A Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Obinutuzumab in Adolescents With Active Class III or IV Lupus Nephritis (POSTERITY)
Primary Purpose
Lupus Nephritis
Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Obinutuzumab
Placebo
Mycophenolate Mofetil
Acetaminophen/paracetamol
Diphenhydramine hydrochloride (HCl)
Methylprednisolone
Prednisone
Sponsored by
About this trial
This is an interventional treatment trial for Lupus Nephritis
Eligibility Criteria
Inclusion Criteria:
- International Society of Nephrology and the Renal Pathology Society (ISN/RPS) 2003 Class III or IV active LN demonstrated on renal biopsy performed in the 12 months prior to or during screening
- Class V disease may be present in addition to Class III or IV LN, but participants with isolated Class V disease are not eligible
- Diagnosis of SLE according to the Systemic Lupus International Collaborating Clinics (SLICC) 2012 criteria
- Significant proteinuria defined by a UPCR above > 0.5 based on a first-morning void (FMV) collection at screening
- During the 12 months prior to or during screening, all participants must have received at least one dose of pulse-range IV methylprednisolone (typically 30 mg/kg, maximum of 1000 mg per dose) or equivalent for the treatment of the current episode of active LN.
Exclusion Criteria:
- Severe, active central nervous system (CNS) SLE, including retinitis, poorly controlled seizure disorder, acute confusional state, myelitis, stroke, cerebellar ataxia, or dementia
- Sclerosis in >50% of glomeruli on renal biopsy
- Purely chronic Class III(c) or Class IV(c) disease on renal biopsy, defined as the absence of any active lesions
- Presence of rapidly progressive glomerulonephritis
- Pure Class V LN
- Intolerance or contraindication to study therapies
- Active infection of any kind (excluding fungal infection of nail beds) or any major episode of infection requiring hospitalization or treatment with IV anti-infective medications within 4 weeks prior to screening, or completion of oral anti-infectives within 2 weeks prior to randomization
- History of or currently active primary or secondary immunodeficiency, including known history of HIV infection and other severe Immunodeficiency blood disorders
- History of serious recurrent or chronic infection
- History of or current cancer, including solid tumors, hematological malignancies, and carcinoma in situ (except basal cell carcinoma and squamous cell carcinoma of the skin that have been excised and cured) within the past 5 years
- Significant or uncontrolled concomitant medical disease which, in the investigator's opinion, would preclude participant participation
- Currently active alcohol or drug abuse or history of alcohol or drug abuse
Sites / Locations
- Loma Linda University healthRecruiting
- University of California San FranciscoRecruiting
- Children's Hospital Colorado, Anchutz Medical CampusRecruiting
- Emory Children's CenterRecruiting
- Indiana University Health University HospitalRecruiting
- Louisiana State UniversityRecruiting
- Cohen Children's Medical Center of New York; PediatricsRecruiting
- Cincinnati Childrens HospitalRecruiting
- Texas Arthritis CenterRecruiting
- Ser Servicos Especializados Em ReumatologiaRecruiting
- Universidade Federal de Sao Paulo - UNIFES
- Hospital das Clinicas - FMUSPRecruiting
- The Hospital for Sick ChildrenRecruiting
- CH de Bicêtre; Pediatrie GeneraleRecruiting
- Hôpital Robert Debré; Nephrologie pediatriqueRecruiting
- Hop Necker Enfants Malades;UIHRecruiting
- CHU de Toulouse - Hôpital des Enfants; Nephro - Rhumato - Medecine Interne - HypertensionRecruiting
- Ospedale Pediatrico Bambino Gesu; U.O. Di Nefrologia E DialisiRecruiting
- IRCCS G. Gaslini; U.O. Nefrologia, Dialisi e TrapiantoRecruiting
- Clinica Pediatrica II De MarchiRecruiting
- CREA Hospital Mexico Americano; Clinica Pediatrica de Reumatologia y Enfermedades AutoinmunesRecruiting
- Clinstile S.A de C.V.Recruiting
- Instituto de Ginecología y ReproducciónRecruiting
- Clinica El GolfRecruiting
- Uniwersyteckie Centrum Kliniczne; Klinika Chorob Nerek i Nadci?nienia Dzieci i MlodziezyRecruiting
