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The European Union Clinical Trials Register   allows you to search for protocol and results information on:
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    The EU Clinical Trials Register currently displays   43234   clinical trials with a EudraCT protocol, of which   7153   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

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    EudraCT Number:2015-000372-95
    Sponsor's Protocol Code Number:ALX0061-C204
    National Competent Authority:Portugal - INFARMED
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2015-06-26
    Trial results View results
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    A. Protocol Information
    A.1Member State ConcernedPortugal - INFARMED
    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
    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
    A.3.2Name or abbreviated title of the trial where available
    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.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.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 point
    B.5.3 Address:
    B.5.3.1Street AddressTechnologiepark 21
    B.5.3.2Town/ cityZwijnaarde
    B.5.3.3Post code9052
    B.5.4Telephone number+3292620000
    B.5.5Fax number+329 262 00 01
    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. cell therapy medicinal product No
    D. therapy medical product No
    D. Engineered Product No
    D. ATIMP (i.e. one involving a medical device) No
    D. 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
    E.1.1.1Medical condition in easily understood language
    Systemic Lupus Erythematosus
    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.
    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.
    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.
    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.
    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.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 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 40–48 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.
    E.5.2.1Timepoint(s) of evaluation of this end point
    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. 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 concerned5
    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
    Czech Republic
    Korea, Republic of
    Russian Federation
    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
    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 state20
    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
    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 Decision2015-08-25
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-09-11
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2018-02-15
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