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An Efficacy and Safety Study of Intravenous Anifrolumab to Treat Systemic Lupus Erythematosus in Pediatric Participants (SLE)

Primary Purpose

Systemic Lupus Erythematosus

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Anifrolumab
Placebo
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Systemic Lupus Erythematosus focused on measuring Systemic Lupus Erythematosus, SLE, Monoclonal Antibody, Anifrolumab, Parallel-group treatment, Pediatric participants, Standard of care therapy, Intravenous

Eligibility Criteria

5 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Participant's parent/caregiver/legally authorized representative and participant (if required per local country regulation) capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the ICF and in this protocol. Informed assent is to be provided by the participant per local country regulation. Diagnosis of SLE according to the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) criteria. Participant should meet all of following tuberculosis (TB) criteria: A. No signs or symptoms of active TB B. No medical history or past physical examinations suggestive of active TB C. No recent contact with a person with active TB or if there has been such contact, referral to a TB specialist for evaluation and initiation of treatment for latent TB, if warranted, prior to the first administration of study intervention in accordance with local SoC D. No history of latent TB without documented completion of treatment prior to initial screening visit Female participants of childbearing potential must have a negative pregnancy test at Screening. Female participants of childbearing and non-childbearing potential and male participants must adhere to the contraception methods. At screening, negative SARS-CoV-2 RT-PCR or antigen test result and no known or suspected COVID-19 infection or exposure between screening and randomization visits. Exclusion Criteria: Known diagnosis of a monogenic form of SLE. History of, or current diagnosis of, clinically significant non-SLE-related vasculitides. History or evidence of suicidal ideation. History of any non-SLE disease that has required treatment with oral or parenteral corticosteroids for more than a total of 2 weeks within the last 24 weeks prior to signing the ICF. Any positive result on Screening for human immunodeficiency virus. Active hepatitis B surface antigen OR hepatitis B core antibody (HBcAb), hepatitis C virus (HCV) antibody and detectable HCV ribonucleic acid (RNA) or any severe case of Herpes Zoster infection. Any clinical cytomegalovirus or Epstein-Barr virus infection that has not completely resolved within 12 weeks prior to signing the ICF. History of severe COVID-19 infection requiring hospitalization, intensive care unit care, or assisted ventilation or any prior COVID-19 infection with unresolved sequelae. Any mild/asymptomatic COVID-19 infection (laboratory confirmed or suspected based on clinical symptoms). Prior use of Anifrolumab.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Anifrolumab

    Placebo

    Arm Description

    Randomized participants will receive a single dose of Anifrolumab via IV infusion every 4 weeks

    Randomized participants will receive matching placebo via IV infusion

    Outcomes

    Primary Outcome Measures

    Part A - Maximum observed serum (peak) drug concentration (Cmax)
    The PK will be characterised and the dose of Anifrolumab will be defined in pediatric participants with moderate to severely active SLE.
    Part A - Area under the serum concentration curve (AUC)
    The PK will be characterised and the dose of Anifrolumab will be defined in pediatric participants with moderate to severe active SLE.
    Part A - Minimum observed serum concentration (Cmin)
    Evaluation of Cmin following single dose or after dose adjustment of IV Anifrolumab or matching placebo will be done in pediatric participants with moderate to severely active SLE.
    Part A - Maximum observed serum (peak) concentration at steady-state (Css, max)
    Evaluation of Css, max following single dose or after dose adjustment of IV Anifrolumab or matching placebo will be done in pediatric participants with moderate to severely active SLE.
    Part A - Area under the serum concentration-time curve at steady-state (AUCss)
    Evaluation of AUCss following single dose or after dose adjustment of IV Anifrolumab or matching placebo will be done in pediatric participants with moderate to severely active SLE.
    Part A - Average serum concentration at steady-state (Css, avg)
    Evaluation of Css, avg following single dose or after dose adjustment of IV Anifrolumab or matching placebo will be done in pediatric participants with moderate to severely active SLE.
    Part B - Number of participants who are British Isles Lupus Assessment Group-based Composite Lupus Assessment (BICLA) responders (yes/no)
    BICLA response is defined as: Reduction of all baseline British Isles Lupus Assessment Group BILAG-2004 A to B/C/D and B to C/D, and no BILAG-2004 worsening in other organ systems, as defined by ≥ 1 new BILAG-2004 A or ≥ 2 new BILAG- 2004 B. No worsening from baseline in SLEDAI-2K, defined as an increase from baseline of > 0 points. No worsening from baseline in participant's lupus disease activity, defined by an increase ≥ 0.30 points on a PGA 3-point visual analogue scale (VAS).