- Szpital Specjalistyczny dla Dzieci i Doroslych; Oddzial Kliniczny Pediatrii i NefrologiiRecruiting
- Saint-Petersburg State; Pediatrics Medical AcademyRecruiting
- Red Cross War Memorial Children?s Hospital; Nephrology UnitRecruiting
- Groote Schuur Hospital; Renal UnitRecruiting
- Hospital Sant Joan De Deu; Servicio de Reumatologia PediatricaRecruiting
- Hospital Ramon y Cajal ; Servicio de ReumatologiaRecruiting
- Hospital de La Paz; Unidad de Reumatologia Pediatrica
- Hospital Universitario la Fe: Servicio de Reumatologia PediatricaRecruiting
- Royal Hospital For ChildrenRecruiting
- Alder Hey Childrens HospitalRecruiting
- Great Ormond Street Hospital for ChildrenRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Obinutuzumab
Placebo
Arm Description
Participants will receive obinutuzumab 1000 milligrams (mg) intravenous (IV) infusions on Day 1, Day 14, Week 24, Week 26 and Week 52. Participants with a body weight of 45 kg or more will receive the 1000 mg dose. Participants with a body weight below 45 kg will receive a weight adjusted dose of 20 mg/kilogram (kg).
Placebo participants will receive obinutuzumab matched placebo on Day 1, Day 14, Week 24, Week 26 and Week 52.
Outcomes
Primary Outcome Measures
Percentage of Participants who Achieve a Complete Renal Response (CRR)
CRR is defined as achievement of all of the following:
Urinary protein-to-creatinine ratio (UPCR) <0.5
Estimated Glomerular Filtration Rate (eGFR) >=85% of baseline
No occurrence of intercurrent events
Secondary Outcome Measures
Percentage of Participants Achieving a CRR
Percentage of Participants who Achieve a Partial Renal Response (PRR)
Percentage of Participants Achieving an Overall Response (CRR or PRR)
PRR is defined as:
achievement of all of the following:
>=50% reduction in urinary protein-to-creatinine ratio (UPCR) from baseline
UPCR < 1 (or < 3 if the baseline UPCR was >=3)
eGFR >=85% of baseline
No occurrence of intercurrent events
Change in UPCR
Change in eGFR
Time to Onset of CRR over the Course of 76 weeks
Percentage of Participants who Experience Treatment Failure
Change in C3 Complement Levels
Change in C4 Complement Levels
Percentage of Participants with Adverse Events According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0
Serum Concentrations of Obinutuzumab
Percentage of Participants Achieving B-cell Depletion via Highly Sensitive Flow Cytometry (HSFC)
Change in Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale (PedsQL)-Fatigue Total Score
Change in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)
Change from Baseline in Child Health Questionnaire-Parent Form 28 (CHQ-PF28) Domain Scores
Full Information
NCT ID
NCT05039619
First Posted
September 1, 2021
Last Updated
September 14, 2023
Sponsor
Hoffmann-La Roche
Collaborators
Genentech, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT05039619
Brief Title
A Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Obinutuzumab in Adolescents With Active Class III or IV Lupus Nephritis
Acronym
POSTERITY
Official Title
A Phase II, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Obinutuzumab in Adolescent Patients With Active Class III or IV Lupus Nephritis
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 12, 2022 (Actual)
Primary Completion Date
March 28, 2025 (Anticipated)
Study Completion Date
March 13, 2027 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche
Collaborators
Genentech, Inc.
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
This phase II, randomized, double-blind, placebo-controlled study is designed to evaluate the safety, efficacy and pharmacokinetics of obinutuzumab in adolescent participants aged 12 to less than 18 with biopsy-confirmed proliferative lupus nephritis (LN).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lupus Nephritis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Obinutuzumab
Arm Type
Experimental
Arm Description
Participants will receive obinutuzumab 1000 milligrams (mg) intravenous (IV) infusions on Day 1, Day 14, Week 24, Week 26 and Week 52. Participants with a body weight of 45 kg or more will receive the 1000 mg dose. Participants with a body weight below 45 kg will receive a weight adjusted dose of 20 mg/kilogram (kg).
