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Study to Evaluate BIIB059 in Cutaneous Lupus Erythematosus (CLE) With or Without Systemic Lupus Erythematosus (SLE) (LILAC)

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ClinicalTrials.gov Identifier: NCT02847598
Recruitment Status : Completed
First Posted : July 28, 2016
Last Update Posted : September 2, 2020
Sponsor:
Information provided by (Responsible Party):
Biogen

Brief Summary:
The primary purpose of the study is to evaluate the efficacy of BIIB059 in reducing disease activity in participants with systemic lupus erythematosus (SLE) with active cutaneous manifestations and joint involvement (Part A), and in participants with active cutaneous lupus erythematosus (CLE) (Subacute cutaneous lupus erythematosus (SCLE) or chronic CLE, including discoid lupus erythematosus (DLE)) with or without systemic manifestations (Part B). The secondary objective is to evaluate additional efficacy parameters of BIIB059 in reducing SLE/CLE disease activity, pharmacokinetic parameters, safety and tolerability of BIIB059 (Parts A and B).

Condition or disease Intervention/treatment Phase
Systemic Lupus Erythematosus Active Cutaneous Lupus Erythematosus Drug: BIIB059 Drug: Placebo Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 264 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A 2-Part Phase 2 Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Efficacy and Safety of BIIB059 in Subjects With Systemic Lupus Erythematosus and Active Skin Manifestations and in Subjects With Active Cutaneous Lupus Erythematosus With or Without Systemic Manifestations
Actual Study Start Date : October 20, 2016
Actual Primary Completion Date : August 28, 2019
Actual Study Completion Date : November 18, 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Lupus

Arm Intervention/treatment
Experimental: Part A: BIIB059 450 mg
BIIB059 450 mg administered subcutaneously (SC) every 4 weeks (Q4W) with an additional dose at Week 2 for a total of 7 doses (Weeks 0, 2, 4, 8, 12, 16, and 20) in participants with systemic lupus erythematosus [SLE] with active skin manifestations and joint involvement.
Drug: BIIB059
Administered as specified in the treatment arm.

Placebo Comparator: Part A: Placebo
BIIB059 matching placebo administered subcutaneously (SC) every 4 weeks (Q4W) with an additional dose at Week 2 for a total of 7 doses (Weeks 0, 2, 4, 8, 12, 16, and 20) in participants with [SLE] with active skin manifestations and joint involvement.
Drug: Placebo
Administered as specified in the treatment arm.

Experimental: Part B: BIIB059 50 mg
BIIB059 50 mg administered subcutaneously (SC) every 4 weeks (Q4W) with an additional loading dose at Week 2 for a total of 5 doses (Weeks 0, 2, 4, 8, and 12) in participants with active cutaneous lupus erythematosus [CLE] with or without systemic manifestations.
Drug: BIIB059
Administered as specified in the treatment arm.

Experimental: Part B: BIIB059 150 mg
BIIB059 150 mg administered subcutaneously (SC) every 4 weeks (Q4W) with an additional loading dose at Week 2 for a total of 5 doses (Weeks 0, 2, 4, 8, and 12) in participants with active [CLE] with or without systemic manifestations.
Drug: BIIB059
Administered as specified in the treatment arm.

Experimental: Part B: BIIB059 450 mg
BIIB059 450 mg administered subcutaneously (SC) every 4 weeks (Q4W) with an additional loading dose at Week 2 for a total of 5 doses (Weeks 0, 2, 4, 8, and 12) in participants with active [CLE] with or without systemic manifestations.
Drug: BIIB059
Administered as specified in the treatment arm.

Placebo Comparator: Part B: Placebo
BIIB059 matching placebo administered subcutaneously (SC) every 4 weeks (Q4W) with an additional loading dose at Week 2 for a total of 5 doses (Weeks 0, 2, 4, 8, and 12) in participants with active [CLE] with or without systemic manifestations.
Drug: Placebo
Administered as specified in the treatment arm.




Primary Outcome Measures :
  1. Part A: Change from Baseline in Active Joint Count (28-joint Assessment) to Week 24 [ Time Frame: Baseline, Week 24 ]
    An active joint is defined as a joint with pain and signs of inflammation (e.g., tenderness, swelling or effusion). A 28-joint assessment will be performed to determine the active joint count, which is defined as the sum of tender and swollen joint counts.