    Secondary Outcome Measures

    Part B - Number of participants who are Systemic Lupus Erythematosus Responder Index of ≥ 4 SRI(4) responders (yes/no)
    SRI-4 response is defined as: ≥ 4-point reduction from baseline in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score. No new organ systems affected as defined by ≥ 1 new BILAG-2004 A or ≥ 2 new BILAG-2004 B items compared to baseline. No worsening from baseline in participant's lupus disease activity, defined by an increase ≥ 0.30 points on a PGA 3-point VAS.
    Part B - Time to first flare in pediatric participants with moderate to severe active SLE
    Time to first flare, where flare is defined as either ≥ 1 new BILAG-2004 A, or ≥ 2 new BILAG-2004 B items compared with the previous visit.
    Part - B Change from baseline through Week 52 in Anifrolumab serum concentration
    The PK of Anifrolumab in pediatric participants with moderate to severe active SLE will be characterized.
    Part - B Change from baseline through Week 52 in antidrug antibody (ADA)
    The immunogenicity of Anifrolumab in pediatric participants with moderate to severe active SLE will be characterized.
    Part - B Change from baseline through Week 52 in anti-dsDNA antibodies
    The PD of Anifrolumab in pediatric participants with moderate to severe active SLE will be characterized.
    Part - B Change from baseline through Week 52 in complement components and CH50
    The PD of Anifrolumab in pediatric participants with moderate to severe active SLE will be characterized.
    Number of participants who are Pediatric Rheumatology International Trials Organization/American College of Rheumatology (PRINTO/ACR) childhood-onset systemic lupus erythematosus (cSLE) responders (yes/no)
    PRINTO/ACR cSLE responders are defined as participants with at least 50% improvement in 2 of 5 core set outcome measures and no more than one of the remaining worsening more than 30%, where the core set measures are: ParentGA 21-circle VAS PGA 3-point VAS SLEDAI-2K PedsQL Generic Core (Physical Functioning Domain) Proteinuria
    Part B - The mean percentage reduction from Baseline through Week 52 in oral corticosteroid(s) (OCS) background dose
    The efficacy of Anifrolumab vs placebo on OCS background dose in pediatric participants with moderate to severe active SLE will be characterized.

    Full Information

    First Posted
    April 18, 2023
    Last Updated
    April 18, 2023
    Sponsor
    AstraZeneca
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05835310
    Brief Title
    An Efficacy and Safety Study of Intravenous Anifrolumab to Treat Systemic Lupus Erythematosus in Pediatric Participants
    Acronym
    SLE
    Official Title
    A Phase III, Randomized, Double-blind, Parallel-group, Placebo Controlled Study to Evaluate the Pharmacokinetics, Pharmacodynamics, Efficacy, and Safety of IV Anifrolumab in Pediatric Participants 5 to < 18 Years of Age With Moderate to Severe Active Systemic Lupus Erythematosus (SLE) While on Background Standard of Care Therapy
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    June 21, 2023 (Anticipated)
    Primary Completion Date
    October 9, 2029 (Anticipated)
    Study Completion Date
    October 9, 2029 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    AstraZeneca

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    A Study to evaluate the PK, PD, efficacy, and safety of Anifrolumab in children with moderate to severe active SLE
    Detailed Description
    This study aims to characterize the pharmacokinetics, pharmacodynamics, efficacy, and safety of Anifrolumab solution for infusion compared with placebo solution for infusion in pediatric participants with severe active systemic lupus erythematosus who are on background standard of care therapy. The study duration for a participant will be approximately 120 weeks, which includes: Screening period of up to 30 days. Part A consists of a four-week, double-blind, placebo-controlled, randomised, pharmacokinetic period. Part B is a double-blind, placebo-controlled, randomised, safety/efficacy period lasting 48 weeks (for rollover participants from Part A) or 52 weeks (for de novo participants). Part C is a 52-week open-label extension period. Part D is a 12-week, safety follow-up period.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Systemic Lupus Erythematosus
    Keywords
    Systemic Lupus Erythematosus, SLE, Monoclonal Antibody, Anifrolumab, Parallel-group treatment, Pediatric participants, Standard of care therapy, Intravenous