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo participants will receive obinutuzumab matched placebo on Day 1, Day 14, Week 24, Week 26 and Week 52.
Intervention Type
Drug
Intervention Name(s)
Obinutuzumab
Other Intervention Name(s)
Gazyva
Intervention Description
Obinutuzumab will be administered by IV infusion at a dose of 1000 mg on Day 1, Day 14, Week 24, Week 26 and Week 52.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo matching obinutuzumab will be administered by IV on Day 1, Day 14, Week 24, Week 26 and Week 52.
Intervention Type
Drug
Intervention Name(s)
Mycophenolate Mofetil
Intervention Description
Mycophenolate Mofetil (MMF) will be taken by home administration orally at a target dose of 1200 mg/m^2/day to a maximum of 2.5g/day from baseline (Day 1) onwards.
Intervention Type
Drug
Intervention Name(s)
Acetaminophen/paracetamol
Intervention Description
Acetaminophen 1000 mg will be administered as pre-medication prior to infusions.
Intervention Type
Drug
Intervention Name(s)
Diphenhydramine hydrochloride (HCl)
Intervention Description
Diphenhydramine HCl 50 mg will be administered as pre-medication prior to infusions.
Intervention Type
Drug
Intervention Name(s)
Methylprednisolone
Intervention Description
Methylprednisolone 80 mg IV will be administered as pre-medication prior to infusions.
Intervention Type
Drug
Intervention Name(s)
Prednisone
Intervention Description
Oral prednisone or equivalent corticosteroid will be taken by home administration daily to a maximum dose of 60mg/day followed by a guided taper to 5mg/day or less by Week 24.
Primary Outcome Measure Information:
Title
Percentage of Participants who Achieve a Complete Renal Response (CRR)
Description
CRR is defined as achievement of all of the following:
Urinary protein-to-creatinine ratio (UPCR) <0.5
Estimated Glomerular Filtration Rate (eGFR) >=85% of baseline
No occurrence of intercurrent events
Time Frame
Week 76
Secondary Outcome Measure Information:
Title
Percentage of Participants Achieving a CRR
Time Frame
Weeks 24 and 52
Title
Percentage of Participants who Achieve a Partial Renal Response (PRR)
Time Frame
Week 76
Title
Percentage of Participants Achieving an Overall Response (CRR or PRR)
Description
PRR is defined as:
achievement of all of the following:
>=50% reduction in urinary protein-to-creatinine ratio (UPCR) from baseline
UPCR < 1 (or < 3 if the baseline UPCR was >=3)
eGFR >=85% of baseline
No occurrence of intercurrent events
Time Frame
Weeks 24, 52, and 76
Title
Change in UPCR
Time Frame
Baseline to Week 76
Title
Change in eGFR
Time Frame
Baseline to Week 76
Title
Time to Onset of CRR over the Course of 76 weeks
Time Frame
Up to Week 76
Title
Percentage of Participants who Experience Treatment Failure
Time Frame
Week 12 to Week 76
Title
Change in C3 Complement Levels
Time Frame
Baseline to Week 76
Title
Change in C4 Complement Levels
Time Frame
Baseline to Week 76
Title
Percentage of Participants with Adverse Events According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0
Time Frame
Baseline to Week 76
Title
Serum Concentrations of Obinutuzumab
Time Frame
Baseline to Week 76
Title
Percentage of Participants Achieving B-cell Depletion via Highly Sensitive Flow Cytometry (HSFC)
Time Frame
Baseline, Weeks 4, 24, 52 and 76
Title
Change in Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale (PedsQL)-Fatigue Total Score
Time Frame
Baseline to Week 76
Title
Change in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)
Time Frame
Baseline to Week 76
Title
Change from Baseline in Child Health Questionnaire-Parent Form 28 (CHQ-PF28) Domain Scores
Time Frame
Baseline to Week 76
10. Eligibility
Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
International Society of Nephrology and the Renal Pathology Society (ISN/RPS) 2003 Class III or IV active LN demonstrated on renal biopsy performed in the 12 months prior to or during screening
Class V disease may be present in addition to Class III or IV LN, but participants with isolated Class V disease are not eligible
Diagnosis of SLE according to the Systemic Lupus International Collaborating Clinics (SLICC) 2012 criteria
Significant proteinuria defined by a UPCR above > 0.5 based on a first-morning void (FMV) collection at screening
During the 12 months prior to or during screening, all participants must have received at least one dose of pulse-range IV methylprednisolone (typically 30 mg/kg, maximum of 1000 mg per dose) or equivalent for the treatment of the current episode of active LN.
