose of 25 mg of prednisone/day and stable for at least 4 weeks prior to baseline.
    b. If subject is on antimalarials, he or she must have received antimalarials for at least 12 weeks with a stable dose of max. 400 mg/day for at least 4 weeks prior to baseline.
    c. If subject is on immunosuppressants: azathioprine (max. 150 mg/day), mycophenolate mofetil (max. 1.5 g/day), methotrexate (max. 25 mg/day), cyclosporine (max. 200 mg), leflunomide (max. 20 mg/day), treatment duration must be at least 12 weeks with a stable dose for at least 4 weeks prior to baseline; either alone or in combination with corticosteroids and/or hydroxychloroquine.
    7. If immunosuppressants were previously given but have been stopped, the last dose should have been received more than 4 weeks prior to baseline; for leflunomide and hydroxychloroquine, a leflunomide or hydroxychloroquine treatment-free period of at least 12 weeks should be respected (unless an adequate cholestyramine wash-out was done for leflunomide).
    8. If subject is on angiotensin-converting-enzyme (ACE) inhibitor or angiotensin receptor blocker, the dose should have been stable for 4 weeks prior to baseline.
    9. Chest radiograph performed within 12 weeks prior to the screening visit (or performed during the screening period) documenting no evidence of malignancy, infection, or abnormalities suggestive of tuberculosis (TB; report must be obtained and available in the subject's study file prior to baseline).
    10. Are considered eligible according to the following TB screening criteria:
    a. Have no history of latent or active TB prior to screening. An exception is made for subjects with a history of latent TB and documentation of having completed appropriate treatment for latent TB prior to screening. It is the responsibility of the Investigator to verify the adequacy of previous anti-TB treatment and provide appropriate documentation.
    b. Have no signs or symptoms suggestive of active TB upon medical history and/or physical examination during screening.
    c. Have had no recent close contact with a person with active TB or, if there has been such contact, will be referred to a physician specialized in TB to undergo additional evaluation and, if warranted, receive appropriate treatment.
    d. Have a negative interferon gamma release assay (IGRA) screening test result. A subject whose initial IGRA test result is indeterminate should have the test repeated while still fulfilling the other TB criteria for inclusion. The test should not be repeated in case other risk factors for TB are present. In case the test is again indeterminate, the subject will be excluded. In case of a positive IGRA test result due to previous latent TB, the subject is eligible if adequate documentation of completed anti-TB treatment prior to screening is available.
    e. Have a chest radiograph, read by a qualified radiologist, whose diagnostic assessment is consistent with no evidence of current active TB or old inactive TB, and taken within 12 weeks prior to screening as part of standard of care or during the screening period. In case local regulations do not allow radiographs during the study, a radiograph as part of standard of care should be available prior to screening.
    11. Female subjects of childbearing potential (excluding postmenopausal women, sterilized, ovariectomized and hysterectomized women) must have a negative pregnancy test and must agree to use two generally accepted adequate contraceptive methods (1 highly effective and 1 barrier method e.g., hormonal contraception in combination with condom by partner) from screening until at least 3 months after last dosing.
    Male subjects must use condoms for the duration of the study and for at least 3 months after last dosing.
    12. Capability to comprehend and willingness to sign an ICF, which must be obtained prior to any study-related procedures (vulnerable subjects will be excluded, except subjects from ethnic minority groups who may participate).
    13. An understanding, ability and willingness to adhere to the study requirements.
    1. Varones y mujeres con una edad >= 18 años y < 65 años en el
    momento de firmar el consentimiento informado.
    2. El sujeto tiene un diagnóstico de LES y cumple los criterios de clasificación de 1997 del ACR o de 2012 de las SLICC durante al menos 6 meses antes del período de selección.
    3. El sujeto padece LES activo moderado a grave, definido como una puntuación SLEDAI-2K >= 6 en el período de selección.
    4. El sujeto tiene al menos una puntuación A o B en los criterios revisados BILAG -2004 para el sistema mucocutáneo y/o musculoesquelético.
    5. El sujeto presenta en el período de selección enfermedad seropositiva
    para ANA >=1:80 y/o anti-ADNbc (>=30 UI/ml) medidos en el laboratorio
    central.
