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    Summary
    EudraCT Number:2021-004648-27
    Sponsor's Protocol Code Number:MS200569_0003
    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:2021-11-19
    Trial 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 number2021-004648-27
    A.3Full title of the trial
    A Phase II, Randomized, Double-Blind, Placebo Controlled Dose-Ranging, Parallel and Adaptive Study to Evaluate the Efficacy and Safety of Enpatoran in Systemic Lupus Erythematosus and in Cutaneous Lupus Erythematosus (Subacute Cutaneous Lupus Erythematosus and/or Discoid Lupus Erythematosus) Participants Receiving Standard of Care
    Estudio en fase II, aleatorizado, doble ciego, de búsqueda de dosis, controlado con placebo, de grupos paralelos y adaptativo para evaluar la eficacia y la seguridad de enpatoran en participantes con lupus eritematoso sistémico y con lupus eritematoso cutáneo (lupus eritematoso cutáneo subagudo o lupus eritematoso discoide) que toman el tratamiento de referencia
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Study of Enpatoran in Patients With Systemic Lupus Erythematosus and
    Cutaneous Lupus Erythematosus
    Un estudio de enpatoran en pacientes con lupus eritematoso sistémico y lupus eritematoso cutáneo
    A.3.2Name or abbreviated title of the trial where available
    WILLOW
    A.4.1Sponsor's protocol code numberMS200569_0003
    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 SponsorMerck Healthcare KGaA
    B.1.3.4CountryGermany
    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 supportMerck Healthcare KGaA
    B.4.2CountryGermany
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMerck Healthcare KGaA
    B.5.2Functional name of contact pointCommunication Center
    B.5.3 Address:
    B.5.3.1Street AddressFrankfurter Str. 250
    B.5.3.2Town/ cityDarmstadt
    B.5.3.3Post code64293
    B.5.3.4CountryGermany
    B.5.4Telephone number+34900810 844
    B.5.5Fax number+496151722000
    B.5.6E-mailservice@merckgroup.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameEnpatoran 25mg
    D.3.2Product code M5049
    D.3.4Pharmaceutical form Film-coated tablet
    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 INNEnpatoran
    D.3.9.1CAS number 2101938-42-3
    D.3.9.2Current sponsor codeM5049
    D.3.9.4EV Substance CodeSUB215545
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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 placeboFilm-coated tablet
    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 (SLE) and cutaneous lupus erythematosus (CLE)
    Lupus eritematoso sistémico (LES) y Lupus eritematoso cutáneo (LEC)
    E.1.1.1Medical condition in easily understood language
    Systemic lupus erythematosus (SLE) and cutaneous lupus
    erythematosus (CLE)
    Lupus eritematoso sistémico (LES) y Lupus eritematoso cutáneo (LEC)
    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 21.1
    E.1.2Level PT
    E.1.2Classification code 10056509
    E.1.2Term Cutaneous lupus erythematosus
    E.1.2System Organ Class 10040785 - Skin and subcutaneous tissue disorders
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10042945
    E.1.2Term Systemic lupus erythematosus
    E.1.2System Organ Class 10028395 - Musculoskeletal and connective tissue disorders
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10057903
    E.1.2Term Subacute cutaneous lupus erythematosus
    E.1.2System Organ Class 10040785 - Skin and subcutaneous tissue disorders
    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 dose-response relationship of enpatoran in reducing disease activity based on Cutaneous Lupus Erythematosus Disease Area and Severity Index-A (CLASI-A)

    To evaluate the dose-response relationship of enpatoran in reducing disease activity based on BILAG-Based Composite Lupus Assessment (BICLA) response rate
    Evaluar la relación dosis-respuesta de enpatoran para reducir la actividad de la enfermedad según el Índice A de gravedad y área de la enfermedad del lupus eritematoso cutáneo (Cutaneous Lupus Erythematosus Disease Area and Severity Index-A, CLASI-A).

