免疫抑制剤未使用および生物学的製剤未使用の全身性エリテマトーデスにおける皮下投与アニフロルマブの治療効果を評価する研究 (SUNFLOWER)
多国籍、介入的、52週間、オープンラベル、単一アーム試験:免疫抑制剤未治療およびバイオロジクス未治療の全身性エリテマトーデス患者におけるアニフロルマブ120 mg週1回皮下投与の治療転帰を評価する試験(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.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
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.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- フェーズ 3
連絡先と場所
研究連絡先
研究連絡先
- 名前:AstraZeneca Clinical Study Information Center
- 電話番号:1-877-240-9479
- メール:information.center@astrazeneca.com
研究場所
-
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Alabama
-
Anniston、Alabama、アメリカ、36207
- 引きこもった
- Research Site
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Birmingham、Alabama、アメリカ、35233
- 募集
- Research Site
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Arizona
-
Phoenix、Arizona、アメリカ、85032
- 募集
- Research Site
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Tucson、Arizona、アメリカ、85748
- 募集
- Research Site
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California
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Fontana、California、アメリカ、92335
- まだ募集していません
- Research Site
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La Jolla、California、アメリカ、92037
- 募集
- Research Site
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La Palma、California、アメリカ、90623
- 募集
- Research Site
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Menifee、California、アメリカ、92586
- 募集
- Research Site
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San Leandro、California、アメリカ、94578
- 募集
- Research Site
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Temecula、California、アメリカ、92592
- 募集
- Research Site
-
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Florida
-
Brandon、Florida、アメリカ、33511
- まだ募集していません
- Research Site
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Miami、Florida、アメリカ、33136
- まだ募集していません
- Research Site
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Miami、Florida、アメリカ、33145
- 募集
- Research Site
-
Miami、Florida、アメリカ、33180
- 一時停止
- Research Site
-
St. Petersburg、Florida、アメリカ、33705
- まだ募集していません
- Research Site
-
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Illinois
-
Willowbrook、Illinois、アメリカ、60527
- 募集
- Research Site
-
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Indiana
-
New Albany、Indiana、アメリカ、47150
- 募集
- Research Site
-
-
Louisiana
-
Lake Charles、Louisiana、アメリカ、70605
- 募集
- Research Site
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Maryland
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Silver Spring、Maryland、アメリカ、20904
- 募集
- Research Site
-
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Missouri
-
Kansas City、Missouri、アメリカ、64151
- 募集
- Research Site
-
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New Jersey
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West Long Branch、New Jersey、アメリカ、07764
- 募集
- Research Site
-
-
Oklahoma
-
Oklahoma City、Oklahoma、アメリカ、73104
- まだ募集していません
- Research Site
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Oklahoma City、Oklahoma、アメリカ、73116
- 募集
- Research Site
-
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Tennessee
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Memphis、Tennessee、アメリカ、38119
- 募集
- Research Site
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Memphis、Tennessee、アメリカ、38104
- まだ募集していません
- Research Site
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Texas
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Austin、Texas、アメリカ、78745
- まだ募集していません
- Research Site
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Baytown、Texas、アメリカ、77521
- 募集
- Research Site
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Colleyville、Texas、アメリカ、76034
- 募集
- Research Site
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Edinburg、Texas、アメリカ、78550
- 募集
- Research Site
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Houston、Texas、アメリカ、77054
- 募集
- Research Site
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Sugar Land、Texas、アメリカ、77479
- 募集
- Research Site
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Washington
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Spokane、Washington、アメリカ、99204
- 募集
- Research Site
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-
-
-
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Brescia、イタリア、25123
- まだ募集していません
- Research Site
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Catania、イタリア、95123
- まだ募集していません
- Research Site
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Ferrara、イタリア、44121
- 募集
- Research Site
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Florence、イタリア、50141
- まだ募集していません
- Research Site
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Milan、イタリア、20122
