Active Systemic Lupus Erythematosus MedDRA version: 20.0 Level: PT Classification code 10042945 Term: Systemic lupus erythematosus System Organ Class: 10028395 - Musculoskeletal and connective tissue disorders
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: - Subject has provided informed consent prior to initiation of any study-specific activities/procedures. - Age ? 18 years to ? 75 years at visit 1. - Fulfills classification criteria for SLE according to the SLICC criteria or by at least 4 of the 11 criteria of the 1997 modification of the ACR classification criteria for SLE, with at least 1 of the following being present at screening: Antinuclear antibody ? 1:80; or Elevated anti-dsDNA antibodies by the Farr assay. - SLEDAI-2K score ? 6 points with "Clinical" SLEDAI-2K score ? 4 points. The "Clinical" SLEDAI-2K is the SLEDAI-2K assessment score without the inclusion of points attributable to any urine or laboratory results including immunologic measures. For a subject whose clinical SLEDAI-2K score requires any of the following components, the subject must meet the following additional criteria: o Arthritis: If a subject qualifies for the study by scoring for arthritis on the SLEDAI-2K form, they must have ?3 swollen and/or tender joints in the hands or wrists, and the distribution should not involve the ankles, elbows, shoulders, or hips. o Alopecia: Subjects scoring for alopecia on the SLEDAI-2K should have patchy hair loss without scarring; subjects should neither have alopecia areata nor androgenic alopecia. o Oral ulcers: Subjects scoring for oral ulcers on the SLEDAI-2K should have physician documented location and appearance. o Rash: To contribute to the minimally required clinical SLEDAI-2K score, rash must have been present for a minimum of 1 week, must cover at least 5% of the body surface area if discoid and 10% of the body surface area if any other type of lupus rash. Rash must have physician documented location and appearance. - Must be taking at least 1 but not more than 2 of the following SLE treatments: mycophenolate mofetil, azathioprine, methotrexate, hydroxychloroquine, chloroquine, dapsone, or quinacrine. Treatment should be taken for ?12 weeks prior to screening and must be a stable dose for ? 8 weeks prior to screening. Patients cannot be taking two immunosuppresants (ie, mycophenolate mofetil, azathioprine, or methotrexate) simultaneously. - For subjects taking OCS, dose must be ? 20 mg/day of prednisone or OCS equivalent, and the dose must be stable ? 4 weeks prior to screening. Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 280 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 20
Exclusion criteria
Exclusion criteria: - History of lupus nephritis requiring induction therapy within 1 year or active lupus nephritis (defined as any of the following: clean catch, spot urine protein creatinine ratio > 3000 mg/g at screening or active urinary sediment attributable to SLE). - History of CNS lupus within 1 year prior to screening or active CNS lupus including, but not limited to, aseptic meningitis, ataxia, CNS vasculitis, cranial neuropathy, demyelinating syndrome, optic neuritis, psychosis, seizures, or transverse myelitis. - Currently present or within 1 year prior to screening a diagnosis of any inflammatory joint or skin disease other than SLE (confirmed accurate by the PI) which would interfere with SLE disease assessment based on investigator judgement. - History of any disease other than SLE that has required treatment with oral or parenteral corticosteroids for > 2 weeks within 6 months prior to screening. - Active infection (including chronic or localized infections) for which anti-infectives were indicated within 4 weeks prior to day 1 OR presence of serious infection, defined as requiring hospitalization or intravenous anti-infectives within 8 weeks prior to day 1. - Known history of active tuberculosis. - Positive test for tuberculosis during screening defined as either positive or indeterminate QuantiFERON®-TB or T-spot test OR positive purified protein derivative (PPD) (? 