Uno studio per valutare i risultati del trattamento con anifrolumab sottocutaneo in pazienti con lupus eritematoso sistemico naive agli immunosoppressori e naive ai biologici (SUNFLOWER)
Studio Multinazionale, Interventistico, di 52 settimane, in Aperto, a Braccio Singolo per Valutare gli Esiti del Trattamento con Anifrolumab 120 mg Sottocutaneo Una Volta alla Settimana in Pazienti con Lupus Eritematoso Sistemico Immunosoppressant-naïve e Biologico-naïve (SUNFLOWER)
The purpose of the SUNFLOWER study is to describe clinical outcomes, including DORIS remission, achieved following the initiation of anifrolumab 120 mg SC once weekly (QW) as add-on therapy to an anti-malarial, with or without GC; in patients not in LLDAS at enrolment.
Patients will be naïve to any prior conventional immunosuppressant including prior biologic therapy at enrolment. The study will also employ a tapering protocol for a systematic approach to GC tapering, seeking to understand better the proportion of patients in remission who can successfully withdraw chronic GC completely.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
In this study, approximately 275 participants will be enrolled and the study duration will be up to approximately 69 weeks, including: A Screening Period lasting up to 35 days and A 52-week treatment period. Also, participants not continuing treatment with any preparation of anifrolumab after Week 52 will have additional safety follow up 12 weeks after last dose of anifrolumab. Anifrolumab will be administered SC via an aPFS during the 52-week Study.
The study population will comprise participants taking antimalarial with or without GCs (there is a recruitment cap of 50% of patients not on GC at baseline) who are IS-naïve and biologic-naïve and are not meeting LLDAS criteria, described by the following cohorts:
- Clinical SLEDAI 2K ≥4 points regardless of GC dose and disease duration.
- Clinical SLEDAI-2K < 4 with GC ≥ 7.5 mg/day for > 5 weeks. After receiving the first dose of anifrolumab (week 0), the participant is allowed to increase the GC dose up until week 4, based on the investigator's recommendation. Between week 5 and week 40, participants taking >5 mg/day GC dose at study entry will attempt a protocolized taper to 5 mg/day over 12 weeks. Participants achieving DORIS remission for 2 consecutive visits will attempt complete withdrawal of GC following a 12-week tapering regimen. Starting week 41 until the end of the study (week 52), there will be no further reduction of GC dose.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 3
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: AstraZeneca Clinical Study Information Center
- Numero di telefono: 1-877-240-9479
- Email: information.center@astrazeneca.com
Luoghi di studio
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Alberta
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Calgary, Alberta, Canada, T2T 5C7
- Non ancora reclutamento
- Research Site
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British Columbia
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Richmond, British Columbia, Canada, V6Z 1Y6
- Non ancora reclutamento
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Manitoba
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Winnipeg, Manitoba, Canada, R3A 1M4
- Non ancora reclutamento
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Ontario
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Hamilton, Ontario, Canada, L8N 3Z5
- Non ancora reclutamento
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Toronto, Ontario, Canada, M5T 2S8
- Non ancora reclutamento
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Clermont-Ferrand, Francia, 63000
- Reclutamento
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Lyon, Francia, 69437
- Reclutamento
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Marseille, Francia, 13385
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Paris, Francia, 75012
- Reclutamento
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Paris, Francia, 75013
- Reclutamento
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Pessac, Francia, 33604
- Reclutamento
- Research Site
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Saint-Denis, Francia, 97405
- Non ancora reclutamento
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Saint-Pierre, Francia, 97448
- Non ancora reclutamento
- Research Site
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Toulon, Francia, 83800, Cedex
- Reclutamento
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Tours, Francia, 37044
- Reclutamento
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Vandœuvre-lès-Nancy, Francia, 54511
- Non ancora reclutamento
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Bad Abbach, Germania, 93077
- Ritirato
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Hamburg, Germania, 22763
- Non ancora reclutamento
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Mainz, Germania, 55131
- Non ancora reclutamento
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München, Germania, 80336
- Non ancora reclutamento
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Brescia, Italia, 25123
- Non ancora reclutamento
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Catania, Italia, 95123
- Non ancora reclutamento
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Ferrara, Italia, 44121
- Reclutamento
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Florence, Italia, 50141
- Non ancora reclutamento
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Milan, Italia, 20122
- Reclutamento
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Milan, Italia, 20122
- Sospeso
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Padova, Italia, 35128
- Non ancora reclutamento
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Pisa, Italia, 56124
- Non ancora reclutamento
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Roma, Italia, 00161
- Non ancora reclutamento
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Roma, Italia, 00168
