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A Study to Evaluate the Efficacy and Safety of CEP-33457 in Patients With Systemic Lupus Erythematosus

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ClinicalTrials.gov Identifier: NCT01135459
Recruitment Status : Completed
First Posted : June 2, 2010
Last Update Posted : July 21, 2016
Sponsor:
Information provided by (Responsible Party):
Teva Pharmaceutical Industries ( Cephalon )

Brief Summary:
The primary objective of this study is to evaluate the efficacy of a 200-mcg dose of CEP-33457 compared with placebo in patients with active systemic lupus erythematosus (SLE) as assessed by the proportion of patients achieving a combined clinical response using the SLE responder index (SRI) at week 24.

Condition or disease Intervention/treatment Phase
Systemic Lupus Erythematosus Drug: Lupuzor Drug: Placebo Phase 2

Detailed Description:
The study consisted of a 2-week screening period (visit 1), a 20-week treatment period beginning with a baseline visit in which randomization was completed and study drug treatment began (visits 2 through 7), and a final assessment was performed 4 weeks after the last dose of study drug (visit 8 [week 24 or early termination]). Patients were randomized to receive either CEP-33457 or placebo subcutaneously every 4 weeks. Plasma samples for measurement of study drug concentration were collected in a subset of patients and study drug was administered at each study visit until the final visit. The dose of background steroid medication may have been increased, if needed, to treat the patient for minor fluctuations in lupus disease activity. One interim analysis was conducted when at least 80 patients completed week 12 or had been withdrawn from the study. Patients who completed the treatment period returned to the study center 4 weeks after the last dose had been administered for final procedures and assessments. Final procedures and assessments for patients who withdrew from the study before 20 weeks of treatment were performed at the last visit. Final procedures and assessments for patients who participated in the study beyond week 24 were to be performed at the next regularly scheduled visit. Patients who complete the study will be eligible for participation in the 12-month open-label study (study C33457/3075; herein referred to as study 3075) to assess continued effectiveness and safety of the CEP-33457 treatment.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 183 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study to Evaluate the Efficacy and Safety of a 200-mcg Dose of CEP-33457 in Patients With Systemic Lupus Erythematosus
Study Start Date : June 2010
Actual Primary Completion Date : January 2012
Actual Study Completion Date : June 2012

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Lupus

Arm Intervention/treatment
Experimental: CEP-33457
200 mcg of CEP-33457
Drug: Lupuzor
200 mcg.
Other Name: CEP-33457

Placebo Comparator: Placebo Drug: Placebo
Matching placebo was administered subcutaneously every 4 weeks for 20 weeks for a maximum of 6 doses.




Primary Outcome Measures :
  1. The proportion of patients achieving a combined clinical response using the SLE responder index (SRI) [ Time Frame: Baseline and Final Assessment (week 24 or early termination) ]

Secondary Outcome Measures :
  1. Proportion of patients achieving an SRI response at each visit during the treatment period [ Time Frame: at weeks 4, 8, 12, 16, 20, and 24 ]
  2. Proportion of patients achieving a reduction of at least 4 points in the SLEDAI-2K total score at the final assessment [ Time Frame: Baseline and Final Assessment (Week 24 or early termination) ]
  3. Effect of CEP-33457 on disease activity, as assessed by the BILAG-2004 disease activity index at each visit during the treatment period [ Time Frame: at weeks 4 and final assessment (week 24 or early termination) ]
  4. Effect of CEP-33457 on the status of disease (PhGA and Patient's Global Assessment [PtGA] scales) at each visit during the treatment period [ Time Frame: at weeks 4, 8, 12, 16, 20, and 24 ]
  5. Effect of CEP-33457 on health-related quality of life, as assessed by completion of the Medical Outcome Survey Short Form 36 (SF-36) [ Time Frame: Baseline, week 12, and Final Assessment (Week 24 or early termination) ]
  6. Evaluation of the safety and tolerability of CEP-33457 [ Time Frame: At protocol-specified timepoints from screening through Week 24 or early terminiation. ]
  7. Medical Outcome Survey Short Form 36 (SF-36) [ Time Frame: At baseline, Weeks 12 and the final assessment (Week 24 or early termination) ]
  8. Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SLICC/ACR) [ Time Frame: Assessed at screening and Week 24 or early termination ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • The patient has an established diagnosis of systemic lupus erythematosus (SLE) as defined by ACR Classification Revised Criteria. The diagnosis is fulfilled provided that at least 4 criteria are met.
  • The patient has a positive test for antinuclear antibody (ANA) at screening and/or a positive test for anti-double-stranded deoxyribonucleic acid antibody (anti-dsDNA Ab) at screening.
  • Women must be surgically sterile, 2 years postmenopausal, or, if of childbearing potential, using a medically accepted method of contraception, and must agree to continued use of this method for the duration of the study and for 30 days after discontinuation of study drug treatment.
  • The patient has a clinical SLEDAI-2K score of at least 6 points during screening.
  • The patient does not have an "A" score on the BILAG-2004 scale.
  • If the patient is using oral corticosteroids, the weekly cumulative dose must not exceed 80 mg of prednisone equivalent; the weekly dose must be stable over the 4 weeks preceding the first dose of study drug.
  • If the patient is using antimalarials, methotrexate, leflunomide, mycophenolate mofetil, or azathioprine, the start date must be at least 3 months prior to the first dose of study drug, and the daily dose must be stable over the 4 weeks preceding the first dose of study drug.
  • If the patient is not currently using corticosteroids, antimalarials, methotrexate, mycophenolate mofetil, or azathioprine, the last dose (in case of previous use) must be at least 4 weeks prior to the first dose of study drug. For leflunomide, the stop date must be at least 8 weeks before the first dose of study drug, unless an adequate cholestyramine washout has been completed.

