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    Summary
    EudraCT Number:2016-004574-17
    Sponsor's Protocol Code Number:CC-220-SLE-002
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2017-04-07
    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 number2016-004574-17
    A.3Full title of the trial
    A PHASE 2, MULTICENTER, RANDOMIZED, DOUBLEBLIND, PLACEBO-CONTROLLED STUDY TO EVALUATE THE EFFICACY AND SAFETY OF CC-220 IN SUBJECTS WITH ACTIVE SYSTEMIC LUPUS ERYTHEMATOSUS
    ESTUDIO DE FASE 2, MULTICÉNTRICO, ALEATORIZADO, DOBLE CIEGO, CONTROLADO CON PLACEBO PARA EVALUAR LA EFICACIA Y LA SEGURIDAD DE CC-220 EN SUJETOS CON LUPUS ERITEMATOSO SISTÉMICO ACTIVO
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to measure how safe CC-220 is and how well CC-220 works in people with lupus.
    Estudio para medir como es de seguro el CC-220 y como de bien funciona en personas con lupus
    A.4.1Sponsor's protocol code numberCC-220-SLE-002
    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 SponsorCelgene Corporation
    B.1.3.4CountryUnited States
    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 supportCelgene Corporation
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCelgene Corporation
    B.5.2Functional name of contact pointClinicalTrialDisclosure
    B.5.3 Address:
    B.5.3.1Street Address9225 Indian Creek Parkway, Suite 900
    B.5.3.2Town/ cityOverland Park, Kansas
    B.5.3.3Post code66210
    B.5.3.4CountryUnited States
    B.5.4Telephone number+34914229000
    B.5.5Fax number+1913266 0394
    B.5.6E-mailClinicalTrialDisclosure@celgene.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.3.2Product code CC-220
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCC-220
    D.3.9.3Other descriptive nameCC-220
    D.3.9.4EV Substance CodeSUB179693
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.15
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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.IMP: 2
    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.3.2Product code CC-220
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCC-220
    D.3.9.3Other descriptive nameCC-220
    D.3.9.4EV Substance CodeSUB179693
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.3
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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.IMP: 3
    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.3.2Product code CC-220
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCC-220
    D.3.9.3Other descriptive nameCC-220
    D.3.9.4EV Substance CodeSUB179693
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.45
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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 placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    SYSTEMIC LUPUS ERYTHEMATOSUS
    LUPUS ERITEMATOSO SISTÉMICO ACTIVO
    E.1.1.1Medical condition in easily understood language
    Heterogeneous, inflammatory, multisystem autoimmune disease in which antinuclear antibodies occur. "Lupus erythematosus" describes the typical rash of SLE.
    Enfermedad autoinmune heterogénea, inflamatoria y multisistémica en la que se producen anticuerpos antinucleares. "Lupus eritematoso" describe la erupción típica de LES.
    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 19.1
    E.1.2Level LLT
    E.1.2Classification code 10025134
    E.1.2Term Lupus erythematosus
    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 evaluate the clinical efficacy of three doses of CC-220 (0.45 mg once per day [QD], 0.3 mg QD or 0.15 mg QD) compared to placebo, for the treatment of active systemic lupus erythematosus (SLE) using the SLE Responder Index at Week 24, defined as:
    - Reduction from baseline of ≥ 4 points in the SLEDAI 2K and
    - No new one or more British Isles Lupus Assessment Group (BILAG) A or new* 2 or more BILAG B items compared to baseline using BILAG 2004 Index and
    - No worsening from baseline defined by an increase of < 0.30 points from baseline on a Physician's Global Assessment (PGA) visual analog scale (VAS) from 0-3
    *new excludes A to B
    Evaluar la eficacia clínica de tres dosis de CC-220 (0,45 mg una vez al día [cada día], 0,3 mg cada día o 0,15 mg cada día) en comparación con placebo, para el tratamiento del LES activo mediante el índice de respuesta de LES (SRI) en la semana 24, definida como:
