A Study of Ustekinumab in Participants With Active Systemic Lupus Erythematosus
Lupus Erythematosus, Systemic
About this trial
This is an interventional treatment trial for Lupus Erythematosus, Systemic
Eligibility Criteria
Inclusion Criteria:
- Be male or female
Has a documented medical history (that is, met at least 1 of the two criteria below) that participant met the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for systemic lupus erythematosus (SLE) at least 3 months prior to first dose of study agent:
- Met a total of at least 4 SLICC criteria, including at least 1 clinical and at least 1 immunologic;
- Has a diagnosis of lupus nephritis, confirmed by renal biopsy and at least 1 of the following autoantibodies: antinuclear antibodies (ANA) or anti-double-stranded deoxyribonucleic acid (anti-dsDNA)
- Has a positive test in the medical history and confirmed at screening for at least 1 of the following autoantibodies: antinuclear antibodies, anti-double-stranded deoxyribonucleic acid, and/or anti-Smith
- Has greater than or equal to (>=) 1 British Isles Lupus Assessment Group (BILAG) A and/or >= 2 BILAG B scores observed during screening
- Has a Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) activity score >=4 (excluding diffuse non-inflammatory alopecia) or >= 4 joints with pain and signs of inflammation at screening, Week 0, or both
- Has a Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score >=6 at screening. Must also have SLEDAI-2K >= 4 for clinical features (excluding headache and laboratory abnormalities) at Week 0
- Cannot be pregnant, nursing, intending to become pregnant, or unwilling to follow contraception or egg/sperm donation guidelines
- Must be receiving stable doses of >=1 protocol-permitted standard of care SLE treatment: oral glucocorticoids, anti-malarials, immunomodulators (methotrexate, azathioprine, 6-mercaptopurine, mycophenolate mofetil, mycophenolic acid)
Exclusion Criteria:
- Has any unstable or progressive SLE manifestation (example: central nervous system lupus, systemic vasculitis, end-stage renal disease, severe or rapidly progressive glomerulonephritis, pulmonary hemorrhage, myocarditis) that may warrant escalation in therapy beyond permitted background medications. Participants requiring renal hemodialysis or peritoneal dialysis are also excluded
- Has other co-existent inflammatory diseases (example: rheumatoid arthritis, psoriasis, psoriatic arthritis, Crohn's disease)
- Has a urinary protein to creatinine ratio of greater than (>)4 gram per gram (g/g) per day
- Has an acute or chronic infectious illness (example: human immunodeficiency virus, hepatitis B or C virus, tuberculosis, opportunistic infections)
- Has a history of cancer or lymphoproliferative disease within the last 5 years except for treated and non-recurrent cutaneous basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma
- Has any condition requiring multiple courses of systemic glucocorticoids (example: uncontrolled asthma, chronic obstructive pulmonary disease)
- Has a history of major surgery within the last month
- Has received live virus or bacterial vaccines within 16 weeks prior to first dose of study agent or Bacille Calmette-Guerin (BCG) vaccination within 12 months of screening
- Has previously received ustekinumab
- Has received cyclophosphamide orally within 90 days or intravenously within 180 days of screening
- Has received a single B-cell targeted therapy (e.g. belimumab) within 3 months, >1 previous B-cell targeted therapy within 6 months, or B-cell depleting therapy (example: rituximab) within 12 months of first dose of study agent
- Has received protocol-prohibited oral or biologic immunomodulatory therapy in the last 3 months or less than (<)5 half-lives (whichever is longer) prior to first dose of study agent
- Has received adrenocorticotropic hormone (ACTH) within 1 month prior to first dose of study agent
- Has received epidural, intravenous, intramuscular, intraarticular, intrabursal, intralesional glucocorticoids within 6 weeks of first dose of study agent
- Locally-delivered therapies except for ophthalmic use of cyclosporine A or topical use of nonsteroidal anti inflammatory drugs (NSAIDs), analgesics, or high-potency glucocorticoids (World Health Organization criteria) are prohibited
Sites / Locations
- Pinnacle Research Group, LLC
- University of Alabama at Birmingham
- Achieve Clinical Research, LLC
- Medvin Clinical Research
- Lugene Eye Institute
- C.V. Mehta, MD Medical Corp.
- University of California at San Diego
- Advanced Medical Research - Lakewood
- Loma Linda University
- Loma Linda University Health Care
- Valerius Medical Group & Research Center
- Keck School of Medicine of USC
- Wallace Rheumatic Study Center
- East Bay Rheumatology Medical Group
- Westlake Medical Research Clinical Trials
- University Clinical Investigators, Inc
- Inland Rheumatology Clinical Trials Inc.