- Sospeso
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Rozzano, Italia, 20089
- Non ancora reclutamento
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Udine, Italia, 33100
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Culiacán, Messico, 80000
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Durango, Messico, 34080
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Guadalajara, Messico, 44160
- Non ancora reclutamento
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Guadalajara, Messico, 44650
- Non ancora reclutamento
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Guadalajara, Messico, 44690
- Sospeso
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Mérida, Messico, 97133
- Non ancora reclutamento
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México, Messico, 14080
- Non ancora reclutamento
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México, Messico, 03100
- Non ancora reclutamento
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Bydgoszcz, Polonia, 85-065
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Częstochowa, Polonia, 42-217
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Katowice, Polonia, 40-611
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Krakow, Polonia, 30-688
- Non ancora reclutamento
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Lodz, Polonia, 90-368
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Lublin, Polonia, 20-607
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Nadarzyn, Polonia, 05-830
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Nowa Sól, Polonia, 67-100
- Reclutamento
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Poznan, Polonia, 60-693
- Non ancora reclutamento
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Poznan, Polonia, 60-681
- Non ancora reclutamento
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Poznan, Polonia, 61-397
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Warsaw, Polonia, 02-637
- Non ancora reclutamento
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Warsaw, Polonia, 01-691
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Warsaw, Polonia, 05-077
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Wroclaw, Polonia, 53-673
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Barcelona, Spagna, 08035
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Barcelona, Spagna, 08036
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Córdoba, Spagna, 14004
- Sospeso
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Galdakao, Spagna, 48960
- Reclutamento
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Madrid, Spagna, 28034
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Madrid, Spagna, 28046
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Madrid, Spagna, 28702
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Sabadell, Spagna, 08208
- Non ancora reclutamento
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Santander, Spagna, 39008
- Non ancora reclutamento
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Seville, Spagna, 41014
- Non ancora reclutamento
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Valencia, Spagna, 46026
- Non ancora reclutamento
- Research Site
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Alabama
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Anniston, Alabama, Stati Uniti, 36207
- Ritirato
- Research Site
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Birmingham, Alabama, Stati Uniti, 35233
- Reclutamento
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Arizona
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Phoenix, Arizona, Stati Uniti, 85032
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Tucson, Arizona, Stati Uniti, 85748
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California
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Fontana, California, Stati Uniti, 92335
- Non ancora reclutamento
- Research Site
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La Jolla, California, Stati Uniti, 92037
- Reclutamento
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La Palma, California, Stati Uniti, 90623
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Menifee, California, Stati Uniti, 92586
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San Leandro, California, Stati Uniti, 94578
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Temecula, California, Stati Uniti, 92592
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Florida
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Brandon, Florida, Stati Uniti, 33511
- Non ancora reclutamento
- Research Site
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Miami, Florida, Stati Uniti, 33136
- Non ancora reclutamento
- Research Site
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Miami, Florida, Stati Uniti, 33145
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Miami, Florida, Stati Uniti, 33180
- Sospeso
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St. Petersburg, Florida, Stati Uniti, 33705
- Non ancora reclutamento
- Research Site
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Illinois
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Willowbrook, Illinois, Stati Uniti, 60527
- Reclutamento
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Indiana
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New Albany, Indiana, Stati Uniti, 47150
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Louisiana
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Lake Charles, Louisiana, Stati Uniti, 70605
- Reclutamento
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Maryland
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Silver Spring, Maryland, Stati Uniti, 20904
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Missouri
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Kansas City, Missouri, Stati Uniti, 64151
- Reclutamento
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New Jersey
