Weaning of Immunosuppression in Nephritis of Lupus (WIN-Lupus)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
open multicenter randomized non-inferiority study, comparing 2 types of therapeutic strategies after 2 years of maintenance treatment:
- Group I: Continuation of immunosuppressive therapy with MMF or AZA, with a background therapy with hydroxychloroquine, and possibly low-dose corticosteroids.
- Group II: immunosuppressive treatment discontinuation, continuation of hydroxychloroquine, and possibly low-dose corticosteroids (15 mg / day).
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
-
Marseille, France, 13354
- Assistance Publique Hôpitaux de Marseille
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- At least 18-years-old patient, woman or man,
- Patient having a lupus according to the criteria of the ACR,
- Patient having presented a glomérulonéphrite lupique proliférative (class III or IV Has +/-C, +/-list(classify) V) - first push or relapse - proved by renal biopsy,
- Patient having received for this push a treatment of attack by steroids with strong doses and cyclophosphamide or mycophénolate mofétil,
- Patient in the course of treatment of interview(maintenance) by azathioprine or mycophénolate mofétil for at least 2 years, and at most for 3 years, with at the time of the inclusion, mycophénolate mofétil? 1 gram / day or azathioprine? 50 in the daytime,
- Patient in reply renal complete or partial (criteria of the European, secondary consensus 2) since? 12 months,
- Patient under Plaquenil ® since? 6 months with a hydroxychloroquinémie = 750 µg / L,
- Patient having accepted of participated in the study and having signed a lit(enlightened) consent.
Exclusion Criteria:
- Patient presenting a severe chronic renal insufficiency (DFG estimated(esteemed) by MDRD < 30 ml / min / 1.73m ²),
- Patient having presented an extra-renal push having required an increase of corticoids à> 20 in the daytime during at least 7 days less than 6 months ago,
- Patient presenting a contraindication to the hydroxychloroquine,
- Unaffiliated patient in a national social security,
- Minor patient.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: immunosuppressive treatment discontinuation,
|
|
|
Active Comparator: Continuation of immunosuppressive therapy
with MMF or AZA, with a background therapy with hydroxychloroquine, and possibly low-dose corticosteroids
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
discontinuation of maintenance immunosuppressive therapy
Time Frame: 2 years
|
to demonstrate that discontinuation of maintenance immunosuppressive therapy does not expose patients to a greater risk of relapse of proliferative lupus nephritis compared to the continuation of this treatment
|
2 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
compare 2 therapeutic strategies
Time Frame: 2 years
|
to compare 2 therapeutic strategies in terms of relapse-free survival, overall survival , cumulative rate of 'relapse and / or death ', rates of adverse events , evolution of renal function , activity of SLE , consumption of steroids, impact on quality of life and economic impact.
|
2 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: NOEMIE JOURDE CHICHE, Assistance Publique Hôpitaux de Marseille
- Study Director: BERNARD BELAIGUES, Assistance Publique Hôpitaux de Marseille
Publications and helpful links
General Publications
- Himbert M, Jourde-Chiche N, Chapart L, Charles N, Baumstarck K, Daugas E. Anti-dsDNA IgE: a potential non-invasive test for prediction of lupus nephritis relapse. RMD Open. 2024 Jun 28;10(2):e004255. doi: 10.1136/rmdopen-2024-004255.
- Jourde-Chiche N, Bobot M, Burtey S, Chiche L, Daugas E. Weaning Maintenance Therapy in Lupus Nephritis: For Whom, When, and How? Kidney Int Rep. 2023 May 22;8(8):1481-1488. doi: 10.1016/j.ekir.2023.05.012. eCollection 2023 Aug.
- Jourde-Chiche N, Chiche L. An era of immunosuppressant withdrawal in systemic lupus erythematosus: winning through weaning. Lancet Rheumatol. 2024 Mar;6(3):e133-e134. doi: 10.1016/S2665-9913(24)00001-8. Epub 2024 Jan 29. No abstract available.
- Chiche L, Jousse-Joulin S, Jourde-Chiche N. [From "Treat to Target" to "Think to Untreat": Therapeutic de-implementation as a new paradigm in systemic lupus erythematosus]. Rev Med Interne. 2023 Mar;44(3):101-104. doi: 10.1016/j.revmed.2022.12.001. Epub 2022 Dec 22. No abstract available. French.
- Jourde-Chiche N, Costedoat-Chalumeau N, Baumstarck K, Loundou A, Bouillet L, Burtey S, Caudwell V, Chiche L, Couzi L, Daniel L, Deligny C, Dussol B, Faguer S, Gobert P, Gondran G, Huart A, Hummel A, Kalbacher E, Karras A, Lambert M, Le Guern V, Lebourg L, Loubiere S, Maillard-Lefebvre H, Maurier F, Pha M, Queyrel V, Remy P, Sarrot-Reynauld F, Verhelst D, Hachulla E, Amoura Z, Daugas E; WIN-Lupus study group. Weaning of maintenance immunosuppressive therapy in lupus nephritis (WIN-Lupus): results of a multicentre randomised controlled trial. Ann Rheum Dis. 2022 Oct;81(10):1420-1427. doi: 10.1136/annrheumdis-2022-222435. Epub 2022 Jun 20.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Kidney Diseases
- Urologic Diseases
- Nephritis
- Sulfur Compounds
- Organic Chemicals
- Heterocyclic Compounds
- Heterocyclic Compounds, 2-Ring
- Heterocyclic Compounds, Fused-Ring
- Fatty Acids
- Lipids
- Nucleic Acids, Nucleotides, and Nucleosides
- Acids, Acyclic
- Carboxylic Acids
- Purines
- Nucleosides
- Caproates
- Thionucleosides
- Mercaptopurine
- Mycophenolic Acid
- Azathioprine
Other Study ID Numbers
Other Study ID Numbers
- 2010-022859-30
- 2010-15 (Other Identifier: AP HM)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.