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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT03517722
Other study ID # CR108440
Secondary ID 2017-001489-53CN
Status Terminated
Phase Phase 3
First received
Last updated
Start date April 16, 2018
Est. completion date November 5, 2020

Study information

Verified date December 2023
Source Janssen Research & Development, LLC
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the efficacy of ustekinumab in participants with active systemic lupus erythematosus (SLE) who have not adequately responded to one or more standard of care treatments.


Description:

This study evaluates the efficacy, safety, and tolerability of ustekinumab in participants with active SLE according to Systemic Lupus International Collaborating Clinics (SLICC) criteria Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score greater than (>=) 6, despite receiving one or more standard-of-care treatments (example, immunomodulators, antimalarial drugs, and/or glucocorticoids). The total duration of the study is up to 182 weeks, consisting of 3 study periods: a screening period (approximately 6 weeks), a double blind period (52 weeks), and an extension period (124 weeks). Other study evaluations will include pharmacokinetics, immunogenicity, biomarkers and pharmacogenomic evaluations. The safety of the participants enrolled in the study will be monitored on an ongoing basis throughout the study.


Recruitment information / eligibility

Status Terminated
Enrollment 516
Est. completion date November 5, 2020
Est. primary completion date November 5, 2020
Accepts healthy volunteers No
Gender All
Age group 16 Years to 75 Years
Eligibility Inclusion Criteria: - Be male or female - Has a documented medical history (that is, met at least 1 of the two criteria below) that participant met the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for systemic lupus erythematosus (SLE) at least 3 months prior to first dose of study agent: 1. Met a total of at least 4 SLICC criteria, including at least 1 clinical and at least 1 immunologic; 2. Has a diagnosis of lupus nephritis, confirmed by renal biopsy and at least 1 of the following autoantibodies: antinuclear antibodies (ANA) or anti-double-stranded deoxyribonucleic acid (anti-dsDNA) - Has a positive test in the medical history and confirmed at screening for at least 1 of the following autoantibodies: antinuclear antibodies, anti-double-stranded deoxyribonucleic acid, and/or anti-Smith - Has greater than or equal to (>=) 1 British Isles Lupus Assessment Group (BILAG) A and/or >= 2 BILAG B scores observed during screening - Has a Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) activity score >=4 (excluding diffuse non-inflammatory alopecia) or >= 4 joints with pain and signs of inflammation at screening, Week 0, or both - Has a Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score >=6 at screening. Must also have SLEDAI-2K >= 4 for clinical features (excluding headache and laboratory abnormalities) at Week 0 - Cannot be pregnant, nursing, intending to become pregnant, or unwilling to follow contraception or egg/sperm donation guidelines - Must be receiving stable doses of >=1 protocol-permitted standard of care SLE treatment: oral glucocorticoids, anti-malarials, immunomodulators (methotrexate, azathioprine, 6-mercaptopurine, mycophenolate mofetil, mycophenolic acid) Exclusion Criteria: - Has any unstable or progressive SLE manifestation (example: central nervous system lupus, systemic vasculitis, end-stage renal disease, severe or rapidly progressive glomerulonephritis, pulmonary hemorrhage, myocarditis) that may warrant escalation in therapy beyond permitted background medications. Participants requiring renal hemodialysis or peritoneal dialysis are also excluded - Has other co-existent inflammatory diseases (example: rheumatoid arthritis, psoriasis, psoriatic arthritis, Crohn's disease) - Has a urinary protein to creatinine ratio of greater than (>)4 gram per gram (g/g) per day - Has an acute or chronic infectious illness (example: human immunodeficiency virus, hepatitis B or C virus, tuberculosis, opportunistic infections) - Has a history of cancer or lymphoproliferative disease within the last 5 years except for treated and non-recurrent cutaneous basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma - Has any condition requiring multiple courses of systemic glucocorticoids (example: uncontrolled asthma, chronic obstructive pulmonary disease) - Has a history of major surgery within the last month - Has received live virus or bacterial vaccines within 16 weeks prior to first dose of study agent or Bacille Calmette-Guerin (BCG) vaccination within 12 months of screening - Has previously received ustekinumab - Has received cyclophosphamide orally within 90 days or intravenously within 180 days of screening - Has received a single B-cell targeted therapy (e.g. belimumab) within 3 months, >1 previous B-cell targeted therapy within 6 months, or B-cell depleting therapy (example: rituximab) within 12 months of first dose of study agent - Has received protocol-prohibited oral or biologic immunomodulatory therapy in the last 3 months or less than (<)5 half-lives (whichever is longer) prior to first dose of study agent - Has received adrenocorticotropic hormone (ACTH) within 1 month prior to first dose of study agent - Has received epidural, intravenous, intramuscular, intraarticular, intrabursal, intralesional glucocorticoids within 6 weeks of first dose of study agent - Locally-delivered therapies except for ophthalmic use of cyclosporine A or topical use of nonsteroidal anti inflammatory drugs (NSAIDs), analgesics, or high-potency glucocorticoids (World Health Organization criteria) are prohibited

