Efficacy and Safety of Four Doses of Cenerimod Compared to Placebo in Adult Subjects With Active Systemic Lupus Erythematosus
Systemic Lupus Erythematosus
About this trial
This is an interventional treatment trial for Systemic Lupus Erythematosus focused on measuring Musculoskeletal and connective tissue disorders
Eligibility Criteria
Inclusion Criteria:
- Signed Informed Consent Form prior to any study-mandated procedure
- Diagnosis of SLE made at least 6 months prior to Screening, by fulfilling at least 4 of the 11 criteria for SLE as defined by the American College of Rheumatology (ACR) criteria
- A mSLEDAI-2K score ≥ 6 of at least 2 points for musculoskeletal or mucocutaneous manifestations (i.e., myositis, arthritis, rash, alopecia, mucosal ulcers).
Currently treated with stable doses of one or more of the following background medications:
- NSAIDs
- Anti-malarials (≤ 400 mg/day hydroxychloroquine, ≤ 500 mg/day chloroquine, ≤ 100 mg/day quinacrine)
- Mycophenolate mofetil (≤ 2 g/day)
- Mycophenolic acid (≤ 1440 mg/day)
- Azathioprine (≤ 2 mg/kg/day)
- Methotrexate (≤ 20 mg/week)
- Corticosteroids (≤ 40 mg/day prednisone or equivalent)
- Belimumab (≤10 mg/kg every 4 weeks intravenously, or 200 mg/week subcutaneously).
- History or presence of positive autoantibodies measured by central laboratory defined as follows: (a) Positive antinuclear antibody (ANA) test measured by immunofluorescence assay (IFA) with titre ≥1:80; AND/OR (b) positive anti-double stranded deoxyribonucleic acid (anti-dsDNA) antibodies with titre ≥30 IU/mL
Women of childbearing potential:
- Must have a negative serum pregnancy test at Screening
- Must agree to undertake monthly urine pregnancy tests during the study
- Must use highly effective methods of contraception from the screening visit until 6 months after taking the last dose of study treatment.
Exclusion Criteria:
- Active lupus nephritis or a renal biopsy demonstrating immune complex mediated glomerulonephritis compatible with lupus nephritis.
- CNS (Central Nervous System) lupus and severe forms of vasculitis requiring systemic immunosuppressive treatment
- A diagnosis of mixed connective tissue disease or any history of overlap syndromes of SLE with rheumatoid arthritis, erosive arthritis, scleroderma or autoimmune hepatitis
- History or presence of Mobitz type II or third-degree atrioventricular block, sick sinus syndrome, symptomatic bradycardia or syncope associated with cardiac disorders
- Subjects who experienced myocardial infarction, unstable angina pectoris, stroke, transient ischemic attack, vascular thrombosis, decompensated heart failure requiring hospitalization, or heart failure defined by the New York Heart Association Class III/IV within six months prior to Screening
- An elevated QT corrected for HR (Heart Rate) on the basis of Fridericia's formula interval of > 470 ms (females) / > 450 ms (males)
- History or presence of severe respiratory disease or pulmonary fibrosis
- Active or latent tuberculosis
- Ongoing bacterial, viral or fungal infection that is of clinical concern in the judgment of the investigator or history of any serious infection
- Subjects who have congenital or acquired severe immunodeficiency or known HIV infection or positive HIV testing
- Presence of macular edema or active uveitis
- Type 1 or 2 diabetes that is poorly controlled according to investigator judgment, or diabetes complicated with organ involvement such as diabetic nephropathy or retinopathy
- Significant hematology abnormality: Lymphocyte count < 800 /μL (0.8 × 10e9/L); hemoglobin < 9 g/dL; WBC (White Blood Cell) count < 2500/μL (2.5 × 10e9/L) or platelets < 75000/μL (75 × 10e9/L)
- Estimated glomerular filtration rate < 60 mL/min/1.73 m2
- Known allergy to S1P (sphingosine-1-phosphate) receptor modulators or any of the cenerimod formulation excipients
Sites / Locations
- Pinnacle Research Group
- University of California San Diego
- Valerius Medical Group and Research Center
- University of Colorado School of Medicine
- Robert W Levin MD PA
- Center for Rheumatology Immunology and Arthritis
- Life Clinical Trials
- San Marcus Research Clinic
- D&H National Research Centers INC
- Millennium Research
- Integral Rheumatology & Immunology Specialists
- Advanced Research Institute Inc Allergy & Rheumatology
- Axiom Clinical Research of Florida
- North Georgia Rheumatology Group - Duluth
- Institute of Arthritis Research
- Washington University School of Medicine
- Innovative Health Research
- New York Presbyterian Columbia University Medical Center
- State University of New York Upstate Medical University
- Joint Muscle Medical Care and Research Institute - Lilington Office
- DJL Clinical Research
- Paramount Medical Research and Consulting
- Altoona Center for Clinical Research
- Office of Ramesh C. Gupta, MD
- Amarillo Center for Clinical Research
- Accurate Clinical Research
- Southwest Rheumatology Research, LLC
- Sun Research Institute
- Accurate Clinical Management
- Multiprofile Hospital For Active Treatment Trimontium
- University Multiprofile Hospital for Active Treatment Pulmed
- Diagnostic and Consulting Center "Aleksandrovska" EOOD
- Diagnostic Consulting Center Fokus-5
- Enroll SpA
- Biomedica Research Group
- Meditek Ltda.