    6. El sujeto debe estar recibiendo al menos uno o más de los siguientes
    tratamientos para el LES: (a) Si está recibiendo corticosteroides orales,
    la dosis debe ser equivalente a una dosis máxima de 25 mg de prednisona/día y haberse mantenido estable durante al menos 4 sem.antes del período basal. (b) Si está recibiendo antipalúdicos, debe haberlos recibido durante al menos 12 sem. con una dosis estable máxima de 400 mg/día durante al menos 4 sem. antes del período basal. (c) Si está recibiendo los inmunosupresores azatioprina (máx. 150mg/día), micofenolato mofetilo (máx. 1,5 g/día), metotrexato (máx. 25mg/día), ciclosporina (máx. 200 mg) o leflunomida (máx. 20 mg/día), el tratamiento debe ser de al menos 12 sem.con una dosis estable durante al menos 4 sem. antes del período basal, solos o en combinación con
    corticosteroides y/o hidroxicloroquina.
    7. Si con anterioridad se han administrado inmunosupresores y luego se ha interrumpido su administración, la última dosis debe haberse recibido más de 4 sem. antes del período basal; para la leflunomida y la hidroxicloroquina debe respetarse un período sin tratamiento de al menos 12 sem. (a menos que se haya dejado un período adecuado de lavado con colestiramina para la leflunomida).
    8. Si está recibiendo un IECA o un antagonista de los receptores de la angiotensina, la dosis debe haberse mantenido estable durante 4 sem. antes del período basal.
    9. Radiografía de tórax realizada en las 12 sem.previas a la visita de selección (o durante la selección) con ausencia de signos de neoplasias malignas, infección o anomalías indicativas de tuberculosis (TB; se debe obtener el informe y tenerlo disponible en el archivo del estudio antes del período basal).
    10. El sujeto se considera elegible de acuerdo con los siguientes criterios
    de cribado de la TB: (a) El sujeto no presenta antecedentes de TB latente ni activa antes del período de selección. Se aplica una excepción a los sujetos con antecedentes de TB latente en los que se haya documentado haber completado el tratamiento apropiado para la TB latente antes de la selección. Es responsabilidad del investigador verificar la idoneidad del tratamiento antituberculoso previo y proporcionar la documentación correspondiente. (b) El sujeto no presenta signos ni síntomas indicativos de TB activa en la anamnesis y/o en la exploración física durante selección. (c) El sujeto no ha estado en contacto directo reciente con una persona con TB activa o, si ha existido dicho contacto, ha sido derivado a un especialista para someterse a una evaluación adicional y si aplica recibir tratamiento apropiado. (d) El sujeto tiene un resultado negativo en el análisis IGRA. Si tiene un resultado indeterminado en el IGRA inicial, deberá repetírsele mientras siga cumpliendo los otros criterios de inclusión relativos a la TB. La prueba no debe repetirse si están presentes otros factores de riesgo de TB. Si el resultado es de nuevo indeterminado, se excluirá al sujeto, y si es positivo debido a una TB latente previa, se considerará elegible si se dispone de la documentación apropiada de que ha completado el tratamiento antituberculoso antes del período de selección. (e) radiografía de tórax evaluada por un radiólogo cualificado, compatible con la ausencia de TB activa actual o TB inactiva antigua, y obtenida en las 12 sem. previas a la selección como parte de la atención habitual o durante el período de selección.
    11. Las mujeres con capacidad reproductiva (excluidas posmenopáusicas, esterilizadas, ovariectomizadas e histerectomizadas) deben tener una prueba de embarazo negativa y comprometerse a usar dos métodos anticonceptivos adecuados generalmente aceptados (1 método de alta eficacia y 1 método de barrera, p.ej. anticonceptivo hormonal en combinación con el uso de preservativos) desde la selección hasta al menos 3 meses después de la última dosis. Los varones deben usar preservativos durante el estudio y al menos 3 meses después de la última dosis.