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Placebo
Participants will receive placebo matching to ustekinumab IV or SC.
Ustekinumab (approximately 6 mg/kg)
Participants will receive ustekinumab approximately 6 mg/kg via IV route based on body weight-range.
Ustekinumab 90 mg
Participants will receive 90 mg ustekinumab via SC route.

Locations

Country Name City State
Argentina Centro Privado de Medicina Familiar Buenos Aires
Argentina Fundacion CENIT para la Investigacion en Neurociencias Buenos Aires
Argentina Instituto Centenario Buenos Aires
Argentina Framingham Centro Medico Ciudad De La Plata
Argentina Hospital Italiano de Cordoba Cordoba
Argentina Hospital Escuela 'Gral. Jose F. de San Martin' Corrientes
Argentina CER San Juan Centro Polivalente de Asistencia e Investigacion Clinica San Juan
Argentina Centro Medico Privado de Reumatologia San Miguel de Tucumán
Bulgaria MHAT Trimantium Plovdiv
Bulgaria Diagnostic-Consultative Center (DCC) Aleksandrovska Sofia
Bulgaria Medical Centre Synexus Sofia
Bulgaria UMHAT St. Ivan Rilski Sofia
Canada University of Calgary Calgary Alberta
Canada McMaster University Hamilton Ontario
Canada CHU de Québec Quebec
Canada Toronto Western Hospital Toronto Ontario
Canada University of Manitoba Winnipeg Manitoba
China The First Affiliated Hospital of Baotou Medical University Baotou
China Peking Union Medical College Hospital Beijing
China West China Hospital, Sichuan University Chengdu
China Guangdong Provincial People's Hospital Guangzhou
China Affiliated Hospital of Inner Mongolia Med U Hohhot
China Shanghai Ruijin Hospital Shanghai
China Tianjin Medical University General Hospital Tianjin
China Tongji Hospital of Tongji Medical College of Huangzhong Univ Wuhan
China The 1st affiliated Hospital of Xi'an Traffic University Xi'an
Colombia Centro de Investigación en Reumatología y especialidades médicas S.A.S. - CIREEM S.A.S. Bogotá
Colombia IPS Medicity SAS Bucaramanga
Colombia Servimed S.A.S Bucaramanga
Colombia Preventive Care Ltda Chia
Colombia Clinica Universitaria Bolivariana Medellin
Colombia Funcentra Montería
Germany Charite - Universitaetsmedizin Berlin (CCM) Berlin
Germany Medizinische Hochschule Hannover Hannover
Germany Rheumazentrum Ruhrgebiet Herne
Germany Rheumatology Unit Leipzig
Germany Universitaetsmedizin Mainz Mainz
Hungary Szt, Istvan and Szt. Laszlo Budapest
Hungary Bekes Megyei Pandy Kalman Korhaz Gyula
Hungary Belvarosi Egeszseghaz Kft. (Leda-Platan Maganklinika es Sebeszeti Kozpont) Zalaegerszeg
Japan Chiba University Hospital Chiba
Japan National Hospital Organization Chibahigashi National Hospital Chiba
Japan National Hospital Organization Kyushu Medical Center Fukuoka
Japan Fukushima Medical University Hospital Fukushima
Japan Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital Hiroshima
Japan Hospital of the University of Occupational and Environmental Health Hukuoka
Japan National Hospital Organization Osaka Minami Medical Center Kawachi-Nagano
Japan Kawasaki Rheumatism and Internal Medicine Clinic Kitakyushu
Japan Toho University Medical Center, Ohashi Hospital Meguro-ku
Japan Nagasaki University Hospital Nagasaki-shi
Japan National Hospital Organization Nagoya Medical Center Nagoya
Japan Kitasato University Hospital Sagamihara
Japan Sapporo City General Hospital Sapporo
Japan Hokkaido University Hospital Sapporo-shi
Japan Sasebo Chuo Hospital Sasebo
Japan Tohoku University Hospital Sendai-shi
Japan Keio University Hospital Shinjuku-ku
Japan National Center for Global Health and Medicine Shinjuku-ku
Japan Juntendo University Hospital Tokyo
Japan St. Luke's International Hospital Tokyo
Japan Fujita Health University Hospital Toyoake
Japan National Hospital Organization Yokohama Medical Center Yokohama
Korea, Republic of Daegu Catholic University Medical Center Daegu
Korea, Republic of Chonbuk National Univ Hospital JeonJu
Korea, Republic of Konkuk University Medical Center Seoul
Korea, Republic of Seoul National University Hospital Seoul
Korea, Republic of Ajou University Hospital Suwon
Lithuania Lietuvos sveikatos mokslu universiteto ligonine Kauno klinik Kaunas
Lithuania Klaipeda University Hospital Klaipeda
