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Open-label Trial of Acthar Gel in Subjects With Moderate to Severe Active Systemic Lupus Erythematosus (ACTH)

Primary Purpose

Lupus Erythematosus Systemic Exacerbation

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
H.P. Acthar Gel
Sponsored by
Fiechtner, Justus J., M.D., P.C.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lupus Erythematosus Systemic Exacerbation focused on measuring Lupus, SLE, ACTH, Acthar

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Subjects must meet all of the following criteria:

  1. In the opinion of the investigator, must have adequate reading and writing abilities (in their native language) such that the subject can comprehend and complete the informed consent, and all protocol-related assessments
  2. Age 18-75 years at the time of screening
  3. Written informed consent and any locally required authorization (eg. HIPAA) obtained from the subject prior to performing any protocol-related procedures, including screening evaluations
  4. Fulfills at least 4 of the 11 American College of Rheumatology (ACR) classification criteria for SLE, including a history of ANA positivity
  5. Diagnosis of pediatric or adult SLE with chronic disease activity requiring ongoing treatment or observation for > 8 weeks prior to screening.
  6. Currently receiving at least one of the following:

    1. A stable dose of oral prednisone (or equivalent) < 20mg/day from at least 4weeks (28 days) prior to signing of the informed consent
    2. Any of the following medications administered at a stable dose for a minimum of 8 weeks (56 days) prior to signing of the informed consent form

    i) Azathioprine ii) Antimalarials (eg. Chloroquine, hydroxychloroquine, quinacrine) iii) Mycophenolate mofetil/mycophenolic acid iv) Weekly administration of oral or SQ Methotrexate

  7. At screening and randomization (Day 0) must meet SLE Flare criteria
  8. Females of childbearing potential must use an effective method of birth control and avoid pregnancy from screening through 90 days after the final dose of Acthar unless surgically sterile (i.e. bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy), has a sterile male partner, is 1 year postmenopausal, or practices abstinence.

    -

Exclusion Criteria:

Any of the following would exclude the subject from participation in the study:

  1. Any condition that, in the opinion of the investigator, would interfere with evaluation of the investigational product or confound interpretation of subject safety or study results
  2. Concurrent enrollment in any other clinical study with an investigational product with 4 weeks (28 days) prior to Day 0 or within 5 half-lives of the investigational product used in that clinical study, whichever is longer
  3. Employees of the clinical study site or any other individuals involved with the conduct of the study or immediate family members of such individuals
  4. Any new oral prednisone therapy (or equivalent) or any change in current oral prednisone dose (or equivalent) anytime from 4 weeks (28 days) prior to signing of the informed consent
  5. A known history of allergy or reaction to any component of the investigational product
  6. Any live or attenuated vaccine within 4 weeks (28 days) prior to signing the informed consent form (administration of killed vaccines is acceptable)
  7. Diagnosis of scleroderma, osteoporosis, fungal infections, ocular herpes simplex, surgery within the past 4 weeks (28 days) or planned surgery within the next 4 weeks (28 days)
  8. History of or presence of peptic ulcer, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency or adrenocortical hyperfunction or sensitivity to proteins of porcine origin
  9. Known history of a primary immunodeficiency or an underlying condition such as human immunodeficiency virus (HIV) infection or splenectomy that predisposes the subject to infection
  10. History of any type of malignancy <5 years before randomization into the study (apart from basal cell carcinoma)
  11. Receipt of more than one prescribed NSAID at an anti-inflammatory dose with 4 weeks (28 days) prior to Day 0

    -

Sites / Locations

  • Justus J. Fiechtner

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

H.P. Acthar Gel SQ injection

Arm Description

Patients will administer single dose (80 units) of Acthar subcutaneously every day for 10 days (with a possible 5 day dosing rescue).

Outcomes

Primary Outcome Measures

SLEDAI-2K score
The primary objective of this study is to evaluate whether the addition of H.P. Acthar Gel to standard treatment of lupus will ameliorate the intensity of flares as measured by changes in SLEDAI score, Patient and Physician global assessments.

Secondary Outcome Measures

BILAG-2004
To evaluate any changes to the subjects BILAG scores and markers of inflammation, e.g. ESR and/or CRP.

Full Information

First Posted
January 15, 2013
Last Updated
July 22, 2013
Sponsor
Fiechtner, Justus J., M.D., P.C.
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1. Study Identification

Unique Protocol Identification Number
NCT01769937
Brief Title
Open-label Trial of Acthar Gel in Subjects With Moderate to Severe Active Systemic Lupus Erythematosus
Acronym
ACTH
Official Title
A Single-site, Investigator Initiated Open-Label Trial of H.P. Acthar Gel (Repository Corticotropin Injection)an Adrenocorticotropic Hormone (ACTH) Analogue in Subjects With Moderately to Severely Active Systemic Lupus Erythematosus (SLE)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2013
Overall Recruitment Status
Completed
Study Start Date
October 2012 (undefined)
Primary Completion Date
April 2013 (Actual)
Study Completion Date
April 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Fiechtner, Justus J., M.D., P.C.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Systemic lupus erythematosus is a serious and potentially life-threatening condition with significant unmet medical need. The aim of this Investigator Initiated, single center, open-label study is to evaluate the efficacy and safety of a daily subcutaneously (SQ) injection of H.P. Acthar Gel for 10 days with an optional 5 day rescue period for non-responders after day 10 dose. The primary objective of this study is to evaluate whether the addition of H.P. Acthar Gel to standard treatment of lupus will ameliorate the intensity of flares as measured by changes in SLEDAI score, Patient and Physician global assessments.
Detailed Description
This is a Phase 4 Open-label Study to Evaluate the Treatment of Lupus Flares with H.P. Acthar Gel. The primary objective is to evaluate whether the addition of H.P. Acthar Gel to standard treatment of lupus will ameliorate the intensity of flares as measured by changes in SLEDAI score, Patient and Physician global assessments. The secondary objective is to evaluate any changes to the subjects BILAG scores and markers of inflammation, e.g. ESR and/or CRP. The Exploratory objective will determine the feasibility of a long-term double-blind study using H.P. Acthar Gel versus other usual treatments for lupus.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lupus Erythematosus Systemic Exacerbation
Keywords
Lupus, SLE, ACTH, Acthar