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West Long Branch, New Jersey, Stati Uniti, 07764
- Reclutamento
- Research Site
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Oklahoma
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Oklahoma City, Oklahoma, Stati Uniti, 73104
- Non ancora reclutamento
- Research Site
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Oklahoma City, Oklahoma, Stati Uniti, 73116
- Reclutamento
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Tennessee
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Memphis, Tennessee, Stati Uniti, 38119
- Reclutamento
- Research Site
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Memphis, Tennessee, Stati Uniti, 38104
- Non ancora reclutamento
- Research Site
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Texas
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Austin, Texas, Stati Uniti, 78745
- Non ancora reclutamento
- Research Site
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Baytown, Texas, Stati Uniti, 77521
- Reclutamento
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Colleyville, Texas, Stati Uniti, 76034
- Reclutamento
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Edinburg, Texas, Stati Uniti, 78550
- Reclutamento
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Houston, Texas, Stati Uniti, 77054
- Reclutamento
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Sugar Land, Texas, Stati Uniti, 77479
- Reclutamento
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Washington
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Spokane, Washington, Stati Uniti, 99204
- Reclutamento
- Research Site
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Kaohsiung City, Taiwan, 833
- Non ancora reclutamento
- Research Site
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Kaohsiung City, Taiwan, 813414
- Non ancora reclutamento
- Research Site
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New Taipei City, Taiwan, 23561
- Non ancora reclutamento
- Research Site
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Taichung, Taiwan, 40705
- Non ancora reclutamento
- Research Site
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Taichung, Taiwan, 40447
- Non ancora reclutamento
- Research Site
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Tainan, Taiwan, 70403
- Non ancora reclutamento
- Research Site
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Tainan County, Taiwan, 71044
- Non ancora reclutamento
- Research Site
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Taipei, Taiwan, 100
- Non ancora reclutamento
- Research Site
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Taoyuan, Taiwan, 33305
- Non ancora reclutamento
- Research Site
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Zhubei, Taiwan, 302
- Non ancora reclutamento
- Research Site
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
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Males or females aged 18 to 70 years of age.
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Participants who have a diagnosis of SLE confirmed by a rheumatologist.
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ANA-positive per the Central Lab at screening:
(a) ANA (b) Anti-dsDNA (c) Anti-Smith (anti-Sm)
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Must be on the standard therapy regimen: antimalarials with or without OCSs
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Must have at screening and baseline:
- Clinical SLEDAI-2K ≥ 4 points OR
- Clinical SLEDAI-2K < 4 with GC dose ≥ 7.5 mg/day (prednisone equivalent)
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Should have no evidence of current active infection, (e.g., pneumonia, tuberculosis [TB]) or previous TB
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Should have no evidence of malignancy; and clinically significant abnormalities (unless due to SLE).
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No medical history or signs or symptoms of active TB prior to or during Screening.
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Body weight ≥ 40.0 kg
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Negative pregnancy test for females during screening
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Normal HPV test result within 2 years prior to Week 0 (Day 1).
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Willing and able to participate in all required study evaluations and procedures including completion of PROs.
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Willing to not use any other forms of experimental treatment during the study.
Exclusion Criteria:
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Subjects with history of, or current diagnosis of, a clinically significant non-SLE related vasculitis syndrome.
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Subjects with antiphospholipid antibody syndrome on stable anticoagulant therapy at an effective dose (e.g., if on warfarin, an international normalized ratio [INR] target 2 to 3 or as appropriate for the clinical situation) are only allowed if this is not the sole or the predominant feature of their SLE.
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Subjects with a serious thrombotic event (e.g., pulmonary embolism stroke, deep vein thrombosis) or unexplained pregnancy loss within 1 year before the screening visit are excluded.
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Subjects with a history of catastrophic antiphospholipid syndrome or saddle embolism.
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Subjects with a history of 3 or more unexplained consecutive pregnancy losses.
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History or evidence of suicidal ideation within the past 6 months; or any suicidal behavior within the past 12 months or recurrent suicidal behavior in the lifetime of the participant based on an assessment with the Columbia Suicide Severity Rating Scale (C SSRS) at Screening.