Lithuania Vaiku ligonine Vilniaus Universiteto ligon. Santariskiu fil Vilnius
Lithuania Vilnius University Hospital Santariskiu Clinics Vilnius
Poland Szpital Uniwersytecki nr 2 im. dr. Jana Biziela w Bydgoszczy Bydgoszcz
Poland Nzoz Bif-Med Bytom
Poland Centrum Medyczne AMED oddzial w Lodzi Lodz
Poland Samodzielny Publiczny Szpital Kliniczny Nr 4 w Lublinie Lublin
Poland Twoja Przychodnia - Centrum Medyczne Nowa Sol Nowa Sol
Poland Centrum Medyczne Medens S.C. Grupowa Praktyka Lekarska Sonoswiec
Poland Centrum Medyczne Pratia Tychy Tychy
Poland Centrum Medyczne Pratia Warszawa Warszawa
Poland Reumatika-Centrum Reumatologii, NZOZ Warszawa
Poland Uniwersytecki Szpital Kliniczny im. J. Mikulicza-Radeckiego Wroclaw
Portugal Hospital Curry Cabral-Centro Hospital Lisboa Central Lisboa
Portugal Hospital da Luz Lisboa
Portugal Instituto Portugues de Reumatologia Lisboa
Portugal ULSAM, EPE - Hospital Conde de Bertiandos Ponte de Lima
Portugal C.H. de Vila Nova de Gaia/Espinho Vila Nova de Gaia
Russian Federation LLL Medical Center Revma-Med Kemerovo
Russian Federation Regional Clinical Hospital for War Veterans Kemerovo
Russian Federation Clinical Diagnostic Center 'Ultramed' Omsk
Russian Federation Leningrad region clinical hospital Saint-Petersburg
Russian Federation City Clinical Hospital #31 St. Petersburg
Russian Federation Northen-Western State Medical University n.a. I.I. Mechnikov St.-Petersburg
Russian Federation Ulyanovsk Regional Clinical Hospital Ulyanovsk
Russian Federation Clinical Emergency Hospital n.a. N.V. Solovyev Yaroslavl
Serbia Clinical Hospital Center Bezanijska Kosa Belgrade
Serbia Institute of Rheumatology Belgrade
Serbia Institute of Rheumatology Belgrade Belgrade
Serbia Military Medical Academy Belgrade
Serbia University Clinical Center Kragujevac Kragujevac
Serbia Institute for Treatment and Rehabilitation Niska Banja Niska Banja
Serbia Clinical Center of Vojvodina Vojvodina
South Africa Panorama Medical Centre Cape Town
South Africa Excellentis Clinical trial Consultants George
South Africa Clinical Research Unit, University of Pretoria Pretoria
South Africa Winelands Medical Research Centre Stellenbosch
Spain Hosp. Univ. Vall D Hebron Barcelona
Spain Hosp. Univ. de Basurto Bilbao
Spain Hosp. Reina Sofia Cordoba
Spain Hosp. Clinico San Carlos Madrid
Spain Hosp. Univ. 12 de Octubre Madrid
Spain Hosp. Regional Univ. de Malaga Málaga
Spain Hosp. Univ. Infanta Sofia San Sebastián de los Reyes
Spain Hosp. Infanta Luisa Sevilla
Spain Hosp. Do Meixoeiro Vigo -Pontevedra
Taiwan Kaohsiung Medical University Chung-Ho Memorial Hospital Kaohsiung
Taiwan Chang Gung Memorial Hospital Kwei-san Hsiang
Taiwan China Medical University Hospital Taichung
Taiwan Chung Shan Medical University Hospital Taichung
Taiwan Cathay General Hospital Taipei
Taiwan National Taiwan University Hospital Taipei
Taiwan Taipei Medical University Taipei
Taiwan Taipei Veterans General Hospital Taipei
Thailand Phramongkutklao Hospital and Medical College Bangkok
Thailand Rajavhiti Hospital Bangkok
Thailand Ramathibodi Hospital Bangkok
Thailand Siriraj Hospital Bangkok
Thailand Songklanagarind hospital Hat Yai
Thailand Chiang Mai University Muang
Ukraine Mechnikov Inst, Miska bagatoprofilna likarnia #18 Kharkiv
Ukraine Kyiv City Clinical Hospital #3 Kyiv
Ukraine Kyivska oblasna klinichna likarnia Kyiv
Ukraine Odeska oblasna klinichna likarnia Odesa
Ukraine Multidisciplinary Medical Center of Odessa National Medical University Odessa
Ukraine MNPE 'Vinnytsia Regional Clinical Hospital named after M.I. Pyrogov of Vinnytsia Regional Council' Vinnytsia
Ukraine Naukovo-doslidnyi inst. Reabilit. Pyrogova [Revmatologichne] Vinnytsia
United States Albuquerque Center for Rheumatology Albuquerque New Mexico
United States Amarillo Center for Clinical Research Amarillo Texas
United States Pinnacle Research Group, LLC Anniston Alabama
United States Emory University Atlanta Georgia
United States Piedmont Healthcare - Piedmont Hospital Atlanta Georgia
United States University of Colorado Aurora Colorado
United States Austin Regional Clinic Austin Texas
United States Arthritis and Rheumatic Disease Specialties Aventura Florida