    12. Capacidad para comprender y estar dispuesto a firmar un CI, que debe obtenerse antes de que se realicen los procedimientos del estudio (se excluirán sujetos vulnerables, excepto los pertenecientes a minorías étnicas)
    13.El sujeto debe comprender y ser capaz de cumplir los requisitos del
    estudio
    E.4Principal exclusion criteria
    1. Have an A score on the revised BILAG-2004 other than in the mucocutaneous and/or musculoskeletal system at screening.
    2. Have a systemic inflammatory disease other than SLE, including but not limited to psoriatic arthritis, ankylosing spondylitis, rheumatoid arthritis or Lyme disease.
    3. Infection treated with i.v. antibiotics, i.v. antivirals, or i.v. antifungals within 4 weeks prior to baseline or oral antibiotics, oral antivirals, or oral antifungals within 2 weeks prior to baseline.
    4. Any active or recurrent viral infection that based on the Investigator´s clinical assessment makes the subject unsuitable for the study, such as current Cytomegalovirus (CMV) or Epstein-Barr Virus (EBV) infection or recurrent / disseminated herpes zoster.
    5. Have a history of, or current, class III or IV congestive heart failure (CHF), as defined by the New-York Heart Association; history of unstable angina pectoris, myocardial infarction, cerebrovascular accident, thromboembolic event within 12 months before screening.
    6. Have active lupus nephritis requiring cyclophosphamide or mycophenolate mofetil more than 1,5 g/day or other therapy not permitted by the protocol.
    7. Have lupus-related central neurological problems (including lupus headache) or severe central nervous system (CNS) disease.
    8. Have drug-induced lupus.
    9. Have a history of demyelinating diseases such as multiple sclerosis.
    10. History of diverticulitis or symptoms of acute diverticulitis with confirmatory imaging (i.e., CT scan).
    11. Any history of malignancy or lymphoproliferative disease, except for successfully-treated non-melanoma skin cancer or resected cervical carcinoma in situ.
    12. Have a transplanted organ or received stem cell transplantation.
    13. Major surgery (including joint surgery) within 8 weeks prior to screening or hospitalization for a clinically relevant event within the 4 weeks prior to screening or planned major surgery during study or within 3 months after study end.
    14. Have been treated with i.v. immunoglobulins, cyclophosphamide or tacrolimus within 12 months prior to baseline.
    15. Have received i.v., intra-articular (i.a.), intramuscular (i.m.) or high dose (> 25 mg/day) oral corticosteroids during the 4 weeks prior to baseline.
    16. Have a known hypersensitivity to the active product or any excipient of the study drug.
    17. Have received approved or investigational biological therapies within 6 months or 5 half-lives of the concerned therapy (whichever is longer) prior to baseline.
    18. Have received non-biological investigational therapies within 4 weeks or 5 half lives of the concerned therapy (whichever is longer) prior to baseline.
    19. Have received prior therapy blocking the IL-6 pathway, such as but not limited to ALX 0061, sirukumab, tocilizumab, sarilumab, clazakizumab, olokizumab, or JAK inhibitors at any time.
    20. Abnormality in screening laboratory test results:
    a. ALT and/or AST >=1.5 times the upper limit of normal (ULN).
    b. Hemoglobin <=85 g/L (8.5 g/dL).
    c. Platelet count <=75 x 109/L (75,000 cells/mm³).
    d. White blood cell count <=2.2 x 109/L (2,200 cells/mm³).
    e. Neutrophils: <=1.5 X 109/L.
    f. Estimated proteinuria > 1 g/day measured by spot urine protein to creatinine ratio of 1.
    g. Estimated glomerular filtration rate (eGFR) < 50 mL/min/1.73 m² (based on the modification of diet in renal disease [MDRD] formula [Appendix 9.4]).
    h. Any other clinically significant abnormal screening laboratory results as evaluated by the Investigator.
    21. Positive screening for hepatitis B, hepatitis C or human immunodeficiency virus (HIV).
    22. Known history or presence of alcohol or drug abuse.
    23. Blood donation (> 500 mL) or a comparable blood loss within 3 months prior to baseline.
    24. Planned donation of germ cells, blood, organs, bone marrow during the course of the study or within 6 months thereafter.