    o Reducción de ≥ 4 puntos en el SLEDAI-2K con respecto al momento basal y
    o Ningún elemento nuevo ni adicional del British Isles Lupus Assessment Group (BILAG) A, ni 2 o más elementos nuevos* del BILAG B, en comparación con el momento basal mediante el índice BILAG 2004 y
    o Sin empeoramiento con respecto al momento basal, definido como un aumento inferior a 0,30 puntos desde el momento basal en una escala visual analógica (EVA) de 0 a 3 en la valoración global del médico (PGA)
    *"nuevos" excluye A y B
    E.2.2Secondary objectives of the trial
    Week 24
    - To evaluate additional measures of clinical disease activity of CC-220 (0.45 mg once per day [QD], 0.3 mg QD or 0.15 mg QD) compared to placebo for the treatment of subjects with active SLE
    - To assess the reduction in steroid use
    - To evaluate the safety and tolerability of 0.45 mg QD, 0.3 mg QD, and 0.15 mg QD of CC-220 compared to placebo in subjects with active SLE
    Week 52
    -To evaluate additional measures of clinical disease activity and maintenance of effect of CC-220 (0.45 mg once per day [QD], 0.3 mg QD or 0.15 mg QD) for the treatment of subjects with active SLE
    - To assess the reduction in steroid use
    - To evaluate the longer term safety and tolerability of 0.45 mg QD, 0.3 mg QD, and 0.15 mg QD of CC-220 in subjects with active SLE
    Semana 24
    o Evaluar indicadores adicionales de la actividad clínica de la enfermedad de CC-220 (0,45 mg una vez al día [cada día], 0,3 mg cada día o 0,15 mg cada día) en comparación con placebo, para el tratamiento de sujetos con LES activo.
    o Evaluar la reducción del uso de corticoesteroides.
    o Evaluar la seguridad y la tolerabilidad de 0,45 mg cada día, 0,3 mg cada día y 0,15 mg cada día de CC-220, en comparación con placebo en sujetos con LES activo.
     Semana 52
    o Evaluar indicadores adicionales de la actividad clínica de la enfermedad y el mantenimiento del efecto de CC-220 (0,45 mg una vez al día [cada día], 0,3 mg cada día o 0,15 mg cada día) para el tratamiento de sujetos con LES activo.
    o Evaluar la reducción del uso de corticoesteroides.
    Evaluar la seguridad y la tolerabilidad de 0,45 mg cada día por vía oral, 0,3 mg cada día y 0,15 mg cada día de CC-220 en sujetos con LES activo
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    •Male or female 18 years of age or older at the time of signing the informed consent.
    •Understand and voluntarily sign informed consent forms (ICFs) prior to the initiation of any study specific assessments/procedures.
    •Able and willing to adhere to the visit schedule and other protocol requirements.
    Disease Specific
    •Have a diagnosis of SLE for at least 6 months prior to the Screening Visit and fulfill the 1997 update of the 1982 American College of Rheumatology (ACR) Classification Criteria for SLE at the Screening Visit.
    •At the Screening Visit a SLEDAI 2K score of ≥ 6 points, at least four points of which are a "clinical" SLEDAI 2K score. The “clinical” score is the SLEDAI 2K assessment score without the inclusion of points attributable to any urine or blood laboratory results including immunologic measures. Neurologic descriptors of the SLEDAI 2K (items 1-7) are not counted towards the SLEDAI study entry criteria.
    •At the Baseline Visit, a clinical SLEDAI 2K score of ≥ 4 points.
    •Positive antibodies associated with SLE, which must include at least one of the following within the Screening Phase:
    Positive antinuclear antibody (ANA) test at the central laboratory with a titer of 1:80 or greater, associated with a diagnosis of SLE,
    Anti-dsDNA antibodies elevated to above normal as per the central laboratory,
    Anti-Smith (anti-Sm) antibody elevated to above normal as per the central laboratory.
    Pregnancy
    All male and female subjects should be counseled about pregnancy precautions and risks of fetal exposure as described in the Pregnancy Prevention Plan (provided separately).
    •Females of childbearing potential (FCBP) must:
    - Have two negative pregnancy tests as verified by the Investigator prior to starting study therapy, one within 10 to 14 days prior to the first dose of CC-220 and again within 24 hours before taking the first dose of CC-220. She must agree to ongoing pregnancy testing during the course of the study, and after end of study treatment. This applies even if the subject practices true abstinence from heterosexual contact.