    Evaluar la relación dosis-respuesta de enpatoran en la reducción de la actividad de la enfermedad según la tasa de respuesta de la evaluación del lupus combinada basada en BILAG (BICLA)
    E.2.2Secondary objectives of the trial
    To evaluate the safety and tolerability of enpatoran compared to placebo

    To evaluate the efficacy in disease control of enpatoran compared to placebo in lupus participants with active lupus rash

    To demonstrate the effect of enpatoran compared with placebo on achieving both BICLA response and clinically meaningful CS reduction in SLE participants on prednisone ≥ 10 mg at Day 1

    To evaluate the efficacy in disease control of enpatoran compared to placebo in lupus participants with predominantly active lupus rash

    To evaluate the efficacy in disease control of enpatoran compared to placebo in participants with active SLE

    To evaluate the efficacy of enpatoran compared to placebo in patient-reported symptoms and functional status, in lupus participants with active lupus rash

    To evaluate the efficacy of enpatoran compared to placebo in patient-reported symptoms, in participants with active SLE
    Evaluar seguridad y tolerabilidad d enpatoran en comparación con placebo.Evaluar eficacia en control d la enfermedad d enpatoran comparado con placebo en participantes con lupus con erupción cutánea lúpica activa
    Demostrar efecto d enpatoran comparado con placebo en la consecución d la respuesta BICLA y la reducción clínicamente significativa d corticoesteroides en participantes con LES en tratamiento con ≥10mg d prednisona en día 1.
    Evaluar eficacia en control d la enfermedad d enpatoran comparado con placebo en participantes con lupus predominantemente con erupción cutánea lúpica activa
    Evaluar eficacia en control d la enfermedad dl enpatoran comparado con placebo en participantes con LES activo
    Evaluar eficacia d enpatoran comparado con placebo en síntomas comunicados por paciente y estado funcional en participantes con lupus con erupción cutánea lúpica activa
    Evaluar eficacia d enpatoran comparado con placebo en síntomas comunicados por paciente en participantes con LES activo
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Age
    1.Are ≥ 18 to ≤ 75 years of age at the time of signing the informed consent. If participants are enrolled in Japan, if a participant is < 20 years of age, the written informed consent from the participant’s parent or guardian will be required in addition to the participant’s written consent for this country.
    Vaccinations
    2.Are up to date, according to local guidelines, with vaccination against Streptococcus pneumoniae and influenza virus (as seasonally required for influenza virus).
    Active SCLE and/or DLE (Cohort A)
    3.Diagnosis of SCLE or DLE documented in medical history. Predominant findings of active lupus rash must be SCLE and/or DLE, but other skin manifestations of CLE will be allowed (e.g., lupus tumidus, Acute Cutaneous Lupus Erythematosus [ACLE], etc) on a case-by-case basis if their main diagnosis is active SCLE and/or DLE. Diagnosis must include one of the following options:
    a.Historical skin biopsy (i.e., pathology report; punch or shave biopsy) within 10 years prior to Screening visit and confirmation of current diagnosis by skin photography at Screening visit.
    OR
    b.Fresh punch skin biopsy at Screening visit.
    OR
    c.If target lesion is unsuitable for biopsy (e.g., malar rash, bridge of the nose, scalp), skin photography at Screening visit may be allowed on a case-by-case basis.
    4.Disease duration of ≥ 6 months from time of diagnosis to Screening.
    5.CLASI-A ≥ 8 at Screening Visit; this must be confirmed at Day 1 Visit.
    Active SLE
    6.Diagnosis of SLE and fulfil Systemic Lupus International Collaborating Clinics (SLICC) classification criteria (Petri 2006), and/or ≥ 4 ACR classification criteria (Hochberg 1997) and/or EULAR/ACR 2019 classification criteria (Aringer 2019).
    7.Disease duration of ≥ 6 months from when participant met 2012 SLICC, and/or 1997 ACR (Hochberg 1997), and/or 2019 EULAR/ACR classification criteria for SLE until Screening Visit.
    8.Positive test results for ANA (human epithelial cell-2 ANA ≥ 1:80) and/or anti dsDNA antibody (≥ 15 IU/mL) and/or anti-Smith antibody during Screening Period.
    9.Presence of either Scenario 1 OR Scenario 2 (See Figure 1). please refer to Protocol
    Weight
    10.Have a body mass index within the range 18.5 to 35.0 kg/m2 (inclusive).
    Sex
    11.Are male or female at birth.
    12.Contraceptive use by males or females will be consistent with local regulations on contraception methods for those participating in clinical studies.
    a.Female participant:
    •Is not breastfeeding.
    •Is not pregnant (i.e., has a negative serum pregnancy test, as required by local regulations, within 24 hours before the first dose of study
    intervention).