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    100 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Anifrolumab
    Arm Type
    Experimental
    Arm Description
    Randomized participants will receive a single dose of Anifrolumab via IV infusion every 4 weeks
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Randomized participants will receive matching placebo via IV infusion
    Intervention Type
    Biological
    Intervention Name(s)
    Anifrolumab
    Other Intervention Name(s)
    (MEDI-546)
    Intervention Description
    Participants will receive a single dose of Anifrolumab via IV infusion.
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Participants will receive matching placebo via IV infusion
    Primary Outcome Measure Information:
    Title
    Part A - Maximum observed serum (peak) drug concentration (Cmax)
    Description
    The PK will be characterised and the dose of Anifrolumab will be defined in pediatric participants with moderate to severely active SLE.
    Time Frame
    Up to Day 29
    Title
    Part A - Area under the serum concentration curve (AUC)
    Description
    The PK will be characterised and the dose of Anifrolumab will be defined in pediatric participants with moderate to severe active SLE.
    Time Frame
    Up to Day 29
    Title
    Part A - Minimum observed serum concentration (Cmin)
    Description
    Evaluation of Cmin following single dose or after dose adjustment of IV Anifrolumab or matching placebo will be done in pediatric participants with moderate to severely active SLE.
    Time Frame
    Up to Day 29
    Title
    Part A - Maximum observed serum (peak) concentration at steady-state (Css, max)
    Description
    Evaluation of Css, max following single dose or after dose adjustment of IV Anifrolumab or matching placebo will be done in pediatric participants with moderate to severely active SLE.
    Time Frame
    Up to Day 29
    Title
    Part A - Area under the serum concentration-time curve at steady-state (AUCss)
    Description
    Evaluation of AUCss following single dose or after dose adjustment of IV Anifrolumab or matching placebo will be done in pediatric participants with moderate to severely active SLE.
    Time Frame
    Up to Day 29
    Title
    Part A - Average serum concentration at steady-state (Css, avg)
    Description
    Evaluation of Css, avg following single dose or after dose adjustment of IV Anifrolumab or matching placebo will be done in pediatric participants with moderate to severely active SLE.
    Time Frame
    Up to Day 29
    Title
    Part B - Number of participants who are British Isles Lupus Assessment Group-based Composite Lupus Assessment (BICLA) responders (yes/no)
    Description
    BICLA response is defined as: Reduction of all baseline British Isles Lupus Assessment Group BILAG-2004 A to B/C/D and B to C/D, and no BILAG-2004 worsening in other organ systems, as defined by ≥ 1 new BILAG-2004 A or ≥ 2 new BILAG- 2004 B. No worsening from baseline in SLEDAI-2K, defined as an increase from baseline of > 0 points. No worsening from baseline in participant's lupus disease activity, defined by an increase ≥ 0.30 points on a PGA 3-point visual analogue scale (VAS).
    Time Frame
    At Week 52
    Secondary Outcome Measure Information:
    Title
    Part B - Number of participants who are Systemic Lupus Erythematosus Responder Index of ≥ 4 SRI(4) responders (yes/no)
    Description
    SRI-4 response is defined as: ≥ 4-point reduction from baseline in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score. No new organ systems affected as defined by ≥ 1 new BILAG-2004 A or ≥ 2 new BILAG-2004 B items compared to baseline. No worsening from baseline in participant's lupus disease activity, defined by an increase ≥ 0.30 points on a PGA 3-point VAS.
    Time Frame
    At Week 52
    Title
    Part B - Time to first flare in pediatric participants with moderate to severe active SLE
    Description
    Time to first flare, where flare is defined as either ≥ 1 new BILAG-2004 A, or ≥ 2 new BILAG-2004 B items compared with the previous visit.
    Time Frame
    Through Week 52
    Title
    Part - B Change from baseline through Week 52 in Anifrolumab serum concentration
    Description
    The PK of Anifrolumab in pediatric participants with moderate to severe active SLE will be characterized.
    Time Frame
    Baseline, Week 52
    Title
    Part - B Change from baseline through Week 52 in antidrug antibody (ADA)
    Description
    The immunogenicity of Anifrolumab in pediatric participants with moderate to severe active SLE will be characterized.
    Time Frame
    Baseline, Week 52
    Title
    Part - B Change from baseline through Week 52 in anti-dsDNA antibodies
    Description
    The PD of Anifrolumab in pediatric participants with moderate to severe active SLE will be characterized.
    Time Frame
    Baseline, Week 52
    Title
    Part - B Change from baseline through Week 52 in complement components and CH50
    Description
    The PD of Anifrolumab in pediatric participants with moderate to severe active SLE will be characterized.
    Time Frame
    Baseline, Week 52
    Title