Exclusion Criteria:
Severe, active central nervous system (CNS) SLE, including retinitis, poorly controlled seizure disorder, acute confusional state, myelitis, stroke, cerebellar ataxia, or dementia
Sclerosis in >50% of glomeruli on renal biopsy
Purely chronic Class III(c) or Class IV(c) disease on renal biopsy, defined as the absence of any active lesions
Presence of rapidly progressive glomerulonephritis
Pure Class V LN
Intolerance or contraindication to study therapies
Active infection of any kind (excluding fungal infection of nail beds) or any major episode of infection requiring hospitalization or treatment with IV anti-infective medications within 4 weeks prior to screening, or completion of oral anti-infectives within 2 weeks prior to randomization
History of or currently active primary or secondary immunodeficiency, including known history of HIV infection and other severe Immunodeficiency blood disorders
History of serious recurrent or chronic infection
History of or current cancer, including solid tumors, hematological malignancies, and carcinoma in situ (except basal cell carcinoma and squamous cell carcinoma of the skin that have been excised and cured) within the past 5 years
Significant or uncontrolled concomitant medical disease which, in the investigator's opinion, would preclude participant participation
Currently active alcohol or drug abuse or history of alcohol or drug abuse
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Reference Study ID Number: WA42985 https://forpatients.roche.com/
Phone
888-662-6728 (U.S. and Canada)
Email
global.rochegenentechtrials@roche.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
Facility Name
Loma Linda University health
City
Loma Linda
State/Province
California
ZIP/Postal Code
92354
Country
United States
Individual Site Status
Recruiting
Facility Name
University of California San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94117
Country
United States
Individual Site Status
Recruiting
Facility Name
Children's Hospital Colorado, Anchutz Medical Campus
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Recruiting
Facility Name
Emory Children's Center
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
20010
Country
United States
Individual Site Status
Recruiting
Facility Name
Indiana University Health University Hospital
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Individual Site Status
Recruiting
Facility Name
Louisiana State University
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71103
Country
United States
Individual Site Status
Recruiting
Facility Name
Cohen Children's Medical Center of New York; Pediatrics
City
Queens
State/Province
New York
ZIP/Postal Code
11042
Country
United States
Individual Site Status
Recruiting
Facility Name
Cincinnati Childrens Hospital
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Individual Site Status
Recruiting
Facility Name
Texas Arthritis Center
City
El Paso
State/Province
Texas
ZIP/Postal Code
79902
Country
United States
Individual Site Status
Recruiting
Facility Name
Ser Servicos Especializados Em Reumatologia
City
Salvador
State/Province
BA
ZIP/Postal Code
40150-150
Country
Brazil
Individual Site Status
Recruiting
Facility Name
Universidade Federal de Sao Paulo - UNIFES
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
04026-000
Country
Brazil
Individual Site Status
Active, not recruiting
Facility Name
Hospital das Clinicas - FMUSP
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
05403-010
Country
Brazil
Individual Site Status
Recruiting
Facility Name
The Hospital for Sick Children
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1X8
Country
Canada
Individual Site Status
Recruiting
Facility Name
CH de Bicêtre; Pediatrie Generale
City
Le Kremlin Bicêtre
ZIP/Postal Code
94275
Country
France
Individual Site Status
Recruiting
Facility Name
Hôpital Robert Debré; Nephrologie pediatrique