    Additional requirements for pregnancy testing during and after study intervention are in Section 8.3.4.
    •Not a Woman of childbearing potential (WOCBP).
    •If a WOCBP, use a highly effective contraceptive method (i.e., with a failure rate of <1% per year), preferably with low user dependency (two
    methods may be considered to achieve optimal results i.e. <1% failure rate per year), as described in Appendix 3 for the following time periods:
    •Before the first dose of the study intervention, if using hormonal contraception:
    -Has completed at least one 4-Week cycle of an oral contraception pill and either had or has begun her menses.
    OR
    -Has used a depot contraceptive or extended-cycle oral contraceptive for least 28 days and has a documented negative pregnancy test using a
    highly sensitive assay.
    AND
    -A barrier method, as described in Appendix 3.
    •During the intervention period.
    •After the study intervention period (i.e., after the last dose of study intervention is administered): for at least 90 days after the last dose of study
    intervention and agree not to donate eggs (ova, oocytes) for reproduction during this period.
    The Investigator evaluates the appropriateness and effectiveness of the contraceptive method in relationship to the first dose of study intervention.
    Note: Estrogen-containing hormonal contraceptives are contraindicated in this study.
    The Investigator reviews the medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a female with an early
    undetected pregnancy.
    b.Male Participants:
    Agree to the following during the study until at least 90 days (a spermatogenesis cycle) after the last dose of study intervention.
    •Refrain from donating fresh unwashed semen.
    PLUS, either:
    •Abstain from any activity that allows for exposure to ejaculate.
    OR
    •Use a male condom:
    -When having sexual intercourse with a WOCBP, who is not currently pregnant, and instruct her to use a highly effective method with a failure rate
    of <1% per year, as described in Appendix 3, since a condom may break or leak.
    -When engaging in any activity that allows for exposure to ejaculate.
    Edad 1. Tienen d ≥18 a ≤75 años en el momento d firma dl CI. Vacunas 2. Están al día, según directrices locales, con la vacunación contra Streptococcus pneumoniae y virus d la gripe (según se requiera en la temporada dl virus de la gripe). LESC o LED activo (cohorte A) 3. Diagnóstico d LESC o LED documentado en antecedentes médicos. Los hallazgos preponderantes de erupción activa de lupus deben ser LESC o LED, pero se permitirán otras manifestaciones cutáneas de LEC (lupus túmido, lupus eritematoso agudo cutáneo [LEAC], etc.) caso x caso si diagnóstico principal es LESC o LED activo. El diagnóstico debe incluir 1 de las siguientes opciones: a. Antecedentes d biopsias cutáneas (informe de morfopatología; biopsia en sacabocados o biopsia por afeitado) en los 10 años anteriores a visita de selección y confirmación dl diagnóstico actual mediante fotografía d la piel en visita d selección O BIEN b. Biopsia cutánea en sacabocados y en fresco en visita de selección O BIEN c. Si la lesión a tratar no es adecuada para la biopsia (eritema vespertilio, puente d la nariz, cuero cabelludo), se puede permitir, según caso, la obtención d 1 fotografía d la piel durante visita de selección 4. Duración d la enfermedad ≥6 meses desde momento del diagnóstico hasta selección 5. CLASI-A ≥8 en visita d selección; esta debe confirmarse en visita dl día 1. LES activo 6. Diagnóstico d LES y cumplimiento d los criterios d clasificación de las Clínicas de colaboración internacional para el lupus sistémico (SLICC) o ≥4 criterios de clasificación del American College of Rheumatology (ACR) o los criterios de clasificación EULAR/ACR 2019. 7. Duración d la enfermedad ≥6 meses desde el momento en que el participante cumplía los criterios d clasificación SLICC 2012, o ACR 1997, o EULAR/ACR 2019 para el LES hasta visita de selección. 8. Resultados positivos para AAN (AAN ≥1:80 en células epiteliales humanas de tipo 2) o anticuerpos anti-ADNbc (≥15 UI/ml) o anticuerpos anti-Smith durante periodo d selección. 9. Existencia d la coyuntura 1 o de la coyuntura 2. Consulte protocolo. Peso 10. Tener índice d masa corporal en intervalo de 18,5 a 35,0 kg/m2 (inclusive). Sexo 11. Hombre o mujer al nacer. 