A Study of Guselkumab in Participants With Active Lupus Nephritis (ORCHID-LN)
Lupus Nephritis
About this trial
This is an interventional treatment trial for Lupus Nephritis
Eligibility Criteria
Inclusion Criteria:
- At screening and randomization, must be receiving oral glucocorticoids at minimum prednisone equivalent dose of 10 milligrams per day (mg/day) and maximum 1 mg/kg/day or less than or equal to (<=) 60 mg/day, whichever is lower. Treated for greater than or equal to (>=) 6 weeks with stable dosing >=2 weeks before randomization
- If receiving angiotensin-converting enzyme (ACE) inhibitor/angiotensin II receptor blockers (ARB), a stable dose for at least 2 weeks prior to randomization
- Positive antinuclear antibody (ANA; >= 1:80 titer by central laboratory test) or anti-double-stranded deoxyribonucleic acid (dsDNA) antibodies (>=30 international units per milliliter ([U/mL] by central laboratory test) detected at screening
- Kidney biopsy documentation of active International Society of Nephrology (ISN)/Renal Pathology Society (RPS) proliferative nephritis: Class III-IV (with or without class V membranous nephritis) within the last 6 months prior to screening or performed during screening
- Urine Protein to Creatinine Ratio (UPCR) >= 1.0 milligram/milligram (mg/mg) assessed on 2 first morning urine void specimens during screening. These 2 specimens do not need to be on consecutive days, however, 2 samples must be tested with UPCR >= 1.0 mg/mg in a row. The UPCR requirement must be met after at least 8 weeks of mycophenolate mofetil (MMF)/mycophenolic acid (MPA) treatment, and after stable glucocorticoid dosing is achieved at the dose intended at time of randomization
Exclusion Criteria:
- Comorbidities (other than lupus nephritis [LN], example, asthma, chronic obstructive pulmonary disease) which have required 3 or more courses of systemic glucocorticoids within the previous 12 months
- Has other inflammatory diseases that might confound the evaluations of efficacy, including but not limited to rheumatoid arthritis (RA), psoriatic arthritis (PsA), RA/lupus overlap, psoriasis, Crohn's disease, or active Lyme disease
- Received PO (orally) or intravenously (IV) cyclophosphamide within 3 months prior to randomization
- History of latent or active granulomatous infection, including histoplasmosis or coccidioidomycosis, before screening
- History of being human immunodeficiency virus (HIV) antibody-positive, or tests positive for HIV at screening
Sites / Locations
- Medvin Clinical Research
- UC San Diego
- Academic Medical Research Institute
- University of Colorado Denver
- University of Florida College of Medicine
- NYU Langone Ambulatory Care Brooklyn Heights
- The Feinstein Institute for Medical Research
- Med Research, Inc.
- Centro Médico Reumatológico (OMI)
- Hospital Ramos Mejia
- ARCIS Salud SRL (Aprillus asistencia e investigacion)
- Instituto Medico Strusberg SA
- Clinica Privada Velez Sarsfield
- Instituto de Reumatologia - Ir Medical Center S.A.
- Instituto Médico de la Fundación de Estudios Clínicos (ECLIN)
- Centro de Investigaciones Médicas Tucumán
- Centro de Investigación y Tratamiento Reumatológico S.C.
- Hospital Civil de Guadalajara Fray Antonio Alcalde
- Unidad Reumatologica las Americas S.C.P.
- Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán
- Consultorio de Reumatologia
- Hospital Central Dr Ignacio Morones Prieto
- Uniwersyteckie Centrum Medyczne, Klinika Nefrologii, Transplantologii i Chorób Wewnętrznych
- Uniwersytecki Szpital Kliniczny nr 1 im. N. Barlickiego
- Uniwersytecki Szpital Kliniczny we Wrocławiu
- LLL Medical Center Revma-Med
- Orenburg State Medical University
- LLC Medical Sanitary Part No. 157
- Saratov Regional Clinical Hospital
- LLC German Clinic
- Hosp. Univ. A Coruña
- Hosp. Univ. Vall D Hebron
- Hosp. Univ. de Basurto
- Hosp. Univ. Infanta Leonor
- Hosp. Univ. Ramon Y Cajal
- Hosp. Univ. 12 De Octubre
- Hosp. Univ. Fuenlabrada
- Hosp. Clinico Univ. De Valencia
- Kaohsiung Veterans General Hospital
- China Medical University Hospital
- National Taiwan University Hospital
- Chang Gung Memorial Hospital
- Phramongkutklao Hospital and Medical College
- Ramathibodi Hospital
- Maharaj Nakorn Chiangmai Hospital
- Songklanagarind hospital
- Communal Noncommercial Enterprise Cherkasy Regional Hospital of Cherkasy Regional Council
- Municipal non-commercial enterprise of Kharkiv Regional Council Regional Clinical Hospital
- City Clinical Hospital No. 2
- Medical Center 'Ok Clinic' of International Institute of Clinical Research LLC
- Kyiv Railway Clinical Hospital #2 Of Branch 'Health Center' Of The Company 'Ukrainian Railway'
- SI National Scientific Center Institute of Cardiology of M.D. Strazhesko of NAMS of Ukraine
- Medical Center 'Consylium Medical'
- State Institution 'Institute of Nephrology of the National Academy of Medical Sciences of Ukraine'
- Municipal Non-profit Enterprise 'Odesa Regional Clinical Hospital' Odesa Regional Council
- Multidisciplinary Medical Center of Odessa National Medical University
- Municipal Non-commercial Enterprise Ternopil University Hospital of Ternopil Regional Council
- MNPE 'Vinnytsia Regional Clinical Hospital named after M.I. Pyrogov of Vinnytsia Regional Council'
- Medical Center LTD Health Clinic Department of Cardiology and Rheumatology
- Medical Center LLC 'Modern Clinic'
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Guselkumab+Standard of Care
Placebo+Standard of Care
Participants will receive guselkumab Dose 1 intravenously (IV) at Weeks 0, 4 and 8 and guselkumab Dose 2 subcutaneous (SC) every 4 weeks (q4w) from Week 12 through Week 48 along with standard-of-care treatment of mycophenolate mofetil (MMF)/mycophenolic acid (MPA) and glucocorticoids. Participants who achieved complete renal response (CRR) at Week 48 and 52 and have completed the Week 52 assessment may have the option to participate in the long-term extension (LTE).
Participants will receive placebo IV at Weeks 0, 4 and 8 and placebo SC q4w from Week 12 through Week 48 along with standard-of-care treatment of MMF/MPA and glucocorticoids. Participants who achieved complete renal response (CRR) at Week 48 and 52 and have completed the Week 52 assessment may have the option to participate in the LTE of the study.