    - Either commit to true abstinence from heterosexual contact (which must be reviewed on a monthly basis and source documented) or agree to use two forms of reliable contraception simultaneously. One must be a highly effective method and one additional effective (barrier) method, and both must be practiced without interruption, 28 days prior to starting investigational product, during the study therapy (including dose interruptions), and for 28 days after discontinuation of study therapy.
    - Male subjects must: Practice true abstinence or agree to use a barrier contraception (male latex condom or non-latex condom NOT made out of natural [animal] membrane [for example, polyurethane]) during sexual contact with a pregnant female or a female of childbearing potential while participating in the study, during dose interruptions and for at least 90 days following investigational product discontinuation, even if he has undergone a successful vasectomy.
    •Male subjects must agree not to donate semen or sperm during therapy and for at least 90 days following the discontinuation of IP.
    •All subjects must:
    - Understand that the IP could have potential teratogenic risk.
    - Agree to abstain from donating blood while taking IP and for 28 days following discontinuation of the IP.
    - Agree not to share IP with another person.
    - Other than the subject, FCBP and males able to father a child should not handle the IP or touch the capsules unless gloves are worn.
    - Be counseled about pregnancy precautions and risks of fetal exposure as described in the Pregnancy Prevention Plan.
    Concomitant Medications
    •If taking steroids, subjects must be on oral corticosteroids (OCS) for at least 4 weeks prior to the Screening Visit, and maintained on a stable dose of ≤ 20 mg/d of prednisone or equivalent for at least 2 weeks prior to the Baseline Visit.
    •If taking hydroxychloroquine, quinacrine, chloroquine, methotrexate, leflunomide, sulfasalazine, mycophenolate mofetil, mycophenolic acid, azathioprine, 6-mercaptopurine, tacrolimus or cyclosporine, subjects must have been treated for 12 weeks prior to and be on a stable dose for at least 4 weeks prior to Baseline. NOTE: For subjects not taking, or are on unstable doses of antimalarials, methotrexate, sulfasalazine, leflunomide, tacrolimus, cyclosporine A, azathioprine, 6-mercaptopurine or mycophenalate, the last dose (in case of previous use) must be at least 8 weeks prior to the Baseline Visit.
    •Subjects taking daily doses of NSAIDs must be on a stable dose two weeks prior to the Screening Visit. Subjects taking NSAIDs or analgesics on an as needed basis must hold them 72 hours prior to the Baseline Visit.
    1.Varones o mujeres con una edad mínima de 18 años en el momento de firmar el documento de consentimiento informado. 2.Entender y firmar voluntariamente los documentos de consentimiento informado antes del inicio del estudio. 3.Ser capaz y estar dispuesto a cumplir el calendario de visitas del estudio y requisitos del protocolo.4.Que se les haya diagnosticado LES como mínimo 6 meses antes de la visita de selección y que cumplan la actualización de 1997 del American College of Rheumatology (ACR) en la V de selección. 5.Presentar una puntuación ≥ 6 puntos en la escala de SLEDAI-2K en la V de selección, de los que al menos cuatro puntos sean una puntación "clínica" del SLEDAI-2K. 6.En la visita basal, una puntuación clínica del SLEDAI-2K ≥ 4 puntos. 7.Resultado positivo para anticuerpos asociados al LES, incluido al menos uno de los siguientes en la fase de selección:•Análisis positivo de anticuerpos antinucleares (AAN) en el laboratorio central, con un valor de 1:80 o superior, asociado a un diagnóstico de LES.•Número de anticuerpos anti-ADNbc por encima del valor normal según el laboratorio central.