Clinical Trial Results:
A Multi-Center, Open-Label Trial to Evaluate the Pharmacokinetics, Safety, and Pharmacodynamics of Subcutaneously Administered Belimumab, a Human Monoclonal Anti-BLyS Antibody, Plus Standard Therapy in Pediatric Participants with Systemic Lupus Erythematosus (SLE)
Summary
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EudraCT number |
2018-004645-16 |
Trial protocol |
DE NL ES |
Global end of trial date |
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Results information
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Results version number |
v2(current) |
This version publication date |
17 Mar 2024
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First version publication date |
01 Feb 2024
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Other versions |
v1 |
Version creation reason |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
200908
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT04179032 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
GlaxoSmithKline
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Sponsor organisation address |
980 Great West Road, Brentford,Middlesex, United Kingdom, TW8 9GS
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Public contact |
GSK Response Center, GlaxoSmithKline, 1 8664357343, GSKClinicalSupportHD@gsk.com
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Scientific contact |
GSK Response Center, GlaxoSmithKline, 1 8664357343, GSKClinicalSupportHD@gsk.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
Yes
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EMA paediatric investigation plan number(s) |
EMEA-000313-PIP20-20 | ||
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
Yes
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Results analysis stage
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Analysis stage |
Interim
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Date of interim/final analysis |
16 Jan 2023
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
16 Jan 2023
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Global end of trial reached? |
No
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General information about the trial
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Main objective of the trial |
To characterize the PK profile of belimumab 200 mg SC in pediatric SLE participants.
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Protection of trial subjects |
None
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
28 Nov 2019
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Long term follow-up planned |
Yes
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Long term follow-up rationale |
Efficacy, Safety, Scientific research | ||
Long term follow-up duration |
3 Years | ||
Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Argentina: 4
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Country: Number of subjects enrolled |
Germany: 4
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Country: Number of subjects enrolled |
Japan: 2
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Country: Number of subjects enrolled |
Mexico: 3
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Country: Number of subjects enrolled |
Netherlands: 2
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Country: Number of subjects enrolled |
Spain: 6
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Country: Number of subjects enrolled |
United States: 4
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Worldwide total number of subjects |
25
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EEA total number of subjects |
12
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
3
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Adolescents (12-17 years) |
22
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Adults (18-64 years) |
0
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
The primary study included Part A which is an open label 12-week treatment phase and Part B an optional 40-week open-label continuation phase, open to all participants who have completed Part A. An optional access extension phase is ongoing and additional data will be provided after study completion date is achieved. | ||||||||||||
Pre-assignment
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Screening details |
A total of 28 participants were screened and 25 were enrolled to the study. | ||||||||||||
Period 1
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Period 1 title |
Part A (Up to Week 12)
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Is this the baseline period? |
Yes | ||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | ||||||||||||
Arms
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Arm title
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Belimumab 200 mg | ||||||||||||
Arm description |
Participants with Systemic Lupus Erythematosus were administered with Belimumab 200 milligram per milliliter (mg/mL) subcutaneous (SC) injection. The dosing frequency was based on body weight. Participants who weigh more than or equal to 50 kilograms were administered every week, who weigh between 30 to less than 50 kg were administered every 10 days and who weigh less than 30 kg were administered every 2 weeks. | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
Belimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled pen
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Cohort 1 (≥50 kg): 200 mg weekly
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Investigational medicinal product name |
Belimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled pen
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Cohort 3 (<30 kg): 200 mg every 2 weeks
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Investigational medicinal product name |
Belimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled pen
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Cohort 2 (≥ 30 kg - <50 kg): 200 mg every 10 days
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Period 2
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Period 2 title |
Part B (Up to Week 52)
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Is this the baseline period? |
No | ||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | ||||||||||||
Arms
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Arm title
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Belimumab 200 mg | ||||||||||||
Arm description |
Participants with Systemic Lupus Erythematosus were administered with Belimumab 200 milligram per milliliter (mg/mL) subcutaneous (SC) injection. The dosing frequency was based on body weight. Participants who weigh more than or equal to 50 kilograms were administered every week, who weigh between 30 to less than 50 kg were administered every 10 days and who weigh less than 30 kg were administered every 2 weeks. | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
Belimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled pen
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Cohort 1 (≥50 kg): 200 mg weekly