- Prosalud
- Clinical Research Chile SpA
- CCR Pardubice
- Centre Hospitalier Regional Universitaire Brest Hôpital de la Cavale Blanche à Brest
- Hôpital Haut-Lévêque
- LTD "New Plasma Clinic"
- Aversi Clinic LTD
- Medi Club Georgia Ltd.
- Ltd. Mtskheta Street Clinic
- The First Medical Center Ltd.
- LLC "Innova"
- LLC Raymann
- LTD "Tbilisi Heart Center"
- Medicore
- Multiprofile Clinic Consilium Medulla
- Städtisches Klinikum Karlsruhe gGmbH
- General Hospital of Athens "Laiko"
- Egyesitett Szent Istvan es Szent Laszlo Korhaz Rendelointezet
- Rambam Healthcare Campus
- Bnai Zion Medical Center
- Galilee Medical Center
- The Chaim Sheba Medical Center
- LUPUS CLINIC c/o DIMI
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
- Ospedale San Raffaele
- Azienda Ospedaliera San Camillo Forlanini
- Fondazione Policlinico Universitario A. Gemelli
- A.O. Mauriziano Umberto I di Torino
- Tomakomai City Hospital
- Karla Adriana Espinosa Bautista
- Consultorio Particular Dr. Miguel Cortés Hernández
- Centro Integral en Reumatología S.A. de C.V.
- Icle S.C.
- Consultorio Privado de Especialidad del Dr. José Javier Orozco Alcalá
- Consultorio Médico del Dr. Federico Galván Villegas
- Morales Vargas Centro de Investigación S.C.
- Centro de Investigación Clínica GRAMEL, S.C.
- Biológicos Especializados S.A. de C.V.
- Accelerium, S. de R.L. de C.V.
- UBAM Unidad Biomédica Avanzada Monterrey
- Unidad de Atención Médica e Investigación en Salud
- Kohler & Milstein Research S.A. de C.V.
- SMIQ, S. de R.L. de C.V.
- Hospital Universitario "Dr. Gonzalo Valdés Valdés"
- Unidad de Investigaciones Reumatológicas A.C.
- Centro de Atención e Investigación Cardiovascular del Potosí, S.C.
- Investigacion Biomedica para el Desarrollo de Farmacos S.A. de C.V.
- Lipa Medix Medical Center
- Angeles University Foundation Medical Center
- Davao Doctors Hospital
- Iloilo Doctors Hospital
- Makati Medical Center
- University of the Philippines Manila - Philippine General Hospital
- Jose R. Reyes Memorial Medical Center
- University of Santo Tomas Hospital
- St. Luke's Medical Center
- Far Eastern University - Nicanor Reyes Medical Foundation
- Szpital Uniwersytecki Number 2 im. dr. Jana Biziela w Bydgoszczy
- Intermedius Uslugi Medyczne
- Szpital Specjalistyczny im. J. Dietla w Krakowie
- Centrum Medyczne Plejady
- Twoja Przychodnia Poznańskie Centrum Medyczne
- Śląskie Centrum Reumatologii, Rehabilitacji i Zapobiegania Niepełnosprawności im gen. Jerzego Zi
- Centro Reumatologico de Caguas
- Centrul Medical de Diagnostic si Tratament Ambulatoriu Neomed
- Spitalul Clinic "Sf. Maria"
- SC Sana Monitoring SRL
- Spitalul Clinic Judetean de Urgenta Cluj-Napoca
- Chelyabinsk Regional Clinical Hospital
- JSC "Center of Family Medicine"
- City Clinical Hospital #15 named after O.M. Filatova
- Federal State Budget Scientific Research Institution "Scientific Research Institute of Rheumatology n.a. V.A. Nasonova"
- Non-governmental private healthcare organization, Scientific Clinical Centre of JSC Russian Railways
- Medical Center "Zdorovaya Semiya", LLC
- Orenburg State Medical University
- Clinical Rheumatological Hospital Number 25
- Polyclinic of Private Security and Detectives
- Medical Research Institute, LLC
- Medical Center Maksimum Zdorovia
- Military Medical Academy S.M. Kirov
- Saratov Regional Clinical Hospital
- State Institution of Health Protection "Clinical Hospital #8"
- Hospital Universitario Regional de Málaga
- Hospital Clinic i Provincial de Barcelona
- Hospital Universitario 12 de Octubre
- Hospital Quirónsalud Infanta Luisa
- Hospital Universitario Doctor Peset
- Kaohsiung Medical University Hospital
- Kaohsiung Veterans General Hospital
- Rajavithi Hospital
- Songklanagarind Hospital
- Istanbul Universitesi Istanbul Tip Fakultesi
- Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
- Kyiv City Clinical Hospital №3
- Clinic of State Institution "National Scientific Centre "Acad. Strazhesko Institute of Cardiology"
- Medical Centre "Consilium medical"
- Municipal Institution Kyiv Regional Council "Kyiv Regional Clinical Hospital"
- Municipal Nonprofit Institution of Lviv Regional Council "Lviv Regional Clinical Hospital"
- Municipal Nonprofit Institution of Lviv Regional Council