•Número de anticuerpos anti-Smith (anti-Sm) por encima del valor normal según el laboratorio central.Embarazo : Se debe orientar a todos los varones y mujeres acerca de las precauciones con respecto al embarazo y los riesgos de la exposición fetal, como se describe en el plan de prevención del embarazo 8.Mujeres con capacidad de procrear (MCP):•Deberán contar con dos pruebas de embarazo negativas, verificadas por el investigador, antes de iniciar el tratamiento del estudio, una entre 10 y 14 días antes de la primera dosis de CC-220 y otra en el plazo de 24 horas antes de tomar la primera dosis de CC-220. Deberán aceptar someterse a pruebas de embarazo continuas durante el curso del estudio y después del final del tratamiento del estudio. Esto es aplicable incluso a las mujeres que practiquen la abstinencia real de relaciones heterosexuales. •Compromiso de abstinencia completa2 de relaciones heterosexuales (que debe revisarse cada mes y documentarse) o utilizar dos métodos anticonceptivos fiables simultáneamente. Uno de ellos debe ser un método muy eficaz y el otro un método eficaz adicional (de barrera) y ambos deben utilizarse sin interrupción durante 28 días antes de comenzar el producto en investigación, durante el tratamiento del estudio (incluidas las interrupciones del tratamiento) y durante 28 días después de la interrupción del tratamiento del estudio.9.Varones: Deberán mantener una abstinencia sexual completa2 o comprometerse a utilizar un método anticonceptivo de barrera (preservativo masculino de látex o de otro material que NO esté fabricado con membranas naturales [de origen animal], durante las relaciones sexuales con mujeres embarazadas o con capacidad para procrear mientras participen en el estudio, durante las interrupciones del tratamiento y durante al menos los 90 días posteriores a la suspensión del producto en investigación, incluso si se han sometido a una vasectomía con éxito.10.Los pacientes varones no deberán donar sangre, semen ni esperma durante el tratamiento ni durante al menos 90 días después de la interrupción del tratamiento con el PEI.11.Todos los sujetos deberán: •Saber que el PEI podría tener riesgo teratógeno. •Comprometerse a no donar sangre mientras reciban el PEI y durante 28 días tras la suspensión del PEI. •Comprometerse a no compartir el PEI con otras personas. •Las mujeres y los varones con capacidad de procrear que no participen en el estudio no deben manipular el PEI ni tocar las cápsulas, a menos que lleven guantes. •Recibir consejo sobre las precauciones con respecto al embarazo y los riesgos de la exposición fetal, como se describe en el plan de prevención del embarazo.12.En caso de tomar corticoides, los sujetos deberán haber seguido un tratamiento con corticoesteroides orales (CEO) durante un mínimo de 4 sem antes de la V de selección, y haber mantenido una dosis estable ≤ 20 mg/día de prednisona o equivalente durante un mínimo de 2 semanas antes de la visita basal. 13.Si toman hidroxicloroquina, quinacrina, cloroquina, metotrexato, leflunomida, sulfasalazina, micofenolato de mofetilo, ácido micofenólico, azatioprina, 6-mercaptopurina, tacrólimus o ciclosporina, el tratamiento deberá haber comenzado 12 semanas antes y los sujetos deberán haber mantenido una dosis estable durante un mínimo de 4 semanas antes del momento basal. Consulte los requisitos de administración. NOTA: En el caso de los sujetos que no estén en tratamiento o no tomen dosis estables de antipalúdicos, deberá administrarse como mínimo 8 semanas antes de la visita basal. 14.Los sujetos que tomen dosis diarias de AINE deberán haber mantenido una dosis estable desde dos semanas antes de la visita de selección (consulte los requisitos de administración) Los sujetos que tomen AINE o analgésicos cuando sea necesario deberán abstenerse de tomarlos durante las 72 horas anteriores a la visita basal
    E.4Principal exclusion criteria
    1.The subject has received:
    a.Cyclophosphamide within 3 months of the Baseline Visit. Previous use of Melphalan or other alkylating agents is prohibited.
    b.Etanercept within 4 weeks prior to the Baseline Visit.
    c.Belimumab within 3 months prior to the Baseline Visit.
    d.B-cell depleting or modulating agents, such as rituximab or anti-CD22 therapy, within one year prior to the Baseline Visit.
    e.Any other biologic or non-biologic immunosuppressive agent within 2 months of 5 pharmacokinetic half-lives (whichever is longer) prior to the Baseline Visit.
    2.The subject has been treated with intra-articular, intralesional, subcutaneous, intradermal, intramuscular or IV pulse corticosteroids 6 weeks prior to the Baseline Visit.
    3.The subject has received high potency topical corticosteroids within two weeks of the Screening Visit (only Class 6 or 7 are permitted).