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Investigational medicinal product name |
Belimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled pen
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Cohort 3 (<30 kg): 200 mg every 2 weeks
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Investigational medicinal product name |
Belimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled pen
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Cohort 2 (≥ 30 kg - <50 kg): 200 mg every 10 days
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Period 3
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Period 3 title |
Access Extension Phase
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Is this the baseline period? |
No | ||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | ||||||||||||
Arms
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Arm title
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Belimumab 200 mg | ||||||||||||
Arm description |
Participants with Systemic Lupus Erythematosus were administered with Belimumab 200 milligram per milliliter (mg/mL) subcutaneous (SC) injection. The dosing frequency was based on body weight. Participants who weigh more than or equal to 50 kilograms were administered every week, who weigh between 30 to less than 50 kg were administered every 10 days and who weigh less than 30 kg were administered every 2 weeks. | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
Belimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled pen
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Cohort 1 (≥50 kg): 200 mg weekly
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Investigational medicinal product name |
Belimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled pen
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Cohort 3 (<30 kg): 200 mg every 2 weeks
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Investigational medicinal product name |
Belimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled pen
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Cohort 2 (≥ 30 kg - <50 kg): 200 mg every 10 days
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Notes [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period. Justification: A total of 28 participants were screened and 25 were enrolled to the study. The primary study included Part A which is an open label 12-week treatment phase and Part B an optional 40-week open-label continuation phase, open to all participants who have completed Part A. An optional access extension phase is ongoing. |
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Baseline characteristics reporting groups
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Reporting group title |
Belimumab 200 mg
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Reporting group description |
Participants with Systemic Lupus Erythematosus were administered with Belimumab 200 milligram per milliliter (mg/mL) subcutaneous (SC) injection. The dosing frequency was based on body weight. Participants who weigh more than or equal to 50 kilograms were administered every week, who weigh between 30 to less than 50 kg were administered every 10 days and who weigh less than 30 kg were administered every 2 weeks. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Belimumab 200 mg
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Reporting group description |
Participants with Systemic Lupus Erythematosus were administered with Belimumab 200 milligram per milliliter (mg/mL) subcutaneous (SC) injection. The dosing frequency was based on body weight. Participants who weigh more than or equal to 50 kilograms were administered every week, who weigh between 30 to less than 50 kg were administered every 10 days and who weigh less than 30 kg were administered every 2 weeks. | ||
Reporting group title |
Belimumab 200 mg
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Reporting group description |
Participants with Systemic Lupus Erythematosus were administered with Belimumab 200 milligram per milliliter (mg/mL) subcutaneous (SC) injection. The dosing frequency was based on body weight. Participants who weigh more than or equal to 50 kilograms were administered every week, who weigh between 30 to less than 50 kg were administered every 10 days and who weigh less than 30 kg were administered every 2 weeks. | ||
Reporting group title |
Belimumab 200 mg
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Reporting group description |
Participants with Systemic Lupus Erythematosus were administered with Belimumab 200 milligram per milliliter (mg/mL) subcutaneous (SC) injection. The dosing frequency was based on body weight. Participants who weigh more than or equal to 50 kilograms were administered every week, who weigh between 30 to less than 50 kg were administered every 10 days and who weigh less than 30 kg were administered every 2 weeks. | ||
Subject analysis set title |
Belimumab 200 mg
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Subject analysis set type |
Intention-to-treat | ||
Subject analysis set description |
Participants with Systemic Lupus Erythematosus were administered with Belimumab 200 milligram per milliliter (mg/mL) subcutaneous (SC) injection. The dosing frequency was based on body weight. Participants who weigh more than or equal to 50 kilograms were administered every week, who weigh between 30 to less than 50 kg were administered every 10 days and who weigh less than 30 kg were administered every 2 weeks.
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End point title |
Observed belimumab concentrations at Week 12 [1] | ||||||||
End point description |
Blood samples were collected for analysis of belimumab concentration. The analysis was performed on the pharmacokinetic (PK) Set that included all participants assigned treatment who received at least one dose of study treatment and for whom at least one post belimumab treatment PK sample was obtained and analyzed.
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End point type |
Primary
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End point timeframe |
At Week 12
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Notes [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: This endpoint was descriptive; hence no statistical analysis to report. |
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No statistical analyses for this end point |
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End point title |
Estimated average concentration (Cavg) of belimumab at steady state [2] | ||||||||
End point description |
Blood samples were collected for measurement of serum concentrations of belimumab at steady state. Average concentrations were analyzed and reported for all time-points from Week 1 through Week 60. The analysis was performed on the PK Set that included all participants assigned treatment who received at least one dose of study treatment and for whom at least one post belimumab treatment PK sample was obtained and analyzed.
