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The BeLimumab Antiphospholipid Syndrome Trial (BLAST) (BLAST)

Primary Purpose

Antiphospholipid Syndrome

Status
Recruiting
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
Belimumab
Sponsored by
University of Turin, Italy
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Antiphospholipid Syndrome

Eligibility Criteria

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

Inclusion Criteria:

• Positive aPL profile defined as: Positive lupus anticoagulant test as defined by the International Society on Thrombosis and Haemostasis, on two or more occasions, at least 12 weeks apart and/or Positive anticardiolipin antibody (aCL) immunoglobulin G(Ig)G/M/A isotype, present in > 40U, on two or more occasions, at least 12 weeks apart and/or Positive anti-β2-glycoprotein-I (aβ2GPI) IgG/M/A isotype, present in > 40U, on two or more occasions, at least 12 weeks apart

AND

• Clinical features attributable to aPL that are resistant to warfarin and/or heparin:

  • Recurrent thrombosis despite ongoing anticoagulation and/or
  • Persistent thrombocytopenia and/or
  • Persistent autoimmune hemolytic anemia and/or
  • Cardiac valve disease and/or
  • Chronic skin ulcers and/or
  • Renal thrombotic microangiopathy and/or
  • Cognitive dysfunction with/without white matter changes

Exclusion Criteria:

  • >=4/11 American College of Rheumatology Classification Criteria for SLE
  • Acute thrombosis (arterial or venous acute thrombosis diagnosis less than 30 days before study screening)
  • History of stroke Acute or chronic pancreatitis
  • Pregnancy
  • Have a history of malignant neoplasm within the last 5 years except basal cell or squamous cell carcinoma of the skin treated with local resection only or carcinoma in situ of the uterine cervix treated locally and with no evidence of metastatic disease for 3 years
  • Have evidence of serious suicide risk including any history of suicidal behaviour in the last 6 months and/or any suicidal ideation in the last 2 months or who in the investigator's judgment, poses a significant suicide risk
  • Have a history of a primary immunodeficiency
  • Have a significant IgG deficiency (IgG level < 400 mg/dL)
  • Have an IgA deficiency (IgA level < 10 mg/dL)
  • Known active bacterial, viral fungal mycobacterial, or other infection
  • Infection history:
  • Currently on any suppressive therapy for a chronic infection (such as tuberculosis, pneumocystis, cytomegalovirus, herpes simplex virus, herpes zoster and atypical mycobacteria)
  • Hospitalization for treatment of infection within 60 days of Day 0.
  • Use of parenteral (IV or IM) antibiotics (anti-bacterial, antiviral, anti-fungal, or antiparasitic agents) within 60 days of Day 0
  • Have current drug or alcohol abuse or dependence, or a history of drug or alcohol abuse or dependence within 365 days prior to Day 0
  • Have a historically positive HIV test or test positive at screening for HIV
  • Hepatitis status:
  • Serologic evidence of current or past Hepatitis B (HB) infection based on the results of testing for HBsAg and HBcAb as follows:
  • Patients positive for HBsAg or HBcAb are excluded
  • Positive test for Hepatitis C antibody
  • Have a history of an anaphylactic reaction to parenteral administration of contrast agents, human or murine proteins or monoclonal antibodies
  • Have any other clinically significant abnormal laboratory value in the opinion of the investigator
  • If Women of Child-Bearing Potential (WCBP) are included, please see special instructions below.
  • Have any intercurrent significant medical or psychiatric illness that the investigator considers would make the candidate unsuitable for the study

Sites / Locations

  • San Giovanni Bosco HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Intervention Arm

Arm Description

INTERVENTION DRUG: BELIMUMAB 10 MG/KG

Outcomes

Primary Outcome Measures

Number of Participants Experiencing Adverse Events
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Secondary Outcome Measures