City
Paris
ZIP/Postal Code
75019
Country
France
Individual Site Status
Recruiting
Facility Name
Hop Necker Enfants Malades;UIH
City
Paris
ZIP/Postal Code
75743
Country
France
Individual Site Status
Recruiting
Facility Name
CHU de Toulouse - Hôpital des Enfants; Nephro - Rhumato - Medecine Interne - Hypertension
City
Toulouse
ZIP/Postal Code
31000
Country
France
Individual Site Status
Recruiting
Facility Name
Ospedale Pediatrico Bambino Gesu; U.O. Di Nefrologia E Dialisi
City
Roma
State/Province
Lazio
ZIP/Postal Code
00165
Country
Italy
Individual Site Status
Recruiting
Facility Name
IRCCS G. Gaslini; U.O. Nefrologia, Dialisi e Trapianto
City
Genova
State/Province
Liguria
ZIP/Postal Code
16148
Country
Italy
Individual Site Status
Recruiting
Facility Name
Clinica Pediatrica II De Marchi
City
Milano
State/Province
Lombardia
ZIP/Postal Code
20122
Country
Italy
Individual Site Status
Recruiting
Facility Name
CREA Hospital Mexico Americano; Clinica Pediatrica de Reumatologia y Enfermedades Autoinmunes
City
Guadalajara
State/Province
Jalisco
ZIP/Postal Code
44620
Country
Mexico
Individual Site Status
Recruiting
Facility Name
Clinstile S.A de C.V.
City
Mexico City
State/Province
Mexico CITY (federal District)
ZIP/Postal Code
06700
Country
Mexico
Individual Site Status
Recruiting
Facility Name
Instituto de Ginecología y Reproducción
City
Lima
Country
Peru
Individual Site Status
Recruiting
Facility Name
Clinica El Golf
City
San Isidro
ZIP/Postal Code
L27 Lima
Country
Peru
Individual Site Status
Recruiting
Facility Name
Uniwersyteckie Centrum Kliniczne; Klinika Chorob Nerek i Nadci?nienia Dzieci i Mlodziezy
City
Gdansk
ZIP/Postal Code
80-952
Country
Poland
Individual Site Status
Recruiting
Facility Name
Szpital Specjalistyczny dla Dzieci i Doroslych; Oddzial Kliniczny Pediatrii i Nefrologii
City
Torun
ZIP/Postal Code
87-100
Country
Poland
Individual Site Status
Recruiting
Facility Name
Saint-Petersburg State; Pediatrics Medical Academy
City
St-peterburg
State/Province
Sankt Petersburg
ZIP/Postal Code
194100
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
Red Cross War Memorial Children?s Hospital; Nephrology Unit
City
Cape Town
ZIP/Postal Code
7700
Country
South Africa
Individual Site Status
Recruiting
Facility Name
Groote Schuur Hospital; Renal Unit
City
Cape Town
ZIP/Postal Code
7925
Country
South Africa
Individual Site Status
Recruiting
Facility Name
Hospital Sant Joan De Deu; Servicio de Reumatologia Pediatrica
City
Esplugas DE Llobregat
State/Province
Barcelona
ZIP/Postal Code
08950
Country
Spain
Individual Site Status
Recruiting
Facility Name
Hospital Ramon y Cajal ; Servicio de Reumatologia
City
Madrid
ZIP/Postal Code
28034
Country
Spain
Individual Site Status
Recruiting
Facility Name
Hospital de La Paz; Unidad de Reumatologia Pediatrica
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Individual Site Status
Active, not recruiting
Facility Name
Hospital Universitario la Fe: Servicio de Reumatologia Pediatrica
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Individual Site Status
Recruiting
Facility Name
Royal Hospital For Children
City
Glasgow
ZIP/Postal Code
G51 4TF
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Alder Hey Childrens Hospital
City
Liverpool
ZIP/Postal Code
L12 2AP
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Great Ormond Street Hospital for Children
City
London
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom
Individual Site Status
Recruiting
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.vivli.org). Further details on Roche's criteria for eligible studies are available here (https://vivli.org/ourmember/roche/). For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).
Learn more about this trial
A Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Obinutuzumab in Adolescents With Active Class III or IV Lupus Nephritis
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