- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02066311
Nelfinavir in Systemic Lupus Erythematosus (NISLE)
Nelfinavir in Systemic Lupus Erythematosus: A Pilot Phase IIa Clinical Trial
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease in which the body's immune system attacks different parts of the body. SLE is characterized by inflammation that leads to tissue damage in different organ systems. Any organ system may be involved, including the skin, the joints, the kidneys, the nervous system, the heart, the lungs, and the blood. The exact cause of SLE is not known. Patients with SLE often have elevated levels of anti-double stranded DNA antibodies. These levels are often associated with disease flares and disease severity. These antibodies can bind to tissue leading to organ damage. Preventing these antibodies from binding to their targets may help decrease disease activity.
Protease inhibitors are medications that have been approved by the Food and Drug Administration (FDA) for use in the treatment of HIV (human immunodeficiency virus). Nelfinavir (also called viracept) is one of these protease inhibitors. Separate from their anti-viral effects, protease inhibitors have been found to decrease inflammation. These medications have been shown to interfere with binding of anti-double stranded DNA antibodies to their targets and may decrease inflammation in SLE. This research study tests whether the protease inhibitor, nelfinavir, will decrease anti-double stranded DNA antibody binding and decrease disease activity.
Study Overview
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
California
-
Los Angeles, California, United States, 90048
- Cedars-Sinai Medical Center
-
Los Angeles, California, United States, 90095
- UCLA David Geffen School of Medicine
-
-
Illinois
-
Chicago, Illinois, United States, 60612
- Rush University Medical Center
-
-
New York
-
Bronx, New York, United States, 10457
- Bronx Lebanon Hospital
-
Manhasset, New York, United States, 11030
- The Feinstein Institute for Medical Research
-
New York, New York, United States, 10032
- Columbia University Medical Center
-
New York, New York, United States, 10016
- New York University School of Medicine
-
New York, New York, United States, 20021
- Hospital for Special Surgery
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Subject is capable of providing written informed consent
- Subject is ≥ 18 years old and ≤ 65 years old
- Meets at least 4 of 11 modified American College of Rheumatology (ACR) (1997) Revised Criteria for the Classification of Systemic Lupus Erythematosus
Has mild to moderate disease activity defined as
- A minimum SLEDAI score of 2 excluding points for serology (anti-dsDNA antibody and complement)
- No active renal or nervous system disease
- No BILAG A in any organ system
- No expectation by the investigator that corticosteroids will need to be added or doses increased during the 8 week treatment period for any reason
- No expectation by the investigator that immunosuppressive medication will need to be added or doses increased during the 8 week treatment period
- Has elevated titers of anti-ds DNA antibody at the time of screening (defined as the titer that meets criteria for "high" in the Core Laboratory at the North Shore/LIJ Health Systems; unequivocal high titer as opposed to borderline, indeterminate or intermediate).
- Has elevated titers of cross-reactive anti-DNA/DWEYS antibodies at the time of screening (the assays for anti-DNA/DWEYS antibodies will be performed in Dr. B. Diamond's laboratory; study sites will be notified of results within 3 days of receipt of the samples).
- If on glucocorticoids, the dose must be ≤10 mg daily and stable for the 4 weeks prior to screening and baseline
- If on immunosuppressive or immunomodulatory medication such as azathioprine, methotrexate, leflunomide, mycophenolate, or hydroxychloroquine, the dose must have been stable for the 3 months prior to screening, and expected to remain stable over the course of the study.
- Males and females with potential for reproduction must agree to practice effective birth control measures (2 approved methods of contraception). Nelfinavir can decrease serum levels of oral contraceptives; the slightly increased risk of pregnancy due to an interaction between oral contraception and nelfinavir will be discussed when appropriate and the requirement for a second approved method of contraception will be addressed.
Exclusion Criteria:
- Current or prior treatment with rituximab, belimumab or anti-CD22 monoclonal antibody in the 12 months prior to this study or any other biologic agent for 90 days prior to this study
- Treatment with cyclophosphamide within the 6 months prior to screening
- Increase in glucocorticoid dose within 4 weeks of screening or addition of a DMARD in the three months prior to study
- A history of drug or alcohol abuse within the 6 months prior to screening
Elevated LFT's:
- ALT or AST ≥ 2 x upper limit of normal at screening
- serum unconjugated bilirubin > 3mg/dL at screening
- Dialysis or serum creatinine >1.5mg/dL
- Hypercholesterolemia: total cholesterol >230 mg/dL or LDL >150 mg/dl or hypertriglyceridemia (triglyceride >200mg/dL) at screening
- Laboratory/clinical evidence of: pancreatitis: amylase/lipase >3x upper limit of normal at screening
- Known current/active infections including HIV, Hepatitis B, Hepatitis C
- History of cancer, excluding skin cancers (squamous cell or basal cell that have been treated)
- Known active tuberculosis or untreated tuberculosis
- Hemoglobin < 8 g/dL
- Expectation by the investigator to increase corticosteroid or immunosuppressive, or immunomodulatory medication dose at screening, baseline, or over the course of the study
- Pregnancy or lactation
- Consumption of > 2 cups of grapefruit juice per day
- Treatment with medications metabolized using the cytochrome P3A4 pathway, such as cyclosporine, tacrolimus, gemfibrozil, niacin, itraconazole, ketoconazole, erythromycin, azithromycin, clarithromycin, bosentan, nefazodone, tricyclic antidepressants
- Any condition that, in the opinion of the Investigator, would jeopardize the subject's safety following exposure to the study drug.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: nelfinavir
Nelfinavir tablets will be taken by oral administration, 750mg (three 250 mg tablets) three times a day
|
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Inhibition of Anti-dsDNA Binding
Time Frame: baseline to Day 56
|
Change in serum anti-dsDNA titer from baseline to Day 56; a decrease in titer ≥ 35% was considered a positive response
|
baseline to Day 56
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Meggan Mackay, MD, Northwell Health
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Immune System Diseases
- Autoimmune Diseases
- Connective Tissue Diseases
- Lupus Erythematosus, Systemic
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Enzyme Inhibitors
- Anti-HIV Agents
- Anti-Retroviral Agents
- Protease Inhibitors
- HIV Protease Inhibitors
- Viral Protease Inhibitors
- Nelfinavir
Other Study ID Numbers
- NISLE
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.
Clinical Trials on Systemic Lupus Erythematosus
-
SanofiCompletedCutaneous Lupus Erythematosus-Systemic Lupus ErythematosusJapan
-
Kyowa Kirin Co., Ltd.RecruitingHealthy Volunteers | Systemic Lupus Erythematosus (SLE) | Cutaneous Lupus Erythematosus (CLE)Japan
-
Second Xiangya Hospital of Central South UniversityNational Natural Science Foundation of China; Hunan Provincial Natural Science... and other collaboratorsActive, not recruitingCutaneous Lupus Erythematosus | Systemic Lupus Erythematosus RashChina
-
University Hospital, BrestRecruitingSystemic Lupus Erythematosus (SLE)France
-
Beijing InnoCare Pharma Tech Co., Ltd.RecruitingSystemic Lupus Erythematosus, SLEChina
-
TJ Biopharma Co., Ltd.TerminatedSystemic Lupus Erythematosus (SLE)China
-
AstraZenecaActive, not recruitingActive Systemic Lupus ErythematosusThailand, Korea, Republic of, Philippines, China, Taiwan, Hong Kong
-
Novartis PharmaceuticalsActive, not recruitingSystemic Lupus Erythematosus (SLE)Hungary, Spain, Germany, Israel, Thailand, France, Russian Federation, China, Japan, Taiwan, Korea, Republic of, Poland, Australia, Argentina, Czechia
-
AstraZenecaPRA Health SciencesCompletedActive Systemic Lupus ErythematosusUnited States, France, Germany, Spain, Belgium, Russian Federation, Japan, Korea, Republic of, Argentina, Bulgaria, South Africa, Mexico, Canada, Brazil, Lithuania
-
Novartis PharmaceuticalsNot yet recruitingSystemic Lupus Erythematosus, SLE
Clinical Trials on Nelfinavir
-
Abramson Cancer Center at Penn MedicineCompletedHead and Neck Squamous Cell CarcinomaUnited States
-
Agouron PharmaceuticalsCompletedHIV Infections | Cytomegalovirus RetinitisUnited States
-
Maastricht Radiation OncologyCompletedColorectal Cancer | Colorectal Tumors | Colorectal Carcinoma | Neoplasms, ColorectalNetherlands
-
Academisch Medisch Centrum - Universiteit van Amsterdam...CompletedCancer | Renal Cell CancerNetherlands
-
Agouron PharmaceuticalsCompletedHIV Infections | Mycobacterium Avium-Intracellulare InfectionUnited States
-
Agouron PharmaceuticalsCompleted
-
Agouron PharmaceuticalsCompletedHIV Infections | Sarcoma, KaposiUnited States
-
Agouron PharmaceuticalsCompleted
-
Maastricht Radiation OncologyMaastricht University Medical CenterCompleted