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Active severe or unstable neuropsychiatric SLE including, but not limited to aseptic meningitis, cerebral vasculitis, myelopathy, demyelination syndromes (ascending, transverse, acute inflammatory demyelinating polyradiculopathy), acute confusional state, impaired level of consciousness, psychosis, acute stroke or stroke syndrome, cranial neuropathy, status epilepticus, cerebellar ataxia, lupus headache and mononeuritis multiplex, where, protocol-specified standard therapy is insufficient.
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Active severe SLE-driven renal disease where, protocol-specified standard therapy is insufficient.
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Current diagnosis of, catastrophic antiphospholipid syndrome (APS).
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History of recurrent infection requiring hospitalization and IV antibiotics (e.g., 3 or more of the same type of infection over the previous 52 weeks).
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Known History of a primary immunodeficiency, splenectomy, or any underlying condition that predisposes the participant to infection, or a positive result for HIV at Screening.
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Confirmed positive test for hepatitis B.
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Any clinical cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection that has not completely resolved within 12 weeks prior to signing the ICF.
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Opportunistic infection requiring hospitalization or IV antimicrobial treatment within 3 years of Week 0 (Day 1).
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Clinically significant chronic infection (e.g., osteomyelitis, bronchiectasis, etc.) within 8 weeks prior to signing the ICF (chronic nail infections are allowed).
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Severe HZ or recurrent HZ.
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Malignancy. History of cancer, apart from:
(a) Squamous or basal cell carcinoma of the skin treated with documented success of curative therapy ≥ 3 months prior to Week 0 (Day 1).
(a) Cervical cancer in situ treated with apparent success with curative therapy ≥ 1 year prior to Week 0 (Day 1).
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Received any SLE-related therapies other than antimalarials and GCs.
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History of allergy or reaction to any component of the study intervention formulation or history of anaphylaxis to any human gamma globulin therapy.
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History of an anaphylactic reaction to human proteins or mAbs.
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Received any live or attenuated vaccine within 8 weeks prior to signing the ICF.
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Blood transfusion or receipt of blood products except albumin.
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Received more than 2 investigational products for the SLE since time of diagnosis.
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Received any investigational product (small molecule or biologic agent) within 4 weeks or 5 half-lives prior to signing of the ICF, whichever is greater.
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Concurrent enrollment in another clinical study with a study intervention.
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Subjects with any abnormal lab result as specified in the protocol.
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Subjects with other autoimmune diseases (e.g., multiple sclerosis, psoriasis, IBD, etc.).
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Subjects with SLE overlap syndromes such as scleroderma and mixed connective tissue disease.
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Subject with non-SLE concomitant illness, as determined by medical judgment, who is likely to require additional systemic glucocorticosteroid therapy during the study (e.g., asthma).
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Any condition would interfere with treatment outcomes of the study intervention or put participant at safety risk.
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Lactating, breastfeeding, or pregnant females or females who intend to become pregnant or begin breastfeeding anytime from initiation of Screening until 16 weeks following last dose of study intervention.
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Spontaneous or induced abortion, still or live birth, or pregnancy ≤ 4 weeks prior to signing the ICF.
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Current alcohol, drug or chemical abuse, or a history of such abuse within 1 year before Week 0 (Day 1).
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Major surgery within 8 weeks before signing the ICF or elective major surgery planned during the study period.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Non randomizzato
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Altro: Anifrolumab
Participants will receive dose A of anifrolumab on X dosing schedule beginning on Day 1 for a maximum of 52 -week during the study |
Patients will receive Anifrolumab subcutaneous
Altri nomi:
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Attainment of DORIS remission
Lasso di tempo: At Week 52
|
Proportion of participants who are in DORIS remission at Week 52 will be assessed. DORIS remission is defined as Clinical SLEDAI-2K (sum of all SLEDAI-2K items except for increased deoxyribonucleic acid [DNA] binding and low complement) = 0; PGA [0-3] < 0.5, prednisone 5 mg/day or less, and stable antimalarials, ISs, and biologics. |
At Week 52
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
To assess the attainment of low level disease activity
Lasso di tempo: At Week 28 and 52
|
Proportion of participants who are in LLDAS, or LLDAS-5 at Week 28 and 52 will be assessed. Low level disease activity as measured by LLDAS and LLDAS 5
|
At Week 28 and 52
|
|
Time spent in DORIS remission, LLDAS or LLDAS-5
Lasso di tempo: At Week 52
|
Time spent in DORIS remission, LLDAS or LLDAS-5 for participants initiated on anifrolumab will be measured. |
At Week 52
|
|
Sustaining DORIS remission, LLDAS or LLDAS-5
Lasso di tempo: All subsequent visits including 52 Week
|
The proportion of participants initiated on anifrolumab, sustaining DORIS remission, LLDAS or LLDAS-5 through to Week 52 will be measured. |
All subsequent visits including 52 Week
|
|
Sustaining DORIS remission, LLDAS or LLDAS-5
Lasso di tempo: At 3 consecutive visits occurring every 4 weeks during the 52 Week study
|
The proportion of participants initiated on anifrolumab, sustaining DORIS remission, LLDAS or LLDAS-5 for three or more consecutive visits will be measured. Consecutive visits' are defined as three back-to-back completed visits. |
At 3 consecutive visits occurring every 4 weeks during the 52 Week study
|
|
Time to attain and sustain DORIS, or LLDAS, or LLDAS-5
Lasso di tempo: Through Week 52
|
The time to attain and sustain DORIS, or LLDAS, or LLDAS-5 will be analyzed. |
Through Week 52
|
|
Daily GC dose
Lasso di tempo: At Week 40 and Week 52
|
The daily GC dose at Week 40 and 52 in participants initiated on anifrolumab alongside a systematic approach to GC tapering and to assess the maintenance of this GC reduction through Week 52 will be assessed. |
At Week 40 and Week 52
|
|
Reduction in GC use
Lasso di tempo: From Week 4 to Week 40
|
The reduction in GC use from Week 4 to Week 40 in participants initiated on anifrolumab alongside a systematic approach to GC tapering will be assessed |
From Week 4 to Week 40
|
|
Maintenance of reduction in GC dose
Lasso di tempo: During 52 Week
|
Maintenance of this percent reduction in GC dose through Week 52 will be assessed |
During 52 Week
|
|
Cumulative GC dose
Lasso di tempo: Week 0 to Week 52
|
The cumulative GC dose from Week 0 to Week 52 in participants initiated on anifrolumab alongside a systematic approach to GC tapering will be assessed. |
Week 0 to Week 52
|
|
Attainment of DORIS-0
Lasso di tempo: From baseline over 52 Weeks
|
Proportion of participants who attain DORIS-0 from baseline over 52 weeks. DORIS-0 is defined as DORIS criteria with prednisone 0 mg daily. |
From baseline over 52 Weeks
|
|
Time to first moderate-to-severe flare
Lasso di tempo: Through Week 52
|
Time to first moderate-to-severe flare through to Week 52 assessed based on MFI. Moderate-to-severe flare is defined as any one criterion present in the moderate or severe flare categories within the MFI will be assessed. |
Through Week 52
|
|
Change in active skin manifestations
Lasso di tempo: At Week 4, Week 16, and Week 52
|
The change in active skin manifestations of SLE measured by CLASI activity score in participants initiated on anifrolumab will be assessed. |
At Week 4, Week 16, and Week 52
|
|
Change in joint activity
Lasso di tempo: At Week 28 and 52
|
The average change in number of active joints (swollen and tender joints) in participants initiated on anifrolumab compared to baseline will be assessed |
At Week 28 and 52
|
|
Change in QoL and fatigue
Lasso di tempo: At 52 Week
|
Change in QoL and fatigue in participants initiated on anifrolumab will be assessed using FACIT-F. |
At 52 Week
|
|
Adverse Events
Lasso di tempo: Up to 52 Weeks
|
Safety and tolerability of anifrolumab will be assessed. |
Up to 52 Weeks
|
|
Change in QoL and fatigue
Lasso di tempo: At 52 Week
|
Change in QoL and fatigue in participants initiated on anifrolumab will be assessed using PROMIS Lupus. |
At 52 Week
|
Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- D3461C00040
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Descrizione del piano IPD
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure
Periodo di condivisione IPD
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Criteri di accesso alla condivisione IPD
When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool. Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information.
Tipo di informazioni di supporto alla condivisione IPD
- STUDIO_PROTOCOLLO
- LINFA
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .