A Study to Evaluate the Safety of Rituximab Retreatment in Subjects With Systemic Lupus Erythematosus (EXPLORER)
Lupus Erythematosus, Systemic
About this trial
This is an interventional treatment trial for Lupus Erythematosus, Systemic focused on measuring Rituxan, SLE, Lupus
Eligibility Criteria
Inclusion Criteria: Diagnosis of systemic lupus erythematosus (SLE). Active disease at screening. Stable use of one immunosuppressive drug. Use of an antimalarial drug. For subjects of reproductive potential (males and females), use of a reliable means of contraception throughout their study participation. Exclusion Criteria: Unstable patients with thrombocytopenia experiencing or at high risk for developing clinically significant bleeding or organ dysfunction requiring therapies such as plasmapheresis or acute blood or platelet transfusions. Active moderate to severe glomerulonephritis. Retinitis, poorly controlled seizure disorder, acute confusional state, myelitis, stroke or stroke syndrome, cerebellar ataxia, or dementia that is currently active and resulting from SLE. Lack of peripheral venous access. Pregnant women or nursing (breast feeding) mothers. History of severe, allergic, or anaphylactic reactions to humanized or murine monoclonal antibodies. Significant, uncontrolled medical disease in any organ system not related to SLE that in the investigator's opinion would preclude subject participation. Concomitant conditions that require oral or systemic corticosteroid use. Known human immunodeficiency virus (HIV) infection. Known active infection of any kind (excluding fungal infection of nail beds) or any major episode of infection requiring hospitalization or treatment with intravenous (IV) antibiotics. History of deep space infection. History of serious recurrent or chronic infection. History of cancer, including solid tumors, hematological malignancies, and carcinoma in situ. Active alcohol or drug abuse, or history of alcohol or drug abuse. Major surgery. Previous treatment with CAMPATH-1H antibody. Previous treatment with any B cell-targeted therapy. Treatment with any investigational agent within 28 days of screening (Day -7) or 5 half-lives of the investigational drug (whichever is longer). Receipt of a live vaccine within 28 days prior to screening. Intolerance or contraindication to oral or IV corticosteroids. Use of a new immunosuppressive drug prior to screening or change in dose of ongoing immunosuppressive drug prior to screening. Prednisone dose of ≥ 1 mg/kg/day prior to screening. Treatment with cyclophosphamide or a calcineurin inhibitor. Treatment with a second immunosuppressive or immunomodulatory drug. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2.5 x the upper limit of normal.
Sites / Locations
- Univ of Alabama School of Med; Clinical Immun Rheumatology
- Rheumatology Assoc of North AL
- Arizona Arthritis & Rheumatology Research, Pllc
- Univ of California, San Diego
- Univ of Calif., Los Angeles; Rheumatology
- Cedars-Sinai Medical Center
- Stanford University Med Ctr;Div of Immunology/Rheumatology
- Univ of Calif, San Francisco; Rheumatology
- Eden Medical Center San Leandro Hospital
- University of Colorado Denver
- Arthritis & Rheumatism; Disease Specialities
- Family Arthritis Center
- Emory Uni ; Division of Rheumatology
- Intermountain Research Center
- Coeur D'Alene Arthritis Clinic
- Northwestern University
- Rheumatology Associates
- University of Chicago
- Tri-State Arth & Rheum Center
- Univ of Kansas Medical Center; Allergy/Clin Imm/Rheum
- Kentuckiana Cancer Institute
- LA State Univ; Medicine
- Johns Hopkins Uni
- Center For Rheumatology & Bone Research
- Tufts - New England Medical Center
- Dana-Farber Cancer Institute; Rheumatology
- University Of Michigan
- Michigan Arthritis Rsrch Ctr
- Washington University; Rheumatology Division
- Center for Rheumatology, State Uni. of New York
- SUNY Downstate Medical Center.
- NS-LIJ Health Systems; Rheum-Allergy Clin Immu
- Feinstein Institute for Medical Research
- NYU-Hosp for Joint Diseases; Rheum and Med
- Hospital for Special Surgery
- Buffalo Rheumatology Associates
- Long Island Osteo/Arth Center
- University of Rochester - Strong Memorial Hospital
- University of North Carolina Hospitals Department of Pharmacy; Investigational Drug Services
- Duke Medical Center
- Physicians East Pa
- Ohio State University; Division of Nephrology
- Bone and Joint Hospital at St. Anthony Research Department
- Oklahoma Medical Research Foundation
- Oklahoma Center For Arthritis Therapy & Research
- Portland Medical Associates
- East Penn Rheumatology Associates, Pc
- Altoona Arthritis & Osteo Center
- Uni of Pennslyvania Medical Center
- Albert Einstein Medical Center
- University of Pittsburgh
- Medical Univ of South Carolina
- Arthritis Associates PLLC
- Metroplex Clinical Research
- Arthritis Centers of Texas
- Houston Inst. For Clinical Research
- Arthritis & Osteoporosis Associates, LLP
- Texas Research Center
- University of Virginia Med Ctr; Div of Ped Respiratory Med
- Virginia Commonwealth University
- Seattle Rheumatology Assoc; Swedish Rheumatology Research
- Seattle Cancer Care Alliance
- Arthritis Northwest, Spokane
- Univ of Manitoba, Health Scien; Arthritis Centre
- St. Joseph'S Health Care Centre
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Rituximab 1000 mg + prednisone
Placebo + prednisone
Participants will receive rituximab 1000 mg intravenously on Days 1, 15, 168, and 182. Participants will also receive an initial dose of prednisone (0.5, 0.75, or 1.0 mg/kg orally once a day) with tapering beginning at Day 16 for 10 weeks to a dose of ≤ 10 mg/day. Participants will also receive acetaminophen 1000 mg orally and diphenhydramine 50 mg orally prior to study drug infusion.
Participants will receive placebo intravenously on Days 1, 15, 168, and 182. Participants will also receive an initial dose of prednisone (0.5, 0.75, or 1.0 mg/kg orally once a day) with tapering beginning at Day 16 for 10 weeks to a dose of ≤ 10 mg/day. Participants will also receive acetaminophen 1000 mg orally and diphenhydramine 50 mg orally prior to study drug infusion.