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A Model About the Response of Belimumab in SLE (MRBS)

Primary Purpose

Systemic Lupus Erythematosus

Status
Not yet recruiting
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Belimumab
Sponsored by
First Affiliated Hospital Xi'an Jiaotong University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Systemic Lupus Erythematosus

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Fulfillment of the 1997 American College of Rheumatology (ACR) revised criteria for SLE;
  • Aged more than 18 years;
  • Active (according to SLEDAI-2K) and refractory SLE manifestations. SLE manifestations are defined as refractory in case of drug intolerance, unresponsiveness, or disease relapse in patients treated with corticosteroids, antimalarials, and/or immunosuppressants. Patients with renal disease were considered as refractory when they had a persistence of 24 hours proteinuria > 1 g after at least 1 year from the start of the initial therapy or when they experienced a renal flare (24 hours proteinuria > 1 g in case of previous complete response or doubling 24 hours proteinuria in other cases) during the subsequent therapy.

Exclusion Criteria:

  • Have a history of malignant neoplasm within the last 5 years except basal cell or squamous cell carcinoma of the skin treated with local resection only or carcinoma in situ of the uterine cervix treated locally and with no evidence of metastatic disease for 3 years;
  • Have evidence of serious suicide risk including any history of suicidal behaviour in the last 6 months and/or any suicidal ideation in the last 2 months or who in the investigator's judgment, poses a significant suicide risk;
  • Have a history of a primary immunodeficiency;
  • Have a significant IgG deficiency (IgG level < 400 mg/dL);
  • Have an IgA deficiency (IgA level < 10 mg/dL)
  • Have cyclophosphamide or rituximab treatment.
  • Infection history:

Currently on any suppressive therapy for a chronic infection (such as tuberculosis, pneumocystis, cytomegalovirus, herpes simplex virus, herpes zoster and atypical mycobacteria) Hospitalization for treatment of infection within 60 days of Day 0; Use of parenteral (IV or IM) antibiotics (anti-bacterial, antiviral, anti-fungal, or anti-parasitic agents) within 60 days of Day 0.

  • Have current drug or alcohol abuse or dependence, or a history of drug or alcohol abuse or dependence within 365 days prior to Day 0;
  • Have a historically positive HIV test or test positive at screening for HIV;
  • Hepatitis status:

Serologic evidence of current or past Hepatitis B (HB) infection based on the results of testing for HBsAg and HBcAb as follows:

Patients positive for HBsAg or HBcAb are excluded Positive test for Hepatitis C antibody

  • Have a history of an anaphylactic reaction to parenteral administration of contrast agents, human or murine proteins or monoclonal antibodies;
  • Have any other clinically significant abnormal laboratory value in the opinion of the investigator;
  • Have any intercurrent significant medical or psychiatric illness that the investigator considers would make the candidate unsuitable for the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Other

    Arm Label

    belimumab

    Arm Description

    All patients with SLE receive belimumab 10mg/kg intravenous infusion over 1 hour on days 0, 14, and 28, and every 28 days through week 48. The patients who had SRI-4 response at week 48 were divided into response group and the patients without SRI-4 response at week 48 were divided into no response group.

    Outcomes

    Primary Outcome Measures

    Establishment of predictive model to assess the SRI response rate.
    An SRI response is defined as a ≥ 4-point reduction in SELENA-SLEDAI score, no new BILAG A organ domain score and no more than 1 new BILAG B score, and no worsening (increase < 0.3) in PGA score versus baseline.

    Secondary Outcome Measures

    The SRI-4 response rate
    An SRI response is defined as a ≥ 4-point reduction in SELENA-SLEDAI score, no new BILAG A organ domain score and no more than 1 new BILAG B score, and no worsening (increase < 0.3) in PGA score versus baseline.
    The rate of adverse events
    all adverse events

    Full Information

    First Posted
    May 16, 2021
    Last Updated
    September 17, 2023
    Sponsor
    First Affiliated Hospital Xi'an Jiaotong University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04893161
    Brief Title
    A Model About the Response of Belimumab in SLE
    Acronym
    MRBS
    Official Title
    A Model to Early Predict the Response of Belimumab Treatment in the Patients With Systemic Lupus Erythematosus
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    June 1, 2024 (Anticipated)
    Primary Completion Date
    January 31, 2026 (Anticipated)
    Study Completion Date
    January 31, 2026 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    First Affiliated Hospital Xi'an Jiaotong University

