E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Active Systemic Lupus Erythematosus
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E.1.1.1 | Medical condition in easily understood language |
Active Systemic Lupus Erythematosus |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10042945 |
E.1.2 | Term | Systemic lupus erythematosus |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of nipocalimab vs placebo in participants with active systemic lupus erythematosus (SLE) |
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E.2.2 | Secondary objectives of the trial |
1. To evaluate the safety and tolerability of nipocalimab vs placebo in participants with active SLE 2. To evaluate the pharmacokinetics (PK) and immunogenicity of nipocalimab in participants with active SLE |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-Male or female, 18 to 65 years of age (inclusive) at the time of consent. -Has a clinical diagnosis of SLE ≥6 months prior to the screening visit and according to Systemic Lupus International Collaborating Clinics (SLICC)-2012 classification criteria: at least 4 criteria fulfilled, with at least one clinical criterion AND one immunologic criterion. -Has at least 1 BILAG A and/or 2 BILAG B scores observed during screening. -Must have at least moderately active SLE, as defined as SLEDAI-2K score ≥6 at screening visit. Must also have SLEDAI 2K ≥4 for clinical features (ie, SLEDAI-2K score excluding headache and laboratory abnormalities) present at Week 0 prior to randomization. -Must be receiving one or more of the following protocol-permitted, systemic standard-of-care treatments: a) Oral GCs (average daily dose ≤20 mg of prednisone or equivalent) for ≥6 weeks and at a stable dose ≥4 weeks prior to first administration of study intervention. If currently not using oral GCs, must not have received them for ≥6 weeks prior to the first administration of study intervention. b) Antimalarials (≤250 mg/day chloroquine, ≤400 mg/day hydroxychloroquine, and/or ≤100 mg/day quinacrine) at a stable dose for ≥12 weeks prior to first administration of study intervention. c) If using one or more of the following immunomodulatory drugs, must be on a stable dose for ≥8 weeks prior to first administration of study intervention: • Mycophenolate mofetil (MMF) ≤2 g/day • Mycophenolic acid (MPA) ≤1.5 g/day • Azathioprine (AZA)/6 mercaptopurine (6-MP) ≤2 mg/kg/day; up to 100 mg/day for participants weighing ≤50 kg • Oral methotrexate (MTX) ≤25 mg/week or SC or intramuscular (IM) MTX ≤20 mg/week with concomitant folic acid or folinic acid. No more than 2 immunomodulatory drugs listed above (MMF, MPA, AZA, 6-MP, MTX) is allowed. |
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E.4 | Principal exclusion criteria |
-Current or history of, severe, progressive, or uncontrolled renal disease, with the exception of active LN. Have severe active LN as determined by sponsor (or designee) adjudication. Control of renal disease must be documented with at least 2 measurements of proteinuria or UPCR over the 6 months prior to screening. -Anticipated to require dialysis within 6 months. -Comorbidities (other than SLE, eg, asthma, chronic obstructive pulmonary disease) which have required 3 or more courses of systemic GCs within the previous 12 months and likely to require multiple courses of GCs within 6 months. -Has any unstable or progressive manifestation of SLE ble or progressive manifestation of SLE -Confirmed or suspected inflammatory diseases that might confound the evaluations of efficacy, including but not limited to rheumatoid arthritis (RA), psoriatic arthritis, RA/lupus overlap, psoriasis, Crohn's disease, or active Lyme disease. Sponsor (or designee) adjudication will determine the final suitability of the potential participant with suspected inflammatory diseases to participate in the study before the participant is randomized. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of participants achieving an SLE Responder Index (SRI)-4 composite response |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
1. Proportion of participants with baseline active mucocutaneous lupus manifestations (Cutaneous Lupus Erythematosus Disease Area and Severity Index [CLASI] activity score ≥6) achieving ≥50% reduction in the CLASI) activity score 2. Proportion of participants with baseline arthritis (with at least 4 active joints at baseline) achieving ≥50% reduction in active joints 3. Proportion of participants with ≥4 point improvement in SLE disease activity index 2000 (SLEDAI-2K) 4. Proportion of participants achieving the British Isles Lupus Assessment Group (BILAG) Composite Lupus Assessment (BICLA) response 5. Time to first flare, with flare defined as either 1 or more new BILAG A or 2 or more new BILAG B scores 6. Proportion of participants achieving SRI-4 composite response 7. Proportion of participants receiving ≥10 mg/day prednisone or equivalent at baseline who achieve Week 6 – 16 glucocorticoid (GC) taper goal (at Week 16 to ≤7.5 mg/day prednisone or equivalent) and maintain that reduction 8. Proportion of participants with treatment emergent adverse events (AEs) 9. Proportion of participants with treatment emergent serious adverse events (SAEs) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Week 24 2. Week 24 3. Week 24 4. Week 24 5. Week 24 6. Week 52 7. Week 24 8. Through Week 58 9. Through Week 58 |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Immunogenicity and tolerability |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 9 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 17 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Argentina |
Colombia |
Ukraine |
Hong Kong |
Taiwan |
Japan |
Russian Federation |
South Africa |
United States |
Bulgaria |
Germany |
Hungary |
Poland |
Spain |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 5 |
E.8.9.1 | In the Member State concerned days | 23 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 8 |
E.8.9.2 | In all countries concerned by the trial days | 29 |