12. El uso d anticonceptivos d hombres o mujeres debe realizarse d conformidad con las normativas locales relativas a los métodos anticonceptivos para los participantes en estudios clínicos. a. Participante d sexo femenino: No está en periodo de lactancia, No está embarazada (tiene una prueba de embarazo en suero negativa, según lo exigido por la normativa local, en las 24h previas a la primera dosis dl tratamiento dl estudio). Los requisitos adicionales para pruebas d embarazo durante y después dl tratamiento dl estudio se indican en el apartado 8.3.4: No es una mujer con posibilidad d quedarse embarazada (MPE). Si es MPE, debe utilizar un método anticonceptivo muy eficaz (con una tasa de ineficacia <1 % al año), de preferencia con baja dependencia del usuario (puede considerarse que dos métodos alcanzan resultados óptimos, es decir, una tasa de ineficacia <1 % al año), como se describe en el anexo 3, durante los siguientes periodos: Antes d la primera dosis dl tratamiento dl estudio, si se utiliza un anticonceptivo hormonal: Ha completado al menos 1 ciclo de 4 semanas d 1 píldora anticonceptiva y ha tenido/ha empezado la menstruación O BIEN Ha utilizado 1 anticonceptivo d liberación lenta o un anticonceptivo oral de ciclo extendido durante al menos 28 días y tiene una prueba d embarazo negativa documentada empleando un método analítico ultrasensible. Y Un método anticonceptivo d barrera (se describe en el anexo 3): Durante el periodo de tratamiento, Después del periodo de tratamiento del estudio: durante al menos 90 días después d la última dosis dl tratamiento del estudio. Además, acepta no donar óvulos para la reproducción durante este periodo. El investigador evalúa la idoneidad y eficacia dl método anticonceptivo en relación con la 1ra dosis dl tratamiento dl estudio. Nota: Los anticonceptivos hormonales que contienen estrógenos están contraindicados en este estudio. El investigador revisa los antecedentes médicos, antecedentes menstruales y actividad sexual reciente para reducir el riesgo de inscribir a una mujer con embarazo incipiente no detectado. b. Participantes d sexo masculino: Deberán aceptar lo siguiente durante el estudio hasta al menos 90 días (1 ciclo de espermatogénesis) después d la última dosis de tratamiento dl estudio. Abstenerse d donar semen fresco no lavado. ADEMÁS D: Abstenerse de cualquier actividad que facilite la exposición al semen O BIEN Utilizar un preservativo masculino: Cuando tenga relaciones sexuales con una MPE que no esté embarazada en ese momento. Además, deberá indicarle que debe usar un método anticonceptivo muy eficaz, con tasa de ineficacia <1 % al año (se describe en el anexo 3), ya que 1 preservativo puede romperse o tener fugas. Cuando participe en cualquier actividad que facilite la exposición al semen.
    E.4Principal exclusion criteria
    Medical Conditions
    1.Primary diagnosis of autoimmune or rheumatic disease other than SLE or CLE (discuss with Medical Monitor if overlap syndrome). Note: Secondary Sjögren’s syndrome or an autoimmune thyroiditis are not exclusionary.
    2.Drug-induced lupus (SLE or CLE).
    3.Any condition including dermatological diseases other than cutaneous manifestations of SLE or CLE (e.g., psoriasis), or any uncontrolled disease (e.g., asthma, interstitial lung disease, pulmonary arterial hypertension, morbid obesity), that in Investigator’s or Sponsor/designee’s opinion constitutes inappropriate risk or contraindication for participation.
    4.Active lupus nephritis on induction therapy, or induction therapy completed within 3 months of Screening visit (stable maintenance therapy with mycophenolate or azathioprine allowed).
    5.Urine protein: creatinine ratio (UPCR) > 4 mg/mg (> 339 mg/mmol), and/or estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73 m2 as calculated by the Modification of Diet in Renal Disease equation by the central laboratory:
    eGFR = 175 × (serum creatinine in mg/dL)–1.154 × (age in years)–0.203 × 0.742 (if female) × 1.212 (if race is black).
    6.Any active signs, symptoms or diagnoses considered related to central nervous system (CNS) lupus within past 3 months or any history of uncontrolled seizures.
    7.Any other history of epilepsy, other neurological disorder with seizure propensity, or neuropsychiatric conditions that may interfere with study evaluations.
    8.Significant cardiovascular events (e.g., acute myocardial infarction, unstable angina or peripheral vascular disease symptoms, hospitalization for congestive heart failure, uncontrolled or New York Heart Association Class 3 or 4 congestive heart failure, cardiac surgery, ischemic or hemorrhagic stroke, or transient ischemic attack), ≤ 6 months before Screening Visit.
    9.Active cardiac arrhythmia or clinically significant abnormality on ECG at Screening Visit or Day 1 that in the Investigator’s or Sponsor/designee’s opinion constitutes inappropriate risk or contraindication for study participation or could interfere with study objectives, conduct or evaluation (included but not limited to long QT syndrome, Wolff Parkinson White syndrome, or a malignant ventricular arrhythmia [e.g., ventricular fibrillation or tachycardia] unless treated). Note: any sinus bradycardia or tachycardia detected in the ECG will not be exclusionary unless other ECG abnormalities are identified.
    10.Significant suicide risk in the last year (including suicidal ideation and/or suicidal behavior on the Columbia-Suicide Severity Rating Scale [C-SSRS] during Screening or Day 1).
    11.History of or planned renal or solid organ transplant.