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Product Manufactured in and Exported from the U.S.
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    A prospective, single-center cohort study aims to determine a predictive model of the response of belimumab at Week 48.
    Detailed Description
    Preamble: Belimumab is an inhibitor of B cell activating factor (BAFF) that has been developed as an agent for the treatment of patients with systemic lupus erythematosus (SLE). In July 2019, belimumab was approved for marketing in China. The belimumab treatment has been proved to reduce the level of autoantibodies and control disease activity in the patients with SLE. The response rate of SLE Responder Index-4 (SRI-4) is approximately 50% in the BLISS-52 and BLISS-76 phase III clinical trials. The goal of this study is to establish a predictive model (including immune marker, inflammatory biomarker and clinical factor) to early estimate the response of belimumab treatment. Objectives: Primary objective: in the patients with SLE, an early predictive model of the response of belimumab treatment will be estimated. Secondary objectives: In subjects with SLE receiving belimumab treatment, to assess the effect of belimumab on: The clinical improvement; The serological variables improvemen. The inflammatory biomarkers improvemen. The quality of life. The dosage of prednisone. The kinetics of B cell phenotype. The function of non-switched memory B cells. The association between the immune, inflammatory and clinical markers and the response of belimumab. The mechanism of BAFF inhibition on the survival and selection of SLE non-switched memory B cells. The recovering of immune checkpoint in non-switched memory B cells from the view of BCR mutation. The rates of adverse events. Overview of study design: This is a prospective, single-center cohort study to estimate a predictive model of the response of belimumab. All patients with SLE receive belimumab 10mg/kg intravenous infusion over 1 hour on days 0, 14, and 28, and every 28 days through week 48. All patients are evaluated at week 0, 2, 4, 8, 12, 24, 36, and 48. The immune markers, inflammatory biomarkers, clinical markers and safety data are assessed following belimumab treatment. Study population: Men or women with SLE who have active (according to SLEDAI-2K) and refractory SLE manifestations. SLE manifestations are defined as refractory in case of drug intolerance, unresponsiveness, or disease relapse in patients treated with corticosteroids, antimalarials, and/or immunosuppressants. Patients with renal disease were considered as refractory when they had a persistence of 24 hours proteinuria > 1 g after at least 1 year from the start of the initial therapy or when they experienced a renal flare (24 hours proteinuria > 1 g in case of previous complete response or doubling 24 hours proteinuria in other cases) during the subsequent therapy.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Systemic Lupus Erythematosus

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Single Group Assignment
    Model Description
    All patients with SLE will be enrolled in one year and administrated belimumab 10mg/kg intravenous infusion over 1 hour on days 0, 14, and 28, and every 28 days through week 48.
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    72 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    belimumab
    Arm Type
    Other
    Arm Description
    All patients with SLE receive belimumab 10mg/kg intravenous infusion over 1 hour on days 0, 14, and 28, and every 28 days through week 48. The patients who had SRI-4 response at week 48 were divided into response group and the patients without SRI-4 response at week 48 were divided into no response group.
    Intervention Type
    Drug
    Intervention Name(s)
    Belimumab
    Other Intervention Name(s)
    The standard care
    Intervention Description
    All patients with SLE will be enrolled in one year and administrated belimumab 10mg/kg intravenous infusion over 1 hour on days 0, 14, and 28, and every 28 days through week 48.
    Primary Outcome Measure Information:
    Title
    Establishment of predictive model to assess the SRI response rate.
    Description
    An SRI response is defined as a ≥ 4-point reduction in SELENA-SLEDAI score, no new BILAG A organ domain score and no more than 1 new BILAG B score, and no worsening (increase < 0.3) in PGA score versus baseline.
    Time Frame
    at week 48
    Secondary Outcome Measure Information:
    Title
    The SRI-4 response rate
    Description
    An SRI response is defined as a ≥ 4-point reduction in SELENA-SLEDAI score, no new BILAG A organ domain score and no more than 1 new BILAG B score, and no worsening (increase < 0.3) in PGA score versus baseline.
    Time Frame
    at week 48
    Title
    The rate of adverse events
    Description
    all adverse events
    Time Frame
    week 0 to week 48

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Fulfillment of the 1997 American College of Rheumatology (ACR) revised criteria for SLE; Aged more than 18 years; Active (according to SLEDAI-2K) and refractory SLE manifestations. SLE manifestations are defined as refractory in case of drug intolerance, unresponsiveness, or disease relapse in patients treated with corticosteroids, antimalarials, and/or immunosuppressants. Patients with renal disease were considered as refractory when they had a persistence of 24 hours proteinuria > 1 g after at least 1 year from the start of the initial therapy or when they experienced a renal flare (24 hours proteinuria > 1 g in case of previous complete response or doubling 24 hours proteinuria in other cases) during the subsequent therapy. Exclusion Criteria: Have a history of malignant neoplasm within the last 5 years except basal cell or squamous cell carcinoma of the skin treated with local resection only or carcinoma in situ of the uterine cervix treated locally and with no evidence of metastatic disease for 3 years; Have evidence of serious suicide risk including any history of suicidal behaviour in the last 6 months and/or any suicidal ideation in the last 2 months or who in the investigator's judgment, poses a significant suicide risk; Have a history of a primary immunodeficiency; Have a significant IgG deficiency (IgG level < 400 mg/dL); Have an IgA deficiency (IgA level < 10 mg/dL) Have cyclophosphamide or rituximab treatment. Infection history: Currently on any suppressive therapy for a chronic infection (such as tuberculosis, pneumocystis, cytomegalovirus, herpes simplex virus, herpes zoster and atypical mycobacteria) Hospitalization for treatment of infection within 60 days of Day 0; Use of parenteral (IV or IM) antibiotics (anti-bacterial, antiviral, anti-fungal, or anti-parasitic agents) within 60 days of Day 0. Have current drug or alcohol abuse or dependence, or a history of drug or alcohol abuse or dependence within 365 days prior to Day 0; Have a historically positive HIV test or test positive at screening for HIV; Hepatitis status: Serologic evidence of current or past Hepatitis B (HB) infection based on the results of testing for HBsAg and HBcAb as follows: Patients positive for HBsAg or HBcAb are excluded Positive test for Hepatitis C antibody Have a history of an anaphylactic reaction to parenteral administration of contrast agents, human or murine proteins or monoclonal antibodies; Have any other clinically significant abnormal laboratory value in the opinion of the investigator; Have any intercurrent significant medical or psychiatric illness that the investigator considers would make the candidate unsuitable for the study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Jing Wang, Dr.
    Phone
    0086-18092691661
    Email
    kidip@163.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Lan He, Dr.
    Organizational Affiliation
    First Affiliated Hospital Xi'an Jiaotong University
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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