    Number of participants who are Pediatric Rheumatology International Trials Organization/American College of Rheumatology (PRINTO/ACR) childhood-onset systemic lupus erythematosus (cSLE) responders (yes/no)
    Description
    PRINTO/ACR cSLE responders are defined as participants with at least 50% improvement in 2 of 5 core set outcome measures and no more than one of the remaining worsening more than 30%, where the core set measures are: ParentGA 21-circle VAS PGA 3-point VAS SLEDAI-2K PedsQL Generic Core (Physical Functioning Domain) Proteinuria
    Time Frame
    At Week 52
    Title
    Part B - The mean percentage reduction from Baseline through Week 52 in oral corticosteroid(s) (OCS) background dose
    Description
    The efficacy of Anifrolumab vs placebo on OCS background dose in pediatric participants with moderate to severe active SLE will be characterized.
    Time Frame
    Baseline, Week 52
    Other Pre-specified Outcome Measures:
    Title
    All parts - Number of participants reporting suicidal ideation and/or suicidal behavior as per Columbia Suicide Severity Rating Scale (C-SSRS)
    Description
    The safety and tolerability of Anifrolumab in pediatric participants with moderate to severe active SLE will be assessed.
    Time Frame
    From Week 0 until the follow-up visit (12 weeks post-last dose)
    Title
    All parts - Number of participants with adverse events
    Description
    The safety and tolerability of Anifrolumab in pediatric participants with moderate to severe active SLE will be assessed.
    Time Frame
    From Week 0 until the follow-up visit (12 weeks post-last dose)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    5 Years
    Maximum Age & Unit of Time
    17 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Participant's parent/caregiver/legally authorized representative and participant (if required per local country regulation) capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the ICF and in this protocol. Informed assent is to be provided by the participant per local country regulation. Diagnosis of SLE according to the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) criteria. Participant should meet all of following tuberculosis (TB) criteria: A. No signs or symptoms of active TB B. No medical history or past physical examinations suggestive of active TB C. No recent contact with a person with active TB or if there has been such contact, referral to a TB specialist for evaluation and initiation of treatment for latent TB, if warranted, prior to the first administration of study intervention in accordance with local SoC D. No history of latent TB without documented completion of treatment prior to initial screening visit Female participants of childbearing potential must have a negative pregnancy test at Screening. Female participants of childbearing and non-childbearing potential and male participants must adhere to the contraception methods. At screening, negative SARS-CoV-2 RT-PCR or antigen test result and no known or suspected COVID-19 infection or exposure between screening and randomization visits. Exclusion Criteria: Known diagnosis of a monogenic form of SLE. History of, or current diagnosis of, clinically significant non-SLE-related vasculitides. History or evidence of suicidal ideation. History of any non-SLE disease that has required treatment with oral or parenteral corticosteroids for more than a total of 2 weeks within the last 24 weeks prior to signing the ICF. Any positive result on Screening for human immunodeficiency virus. Active hepatitis B surface antigen OR hepatitis B core antibody (HBcAb), hepatitis C virus (HCV) antibody and detectable HCV ribonucleic acid (RNA) or any severe case of Herpes Zoster infection. Any clinical cytomegalovirus or Epstein-Barr virus infection that has not completely resolved within 12 weeks prior to signing the ICF. History of severe COVID-19 infection requiring hospitalization, intensive care unit care, or assisted ventilation or any prior COVID-19 infection with unresolved sequelae. Any mild/asymptomatic COVID-19 infection (laboratory confirmed or suspected based on clinical symptoms). Prior use of Anifrolumab.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    AstraZeneca Clinical Study Information Center
    Phone
    1-877-240-9479
    Email
    information.center@astrazeneca.com

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com /ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.
    IPD Sharing Time Frame
    AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please refer to our disclosure commitment at: https://astrazenecagrouptrials.pharmacm.com /ST/Submission/Disclosure.
    IPD Sharing Access Criteria
    When a request has been approved AstraZeneca will provide access to the de-identified individual patientlevel data in an approved sponsored tool. Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at: https://astrazenecagrouptrials.pharmacm.com /ST/Submission/Disclosure.
    IPD Sharing URL
    https://astrazenecagroup-dt.pharmacm.com/DT/Home

    Learn more about this trial

    An Efficacy and Safety Study of Intravenous Anifrolumab to Treat Systemic Lupus Erythematosus in Pediatric Participants

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