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
H.P. Acthar Gel SQ injection
Arm Type
Experimental
Arm Description
Patients will administer single dose (80 units) of Acthar subcutaneously every day for 10 days (with a possible 5 day dosing rescue).
Intervention Type
Drug
Intervention Name(s)
H.P. Acthar Gel
Other Intervention Name(s)
ACTH
Intervention Description
Open-label H.P. Acthar Gel given subcutaneous injection once daily for 10 days with potential for additional 5 days of dosing
Primary Outcome Measure Information:
Title
SLEDAI-2K score
Description
The primary objective of this study is to evaluate whether the addition of H.P. Acthar Gel to standard treatment of lupus will ameliorate the intensity of flares as measured by changes in SLEDAI score, Patient and Physician global assessments.
Time Frame
14 days
Secondary Outcome Measure Information:
Title
BILAG-2004
Description
To evaluate any changes to the subjects BILAG scores and markers of inflammation, e.g. ESR and/or CRP.
Time Frame
14 days
Other Pre-specified Outcome Measures:
Title
Fatigue (FACIT-FATIGUE)
Description
This study will investigate the effects of Acthar on other endpoints such as Fatigue (FACIT-FATIGUE), Lupus Quality of Life (LupusQoL), and painful, swollen and tender joint counts
Time Frame
14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must meet all of the following criteria: In the opinion of the investigator, must have adequate reading and writing abilities (in their native language) such that the subject can comprehend and complete the informed consent, and all protocol-related assessments Age 18-75 years at the time of screening Written informed consent and any locally required authorization (eg. HIPAA) obtained from the subject prior to performing any protocol-related procedures, including screening evaluations Fulfills at least 4 of the 11 American College of Rheumatology (ACR) classification criteria for SLE, including a history of ANA positivity Diagnosis of pediatric or adult SLE with chronic disease activity requiring ongoing treatment or observation for > 8 weeks prior to screening. Currently receiving at least one of the following: A stable dose of oral prednisone (or equivalent) < 20mg/day from at least 4weeks (28 days) prior to signing of the informed consent Any of the following medications administered at a stable dose for a minimum of 8 weeks (56 days) prior to signing of the informed consent form i) Azathioprine ii) Antimalarials (eg. Chloroquine, hydroxychloroquine, quinacrine) iii) Mycophenolate mofetil/mycophenolic acid iv) Weekly administration of oral or SQ Methotrexate At screening and randomization (Day 0) must meet SLE Flare criteria Females of childbearing potential must use an effective method of birth control and avoid pregnancy from screening through 90 days after the final dose of Acthar unless surgically sterile (i.e. bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy), has a sterile male partner, is 1 year postmenopausal, or practices abstinence. - Exclusion Criteria: Any of the following would exclude the subject from participation in the study: Any condition that, in the opinion of the investigator, would interfere with evaluation of the investigational product or confound interpretation of subject safety or study results Concurrent enrollment in any other clinical study with an investigational product with 4 weeks (28 days) prior to Day 0 or within 5 half-lives of the investigational product used in that clinical study, whichever is longer Employees of the clinical study site or any other individuals involved with the conduct of the study or immediate family members of such individuals Any new oral prednisone therapy (or equivalent) or any change in current oral prednisone dose (or equivalent) anytime from 4 weeks (28 days) prior to signing of the informed consent A known history of allergy or reaction to any component of the investigational product Any live or attenuated vaccine within 4 weeks (28 days) prior to signing the informed consent form (administration of killed vaccines is acceptable) Diagnosis of scleroderma, osteoporosis, fungal infections, ocular herpes simplex, surgery within the past 4 weeks (28 days) or planned surgery within the next 4 weeks (28 days) History of or presence of peptic ulcer, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency or adrenocortical hyperfunction or sensitivity to proteins of porcine origin Known history of a primary immunodeficiency or an underlying condition such as human immunodeficiency virus (HIV) infection or splenectomy that predisposes the subject to infection History of any type of malignancy <5 years before randomization into the study (apart from basal cell carcinoma) Receipt of more than one prescribed NSAID at an anti-inflammatory dose with 4 weeks (28 days) prior to Day 0 -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Justus J Fiechtner, MD, MPH
Organizational Affiliation
Justus J. Fiechtner, MD, PC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Justus J. Fiechtner
City
Lansing
State/Province
Michigan
ZIP/Postal Code
48910
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Open-label Trial of Acthar Gel in Subjects With Moderate to Severe Active Systemic Lupus Erythematosus

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