    4.The subject has undergone plasmapheresis within 3 months of the Baseline Visit.
    5.The subject has received IV immunoglobulin within 3 months of the Baseline Visit.
    6.The subject has received strong inhibitors or inducers of CYP3A4/5 including grapefruit, St. John’s Wort or related products within two weeks prior to the Baseline Visit.
    7.The subject has a planned or received immunization with a live or live attenuated vaccine within 2 months prior to the Baseline Visit and for 2 months after administration of the last dose of IP.
    Disease Severity
    8.The subject has severe lupus nephritis defined as: estimated glomerular filtration rate (eGFR) of < 45 mL/1.73 m2 or proteinuria > 2000 mg/day if stable for the past 3 months, or proteinuria > 500 mg/day if unstable. Proteinuria will be based upon spot urine testing.
    9.The subject has active, severe or unstable neuropsychiatric lupus disease (e.g., poorly controlled seizure disorder, acute confusional state, myelitis, stroke or stroke syndrome, cerebellar ataxia or dementia related to SLE, psychosis, organic brain syndrome, cerebrovascular accident [CVA], cerebritis or CNS vasculitis), within 6 months of the Screening Visit.
    Concomitant Disease
    10.The subject has QTcF of > 450 milliseconds.
    11.The subject has a history of hepatitis B and/or hepatitis C.
    12.The subject has a confirmed positive test for Hepatitis B or Hepatitis C during the Screening Phase. Subjects with isolated positive hepatitis B surface antibody are not excluded.
    13.The subject has a history of congenital and/or acquired immunodeficiencies (eg, common variable immunodeficiency, human immunodeficiency virus [HIV], etc).
    14.The subject has active or history of recurrent bacterial, viral, fungal, mycobacterial or other infections, or any major episode of infection requiring hospitalization or treatment with intravenous or oral antibiotics within 4 weeks of the Screening Visit and at any time during the Screening Phase, up through the first dose of IP.
    15.The subject has a history of latent or active TB, unless there is medical record documentation of successful completion of a standard course of treatment per local guidelines.
    16.The subject has an abnormal chest radiograph with evidence of active infection or possible malignancy. Alternatively, PA or PA/lateral radiographs that were taken within the 3 months (or longer periods based on local health authority requirements) prior to the Screening Visit will be accepted for evaluation for participation in the study.
    17.The subject has malignancy or history of malignancy, except for:
    •treated (eg, cured) basal cell or squamous cell in situ skin carcinomas
    •treated (eg, cured) cervical intraepithelial neoplasia or carcinoma in situ of the cervix with no evidence of recurrence within 5 years of the Screening Visit.
    18.The subject has a diagnosis of Antiphospholipid Syndrome.
    19.The subject has any history of arterial or venous thrombosis within one year of the Screening Visit.
    20.The subject has a history or current diagnosis of peripheral neuropathy (sensory or motor) ≥ Grade 2.
    21.The subject has a presence of active uveitis or any other ophthalmological finding that in the opinion of the Investigator is clinically significant.
    22.The subject has dermatomyositis, polymyositis, scleroderma, rheumatoid arthritis or other non-SLE driven inflammatory joint or skin disease or overlap syndromes as the primary disease.