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End point type |
Primary
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End point timeframe |
Pre dose on Week 1, Week 2, Week 4, Week 8, Week 12, Week 16, Week 24, Week 36, Week 52, and Week 60
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Notes [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: This endpoint was descriptive; hence no statistical analysis to report. |
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No statistical analyses for this end point |
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End point title |
Estimated maximum concentration (Cmax) of belimumab at steady state [3] | ||||||||
End point description |
Blood samples were collected for measurement of serum concentrations of belimumab at steady state. Cmax was analyzed and reported for all time-points from Week 1 through Week 60The analysis was performed on the PK Set that included all participants assigned treatment who received at least one dose of study treatment and for whom at least one post belimumab treatment PK sample was obtained and analyzed.
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End point type |
Primary
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End point timeframe |
Pre dose on Week 1, Week 2, Week 4, Week 8, Week 12, Week 16, Week 24, Week 36, Week 52, and Week 60
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Notes [3] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: This endpoint was descriptive; hence no statistical analysis to report. |
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No statistical analyses for this end point |
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End point title |
Estimated minimum concentration (Cmin) of belimumab at steady state [4] | ||||||||
End point description |
Blood samples were collected for measurement of serum concentrations of belimumab at steady state. Cmin was analyzed and reported for all time-points from Week 1 through Week 60 The analysis was performed on the PK Set that included all participants assigned treatment who received at least one dose of study treatment and for whom at least one post belimumab treatment PK sample was obtained and analyzed.
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End point type |
Primary
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End point timeframe |
Pre dose on Week 1, Week 2, Week 4, Week 8, Week 12, Week 16, Week 24, Week 36, Week 52, and Week 60
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Notes [4] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: This endpoint was descriptive; hence no statistical analysis to report. |
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No statistical analyses for this end point |
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End point title |
Number of participants with adverse events (AEs) | ||||||
End point description |
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study intervention, whether or not considered related to the study intervention. The safety analysis was performed on the Intent-To-Treat (ITT) set that included all participants assigned treatment who received at least one dose of study treatment.
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End point type |
Secondary
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End point timeframe |
Up to Week 68
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No statistical analyses for this end point |
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End point title |
Number of participants with serious adverse events (SAEs) | ||||||
End point description |
A SAE is any untoward medical occurrence that, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent disability/incapacity and/or can result in death. The safety analysis was performed on the Intent-To-Treat (ITT) set that included all participants assigned treatment who received at least one dose of study treatment.
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End point type |
Secondary
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End point timeframe |
Up to Week 68
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No statistical analyses for this end point |
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End point title |
Number of participants with adverse events of special interest (AESIs) | ||||||||||||||
End point description |
AESI included post-injection systemic reactions and hypersensitivity reactions, infections, malignancies, and depression/suicidality/self-injury. AESIs were followed until the event is resolved, stabilized, otherwise explained, or the participant is lost to follow-up. The safety analysis was performed on the Intent-To-Treat (ITT) set that included all participants assigned treatment who received at least one dose of study treatment.
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End point type |
Secondary
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End point timeframe |
Up to Week 68
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No statistical analyses for this end point |
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End point title |
Percent Change from Baseline in anti-double stranded deoxyribonucleic acid (dsDNA) Antibodies at Week 12 and Week 52 | ||||||||||||
End point description |
Blood samples were collected for anti-dsDNA- antibody biomarker analysis. Baseline status are defined as positive (Anti-dsDNA antibody >= 30 International Units Per Milliliter (IU/mL)) or negative (Anti-dsDNA antibody< 30 IU/mL). Percent change from Baseline was calculated by subtracting the Baseline value from value at Week 12 and 52 divided by the Baseline value X 100. The analysis was performed on the ITT set that included all participants assigned treatment who received at least one dose of study treatment. Participants who had positive anti-dsDNA antibody levels at baseline were included in the analysis.
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End point type |
Secondary
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End point timeframe |
Baseline (Day 1), Week 12 and Week 52
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No statistical analyses for this end point |
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End point title |
Percent Change from Baseline in Complement C3 and Complement C4 at Week 12 and Week 52 | ||||||||||||||||
End point description |
Blood samples were collected from participants to assess complement C3 and complement C4 levels. Baseline status are defined as low complement [C3 less than (<) 90 milligrams per deciliter (mg/dL)] or normal/high (C3 >= 90 mg/dL) and low (C4 < 13 mg/dL) or normal/high (C4 >= 13 mg/dL) respectively. Percent change from Baseline was calculated by subtracting the Baseline value from value at Week 12 and 52 divided by the Baseline value X 100. The analysis was performed on the ITT set that included all participants assigned treatment who received at least one dose of study treatment. Participants who had low baseline C3 and C4 levels were included in the respective analysis. Number of participants analyzed signifies those participants who were evaluable for this outcome measure.