- University of Colorado
- Denver Arthritis Clinic
- UPMC Lupus Center of Excellence
- Stamford Therapeutics Consortium
- Arthritis and Rheumatic Disease Specialties
- Bay Area Arthritis and Osteoporosis
- Centre for Rheumatology, Immunology and Arthritis
- University of Florida Health Jacksonville - Rheumatology
- University of Miami Miller School of Medicine
- New Horizon Research Center
- Rheumatology Associates of Central Florida, PA
- Omega Research Consultants
- Millennium Research
- Integral Rheumatology & Immunology Specialists
- Clinical Research of West Florida
- Emory University
- Piedmont Healthcare - Piedmont Hospital
- DeKalb Medical Specialty Center
- Rush University Medical Center
- University of Chicago
- Graves-Gilbert Clinic - Bowling Green
- Arthritis and Diabetes Clinic
- The Center for Rheumatology and Bone Research
- June DO, PC.
- St Paul Rheumatology PA
- University of Mississippi Medical Center
- Oklahoma Medical Research Foundation
- Innovative Health Research
- Albuquerque Center for Rheumatology
- Biomedical Research Alliance Of New York
- The Feinstein Institute for Medical Research
- NYU Center for Musculoskeletal Care
- Hospital for Special Surgery
- SUNY Upstate Medical University
- Joint and Muscle Research Institute
- DJL Clinical Research, PLLC
- Duke University Medical Center
- Wake Forest Baptist Medical Center
- OK Center for Arthritis Therapy & Research, Inc.
- Lewis Katz School of Medicine, Temple University
- Allegheny Rheumatology/Allegheny Singer Research Institute
- Columbia Arthritis Center
- West Tennessee Research Institute
- Dr. Ramesh Gupta
- Vanderbilt University Medical Center
- Amarillo Center for Clinical Research
- Austin Regional Clinic
- Arthritis Centers of Texas
- Sun Research Institute
- UT Health Science Center at San Antonio
- University of Washington
- Rheumatology & Pulmonary Clinic
- Fundación CENIT para la Investigación en Neurociencias
- Instituto Centenario
- Centro Privado de Medicina Familiar
- Framingham Centro Medico
- Hospital Italiano de Cordoba
- Hospital Escuela 'Gral. Jose F. de San Martin'
- CER San Juan Centro Polivalente de Asistencia e Investigacion Clinica
- Centro Medico Privado de Reumatologia
- MHAT Trimantium
- Diagnostic-Consultative Center (DCC) Aleksandrovska
- UMHAT St. Ivan Rilski
- Medical Centre Synexus
- University of Calgary
- University of Manitoba
- Toronto Western Hospital
- McMaster University
- CHU de Québec
- The First Affiliated Hospital of Baotou Medical University
- Peking Union Medical College Hospital
- West China Hospital, Sichuan University
- Guangdong Provincial People's Hospital
- Affiliated Hospital of Inner Mongolia Med U
- Shanghai Ruijin Hospital
- Tianjin Medical University General Hospital
- Tongji Hospital of Tongji Medical College of Huangzhong Univ
- The 1st affiliated Hospital of Xi'an Traffic University
- Centro de Investigación en Reumatología y especialidades médicas S.A.S. - CIREEM S.A.S.