    23.Laboratory criteria:
    •Neutrophil count < 1.0 x 109/L
    •White blood cell (WBC) count ≤ 2500 /µL (≤ 2.5 X 109/L) or > 20,000/µL (> 20 X 109/L)
    •Lymphocyte count ≤ 500/mm3 or 0.5 x 109/L
    •Platelet count ≤ 75 x 109/L and > 550 x 109/L
    •Hemoglobin < 8g/dL or > 18 g/dL
    •Serum creatinine > 1.8 mg/dL (> 159.12 µmol/L)
    •Total bilirubin > 2 x ULN
    •Aspartate transaminase (AST [serum glutamic oxaloacetic transaminase, SGOT]) > 2 x upper limit of normal (ULN)
    •Alanine transaminase (ALT [serum glutamic pyruvic transaminase, SGPT]) > 2 x upper limit of normal (ULN)
    1.El sujeto ha recibido a.Ciclofosfamida en los 3 meses previos a la V basal. Está prohibido el uso previo de melfalán y otros alquilantes.b.Etanercept en el plazo de 4 semanas antes de la V basal.c.Belimumab en el plazo de 3 meses antes de la V basal.d.Agentes reductores o reguladores de linfocitos B, como rituximab o tratamientos anti-CD22, en un año antes de la visita basal.e.Otros agentes inmunosupresores biológicos o no biológicos en el plazo de 2 meses o 5 semividas farmacocinéticas (lo que suponga más tiempo) antes de la V basal.2.El sujeto ha recibido tto con corticoesteroides . 6 semanas antes de la visita basal. 3.El sujeto ha recibido corticoesteroides tópicos de alta potencia en el plazo de dos semanas antes de la visita de selección (solo se permiten los de los grupos 6 o 4.El sujeto se ha sometido a plasmaféresis en el plazo de 3 meses antes de la V basal.5.El sujeto ha recibido inmunoglobulina 3 meses antes de la visita basal.6.El sujeto ha recibido inhibidores o inductores potentes de la enzima CYP3A4/5, como pomelo, hierba de San Juan o productos relacionados, dos semanas antes de la V basal 8.Está previsto que el sujeto reciba o ya ha recibido una vacuna de virus vivos o atenuados en los 2 meses antes a la V basal y durante los 2 meses despues a la administración de la última dosis del PEI.9.El sujeto sufre nefritis lúpica grave definida como: una tasa de filtración glomerular estimada (FGe) inferior a 45 ml/1,73 m2 o proteinuria superior a 2000 mg/día si se ha mantenido estable durante los 3 meses previos, o proteinuria superior a 500 mg/día si ha sido inestable. La proteinuria se basará en análisis de muestras puntuales de orina.10.El sujeto sufre lupus neuropsiquiátrico activo, grave o inestable 6 semanas antes de la visita de selección. 11.El sujeto presenta un QTcF > 450 milisegundos.12.El sujeto tiene antecedentes de hepatitis B o C.13. El sujeto cuenta con un resultado positivo confirmado de un análisis de hepatitis B o C realizado durante la fase de selección No se excluirá a los sujetos con resultado positivo para anticuerpos de superficie del virus de la hepatitis B aislados.14.El sujeto tiene antecedentes de inmunodeficiencia congénita o adquirida . 15.El sujeto presenta o ha presentado infecciones recurrentes bacterianas, víricas, fúngicas, por micobacterias o de otro tipo o cualquier otro episodio importante de infección que haya precisado hospitalización o tratamiento con antibióticos intravenosos u orales en el plazo de 4 semanas antes de la visita de selección y en cualquier momento durante la fase de selección, hasta la primera dosis del PEI.16.El sujeto presenta antecedentes de TB activa o latente, a menos que en la historia clínica conste la finalización satisfactoria de un ciclo estándar de tratamiento según las directrices locales. 17.El sujeto presenta una radiografía de tórax anómala con signos de infección activa o posible neoplasia maligna. Como alternativa, se aceptarán como evaluación para la participación en el estudio las radiografías PA o PA/laterales que se hayan realizado en el plazo de 3 meses (o períodos más largos, en función de los requisitos de las autoridades sanitarias locales) antes de la visita de selección. 19.El sujeto sufre neoplasia maligna o presenta antecedentes de neoplasias malignas, excepto:•Carcinomas basocelulares o epidermoides de piel localizados tratados (es decir, curados). •Neoplasia intraepitelial cervicouterina tratada (es decir, curada) o carcinoma de cuello uterino localizado sin signos de recidiva en los 5 años previos a la visita de selección.20.Al sujeto se le ha diagnosticado síndrome antifosfolipídico (consulte los criterios del SAAF en el Error! Reference source not found.)21.El sujeto presenta antecedentes de trombosis arterial o venosa en el año previo a la visita de selección.22.El sujeto tiene antecedentes o diagnóstico actual de neuropatía periférica (sensitiva o motora) de grado ≥ 2 23.El sujeto presenta uveítis activa u otro hallazgo oftalmológico que, según el criterio del investigador, es clínicamente significativo.25.El sujeto padece dermatomiositis, polimiositis, esclerodermia, artritis reumatoide u otras enfermedades inflamatorias de la piel o las articulaciones no provocadas por el LES u otros síndromes mixtos del tejido conjuntivo como enfermedad principal.27.•Recuento de neutrófilos < 1,0 x 109/l•Recuento de leucocitos ≤ 2500/µl (≤ 2,5 X 109/l) o > 20 000/µl (> 20 X 109/l)•Recuento de linfocitos ≤ 500/mm3 o 0,5 x 109/l •Recuento de plaquetas ≤ 75 x 109/l y > 550 x 109/l•Hemoglobina < 8 g/dl o > 18 g/dl