Exclusion Criteria:

  • The patient has been treated with intramuscular or intravenous (iv) pulse steroids (ie, 250 to 1000 mg iv total daily dose of methylprednisolone) within 4 weeks of the first dose of study drug. The use of intra-articular steroids may be allowed after consultation with the medical expert.
  • The patient has received tacrolimus, cyclosporine A, or iv immunoglobulins (IVIG) within 3 months of the first dose of study drug.
  • The patient has received cyclophosphamide within 12 months prior to the first dose of study drug.
  • The patient has been treated for SLE with agents such as fusion proteins, therapeutic proteins, or monoclonal antibodies or antibody fragments, within 12 months of the first dose of study drug.
  • The patient has received B-cell depleting agents such as rituximab and has not yet normalized the B-cell count (ie, CD20+ B-cell count is less than 200 and the absolute lymphocyte count [ALC] is less than 1500/μL).
  • The patient has New York Heart Association (NYHA) Class III or IV congestive heart failure.
  • The patient has severe active lupus nephritis or cerebritis.
  • The patient has an estimated glomerular filtration rate (eGFR) of less than 30 mL/min/1.73 m2 (via Modification of Diet in Renal Disease [MDRD] equation).
  • The patient has an aspartate aminotransferase (AST) or alanine aminotransferase (ALT) value greater than 2 times the upper limit of normal (ULN) or a total bilirubin level greater than 1.5 times ULN.
  • The patient has a planned immunization with a live or live attenuated vaccine within 3 months prior to administration of the first dose of study drug and for 3 months after administration of the last dose of study drug.
  • The patient has any clinically significant abnormalities on ECG that are not related to SLE, as determined by the investigator. Patients with stable ECG changes without evidence of active cardiovascular disease may participate at the discretion of the investigator and medical monitor.
  • The patient has an ongoing active systemic infection requiring treatment or a history of severe infection, such as hepatitis or pneumonia, in the 3 months prior to administration of the first dose of study drug. Less severe infections in the 3 months prior to administration of the first dose of study drug are permitted at the discretion of the investigator and medical monitor.
  • The patient has any concomitant medical condition unrelated to SLE that may interfere with his or her safety or with evaluation of the study drug, as determined by the investigator.
  • The patient has a history of a medical condition other than SLE that has required treatment with steroids in excess of 80 mg of prednisone equivalent/week within 6 months of the first dose of study drug.
  • The patient has a positive test result for hepatitis B surface antigen (HBsAg) or antibodies to hepatitis C (HCV Ab).
  • The patient has a known positive history of antibodies to human immunodeficiency virus (HIV) or HIV disease.
  • The patient has a history of alcohol or substance dependence or abuse (with the exception of nicotine), according to the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, Fourth Edition, Text Revision (DSM-IV-TR), within 3 months of the screening visit or has current substance abuse.
  • The patient has a history of severe allergic reactions to or hypersensitivity to any component of the study drug or placebo.
  • The patient has undergone or is undergoing treatment with another investigational drug for the treatment of lupus within 6 months prior to the 1st dose of study drug or has received any other investigational drug for any other condition within 30 days prior to the 1st dose of study drug.
  • The patient has previously participated in a Cephalon- or ImmuPharma-sponsored clinical study with CEP-33457.
  • The patient is a pregnant or lactating woman. (Any women becoming pregnant during the study will be withdrawn from the study.)
  • The patient is unlikely to comply with the study protocol or is unsuitable for any other reason, as judged by the investigator or medical monitor.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01135459


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Sponsors and Collaborators
Cephalon
Investigators
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Study Director: Sponsor's Medical Expert Cephalon

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Responsible Party: Cephalon
ClinicalTrials.gov Identifier: NCT01135459     History of Changes
Other Study ID Numbers: C33457/2047
First Posted: June 2, 2010    Key Record Dates
Last Update Posted: July 21, 2016
Last Verified: July 2016

Keywords provided by Teva Pharmaceutical Industries ( Cephalon ):
Lupus

Additional relevant MeSH terms:
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Lupus Erythematosus, Systemic
Connective Tissue Diseases
Autoimmune Diseases
Immune System Diseases