The Efficacy of Belimumab-thrombocytopenia
Outcome measures scored as complete response (CR), partial (PR), and none (NR) at 24, 52, 104 weeks. For thrombocytopenia, CR defined as a platelet count of ≥150×109/μl,PR as 100-149,and NR as <100.
The Efficacy of Belimumab-CVD
Outcome measures scored as complete response (CR), partial (PR), and none (NR) at 24, 52, 104 weeks.For CVD,CR defined as the disappearance of cardiac lesions, PR as 50%improvement,and NR as no change.
The Efficacy of Belimumab-renal involvement
Outcome measures scored as complete response (CR), partial (PR), and none (NR) at 24, 52, 104 weeks. For aPL nephropathy, CR defined as a normal serum creatinine level, inactive urinary sediment, and urinary protein: creatinine 0.5;PR as a serum cr level 15% above baseline, RBCs per high-power field 50% above baseline with no casts, 50%improvement in the urinary prt:cr, and estimated GFR 10%above baseline; and NR as the absence of C/PR.
The Efficacy of Belimumab-cognitive impairment
Outcome measures scored as complete response (CR), partial (PR), and none (NR) at 24, 52, 104 weeks. For cognitive dysfunction,CR defined as normalization of the cognitive impairment index with 50%improvement,PR as abnormal index with 50%, and NR as no change.
The Efficacy of Belimumab-thrombosis
Rate of documented thrombotic events
Change in aPL profile
Change in aPL levels at 24, 52, 104 weeks

Full Information

First Posted
July 29, 2021
Last Updated
January 11, 2023
Sponsor
University of Turin, Italy
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1. Study Identification

Unique Protocol Identification Number
NCT05020782
Brief Title
The BeLimumab Antiphospholipid Syndrome Trial (BLAST)
Acronym
BLAST
Official Title
Open-label, Prospective, Phase II Descriptive Pilot Trial of Belimumab Therapy for Refractory and/or Non-criteria Manifestations of Antiphospholipid Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Recruiting
Study Start Date
June 1, 2022 (Actual)
Primary Completion Date
October 1, 2024 (Anticipated)
Study Completion Date
January 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Turin, Italy

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
AIM: The primary objective of the BeLimumab Antiphospholipid Syndrome Trial (BLAST) is to evaluate the safety and tolerability of belimumab for up to 24 months in patients with persistent aPL positivity and clinical features attributable to aPL that are resistant to warfarin and/or heparin.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Antiphospholipid Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Intervention Arm
Arm Type
Experimental
Arm Description
INTERVENTION DRUG: BELIMUMAB 10 MG/KG
Intervention Type
Drug
Intervention Name(s)
Belimumab
Intervention Description
INTERVENTION DRUG: BELIMUMAB 10 MG/KG
Primary Outcome Measure Information:
Title
Number of Participants Experiencing Adverse Events
Description
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame
104 weeks
Secondary Outcome Measure Information:
Title
The Efficacy of Belimumab-thrombocytopenia
Description
Outcome measures scored as complete response (CR), partial (PR), and none (NR) at 24, 52, 104 weeks. For thrombocytopenia, CR defined as a platelet count of ≥150×109/μl,PR as 100-149,and NR as <100.
Time Frame
104 weeks
Title
The Efficacy of Belimumab-CVD
Description
Outcome measures scored as complete response (CR), partial (PR), and none (NR) at 24, 52, 104 weeks.For CVD,CR defined as the disappearance of cardiac lesions, PR as 50%improvement,and NR as no change.
Time Frame
104 weeks
Title
The Efficacy of Belimumab-renal involvement
Description
Outcome measures scored as complete response (CR), partial (PR), and none (NR) at 24, 52, 104 weeks. For aPL nephropathy, CR defined as a normal serum creatinine level, inactive urinary sediment, and urinary protein: creatinine 0.5;PR as a serum cr level 15% above baseline, RBCs per high-power field 50% above baseline with no casts, 50%improvement in the urinary prt:cr, and estimated GFR 10%above baseline; and NR as the absence of C/PR.
Time Frame
104 weeks
Title
The Efficacy of Belimumab-cognitive impairment
Description
Outcome measures scored as complete response (CR), partial (PR), and none (NR) at 24, 52, 104 weeks. For cognitive dysfunction,CR defined as normalization of the cognitive impairment index with 50%improvement,PR as abnormal index with 50%, and NR as no change.
Time Frame
104 weeks
Title
The Efficacy of Belimumab-thrombosis
Description
Rate of documented thrombotic events
Time Frame
104 weeks
Title
Change in aPL profile
Description
Change in aPL levels at 24, 52, 104 weeks
Time Frame
104 weeks