    Please refer to the Protocol for the full list.
    Afecciones médicas
    1. Diagnóstico principal de enfermedad autoinmunitaria o reumática distinta al LES o LEC (hablar con el monitor médico en caso de síndromes mixtos del tejido conjuntivo). Nota: El síndrome de Sjögren secundario o una tiroiditis autoinmunitaria no son motivo de exclusión.
    2. Lupus medicamentoso (LES o LEC).
    3. Cualquier afección entre las que se incluyen enfermedades dermatológicas distintas de las manifestaciones cutáneas de LES o LEC (p. ej., psoriasis) o cualquier enfermedad no controlada (p. ej., asma, enfermedad pulmonar intersticial, hipertensión arterial pulmonar, obesidad mórbida), que, a juicio del investigador, del promotor o de la persona designada, constituya un riesgo inadecuado o una contraindicación para la participación.
    4. Nefritis lúpica activa durante el tratamiento de inducción o tratamiento de inducción completado en los 3 meses anteriores a la visita de selección (se permite el tratamiento de mantenimiento estable con micofenolato o azatioprina).
    5. Cociente entre proteína y creatinina en orina (UPCR) >4 mg/mg (>339 mg/mmol) o filtración glomerular estimada (FGe) <45 ml/min/1,73 m2, calculada mediante la ecuación de modificación de la dieta en la enfermedad renal por parte del laboratorio central:
    FGe = 175 × (creatinina sérica en mg/dl) – 1,154 × (edad en años) – 0,203 × 0,742 (si es mujer) × 1,212 (si es de raza negra).
    6. Cualquier signo o síntoma activos, o diagnóstico, que se considere relacionado con el lupus del sistema nervioso central (SNC) en los últimos 3 meses o antecedentes de convulsiones no controladas.
    7. Cualquier otro antecedente de epilepsia, otro trastorno neurológico con propensión convulsiva o afecciones neuropsiquiátricas que puedan interferir con las evaluaciones del estudio.
    8. Acontecimientos cardiovasculares importantes (p. ej., infarto agudo de miocardio, angina inestable o síntomas de enfermedad vascular periférica, hospitalización por insuficiencia cardíaca congestiva, insuficiencia cardíaca congestiva no controlada o de clase 3 o 4 según la Asociación de Cardiología de Nueva York [New York Heart Association], cirugía cardíaca, accidente cerebrovascular isquémico o hemorrágico, o accidente isquémico transitorio) ≤6 meses antes de la visita de selección.
    9. Arritmia cardíaca activa o anomalía clínicamente significativa en ECG durante la visita de selección o el día 1 que, a juicio del investigador, del promotor o de la persona designada constituya un riesgo inadecuado o una contraindicación para la participación en el estudio o pueda interferir con los objetivos del estudio, la realización o la evaluación (incluidos, entre otros, el síndrome del intervalo QT largo, el síndrome de Wolff-Parkinson-White o la arritmia ventricular maligna [p. ej., fibrilación ventricular o taquicardia ventricular] a menos que se traten). Nota: La bradicardia o taquicardia sinusal detectadas en el ECG no serán motivo de exclusión a menos que se identifiquen otras anomalías en ECG.
    10. Riesgo significativo de suicidio en el último año (incluidos pensamientos o comportamientos suicidas según la escala Columbia para evaluar el riesgo de suicidio [C-SSRS] durante la selección o el día 1).
    11. Antecedentes o previsión de trasplante renal o de vísceras macizas.
    Consulte el protocolo para obtener la lista completa.
    E.5 End points
    E.5.1Primary end point(s)
    Percent change from baseline in CLASI-A at Week 16