    25. Female subjects who are planning to become pregnant during the study or within 3 months after last dosing or male subjects who are considering fathering a child during the study and within 3 months after last dosing.
    26. Pregnant woman or female subjects who are breastfeeding.
    27. History of anaphylactic reactions.
    28. Administration of a live, attenuated vaccine within 3 months before dosing with ALX 0061, or anticipation that such a live attenuated vaccine will be required during the study or within 6 months after last dosing.
    29. Subject is considered by the Investigator, for any reason, to be an unsuitable candidate for the study.
    1. Puntaución A en la selección de los criterios revisados BILAG-2004 en un sistema distinto del mucocutáneo y/o el musculoesquelético.
    2. Enfermedad inflamatoria sistémica distinta del LES, incluidas entre otras artritis psoriásica, espondilitis anquilosante, artritis reumatoide y enfermedad de Lyme.
    3. Infección tratada con antibióticos, antivirales o antimicóticos intravenosos en las 4 semanas previas al período basal, o con antibióticos, antivirales o antimicóticos orales en las 2 semana previas al período basal.
    4. Infección vírica activa o recidivante que, según la evaluación del investigador, hace que no sea apto para el estudio, como una infección actual por citomegalovirus (CMV) o por el virus de Epstein-Barr (VEB) o un herpes-zóster recidivante/diseminado.
    5. Antecedentes o presenta actualmente insuficiencia cardíaca congestiva (ICC) de clase III o IV conforme a la clasificación de la NYHA; antecedentes de angina de pecho inestable, infarto de miocardio, accidente cerebrovascular o episodio tromboembólico en los 12 meses previos al período de selección.
    6. Nefritis lúpica activa que requiere tratamiento con ciclofosfamida o con micofenolato mofetilo en dosis superiores a 1,5 g/día u otro tratamiento no permitido por el protocolo.
    7. Problemas neurológicos centrales relacionados con el lupus (incluida la cefalea lúpica) o enfermedad grave del sistema nervioso central (SNC).
    8. Lupus inducido por fármacos.
    9. Antecedentes de enfermedades desmielinizantes como esclerosis múltiple.
    10. Antecedentes o síntomas de diverticulitis aguda confirmada con un estudio de imagen (p.e., TAC).
    11. Antecedentes de neoplasias malignas o enfermedad linfoproliferativa, excepto el cáncer de piel distinto del melanoma tratado con éxito y el carcinoma in situ de cuello uterino extirpado.
    12. Trasplante de órgano o de células madre.
    13. Cirugía mayor (incluida la cirugía articular) en las 8 semanas previas al período de selección u hospitalización por un episodio significativo en las 4 semanas previas al período de selección o cirugía mayor programada durante o en los 3 meses posteriores al final del estudio.
    14. Tratamiento con ciclofosfamida, tacrolimus o inmunoglobulinas por vía intravenosa en los 12 meses previos al período basal.
    15. Corticosteroides intravenosos, intraarticulares (IA) o intramusculares (IM) o corticosteroides orales en dosis altas (> 25mg/día) durante las 4 semanas previas al período basal.
    16. Hipersensibilidad conocida al producto activo o a alguno de los excipientes del fármaco del estudio.
    17. Tratamientos biológicos aprobados o experimentales en los 6 meses previos al período basal o en un período previo al período basal equivalente a 5 semividas del tratamiento (lo que suponga más tiempo).
    18. Tratamientos no biológicos experimentales en los 4 meses previos al período basal o en un período previo al período basal equivalente a 5 semividas del tratamiento (lo que sea más largo).
    19. Tratamiento previo de bloqueo de la vía de la IL-6, entre otros ALX-0061, sirukumab, tocilizumab, sarilumab, clazakizumab, olokizumab o inhibidores de la quinasa Janus (JAK) en cualquier momento.