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: • Positive aPL profile defined as: Positive lupus anticoagulant test as defined by the International Society on Thrombosis and Haemostasis, on two or more occasions, at least 12 weeks apart and/or Positive anticardiolipin antibody (aCL) immunoglobulin G(Ig)G/M/A isotype, present in > 40U, on two or more occasions, at least 12 weeks apart and/or Positive anti-β2-glycoprotein-I (aβ2GPI) IgG/M/A isotype, present in > 40U, on two or more occasions, at least 12 weeks apart AND • Clinical features attributable to aPL that are resistant to warfarin and/or heparin: Recurrent thrombosis despite ongoing anticoagulation and/or Persistent thrombocytopenia and/or Persistent autoimmune hemolytic anemia and/or Cardiac valve disease and/or Chronic skin ulcers and/or Renal thrombotic microangiopathy and/or Cognitive dysfunction with/without white matter changes Exclusion Criteria: >=4/11 American College of Rheumatology Classification Criteria for SLE Acute thrombosis (arterial or venous acute thrombosis diagnosis less than 30 days before study screening) History of stroke Acute or chronic pancreatitis Pregnancy Have a history of malignant neoplasm within the last 5 years except basal cell or squamous cell carcinoma of the skin treated with local resection only or carcinoma in situ of the uterine cervix treated locally and with no evidence of metastatic disease for 3 years Have evidence of serious suicide risk including any history of suicidal behaviour in the last 6 months and/or any suicidal ideation in the last 2 months or who in the investigator's judgment, poses a significant suicide risk Have a history of a primary immunodeficiency Have a significant IgG deficiency (IgG level < 400 mg/dL) Have an IgA deficiency (IgA level < 10 mg/dL) Known active bacterial, viral fungal mycobacterial, or other infection Infection history: Currently on any suppressive therapy for a chronic infection (such as tuberculosis, pneumocystis, cytomegalovirus, herpes simplex virus, herpes zoster and atypical mycobacteria) Hospitalization for treatment of infection within 60 days of Day 0. Use of parenteral (IV or IM) antibiotics (anti-bacterial, antiviral, anti-fungal, or antiparasitic agents) within 60 days of Day 0 Have current drug or alcohol abuse or dependence, or a history of drug or alcohol abuse or dependence within 365 days prior to Day 0 Have a historically positive HIV test or test positive at screening for HIV Hepatitis status: Serologic evidence of current or past Hepatitis B (HB) infection based on the results of testing for HBsAg and HBcAb as follows: Patients positive for HBsAg or HBcAb are excluded Positive test for Hepatitis C antibody Have a history of an anaphylactic reaction to parenteral administration of contrast agents, human or murine proteins or monoclonal antibodies Have any other clinically significant abnormal laboratory value in the opinion of the investigator If Women of Child-Bearing Potential (WCBP) are included, please see special instructions below. Have any intercurrent significant medical or psychiatric illness that the investigator considers would make the candidate unsuitable for the study
Facility Information:
Facility Name
San Giovanni Bosco Hospital
City
Turin
State/Province
Piedmont
ZIP/Postal Code
10154
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Savino Sciascia, MD;PhD
Phone
+390112402051
Email
savino.sciascia@unito.it

12. IPD Sharing Statement

Learn more about this trial

The BeLimumab Antiphospholipid Syndrome Trial (BLAST)

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