- IPS Medicity SAS
- Servimed S.A.S
- Preventive Care Ltda
- Clinica Universitaria Bolivariana
- Funcentra
- Charite - Universitatsmedizin Berlin (CCM)
- Medizinische Hochschule Hannover
- Rheumazentrum Ruhrgebiet
- Rheumatology Unit
- Universitaetsmedizin Mainz
- Szt, Istvan and Szt. Laszlo
- Bekes Megyei Pandy Kalman Korhaz
- Belvarosi Egeszseghaz Kft. (Leda-Platan Maganklinika es Sebeszeti Kozpont)
- Chiba University Hospital
- National Hospital Organization Chibahigashi National Hospital
- National Hospital Organization Kyushu Medical Center
- Fukushima Medical University Hospital
- Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital
- Hospital of the University of Occupational and Environmental Health
- National Hospital Organization Osaka Minami Medical Center
- Kawasaki Rheumatism and Internal Medicine Clinic
- Toho University Medical Center, Ohashi Hospital
- Nagasaki University Hospital
- National Hospital Organization Nagoya Medical Center
- Kitasato University Hospital
- Hokkaido University Hospital
- Sapporo City General Hospital
- Sasebo Chuo Hospital
- Tohoku University Hospital
- Keio University Hospital
- National Center for Global Health and Medicine
- St. Luke's International Hospital
- Juntendo University Hospital
- Fujita Health University Hospital
- National Hospital Organization Yokohama Medical Center
- Daegu Catholic University Medical Center
- Chonbuk National Univ Hospital
- Seoul National University Hospital
- Konkuk University Medical Center
- Ajou University Hospital
- Lietuvos sveikatos mokslų universiteto ligoninė Kauno klinik
- Klaipeda University Hospital
- Vaiku ligonine Vilniaus Universiteto ligon. Santariskiu fil
- Vilnius University Hospital Santariskiu Clinics
- Szpital Uniwersytecki nr 2 im. dr. Jana Biziela w Bydgoszczy
- Nzoz Bif-Med
- Centrum Medyczne AMED oddzial w Lodzi
- Samodzielny Publiczny Szpital Kliniczny Nr 4 w Lublinie
- Twoja Przychodnia - Centrum Medyczne Nowa Sol
- Centrum Medyczne Medens S.C. Grupowa Praktyka Lekarska
- Centrum Medyczne Pratia Tychy
- Centrum Medyczne Pratia Warszawa
- Reumatika-Centrum Reumatologii, NZOZ
- Uniwersytecki Szpital Kliniczny im. J. Mikulicza-Radeckiego
- Instituto Portugues de Reumatologia
- Hospital Curry Cabral-Centro Hospital Lisboa Central
- Hospital da Luz
- ULSAM, EPE - Hospital Conde de Bertiandos
- C.H. de Vila Nova de Gaia/Espinho
- Regional Clinical Hospital for War Veterans
- LLL Medical Center Revma-Med
- Clinical Diagnostic Center 'Ultramed'
- Leningrad region clinical hospital
- City Clinical Hospital #31
- Northen-Western State Medical University n.a. I.I. Mechnikov
- Ulyanovsk Regional Clinical Hospital
- Clinical Emergency Hospital n.a. N.V. Solovyev
- Institute of Rheumatology Belgrade
- Institute of Rheumatology
- Military Medical Academy
- Clinical Hospital Center Bezanijska Kosa
- University Clinical Center Kragujevac
- Institute for Treatment and Rehabilitation Niska Banja
- Clinical Center of Vojvodina
- Panorama Medical Centre
- Excellentis Clinical trial Consultants
- Clinical Research Unit, University of Pretoria
- Winelands Medical Research Centre
- Hosp. Univ. Vall D Hebron
- Hosp. Univ. de Basurto
- Hosp. Reina Sofia
- Hosp. Clinico San Carlos
- Hosp. Univ. 12 de Octubre
- Hosp. Regional Univ. de Malaga
- Hosp. Univ. Infanta Sofia
- Hosp. Infanta Luisa
- Hosp. Do Meixoeiro
- Kaohsiung Medical University Chung-Ho Memorial Hospital
- Chang Gung Memorial Hospital
- Chung Shan Medical University Hospital
- China Medical University Hospital
- National Taiwan University Hospital
- Cathay General Hospital
- Taipei Medical University
- Taipei Veterans General Hospital
- Phramongkutklao Hospital and Medical College
- Rajavhiti Hospital
- Ramathibodi Hospital
- Siriraj Hospital
- Songklanagarind hospital
- Chiang Mai University
- Mechnikov Inst, Miska bagatoprofilna likarnia #18
- Kyiv City Clinical Hospital #3
- Kyivska oblasna klinichna likarnia
- Odeska oblasna klinichna likarnia
- Multidisciplinary Medical Center of Odessa National Medical University
- MNPE 'Vinnytsia Regional Clinical Hospital named after M.I. Pyrogov of Vinnytsia Regional Council'
- Naukovo-doslidnyi inst. Reabilit. Pyrogova [Revmatologichne]
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Ustekinumab
Placebo
Participants will receive ustekinumab approximately 6 milligram per kilogram (mg/kg) intravenously (IV) based on body weight-range at Week 0 followed by 90 mg ustekinumab subcutaneously (SC) at Week 8 and every 8 weeks (q8w) thereafter through Week 48 during double-blind period. Eligible participants who will enter the extension period will continue to receive 90 mg ustekinumab SC q8w through Week 160.
Participants will receive matching placebo to ustekinumab IV at Week 0, followed by matching placebo to ustekinumab SC at Week 8 and q8w thereafter through Week 48 during double-blind period. Eligible participants who will enter the extension period will cross-over to receive 90 mg ustekinumab SC q8w through Week 160.