    BICLA response at Week 24
    Cambio porcentual desde el inicio en el CLASI-A en la semana 16

    Respuesta BICLA en la semana 24
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 16 and Week 24
    Semana 16 y Semana 24
    E.5.2Secondary end point(s)
    From Day 1 to the end of Safety Follow-up period
    •Occurrence of TEAEs, SAEs and AESI
    •Occurrence of abnormalities (Grade 3) in laboratory parameters
    •Occurrence of Clinically Important increases in QT Interval Corrected Using Fridericia's Formula (QTcF)

    •Change from baseline in Cutaneous Lupus Activity Investigator’s Global Assessment (CLA-IGA) at Week 16 and Week 24
    •Change from baseline in Physician’s Global Assessment of Cutaneous Lupus Disease Activity at Week 16 and 24

    •BICLA response and clinically meaningful CS reduction, defined as reduction of daily prednisone-equivalent dose from ≥ 10 mg at Day 1 to ≤ 5 mg by the Week 12 visit and sustained through Week 24

    •Clinically meaningful CS reduction, defined as reduction of daily prednisone-equivalent dose from ≥ 10 mg at Day 1 to ≤ 5 mg by the Week 12 visit and sustained through Week 24
    •Occurrence of CLA-IGA 0 or 1 at Week 16 and Week 24

    •Systemic lupus erythematosus Responder Index-4 (SRI-4) response at Week 24
    •Lupus Low Disease Activity State (LLDAS) attainment at Week 24
    •Remission attainment at Week 24
    •Clinically meaningful CS reduction, defined as reduction of daily prednisone-equivalent dose from ≥ 10 mg at Day 1 to < 5 mg by the Week 12 visit and sustained through Week 24
    •Change in the number of joints which are tender and swollen in 28 joint count from baseline at Week 24
    •Change from baseline in Physician’s Global Assessment at Week 24
    •Time to first moderate/severe British Isles Lupus Assessment Group (BILAG) flare from Day 1 through Week 24
    •Time to first SFI severe flare from Day 1 through Week 24

    •Change from Baseline in the Skindex 29+3 Symptom domain score at Week 24
    •Change from Baseline in the Skindex 29+3 Functioning and Emotion domain scores at Week 24
    •Change from Baseline in the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scores at Week 24