United States Rheumatology & Pulmonary Clinic Beckley West Virginia
United States University of Alabama at Birmingham Birmingham Alabama
United States Graves-Gilbert Clinic - Bowling Green Bowling Green Kentucky
United States Bay Area Arthritis and Osteoporosis Brandon Florida
United States DJL Clinical Research, PLLC Charlotte North Carolina
United States Joint and Muscle Research Institute Charlotte North Carolina
United States Rush University Medical Center Chicago Illinois
United States University of Chicago Chicago Illinois
United States Columbia Arthritis Center Columbia South Carolina
United States Medvin Clinical Research Covina California
United States Arthritis Centers of Texas Dallas Texas
United States DeKalb Medical Specialty Center Decatur Georgia
United States Denver Arthritis Clinic Denver Colorado
United States Duke University Medical Center Durham North Carolina
United States St Paul Rheumatology PA Eagan Minnesota
United States Centre for Rheumatology, Immunology and Arthritis Fort Lauderdale Florida
United States Lugene Eye Institute Glendale California
United States C.V. Mehta, MD Medical Corp. Hemet California
United States University of Mississippi Medical Center Jackson Mississippi
United States West Tennessee Research Institute Jackson Tennessee
United States University of Florida Health Jacksonville Jacksonville Florida
United States University of California at San Diego La Jolla California
United States Biomedical Research Alliance Of New York Lake Success New York
United States Advanced Medical Research - Lakewood Lakewood California
United States June DO, PC. Lansing Michigan
United States Innovative Health Research Las Vegas Nevada
United States Oklahoma Medical Research Foundation Las Vegas Nevada
United States Loma Linda University Loma Linda California
United States Loma Linda University Health Care Loma Linda California
United States Valerius Medical Group & Research Center Los Alamitos California
United States Keck School of Medicine of USC Los Angeles California
United States Wallace Rheumatic Study Center Los Angeles California
United States The Feinstein Institute for Medical Research Manhasset New York
United States Dr. Ramesh Gupta Memphis Tennessee
United States New Horizon Research Center Miami Florida
United States University of Miami Miller School of Medicine Miami Florida
United States Arthritis and Diabetes Clinic Monroe Louisiana
United States Vanderbilt University Medical Center Nashville Tennessee
United States UPMC Lupus Center of Excellence New Haven Connecticut
United States Hospital for Special Surgery New York New York
United States NYU Center for Musculoskeletal Care New York New York
United States Omega Research Consultants Orlando Florida
United States Rheumatology Associates of Central Florida, PA Orlando Florida
United States Millennium Research Ormond Beach Florida
United States Lewis Katz School of Medicine, Temple University Philadelphia Pennsylvania
United States Integral Rheumatology & Immunology Specialists Plantation Florida
United States Sun Research Institute San Antonio Texas
United States UT Health Science Center at San Antonio San Antonio Texas
United States East Bay Rheumatology Medical Group San Leandro California
United States University of Washington Seattle Washington
United States Stamford Therapeutics Consortium Stamford Connecticut
United States SUNY Upstate Medical University Syracuse New York
United States Clinical Research of West Florida Tampa Florida
United States Westlake Medical Research Clinical Trials Thousand Oaks California
United States OK Center for Arthritis Therapy & Research, Inc. Tulsa Oklahoma
United States University Clinical Investigators, Inc Tustin California
United States Inland Rheumatology Clinical Trials Inc. Upland California
United States Achieve Clinical Research, LLC Vestavia Hills Alabama
United States Allegheny Rheumatology/Allegheny Singer Research Institute Wexford Pennsylvania
United States The Center for Rheumatology and Bone Research Wheaton Maryland
United States Wake Forest Baptist Medical Center Winston-Salem North Carolina