    20. Anomalías en los resultados de los análisis clínicos de selección: (a)Alanina-aminotransferasa (ALT) y/o aspartato-aminotransferasa (AST)>= 1,5 veces el límite superior de la normalidad (LSN). (b) Hemoglobina <=85 g/l (8,5 g/dl). (c) Recuento de plaquetas <=75 x 109/l (75.000 células/mm³). (d)Recuento de leucocitos <=2,2 x 109/l (2.200 células/mm³). (e) Neutrófilos: <= 1,5 x 109/l. (f) Proteinuria calculada > 1 g/día medida por un cociente proteínas/creatinina en una muestra aislada de orina de 1. (g) Índice de filtración glomerular estimado (IFGe)< 50 ml/min/1,73 m² (basado en la fórmula modificación de la dieta en la nefropatía [MDRD]). (h) Cualquier otro resultado anómalo clínicamente significativo en los análisis clínicos de selección, según la evaluación del investigador.
    21. Prueba de cribado positiva para el VHB, VHC o VIH
    22. Abuso en la actualidad o en el pasado de alcohol o drogas.
    23. Donación de sangre (> 500 ml) o pérdida de sangre comparable en
    los 3 meses previos al período basal.
    24. Donación prevista de células germinales, sangre, órganos o médula
    ósea durante el curso del estudio o en los 6 meses siguientes
    25. Mujeres con intención de quedarse embarazadas durante el estudio o
    en los 3 meses siguientes a la última dosis del fármaco del estudio.
    Varones con intención de engendrar un hijo durante el estudio o los 3 meses siguientes a la última dosis del fármaco del estudio
    26. Mujeres embarazadas o lactantes
    27. Antecedentes de reacciones anafilácticas
    28. Administración de una vacuna de microorganismos vivos atenuados en los 3 meses previos a la administración de ALX-0061, o previsión de que se requerirá la misma durante el estudio o en los 6 meses posteriores a la última dosis
    29. El investigador considera que el sujeto no es un candidato adecuado
    para el estudio
    E.5 End points
    E.5.1Primary end point(s)
    The percentage of subjects who achieved a response at Week 24 according to the composite mBICLA (BILAG-based Combined Lupus Assessment) score.
    Porcentaje de sujetos que alcanza una respuesta en la semana 24
    conforme a la puntuación mBICLA (Evaluación combinada del lupus
    basada en el índice BILAG) compuesta.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 24
    Semana 24
    E.5.2Secondary end point(s)
    Secondary endpoints will include:
    -Composite endpoint (m)BICLA over time.
    -Composite endpoint mSRI as well as standard SRI over time.
    -(m)SRI with more stringent (m)SLEDAI-cut-offs: SRI-5, SRI-6, SRI-7, SRI-8 over time.
    -Change from baseline in mSLEDAI-2K total score as well as standard SLEDAI 2K measured over time.
    -Number and percent of subjects with BILAG-2004 improvement.
    -BILAG-2004 (total score) over time.
    -Improvement in individual organ systems of the BILAG-2004 over time.
    -Number of BILAG-2004 systems in which activity increased, decreased or remained the same compared to previous visit (BILAG-2004 systems tally) over time.
    -Change from baseline in PGA over time.
    -Change from baseline in patient's global assessment over time.
    -Change from baseline in proteinuria/urine sediment/serum creatinine/eGFR over time.
    -Proportion of treatment failures (defined as non-protocol allowed increase in steroid dose, start i.v. or i.m. steroids, start or increase of immunosuppressant) at Week 24 and at Week 48.
    -Reduction in flare rate at Week 24 and at Week 48.
    Severe flare defined as a new A score in any system of the BILAG-2004 index; moderate flare defined as a new B score following a C, D or E score.
    SLEDAI flare index (SFI).
    -Percent change from baseline in daily dose of steroids at Week 24 and 48.
    -Percent subjects whose prednisone equivalent dose was >7.5 mg/day at baseline and reduced to <=7.5 mg/day during Weeks 40 to 48 without experiencing a flare.
    -Percent subjects who are able to discontinue prednisone by Week 48 without experiencing a flare.
    -Changes from baseline in the physical and mental component scores of SF-36 at Week 24 and at Week 48.
    -28 Joints count over time and change from baseline in 28 joint count over time.
    -Cutaneous lupus erythematosus disease area and severity index (CLASI) over time and change from baseline evaluation at Week 12, 24 and Week 48.