    •Creatinina sérica > 1,8 mg/dl (> 159,12 µmol/l) •Bilirrubina total > 2 x LSN•Aspartato aminotransferasa (AST [glutámico-oxalacético aminotransferasa sérica, SGOT]) > 2 x límite superior de la normalidad (LSN) • Alanina aminotransferasa (ALT [glutámico-pirúvico aminotransferasa sérica, SGPT]) > 2 x límite superior de la normalidad (LSN)
    E.5 End points
    E.5.1Primary end point(s)
    SRI(4) response
    Índice de respuesta de LES (SRI) (4)
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 24
    Semana 24
    E.5.2Secondary end point(s)
    SRI(4)
    SLEDAI 2K
    CLASI
    BILAG
    Joint Counts
    PGA
    Fatigue
    BILAG
    Corticosteroid Reduction
    Flare
    SLE Damage
    SRI(4)
    SLEDAI 2K
    CLASI
    BILAG
    Recuento de articulaciones
    PGA
    Cansancio
    BILAG
    Reduccion de Corticoestoroides
    Exacerbación
    SLE Damage
    E.5.2.1Timepoint(s) of evaluation of this end point
    SRI(4): Week 52
    SLEDAI 2K: Week 24 and Week 52
    CLASI: Week 24 and Week 52
    BILAG: Week 24 and Week 52
    Joint Counts: Week 24 and Week 52
    PGA: Week 24 and Week 52
    Fatigue: Week 24 and Week 52
    BILAG: Week 24 and Week 52
    Corticosteroid Reduction: Week 24 and Week 52
    Flare: All visits
    SLE Damage: Week 52
    SRI(4): semana 52
    SLEDAI 2K: Semana 24 y Semana 52
    CLASI: Semana 24 y Semana 52
    BILAG: Semana 24 y Semana 52
    Joint Counts: Semana 24 y Semana 52
    PGA: Semana 24 y Semana 52
    Cansancio : Semana 24 y Semana 52
    BILAG: Semana 24 y Semana 52
    Reducción de los corticosesteroides: Semana 24 y Semana 52
    Exacerbación: Todas las Visitas
    Daño del LES: Semana 52
    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 Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    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 trial4
    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 EEA43
    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
    Belgium
    Brazil
    Canada
    Colombia
    Germany
    Hungary
    Italy
    Mexico
    Poland
    Russian Federation
    Serbia
    Spain
    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
    The End of Trial is defined as either the date of the last visit of the last subject to complete the post-treatment follow-up, or the date of receipt of the last data point from the last subject that is required for primary, secondary and/or exploratory analysis, as pre-specified in the protocol, whichever is the later date.
    El final del ensayo se define como la fecha de la última visita del último sujeto que finalice el seguimiento posterior al tratamiento o la fecha de recepción de los últimos datos correspondientes al último sujeto que sean necesarios para los análisis principales, secundarios o exploratorios, tal como se establece en el protocolo, la que sea posterior.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months2
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months2
    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: 250
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 30
    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 97
    F.4.2.2In the whole clinical trial 280
    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)
    A long-term extension study is planned to be implemented to provide CC-220 for those subjects who derived benefit from CC-220 during the CC-220-SLE-002 study and for whom it is medically appropriate to continue to receive drug.
    Se planea un estudio de extensión a largo plazo que sera puesto en marcha para proporcionar CC-220 para aquellos sujetos tuvieron beneficio del CC-220 en el estudio CC-220-SLE-002 y para quien es médicamente apropiado seguir recibiéndolo.
    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 Decision2017-06-08
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-05-19
    P. End of Trial
    P.End of Trial StatusOngoing
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