- 募集
- Research Site
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Milan、イタリア、20122
- 一時停止
- Research Site
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Padova、イタリア、35128
- まだ募集していません
- Research Site
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Pisa、イタリア、56124
- まだ募集していません
- Research Site
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Roma、イタリア、00161
- まだ募集していません
- Research Site
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Roma、イタリア、00168
- 一時停止
- Research Site
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Rozzano、イタリア、20089
- まだ募集していません
- Research Site
-
Udine、イタリア、33100
- まだ募集していません
- Research Site
-
-
-
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Alberta
-
Calgary、Alberta、カナダ、T2T 5C7
- まだ募集していません
- Research Site
-
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British Columbia
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Richmond、British Columbia、カナダ、V6Z 1Y6
- まだ募集していません
- Research Site
-
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Manitoba
-
Winnipeg、Manitoba、カナダ、R3A 1M4
- まだ募集していません
- Research Site
-
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Ontario
-
Hamilton、Ontario、カナダ、L8N 3Z5
- まだ募集していません
- Research Site
-
Toronto、Ontario、カナダ、M5T 2S8
- まだ募集していません
- Research Site
-
-
-
-
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Barcelona、スペイン、08035
- 募集
- Research Site
-
Barcelona、スペイン、08036
- 募集
- Research Site
-
Córdoba、スペイン、14004
- 一時停止
- Research Site
-
Galdakao、スペイン、48960
- 募集
- Research Site
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Madrid、スペイン、28034
- 募集
- Research Site
-
Madrid、スペイン、28046
- 募集
- Research Site
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Madrid、スペイン、28702
- 募集
- Research Site
-
Sabadell、スペイン、08208
- まだ募集していません
- Research Site
-
Santander、スペイン、39008
- まだ募集していません
- Research Site
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Seville、スペイン、41014
- まだ募集していません
- Research Site
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Valencia、スペイン、46026
- まだ募集していません
- Research Site
-
-
-
-
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Bad Abbach、ドイツ、93077
- 引きこもった
- Research Site
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Hamburg、ドイツ、22763
- まだ募集していません
- Research Site
-
Mainz、ドイツ、55131
- まだ募集していません
- Research Site
-
München、ドイツ、80336
- まだ募集していません
- Research Site
-
-
-
-
-
Clermont-Ferrand、フランス、63000
- 募集
- Research Site
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Lyon、フランス、69437
- 募集
- Research Site
-
Marseille、フランス、13385
- 募集
- Research Site
-
Paris、フランス、75012
- 募集
- Research Site
-
Paris、フランス、75013
- 募集
- Research Site
-
Pessac、フランス、33604
- 募集
- Research Site
-
Saint-Denis、フランス、97405
- まだ募集していません
- Research Site
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Saint-Pierre、フランス、97448
- まだ募集していません
- Research Site
-
Toulon、フランス、83800, Cedex
- 募集
- Research Site
-
Tours、フランス、37044
- 募集
- Research Site
-
Vandœuvre-lès-Nancy、フランス、54511
- まだ募集していません
- Research Site
-
-
-
-
-
Bydgoszcz、ポーランド、85-065
- 募集
- Research Site
-
Częstochowa、ポーランド、42-217
- 募集
- Research Site
-
Katowice、ポーランド、40-611
- 募集
- Research Site
-
Krakow、ポーランド、30-688
- まだ募集していません
- Research Site
-
Lodz、ポーランド、90-368
- 募集
- Research Site
-
Lublin、ポーランド、20-607
- 募集
- Research Site
-
Nadarzyn、ポーランド、05-830
- 募集
- Research Site
-
Nowa Sól、ポーランド、67-100
- 募集
- Research Site
-
Poznan、ポーランド、60-693
- まだ募集していません
- Research Site
-
Poznan、ポーランド、60-681
- まだ募集していません
- Research Site
-
Poznan、ポーランド、61-397
- 募集
- Research Site
-
Warsaw、ポーランド、02-637
- まだ募集していません
- Research Site
-
Warsaw、ポーランド、01-691
- 募集
- Research Site
-
Warsaw、ポーランド、05-077
- 募集
- Research Site
-
Wroclaw、ポーランド、53-673
- 募集
- Research Site
-
-
-
-
-
Culiacán、メキシコ、80000
- まだ募集していません
- Research Site
-
Durango、メキシコ、34080
- まだ募集していません
- Research Site
-
Guadalajara、メキシコ、44160
- まだ募集していません
- Research Site
-
Guadalajara、メキシコ、44650
- まだ募集していません
- Research Site
-
Guadalajara、メキシコ、44690
- 一時停止
- Research Site
-
Mérida、メキシコ、97133
- まだ募集していません
- Research Site
-
México、メキシコ、14080
- まだ募集していません
- Research Site
-
México、メキシコ、03100
- まだ募集していません
- Research Site
-
-
-
-
-
Kaohsiung City、台湾、833
- まだ募集していません
- Research Site
-
Kaohsiung City、台湾、813414
- まだ募集していません
- Research Site
-
New Taipei City、台湾、23561
- まだ募集していません
- Research Site
-
Taichung、台湾、40705
- まだ募集していません
- Research Site
-
Taichung、台湾、40447
- まだ募集していません
- Research Site
-
Tainan、台湾、70403
- まだ募集していません
- Research Site
-
Tainan County、台湾、71044
- まだ募集していません
- Research Site
-
Taipei、台湾、100
- まだ募集していません
- Research Site
-
Taoyuan、台湾、33305
- まだ募集していません
- Research Site
-
Zhubei、台湾、302
- まだ募集していません
- Research Site
-
-
参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
-
Males or females aged 18 to 70 years of age.
-
Participants who have a diagnosis of SLE confirmed by a rheumatologist.
-
ANA-positive per the Central Lab at screening:
(a) ANA (b) Anti-dsDNA (c) Anti-Smith (anti-Sm)
-
Must be on the standard therapy regimen: antimalarials with or without OCSs
-
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)
-
Should have no evidence of current active infection, (e.g., pneumonia, tuberculosis [TB]) or previous TB
-
Should have no evidence of malignancy; and clinically significant abnormalities (unless due to SLE).
-
No medical history or signs or symptoms of active TB prior to or during Screening.
-
Body weight ≥ 40.0 kg
-
Negative pregnancy test for females during screening
-
Normal HPV test result within 2 years prior to Week 0 (Day 1).
-
Willing and able to participate in all required study evaluations and procedures including completion of PROs.
-
Willing to not use any other forms of experimental treatment during the study.
Exclusion Criteria:
-
Subjects with history of, or current diagnosis of, a clinically significant non-SLE related vasculitis syndrome.
-
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.
-
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.
-
Subjects with a history of catastrophic antiphospholipid syndrome or saddle embolism.
-
Subjects with a history of 3 or more unexplained consecutive pregnancy losses.
-
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.
-
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.
-
Active severe SLE-driven renal disease where, protocol-specified standard therapy is insufficient.
-
Current diagnosis of, catastrophic antiphospholipid syndrome (APS).
-
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).
-
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.
-
Confirmed positive test for hepatitis B.
-
Any clinical cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection that has not completely resolved within 12 weeks prior to signing the ICF.
-
Opportunistic infection requiring hospitalization or IV antimicrobial treatment within 3 years of Week 0 (Day 1).
-
Clinically significant chronic infection (e.g., osteomyelitis, bronchiectasis, etc.) within 8 weeks prior to signing the ICF (chronic nail infections are allowed).
-
Severe HZ or recurrent HZ.
-
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).
-
Received any SLE-related therapies other than antimalarials and GCs.
-
History of allergy or reaction to any component of the study intervention formulation or history of anaphylaxis to any human gamma globulin therapy.
-
History of an anaphylactic reaction to human proteins or mAbs.
-
Received any live or attenuated vaccine within 8 weeks prior to signing the ICF.
-
Blood transfusion or receipt of blood products except albumin.
-
Received more than 2 investigational products for the SLE since time of diagnosis.
-
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.
-
Concurrent enrollment in another clinical study with a study intervention.
-
Subjects with any abnormal lab result as specified in the protocol.
-
Subjects with other autoimmune diseases (e.g., multiple sclerosis, psoriasis, IBD, etc.).
-
Subjects with SLE overlap syndromes such as scleroderma and mixed connective tissue disease.
-
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).
-
Any condition would interfere with treatment outcomes of the study intervention or put participant at safety risk.
-
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.
-
Spontaneous or induced abortion, still or live birth, or pregnancy ≤ 4 weeks prior to signing the ICF.
-
Current alcohol, drug or chemical abuse, or a history of such abuse within 1 year before Week 0 (Day 1).
-
Major surgery within 8 weeks before signing the ICF or elective major surgery planned during the study period.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
他の: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
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Attainment of DORIS remission
時間枠: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
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
To assess the attainment of low level disease activity
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠:Through Week 52
|
The time to attain and sustain DORIS, or LLDAS, or LLDAS-5 will be analyzed. |
Through Week 52
|
|
Daily GC dose
時間枠: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
時間枠: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
時間枠:During 52 Week
|
Maintenance of this percent reduction in GC dose through Week 52 will be assessed |
During 52 Week
|
|
Cumulative GC dose
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠:At 52 Week
|
Change in QoL and fatigue in participants initiated on anifrolumab will be assessed using FACIT-F. |
At 52 Week
|
|
Adverse Events
時間枠:Up to 52 Weeks
|
Safety and tolerability of anifrolumab will be assessed. |
Up to 52 Weeks
|
|
Change in QoL and fatigue
時間枠:At 52 Week
|
Change in QoL and fatigue in participants initiated on anifrolumab will be assessed using PROMIS Lupus. |
At 52 Week
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- D3461C00040
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
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
IPD 共有時間枠
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.
IPD 共有アクセス基準
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.
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。