    -PK parameters.
    -PD markers, including total sIL-6R, CRP, fibrinogen, anti-dsDNA, C3, C4, CH50.
    Los criterios secundarios de valoración incluirán:
    -Criterio de valoración compuesto (m)BICLA a lo largo del tiempo.
    -Criterio de valoración compuesto mSRI así como el SRI estándar a lo
    largo del tiempo.
    -(m)SRI con valores de corte del (m)SLEDAI más estrictos: SRI-5, SRI-6,
    SRI-7 y SRI-8 a lo largo del tiempo.
    -Cambio con respecto al valor basal en la puntuación mSLEDAI-2K total y
    en el SLEDAI-2K estándar a lo largo del tiempo.
    -Número y porcentaje de sujetos con una mejoría en el BILAG-2004.
    -BILAG-2004 (puntuación total) a lo largo del tiempo.
    -Mejoría en sistemas de órganos individuales del BILAG-2004 a lo largo
    del tiempo.
    -Número de sistemas del BILAG-2004 en los que la actividad ha aumentado, ha disminuido o no ha variado en comparación con la visita previa (recuento de sistemas del BILAG-2004) a lo largo del tiempo.
    -Cambio en la PGA con respecto al período basal a lo largo del tiempo.
    -Cambio con respecto al período basal en la evaluación global por el paciente a lo largo del tiempo.
    -Cambio con respecto al valor basal en la proteinuria/sedimento en la orina/creatinina sérica/IFGe a lo largo del tiempo.
    -Proporción de fracasos del tratamiento (definidos como aumento no permitido por el protocolo de la dosis de esteroides, inicio de esteroides intravenosos o intramusculares, inicio o aumento de inmunosupresores) en la semana 24 y en la semana 48.
    -Reducción de la tasa de exacerbaciones en la semana 24 y en la semana 48.
    Se define exacerbación intensa como una puntuación A nueva en cualquier sistema del índice BILAG-2004; se define exacerbación moderada como una puntuación B nueva después de una puntuación C, D o E.
    Índice de exacerbación basado en el SLEDAI (SFI).
    -Cambio porcentual con respecto al período basal en la dosis diaria de esteroides en las semanas 24 y 48.
    -Porcentaje de sujetos cuya dosis de equivalente de prednisona era >7,5 mg/día en el período basal y disminuyó a <= 7,5 mg/día durante las semanas 40-48 sin sufrir una exacerbación.
    -Porcentaje de sujetos que pudieron suspender la prednisona en la semana 48 sin sufrir una exacerbación.
    -Cambios con respecto al período basal en las puntuaciones de los componentes físicos y mentales del SF-36 en las semanas 24 y 48.
    -Recuento en 28 articulaciones a lo largo del tiempo y cambio con respecto al período basal en el recuento en 28 articulaciones a lo largo del tiempo.
    -Índice de superficie e intensidad de la enfermedad en el lupus eritematoso cutáneo (CLASI) a lo largo del tiempo y cambio con respecto a la evaluación basal en las semanas 12, 24 y 48
    -Parámetros farmacocinéticos.
    -Marcadores farmacodinámicos, tales como sIL-6R total, PCR, fibrinógeno, anticuerpos anti-ADNbc, C3, C4 y CH50
    E.5.2.1Timepoint(s) of evaluation of this end point
    Monthly
    Mensual
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial5
    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.8.4.1Number of sites anticipated in Member State concerned8
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA31
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Chile
    Czech Republic
    Germany
    Hungary
    Korea, Republic of
    Mexico
    Peru
    Philippines
    Poland
    Portugal
    Russian Federation
    Serbia
    Spain
    Taiwan
    Ukraine
    United States
    E.8.7Trial 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
    LVLS
    Ultima visita último sujeto
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months4
    E.8.9.1In the Member State concerned days28
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months8
    E.8.9.2In all countries concerned by the trial days28
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 300
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state25
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 100
    F.4.2.2In the whole clinical trial 300
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Standard of Care
    Tratamiento de práctica habitual
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2015-08-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-08-03
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2018-01-16
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