5 mm of induration at 48 to 72 hours after test is placed). - Positive for hepatitis B surface antigen, hepatitis B core antibody (confirmed by hepatitis B DNA polymerase chain reaction [PCR] test) or detectable hepatitis C virus RNA by PCR (screening is generally done by hepatitis C antibody [HepCAb], followed by hepatitis C virus RNA by PCR if HepCAb is positive). A history of hepatitis B vaccination without history of hepatitis B is allowed. - Known history of HIV or positive serology for HIV antibodies at screening. - Presence of 1 or more significant concurrent medical conditions per investigator judgment, including but not limited to the following: o poorly controlled diabetes or hypertension (ie, systolic blood pressure > 170 mmHg and/or diastolic blood pressure > 100 mmHg) o symptomatic heart failure (New York Heart Association class III or IV) o myocardial infarction or unstable angina pectoris within the past 12 months prior to randomization o severe chronic pulmonary disease (eg, requiring oxygen therapy) o multiple sclerosis or any other demyelinating disease o major chronic inflammatory disease or connective tissue disease other than SLE (eg, RA, mixed connective tissue disease [MCTD], antiphospholipid antibody syndrome) - Currently receiving or had treatment with: cyclophosphamide, chlorambucil, nitrogen mustard, or any other alkylating agent ? 6 months prior to day 1 OR oral calcineurin inhibitors (eg, cyclosporine, tacrolimus, sirolimus, voclosporin) ? 4 weeks prior to day 1. - Currently receiving or had treatment with a JAK inhibitor or oral, targeted investigational agent (eg, Bruton’s tyrosine kinase inhibitor) < 3 months or 5 half-lives (whichever is longer) prior to day 1. - Prior treatment with an immune checkpoint inhibitor (eg, PD-1 inhibitor, PD-L1 inhibitor, CTLA-4 inhibitor). - Current or previous treatment for SLE with a biologic agent as follows: rituximab < 6 months prior to day 1 and undetectable B cell count; belimumab or anifrolumab < 6 months prior to day 1; abatacept < 6 months prior to day 1; or any other biologics < 5
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: To evaluate the efficacy of AMG 570 at week 24 as measured by the Systemic Lupus Erythematosus Responder Index (SRI-4) in subjects with SLE with inadequate response to SOC therapy;Secondary Objective: - To evaluate the efficacy of AMG 570 with oral corticosteroid (OCS)-tapering in subjects with SLE with inadequate response to SOC therapy (key secondary). - To evaluate the effect of AMG 570 on the efficacy response after 52 weeks of treatment (key secondary). - To evaluate the effect of AMG 570 on additional SLE efficacy endpoints. - To describe the effect of treatment with AMG 570 using patient reported outcome. - To characterize the safety of AMG 570. - To characterize the pharmacokinetics (PK) of AMG 570.;Primary end point(s): - SRI-4 response at week 24.;Timepoint(s) of evaluation of this end point: - Week 24 | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): - SRI-4 at week 52 with reduction of OCS to ? 7.5 mg/day by week 44 and sustained through week 52 in subjects with a baseline OCS dose ? 10 mg/day (key secondary). - SRI-4 response at week 52 (key secondary). - Tender and swollen joint count ? 50% improvement from baseline at week 12, 24, 36, and 52 in subjects with ? 6 tender and ? 6 swollen joints at baseline. - Cutaneous Lupus Erythematosus Area and Severity Index (CLASI) activity score ? 50% improvement from baseline at week 12, 24, 36, and 52 in subjects with a CLASI score ? 10 at baseline. - Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) score and change from baseline at week 12, 24, 36, 44, and 52. - Medical Outcomes Short Form 36 version 2 Questionnaire (SF36v2) score and change from baseline at week 12, 24, 36, 44, and 52. - Modified Lupus QoL score and change from baseline at week 12, 24, 36, 44, and 52. - Patient Global Assessment (PtGA) score and change from baseline at week 12, 24, 36, 44, and 52. - Adverse events, Serious adverse events and Significant changes in laboratory values and vital signs.;Timepoint(s) of evaluation of this end point: - Weeks 52 and 44 - Week 52 - Weeks 12, 24, 36 and 52 - Weeks 12, 24, 36 and 52 - Weeks 12, 24, 36, 44 and 52 - Weeks 12, 24, 36, 44 and 52 - Weeks 12, 24, 36, 44 and 52 - Weeks 12, 24, 36, 44 and 52 - Duration of the study | — |
Countries
Australia, Austria, Bulgaria, Canada, Czech Republic, France, Germany, Greece, Hungary, Italy, Japan, Korea, Republic of, Mexico, Poland, Portugal, Russian Federation, Switzerland, United Kingdom, United States
Contacts
Amgen SAS