- Lviv Regional Clinical Hospital
- Poltava Regional Clinical Hospital named after M.V. Sklifossovsky
- Ternopil University Clinic - Rheumatology department
- Zakarpattya Regional Clinical Hospital n.a. A.Novak - Rheumatology Department
- Private Small Scale Medical Center "Pulse"
- Medical Center "Health Clinic", LLC
- Municipal Nonprofit Institution "Vinnytsia City Clinical Hospital №1"
- Scientific and Research Institute of Invalid Rehabilitation (EST Complex) of Vinnytsia M.I.Pyrogov NMU MOHU,
- Vinnytsya Regional Clinical Hospital - Rheumatology Department
- Municipal Institution "Zaporizhzhya Regional Clinical Hospital"
- Municipal institution "Regional Clinical Hospital n.a. O.F. Herbachevskoho"
- Cambridge University Hospitals NHS Foundation Trust
- Guy's and Saint Thomas' NHS Foundation Trust
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Experimental
Experimental
Experimental
Experimental
Placebo Comparator
Experimental
Placebo Comparator
Cenerimod 0.5 mg
Cenerimod 1 mg
Cenerimod 2 mg
Cenerimod 2 mg (Ex-4mg)
Placebo (Ex-4mg)
Cenerimod 4 mg
Placebo
Participants will receive cenerimod 0.5 mg once daily in addition to background SLE therapy. Treatment Period 1 is 6 months long. It will start with the administration of the first dose of study treatment, after randomization, and end at the Month 6 visit. All randomized participants need to complete Treatment Period 1 before continuing in Treatment Period 2. In Treatment Period 2 participants will continue with cenerimod 0.5 mg for a further 6 months and end study treatment at the Month 12 visit.
Participants will receive cenerimod 1 mg once daily in addition to background SLE therapy. Treatment Period 1 is 6 months long. It will start with the administration of the first dose of study treatment, after randomization, and end at the Month 6 visit. All randomized participants need to complete Treatment Period 1 before continuing in Treatment Period 2. In Treatment Period 2 participants will continue with cenerimod 1 mg for a further 6 months and end study treatment at the Month 12 visit.
Participants will receive cenerimod 2 mg once daily in addition to background SLE therapy. Treatment Period 1 is 6 months long. It will start with the administration of the first dose of study treatment, after randomization, and end at the Month 6 visit. All randomized participants need to complete Treatment Period 1 before continuing in Treatment Period 2. In Treatment Period 2 participants will continue with cenerimod 2 mg for a further 6 months and end study treatment at the Month 12 visit.
Half the participants that complete treatment with cenerimod 4 mg in Treatment Period 1 will be re-randomized to cenerimod 2 mg once daily in addition to background SLE therapy during Treatment Period 2. Participants will receive cenerimod 2 mg for 6 months and end study treatment at the Month 12 visit.
Half the participants that complete treatment with cenerimod 4 mg in Treatment Period 1 will be re-randomized to placebo (matching cenerimod) once daily in addition to background SLE therapy during Treatment Period 2. Participants will receive cenerimod 2 mg for 6 months and end study treatment at the Month 12 visit.
Participants will received cenerimod 4 mg once daily in addition to background SLE therapy for up to 6 months in Treatment Period 1. The participants randomized to the 4 mg treatment who were still on treatment at Month 6 were re-randomized in a 1:1 ratio to placebo or cenerimod 2 mg to enter Treatment Period 2. The participants who did not complete 6 months of cenerimod 4 mg treatment will be analyzed in the "Non Re-randomized (Ex-4mg)" treatment group.
Participants will receive placebo (matching cenerimod) once daily in addition to background SLE therapy. Treatment Period 1 is 6 months long. It will start with the administration of the first dose of study treatment, after randomization, and end at the Month 6 visit. All randomized participants need to complete Treatment Period 1 before continuing in Treatment Period 2. In Treatment Period 2 participants will continue with placebo (matching cenerimod) for a further 6 months and end study treatment at the Month 12 visit.