  2. Part B: Percent Change from Baseline in Cutaneous Lupus Erythematosus Disease Area and Severity Index Activity (CLASI-A) Score to Week 16 [ Time Frame: Baseline, Week 16 ]
    The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a clinical tool that quantifies disease activity and damage in cutaneous lupus erythematosus (CLE). The activity scale (CLASI-A) includes measurements of erythema, scale and hypertrophy, and mucous membrane disease. Each part of the body is listed separately, from the scalp to the feet, in addition to sections focusing on mucous membrane involvement and alopecia. Points are given for the presence of erythema, scale, mucous membrane lesions, recent hair loss, and inflammatory alopecia. Composite scores are calculated by summing the individual component scores. CLASI-A scores of 0-9, 10-20, and 21-70 represent disease severity of mild, moderate, and severe, respectively.


Secondary Outcome Measures :
  1. Percentage of Participants with CLASI-50 Response at Week 24 (Part A) and Weeks 12 and 16 (Part B) [ Time Frame: Baseline up to Week 24 ]

    CLASI-50 Response is defined as a 50% improvement from baseline in CLASI-A score at Week 24 (Part A) and Weeks 12 and 16 (Part B).

    The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a clinical tool that quantifies disease activity and damage in cutaneous lupus erythematosus (CLE). The activity scale (CLASI-A) includes measurements of erythema, scale and hypertrophy, and mucous membrane disease. Each part of the body is listed separately, from the scalp to the feet, in addition to sections focusing on mucous membrane involvement and alopecia. Points are given for the presence of erythema, scale, mucous membrane lesions, recent hair loss, and inflammatory alopecia. Composite scores are calculated by summing the individual component scores. CLASI-A scores of 0-9, 10-20, and 21-70 represent disease severity of mild, moderate, and severe, respectively.


  2. Percent Change from Baseline in CLASI-A Score to Weeks 12, 16, and 24 (Part A) and Week 12 (Part B) [ Time Frame: Baseline up to Week 24 ]
    The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a clinical tool that quantifies disease activity and damage in cutaneous lupus erythematosus (CLE). The activity scale (CLASI-A) includes measurements of erythema, scale and hypertrophy, and mucous membrane disease. Each part of the body is listed separately, from the scalp to the feet, in addition to sections focusing on mucous membrane involvement and alopecia. Points are given for the presence of erythema, scale, mucous membrane lesions, recent hair loss, and inflammatory alopecia. Composite scores are calculated by summing the individual component scores. CLASI-A scores of 0-9, 10-20, and 21-70 represent disease severity of mild, moderate, and severe, respectively.

  3. Percentage of Participants with a ≥ 4-point reduction in CLASI-A score Relative to Baseline at Weeks 12 and 16 (Part B), and Week 24 (Part A) [ Time Frame: Baseline up to Week 24 ]
    The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a clinical tool that quantifies disease activity and damage in cutaneous lupus erythematosus (CLE). The activity scale (CLASI-A) includes measurements of erythema, scale and hypertrophy, and mucous membrane disease. Each part of the body is listed separately, from the scalp to the feet, in addition to sections focusing on mucous membrane involvement and alopecia. Points are given for the presence of erythema, scale, mucous membrane lesions, recent hair loss, and inflammatory alopecia. Composite scores are calculated by summing the individual component scores. CLASI-A scores of 0-9, 10-20, and 21-70 represent disease severity of mild, moderate, and severe, respectively.

  4. Percentage of Participants with a Composite Response (Part A) [ Time Frame: Baseline, Week 24 ]

    Composite response is defined as:

    Participants with a Systemic Lupus Erythematosus (SLE) Responder Index (SRI) of ≥4 (SRI-4) at Week 24. SRI-4 is defined as a reduction from baseline of ≥4 points in SLE Disease Activity Index 2000 (SLEDAI-2K). Participants will also have no new organ system affected, as defined by no new British Isles Lupus Activity Group (BILAG)-2004 A and no more than one new BILAG-2004 B. No worsening from baseline in the participant's lupus disease activity is to be present, defined by <0.3 point increase in Physician's Global Assessment (PGA) visual analogue scale (VAS). Lastly, the participants will have no protocol-prohibited medication or treatment, concomitant corticosteroid dosage at Week 24 is <=10 mg/day, concomitant corticosteroid dosage at Week 24 is <=Day 1 corticosteroid dosage, and there is to be no increase in corticosteroid dose between Weeks 17 and 24.


  5. Change from Baseline in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) Score to Week 24 (Part A) [ Time Frame: Baseline, Week 24 ]
    The SLEDAI-2K is a reliable, valid, simple, 1-page activity index that measures disease activity and records features of active lupus as present or not. It uses a weighted checklist to assign a numeric score based on the presence or absence of 24 symptoms at the time of assessment or during the previous 28 days. Each symptom present is assigned between 1 and up to 8 points based on its usual clinical importance, yielding a total score that ranges from 0 points (no symptoms) to 105 points (presence of all defined symptoms).

  6. Percentage of Participants with no New Organ System Affected (Part A) [ Time Frame: Baseline, Week 24 ]
    No new organ system affected, as defined by no new British Isles Lupus Activity Group (BILAG)-2004 A and no more than one new BILAG-2004 B.

  7. Change from baseline in Physician's Global Assessment (PGA) visual analog scale (VAS) score (Part A) [ Time Frame: Baseline, Week 24 ]
  8. BIIB059 Clearance [ Time Frame: Up to Week 36 ]
  9. BIIB059 Volume of Distribution [ Time Frame: Up to Week 36 ]
  10. BIIB059 Absorption Rate [ Time Frame: Up to Week 36 ]
  11. Number of participants experiencing Adverse Events (AEs) and Serious Adverse Events (SAEs) [ Time Frame: Baseline up to 36 weeks ]
    An AE is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An SAE is any untoward medical occurrence that at any dose: Results in death; in the view of the Investigator, places the subject at immediate risk of death (a life-threatening event); however, this does not include an event that, had it occurred in a more severe form, might have caused death; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; results in a congenital anomaly/birth defect.

  12. Number of Participants with Clinically Significant Laboratory Assessment Abnormalities [ Time Frame: Up to Week 36 ]
  13. Number of Participants with Clinically Significant Vital Sign Abnormalities [ Time Frame: Up to Week 36 ]
  14. Number of Participants with Clinically Significant 12-Lead Electrocardiograms (ECGs) Abnormalities [ Time Frame: Up to Week 36 ]
  15. Number of Participants with Positive Serum BIIB059 Antibodies [ Time Frame: Up to Week 36 ]
  16. Absolute Change From Baseline Over Time in Immunoglobulin Levels [ Time Frame: Up to Week 36 ]
  17. Absolute Change From Baseline Over Time in Vaccine Titers [ Time Frame: Up to Week 36 ]
  18. Percent Change From Baseline Over Time in Immunoglobulin Levels [ Time Frame: Up to Week 36 ]
  19. Percent Change From Baseline Over Time in Vaccine Titers [ Time Frame: Up to Week 36 ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

Part A:

  1. Diagnosis of systemic lupus erythematosus (SLE) fulfilling at least 4 out of 11 of the 1997 revised American College of Rheumatology (ACR) classification criteria for SLE along with active skin manifestations and joint involvement.
  2. At least 4 tender joints and at least 4 swollen joints with at least 4 of the swollen joints in the proximal interphalangeal (PIP) joints, metacarpophalangeal (MCP) joints and/or wrist.
  3. Demonstrate at least one sign of active lupus skin disease, including acute cutaneous lupus erythematosus (ACLE), subacute cutaneous lupus erythematosus (SCLE), and/or chronic cutaneous lupus erythematosus (CCLE) (e.g., discoid lupus erythematosus (DLE)), with skin activity defined by SLE Disease Activity Index 2000 (SLEDAI-2K) at the time of Screening and randomization.

Part B:

1. Active skin manifestations Cutaneous Lupus Erythematosus Disease Area and Severity Index Activity (CLASI-A) ≥8)) and a diagnosis of cutaneous lupus erythematosus (CLE) that has been histologically confirmed (in the past or at Screening), with or without SLE manifestations.

Key Exclusion Criteria:

  1. Active lupus nephritis or moderate-to-severe or chronic kidney disease.
  2. Any active skin conditions other than CLE that may interfere with the study (e.g., psoriasis, non-LE skin lupus, drug-induced lupus).
  3. History of chronic, recurrent (3 or more of the same type of infection in a 12-month period), or recent serious infection (e.g., pneumonia, septicemia, herpes zoster) as determined by the Investigator and requiring anti-infective treatment within 12 weeks prior to Screening.
  4. Use of immunosuppressive or disease-modifying treatments for SLE or CLE that were initiated less than 12 weeks prior to Randomization.

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply


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): NCT02847598


Locations
Show Show 129 study locations
Sponsors and Collaborators
Biogen
Investigators
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Study Director: Medical Director Biogen
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Biogen
ClinicalTrials.gov Identifier: NCT02847598    
Other Study ID Numbers: 230LE201
2015-004359-32 ( EudraCT Number )
First Posted: July 28, 2016    Key Record Dates
Last Update Posted: September 2, 2020
Last Verified: August 2020

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Biogen:
CLE, SLE, Cutaneous Lupus Erythematosus, Systemic Lupus Erythematosus, Lupus
Additional relevant MeSH terms:
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Lupus Erythematosus, Systemic
Lupus Erythematosus, Cutaneous
Connective Tissue Diseases
Autoimmune Diseases
Immune System Diseases
Skin Diseases