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End point type |
Secondary
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End point timeframe |
Baseline (Day 1), Week 12 and Week 52
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No statistical analyses for this end point |
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End point title |
Percent Change from Baseline in CD19+ Total B cells and CD20+ B Cells at Week 12 and Week 52 | ||||||||||||||||
End point description |
Blood samples were collected for biomarker analysis. B cell subsets included CD19+ total B cells and CD 20+ B cells. Percent change from Baseline was calculated by subtracting the Baseline value from value at Week 12 and 52 divided by the Baseline value X 100. The analysis was performed on the ITT set that included all participants assigned treatment who received at least one dose of study treatment. Number of participants analyzed signifies those participants who were evaluable for this outcome measure.
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End point type |
Secondary
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End point timeframe |
Baseline (Day 1), Week 12 and Week 52
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No statistical analyses for this end point |
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End point title |
Percent Change from Baseline in Naïve B Cells and Memory B Cells at Week 12 and Week 52 | ||||||||||||||||
End point description |
Blood samples were collected for biomarker analysis and included CD20+ CD27- Naïve B cells and CD20+ CD27+ memory B cells. Percent change from Baseline was calculated by subtracting the Baseline value from value at Week 12 and 52 divided by the Baseline value X 100. The analysis was performed on the ITT set that included all participants assigned treatment who received at least one dose of study treatment.
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End point type |
Secondary
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End point timeframe |
Baseline (Day 1), Week 12 and Week 52
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No statistical analyses for this end point |
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End point title |
Percent Change from Baseline in Immunoglobulin A (IgA), Immunoglobulin G (IgG) and Immunoglobulin M (IgM) at Week 12 | ||||||||||||||
End point description |
Blood samples were collected for analysis of immunoglobulins: Immunoglobulin A (IgA), Immunoglobulin G (IgG), and Immunoglobulin M (IgM). Percent change from Baseline was calculated by subtracting the Baseline value from value at Week 12 divided by the Baseline value X 100. The analysis was performed on the ITT set that included all participants assigned treatment who received at least one dose of study treatment.
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End point type |
Secondary
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End point timeframe |
Baseline (Day 1) and Week 12
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No statistical analyses for this end point |
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End point title |
Percent Change from Baseline in in CD27bright CD38bright Plasma blasts at Week 12 and Week 52 | ||||||||||||
End point description |
Blood samples were collected for CD27bright CD38bright Plasma blasts biomarker analysis. Percent change from Baseline was calculated by subtracting the Baseline value from value at Week 12 and 52 divided by the Baseline value X 100. The analysis was performed on the ITT set that included all participants assigned treatment who received at least one dose of study treatment.
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End point type |
Secondary
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End point timeframe |
Baseline (Day 1), Week 12 and Week 52
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No statistical analyses for this end point |
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End point title |
Percent Change from Baseline in Immunoglobulin A (IgA), Immunoglobulin G (IgG) and Immunoglobulin M (IgM) at Week 52 | ||||||||||||||
End point description |
Blood samples were collected for analysis of immunoglobulins: Immunoglobulin A (IgA), Immunoglobulin A (IgG), and Immunoglobulin M (IgM). Percent change from Baseline was calculated by subtracting the Baseline value from value at Week 52 divided by the Baseline value X 100. The analysis was performed on the ITT set that included all participants assigned treatment who received at least one dose of study treatment.
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End point type |
Secondary
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End point timeframe |
Baseline (Day 1) and Week 52
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Up to Week 68 (treatment: up to 52 weeks [12 weeks Part A plus 40 weeks Part B extension phase] and follow-up: 16 weeks)
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Adverse event reporting additional description |
The safety analysis was based on the Intent-To-Treat set that comprised of all participants assigned treatment who received at least one dose of study treatment.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
25.1
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Reporting groups
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Reporting group title |
Belimumab 200 mg
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Reporting group description |
Participants with Systemic Lupus Erythematosus were administered with Belimumab 200 milligram per milliliter (mg/mL) subcutaneous (SC) injection. The dosing frequency was based on body weight. Participants who weigh more than or equal to 50 kilograms were administered every week, who weigh between 30 to less than 50 kg were administered every 10 days and who weigh less than 30 kg were administered every 2 weeks. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 2% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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29 Apr 2019 |
Original protocol (00) |
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24 Jul 2019 |
Amendment 1 |
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24 Apr 2020 |
Amendment 2 |
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14 Jul 2021 |
Amendment 3 |
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14 Dec 2022 |
Amendment 4 |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |