Evaluation of Lenalidomide (REVLIMID®) to Treat Subjects With Cutaneous Lupus Erythematosus (CLE)

This study has been completed.
Sponsor:
Collaborator:
Celgene Corporation
Information provided by:
University of Pennsylvania
ClinicalTrials.gov Identifier:
NCT00633945
First received: March 4, 2008
Last updated: February 18, 2011
Last verified: March 2009
  Purpose

This study is being conducted to evaluate the safety and effectiveness of lenalidomide (Revlimid®) in subjects with Cutaneous Lupus Erythematosus (CLE). The study drug will be used in an off-label indication to treat 6 subjects for 12 months each. Men and women over the age of 18, who have a biopsy proven diagnosis of CLE and who have failed standard treatment, will be included in the study.


Condition Intervention
Cutaneous Lupus Erythematosus (CLE)
Drug: lenalidomide (Revlimid®)

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Evaluation of Lenalidomide (REVLIMID®) in Cutaneous LE: A Prospective, Non Controlled, Open Label Pilot Study to Evaluate the Off-Label Use of the FDA-approved Drug Lenalidomide (REVLIMID®) in Patients With Cutaneous Lupus Erythematosus

Resource links provided by NLM:


Further study details as provided by University of Pennsylvania:

Primary Outcome Measures:
  • Evaluate the biologic activity and effects of lenalidomide (REVLIMID®) for treatment of CLE through the following: -PBMC samples analyzed by flow cytometry -Skin specimens analyzed by staining for cell types -Clinical improvement assessments [ Time Frame: Weeks 0 through 52 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Evaluate quality of life measurements using subject and physician assessment tools. [ Time Frame: Weeks 0 through 52 ] [ Designated as safety issue: No ]

Estimated Enrollment: 6
Study Start Date: November 2007
Study Completion Date: October 2009
Primary Completion Date: July 2009 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: lenalidomide (Revlimid®)
    The drug will be administered in oral form. The dosage of lenalidomide (REVLIMID®) will be lower or equivalent to the dosages indicated for the above uses. The dose will be as low as 5 mg every other day, or will be as high as 10 mg daily. Subjects will be treated with medication for 48 weeks.
    Other Name: Revlimid®
Detailed Description:

Cutaneous lupus erythematosus (CLE) is a chronic and often disabling disease which affects the skin. Many patients experience scarring and inflammation of the skin, which often occur on the face. Moderate to severe CLE is most frequently treated with antimalarial drugs such as hydroxychloroquine, quinacrine or chloroquine. Up to 70% of CLE patients treated with antimalarials experience a beneficial clinical response, while the remainder of patients show no response or continue to experience progression of the disease. Thalidomide has been used successfully in such patients, with up to 75% clinical response rate in refractory CLE patients. However, thalidomide is a known teratogen and can cause severe birth defects, including short, malformed limbs and damage to peripheral nerves in the extremities, requiring patients to be monitored for pregnancy. In addition, up to 25% of patients on thalidomide develop peripheral neuropathy. A new drug, lenalidomide (REVLIMID®), an analogue of thalidomide, has been developed to treat neoplastic and inflammatory conditions, including various oncologic conditions such as multiple myeloma, myelodysplastic syndrome and solid tumors. Unlike thalidomide, lenalidomide (REVLIMID®) is not known to cause the extent of serious side effects caused by thalidomide; however, it must also be monitored for side effects and be distributed under the RevAssist program authorized by the drug manufacturer, Celgene Corporation.

The primary goal of this investigator-initiated, small pilot study is to evaluate the safety and effectiveness of lenalidomide (REVLIMID®) in CLE subjects using measurements such as the CLASI (Cutaneous Lupus Activity and Severity Index). The study drug will be used in an off-label indication to treat 6 subjects, for whom lenalidomide (REVLIMID®) will be provided at no cost by the drug manufacturer. Men and women over the age of 18, who have a biopsy proven diagnosis of refractory CLE and who have failed standard treatment with hydroxychloroquine for up to three months, will be included in the study. Secondarily, the study will evaluate the biologic effects of lenalidomide on pathogenic and immunologic mechanisms of the CLE disease process during the treatment period by collecting skin specimens (biopsies) and blood samples.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Subjects must understand and voluntarily sign Informed Consent and HIPAA forms.
  • Males and females over the age of 18 at the time of signing informed consent form.
  • Able to adhere to the study visit schedule and other protocol requirements
  • Subjects must have biopsy proven Cutaneous Lupus Erythematosus (CLE) either in the form of Discoid Lupus Erythematosus (DLE) or Subacute Lupus Erythematosus (SCLE), with or without systemic involvement.
  • Subjects must have grade II erythema in at least three skin locations as defined by the Cutaneous Lupus Activity and Severity Index (CLASI).
  • Subjects must have failed standard treatment with hydroxychloroquine (Plaquenil) for up to three months.
  • Female subjects who are not pregnant.
  • Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days prior to and again within 24 hours of starting lenalidomide and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional method AT THE SAME TIME, at least 28 days before starting to take lenalidomide (Revlimid®). FCBP must also agree to ongoing pregnancy testing. Males must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy. All subjects must be counseled at a minimum of every 28 days about pregnancy precautions and risks of fetal exposure.
  • If pregnancy or a positive pregnancy test is noted in a study subject or in the partner of a male study subject during study participation, the study drug must be discontinued immediately.

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Female subjects who are pregnant, plan to be pregnant during the study, or who are breastfeeding.
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk for study participation, or confounds the ability to interpret data from the study.
  • Use of any other experimental drug or therapy within 28 days of baseline.
  • Known hypersensitivity to thalidomide.
  • The development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs.
  • Prior history of deep vein thrombosis (DVT).
  • Prior history of pulmonary embolus (PE).
  • Known positive for HIV viral DNA by qPCR.
  • Positive hepatitis B surface antigen, or hepatitis C.
  • Platelet count < 50,000/mcL.
  • Absolute neutrophil count < 750/mcL
  • Lymphopenia < 500/mcL.
  • Have current signs or symptoms of severe progressive or uncontrolled renal disease (creatinine ≥1.5 x ULN).
  • If female, unwillingness to use one highly effective method and one additional method of birth control.
  • If male, unwillingness to use a latex condom during intercourse with females of childbearing potential.
  • Continued therapy with thalidomide.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00633945

Locations
United States, Pennsylvania
Hospital of the University of Pennsylvania, Department of Dermatology
Philadelphia, Pennsylvania, United States, 19104
Sponsors and Collaborators
University of Pennsylvania
Celgene Corporation
Investigators
Principal Investigator: Victoria P Werth, MD University of Pennsylvania, Department of Dermatology
  More Information

No publications provided by University of Pennsylvania

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Victoria Werth, MD, University of Pennsylvania
ClinicalTrials.gov Identifier: NCT00633945     History of Changes
Other Study ID Numbers: 806259
Study First Received: March 4, 2008
Last Updated: February 18, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Pennsylvania:
Cutaneous Lupus Erythematosus
CLE
lenalidomide
revlimid
thalidomide derivative
drug
lupus

Additional relevant MeSH terms:
Lupus Erythematosus, Systemic
Lupus Erythematosus, Cutaneous
Connective Tissue Diseases
Autoimmune Diseases
Immune System Diseases
Skin Diseases
Lenalidomide
Thalidomide
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Growth Inhibitors
Antineoplastic Agents
Therapeutic Uses
Immunosuppressive Agents
Leprostatic Agents
Anti-Bacterial Agents
Anti-Infective Agents

ClinicalTrials.gov processed this record on September 29, 2014