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Safety and Efficacy of SM934 Compared to Placebo in Adult Subjects With Active Systemic Lupus Erythematosus

Primary Purpose

Systemic Lupus Erythematosus

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
SM934
Placebos
Sponsored by
RenJi Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Systemic Lupus Erythematosus

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age: 18 to 70;
  • Have a clinical diagnosis of SLE according to SLICC-2012 classification criteria;
  • Have active SLE with SLEDAI-2k ≥ 6;
  • Have positive anti-nuclear antibody (ANA) test results;
  • Are on a stable steroids treatment (equals to prednison more than 7.5mg daily but no more than 0.5mg/kg/d) for SLE for at least 30 days prior to first dose of study agent;
  • Females of childbearing age are willing to use appropriate contraception;
  • Are voluntary to to provide and sign voluntary informed consent is given;

Exclusion Criteria:

  • Have any unstable or progressive manifestation of SLE, including but not limited to Central nervous system (CNS) involvement, transverse myelitis, systemic vasculitis, vasculitis with GI involvement, severe or rapidly progressive lupus nephritis, lupus nephritis with proteinuria > 3g/24h, pulmonary hemorrhage, myocarditis;
  • Have abnormal liver function test or renal function test: Alanine aminotransferase(ALT)or aspartate aminotransferase (AST) >2 upper limit of normal (ULN); Gamma-glutamyl transferase (GGT) >1.5 ULN; Creatinine or Blood urea nitrogen (BUN) >1.5 ULN;
  • Have a history of acute myocardiac infarction, unstable angina, severe arrhythmias within 6 months prior to first dose of study agent;
  • Have any major illness/condition or evidence of an unstable clinical condition not due to SLE (eg, cardiovascular, pulmonary, hematologic, gastrointestinal, hepatic, renal, psychiatric), which, in the Investigator's judgment, will substantially increase the risk to the participant if he or she participates in the study;
  • Have any acute or chronic infectious disease, which requires medical intervention;
  • Have a history of cancer within the last 5 years, except for adequately treated skin cancer, or carcinoma in situ of the uterine cervix;
  • Have a planned surgical procedure;
  • Have received a biologic investigational agent in the past one year;
  • Have received the following treatment within 30 days prior to first dose of study agent: live vaccine; change of glucocorticoids dose; IV, intra-muscular (IM), intra-articular (IA) administration of glucocorticoids; other immunosuppressants/immunomodulators; anti-malarial drugs; traditional medicines which has proved to be effective in SLE;
  • Have had a major organ transplant;
  • Have a history of HIV, or test positive at screening for HIV;
  • Test positive for Hepatitis B virus (HBV)-DNA or Hepatitis C virus (HCV)-RNA;
  • Have or have had a substance abuse (drug, alcohol) problem in the past one year;
  • Are currently using or planned to use estrogen-containing contraceptive methods;
  • Have enrolled in an investigational study within 3 months prior to first dose of study agent;
  • Investigator considers candidates not appropriating for the study.

Sites / Locations

  • Department of Rheumatology, RenJi Hospital, School of Medicine, Shanghai JiaoTong UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

SM934 10mg

SM934 30mg

SM934 50mg

Placebo

Arm Description

SM934 10mg(1 tablet)+Placebo(4 tablets)p.o. qd in combination with steroids

SM934 10mg(3 tablet)+ Placebo(2 tablets)p.o. qd in combination with steroids

SM934 10mg(5 tablet)p.o. qd in combination with steroids

Placebo(5 tablets)p.o. qd in combination with steroids

Outcomes

Primary Outcome Measures

Percentage of Subjects with Lupus Low Disease Activity Score (LLDAS) in each group
LLDAS is defined as meeting the following criteria: SLEDAI-2K ≤4, with no activity in major organ systems (renal, CNS, cardiopulmonary, vasculitis), and no reported fever, hemolytic anemia, or gastrointestinal activity) No new disease activity compared with the previous assessment (no new British isles lupus assessment group (BILAG) A domain score or no more than 1 new BILAG B domain score) PGA ≤1 on a 0-3 scale visual visual analogue scale (VAS) A current prednisone (or equivalent) dose of ≤7.5 mg daily Well-tolerated standard maintenance doses of permitted immunosuppressive drugs
Percentage of Subjects with Systemic Lupus Erythematosus Responder Index - 4 (SRI-4) response in each group
SRI-4 response is defined as: ≥ 4-point reduction from baseline in SLEDAI-2K score No new BILAG A and no more than 1 new BILAG B domain score No worsening from baseline in the PGA (<10% worsening from baseline).
Percentage of Subjects with Treatment-Emergent Adverse Events (TEAEs) in each group
Percentage of Subjects with TEAEs in each group

Secondary Outcome Measures

Percentage change of SLEDAI-2000 and Physician Global Assessment (PGA) from baseline in each group
Percentage change of SLEDAI-2000 and PGA from baseline in each group
Percentage of Subjects with 30% improvement in Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) score in each group
Percentage of subjects who have at least 30% improvement in CLASI score compared to baseline.
Change of SLICC/ACR from baseline
Change of SLICC/ACR score from baseline
Percentage of subjects and number of days with steroids dose equal or less to prednisone 7.5mg per day
Percentage of subjects and number of days with steroids dose equal or less to prednisone 7.5mg per day
Percentage of subjects with Proteinuria < 0.5g/24h in each group
Percentage of subjects with 24hour urine protein level less than 0.5g in each group
Percentage change of complement 3 (C3) and complement 4 (C4) from baseline in each group
Percentage change of complement 3 (C3) and complement 4 (C4) from baseline in each group
Percentage change of anti-dsDNA level from baseline in each group
Percentage change of anti-dsDNA level from baseline in each group
Time to SLE flare and Percentage of subjects with SLE flare
SLE flare is defined as: Compared to baseline, one new BILAG A or more than 1 new BILAG B domain score. Time to SLE flare is defined as the date of SLE flare minus the date of treatment initiation plus one.

Full Information

First Posted
May 14, 2019
Last Updated
September 3, 2019
Sponsor
RenJi Hospital
Collaborators
Jiangsu ZuoYou Medicine Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03951259
Brief Title
Safety and Efficacy of SM934 Compared to Placebo in Adult Subjects With Active Systemic Lupus Erythematosus
Official Title
A Randomised, Double-blind, Placebo-controlled, Phase 2 Study Evaluating the Safety and Efficacy of SM934 in Adult Subjects With Active Systemic Lupus Erythematosus
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Unknown status
Study Start Date
July 24, 2019 (Actual)
Primary Completion Date
December 31, 2020 (Anticipated)
Study Completion Date
December 31, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
RenJi Hospital
Collaborators
Jiangsu ZuoYou Medicine Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a single-center, randomized, double-blind, placebo-controlled, phase 2 study. The purpose of the study is to initially evaluate the safety and efficacy of SM934 combined with steroids compared to placebo in adult subjects with active systemic lupus erythematosus (SLE) over a 12-week period.

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 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
48 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SM934 10mg
Arm Type
Experimental
Arm Description
SM934 10mg(1 tablet)+Placebo(4 tablets)p.o. qd in combination with steroids
Arm Title
SM934 30mg
Arm Type
Experimental
Arm Description
SM934 10mg(3 tablet)+ Placebo(2 tablets)p.o. qd in combination with steroids
Arm Title
SM934 50mg
Arm Type
Experimental
Arm Description
SM934 10mg(5 tablet)p.o. qd in combination with steroids
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo(5 tablets)p.o. qd in combination with steroids
Intervention Type
Drug
Intervention Name(s)
SM934
Intervention Description
In this study, the investigating intervention is oral administration of SM934. SM934 is a water-soluble derivative of arteminisin, which exerts immunosuppressive functions in vitro and in vivo.
Intervention Type
Drug
Intervention Name(s)
Placebos
Intervention Description
The placebo pills are made identical to the investigating SM934 in appearance.
Primary Outcome Measure Information:
Title
Percentage of Subjects with Lupus Low Disease Activity Score (LLDAS) in each group
Description
LLDAS is defined as meeting the following criteria: SLEDAI-2K ≤4, with no activity in major organ systems (renal, CNS, cardiopulmonary, vasculitis), and no reported fever, hemolytic anemia, or gastrointestinal activity) No new disease activity compared with the previous assessment (no new British isles lupus assessment group (BILAG) A domain score or no more than 1 new BILAG B domain score) PGA ≤1 on a 0-3 scale visual visual analogue scale (VAS) A current prednisone (or equivalent) dose of ≤7.5 mg daily Well-tolerated standard maintenance doses of permitted immunosuppressive drugs
Time Frame
Week 12
Title
Percentage of Subjects with Systemic Lupus Erythematosus Responder Index - 4 (SRI-4) response in each group
Description
SRI-4 response is defined as: ≥ 4-point reduction from baseline in SLEDAI-2K score No new BILAG A and no more than 1 new BILAG B domain score No worsening from baseline in the PGA (<10% worsening from baseline).
Time Frame
Week 12
Title
Percentage of Subjects with Treatment-Emergent Adverse Events (TEAEs) in each group
Description
Percentage of Subjects with TEAEs in each group
Time Frame
Baseline through Week 13
Secondary Outcome Measure Information:
Title
Percentage change of SLEDAI-2000 and Physician Global Assessment (PGA) from baseline in each group
Description
Percentage change of SLEDAI-2000 and PGA from baseline in each group
Time Frame
Week 12
Title
Percentage of Subjects with 30% improvement in Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) score in each group
Description
Percentage of subjects who have at least 30% improvement in CLASI score compared to baseline.
Time Frame
Week 12
Title
Change of SLICC/ACR from baseline
Description
Change of SLICC/ACR score from baseline
Time Frame
Week 12
Title
Percentage of subjects and number of days with steroids dose equal or less to prednisone 7.5mg per day
Description
Percentage of subjects and number of days with steroids dose equal or less to prednisone 7.5mg per day
Time Frame
Week 12
Title
Percentage of subjects with Proteinuria < 0.5g/24h in each group
Description
Percentage of subjects with 24hour urine protein level less than 0.5g in each group
Time Frame
Week 12
Title
Percentage change of complement 3 (C3) and complement 4 (C4) from baseline in each group
Description
Percentage change of complement 3 (C3) and complement 4 (C4) from baseline in each group
Time Frame
Week 12
Title
Percentage change of anti-dsDNA level from baseline in each group
Description
Percentage change of anti-dsDNA level from baseline in each group
Time Frame
Week 12
Title
Time to SLE flare and Percentage of subjects with SLE flare
Description
SLE flare is defined as: Compared to baseline, one new BILAG A or more than 1 new BILAG B domain score. Time to SLE flare is defined as the date of SLE flare minus the date of treatment initiation plus one.
Time Frame
Baseline through week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age: 18 to 70; Have a clinical diagnosis of SLE according to SLICC-2012 classification criteria; Have active SLE with SLEDAI-2k ≥ 6; Have positive anti-nuclear antibody (ANA) test results; Are on a stable steroids treatment (equals to prednison more than 7.5mg daily but no more than 0.5mg/kg/d) for SLE for at least 30 days prior to first dose of study agent; Females of childbearing age are willing to use appropriate contraception; Are voluntary to to provide and sign voluntary informed consent is given; Exclusion Criteria: Have any unstable or progressive manifestation of SLE, including but not limited to Central nervous system (CNS) involvement, transverse myelitis, systemic vasculitis, vasculitis with GI involvement, severe or rapidly progressive lupus nephritis, lupus nephritis with proteinuria > 3g/24h, pulmonary hemorrhage, myocarditis; Have abnormal liver function test or renal function test: Alanine aminotransferase(ALT)or aspartate aminotransferase (AST) >2 upper limit of normal (ULN); Gamma-glutamyl transferase (GGT) >1.5 ULN; Creatinine or Blood urea nitrogen (BUN) >1.5 ULN; Have a history of acute myocardiac infarction, unstable angina, severe arrhythmias within 6 months prior to first dose of study agent; Have any major illness/condition or evidence of an unstable clinical condition not due to SLE (eg, cardiovascular, pulmonary, hematologic, gastrointestinal, hepatic, renal, psychiatric), which, in the Investigator's judgment, will substantially increase the risk to the participant if he or she participates in the study; Have any acute or chronic infectious disease, which requires medical intervention; Have a history of cancer within the last 5 years, except for adequately treated skin cancer, or carcinoma in situ of the uterine cervix; Have a planned surgical procedure; Have received a biologic investigational agent in the past one year; Have received the following treatment within 30 days prior to first dose of study agent: live vaccine; change of glucocorticoids dose; IV, intra-muscular (IM), intra-articular (IA) administration of glucocorticoids; other immunosuppressants/immunomodulators; anti-malarial drugs; traditional medicines which has proved to be effective in SLE; Have had a major organ transplant; Have a history of HIV, or test positive at screening for HIV; Test positive for Hepatitis B virus (HBV)-DNA or Hepatitis C virus (HCV)-RNA; Have or have had a substance abuse (drug, alcohol) problem in the past one year; Are currently using or planned to use estrogen-containing contraceptive methods; Have enrolled in an investigational study within 3 months prior to first dose of study agent; Investigator considers candidates not appropriating for the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nan Shen, MD & PhD
Phone
+86-21-63260477
Email
nanshensibs@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Huihua Ding, MD
Phone
+86-21-53882280
Email
dinghuihua@outlook.com
Facility Information:
Facility Name
Department of Rheumatology, RenJi Hospital, School of Medicine, Shanghai JiaoTong University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200001
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nan Shen, MD & PhD
Phone
+86-21-63260477
Email
nanshensibs@gmail.com
First Name & Middle Initial & Last Name & Degree
Huihua Ding, MD
Phone
+86-21-53882280
Email
dinghuihua@outlook.com
First Name & Middle Initial & Last Name & Degree
Nan Shen, MD & PhD
First Name & Middle Initial & Last Name & Degree
Qiang Guo, MD & PhD
First Name & Middle Initial & Last Name & Degree
Min Dai, MD
First Name & Middle Initial & Last Name & Degree
Huihua Ding, MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
19772931
Citation
Hou LF, He SJ, Wang JX, Yang Y, Zhu FH, Zhou Y, He PL, Zhang Y, Yang YF, Li Y, Tang W, Zuo JP. SM934, a water-soluble derivative of arteminisin, exerts immunosuppressive functions in vitro and in vivo. Int Immunopharmacol. 2009 Dec;9(13-14):1509-17. doi: 10.1016/j.intimp.2009.09.003. Epub 2009 Sep 19.
Results Reference
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Safety and Efficacy of SM934 Compared to Placebo in Adult Subjects With Active Systemic Lupus Erythematosus

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