    •Change from Baseline in the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scores Week 24
    Desde el día 1 hasta el final del periodo de seguimiento de la seguridad
    • Aparición de AAST, AAG y AAEI
    • Aparición de anomalías (grado 3) en los parámetros analíticos
    • Aparición de aumentos clínicamente importantes en el intervalo QT corregido usando la fórmula de Fridericia (QTcF)

    • Cambio con respecto al inicio en la evaluación global por parte del investigador de la actividad cutánea del lupus (Cutaneous Lupus Activity Investigator’s Global Assessment, CLA-IGA) en la semana 16 y la semana 24
    • Cambio con respecto al inicio en la evaluación global por parte del médico de la actividad de la enfermedad del lupus cutáneo en las semanas 16 y 24

    • Respuesta BICLA y reducción clínicamente significativa de los CE, definida como la reducción de la dosis diaria del equivalente de prednisona de ≥10 mg en el día 1 a ≤5 mg en la visita de la semana 12 y se mantiene hasta la semana 24.

    • Reducción clínicamente significativa de los CE, definida como la reducción de la dosis diaria de equivalente de prednisona de ≥10 mg en el día 1 a ≤5 mg en la visita de la semana 12 y sostenida hasta la semana 24
    • Incidencia de CLA-IGA 0 o 1 en la semana 16 y la semana 24

    • Respuesta del índice de respuesta del lupus eritematoso sistémico-4 (Systemic Lupus Erythematosus Responder Index-4, SRI-4) en la semana 24
    • Consecución del estado de baja actividad del lupus (LLDAS) en la semana 24
    • Consecución de la remisión en la semana 24
    • Reducción clínicamente significativa de los CE, definida como la reducción de la dosis diaria de equivalente de prednisona de ≥10 mg en el día 1 a ≤5 mg en la visita de la semana 12 y sostenida hasta la semana 24.
    • Cambio en el número de articulaciones dolorosas a la palpación e hinchadas en el recuento de 28 articulaciones con respecto al inicio en la semana 24
    • Cambio con respecto al inicio en la evaluación global por parte del médico en la semana 24
    • Tiempo hasta el primer brote moderado/intenso según el Grupo de evaluación del lupus de las islas británicas (BILAG) desde el día 1 hasta la semana 24
    • Tiempo hasta el primer brote intenso según SFI desde el día 1 hasta la semana 24

    • Cambio con respecto al inicio en la puntuación del dominio de síntomas de Skindex 29+3 en la semana 24
    • Cambio con respecto al inicio en la puntuación del dominio funcional y emocional de Skindex 29+3 en la semana 24
    • Cambio con respecto al inicio en las puntuaciones de fatiga de la evaluación funcional del tratamiento de enfermedades crónicas (Functional Assessment of Chronic Illness Therapy, FACIT) en la semana 24

    • Cambio con respecto al inicio en las puntuaciones de fatiga de la evaluación funcional del tratamiento de enfermedades crónicas (FACIT) en la semana 24
    E.5.2.1Timepoint(s) of evaluation of this end point
    As described in section E.5.2.
    Como se describen en la sección E.5.2.
    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 Yes
    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 Yes
    E.8.1.7.1Other trial design description
    Canasta
    Basket.
    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 concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA29
    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
    Australia
    Brazil
    Chile
    China
    Colombia
    Japan
    Mauritius
    Mexico
    Moldova, Republic of
    Philippines
    Russian Federation
    Serbia
    South Africa
    Ukraine
    United States
    Bulgaria
    Hungary
    Poland
    Spain
    Argentina
    Greece
    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
    Last scheduled procedure for the last participant in the study.
    Último procedimiento programado para el último participante del estudio.
    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 months7
    E.8.9.1In the Member State concerned days23
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months7
    E.8.9.2In all countries concerned by the trial days23
    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: 430
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 10
    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 state19
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 75
    F.4.2.2In the whole clinical trial 440
    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)
    None.
    Ninguno.
    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 Decision2022-03-21
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-01-25
    P. End of Trial
    P.End of Trial StatusOngoing
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