Sponsors (1)

Lead Sponsor Collaborator
Janssen Research & Development, LLC

Countries where clinical trial is conducted

United States,  Argentina,  Bulgaria,  Canada,  China,  Colombia,  Germany,  Hungary,  Japan,  Korea, Republic of,  Lithuania,  Poland,  Portugal,  Russian Federation,  Serbia,  South Africa,  Spain,  Taiwan,  Thailand,  Ukraine, 

Outcome

Type Measure Description Time frame Safety issue
Primary Percentage of Participants Achieving a Systemic Lupus Erythematosus Responder Index-4 (SRI-4) Composite Response at Week 52 SRI-4 response:>=4-point reduction in SLEDAI-2K total score, no British Isles Lupus Assessment Group (BILAG) A (severe disease) and no more than 1 new BILAG B (moderate disease) domain score and no worsening (<10 % increase)from baseline in Physician's Global Assessment(PGA).SLEDAI measures disease activity in 9 organ systems,higher scores=more severe disease activity.Each organ system measured as either absent/present within last 30 days and weighted score across systems was utilized to calculate total SLEDAI score(range:0=no symptoms to 105=presence of all defined symptoms). Improvement is defined as reduction in SLEDAI score (BILAG) Index: assessing clinical signs, symptoms,or laboratory parameters related to SLE,divided into 9 domains. Each domain can range from A=new domain activity, B=worse domain activity, C=same domain activity, D=improving domain activity to E=absence of domain activity. PGA assesses disease activity on visual analogue scale from very well(0)-very poor(10). Week 52
Secondary Time to First Flare Time to flare is defined as the time (in days) post baseline when the first flare occurs. It was calculated with flare defined as either 1 or more BILAG A (severe disease activity) or 2 or more new BILAG B (moderate disease activity) domain scores relative to baseline. BILAG was defined as a measure of alterations or intensification to therapy consisting of 97 questions in 9 domains. Each domain can range from A=new domain activity, B=worse domain activity, C=same domain activity, D=improving domain activity to E=absence of domain activity. BILAG A flare was defined as at least 1 new BILAG A scores. BILAG B flare was defined as at least 2 new BILAG B scores. Up to Week 52
Secondary Percentage of Participants With an SRI-4 Composite Response at Week 24 SRI-4 response:>=4-point reduction in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) total score, no BILAG A (severe disease) and no more than 1 new BILAG B (moderate disease) domain score and no worsening (<10 % increase)from baseline in PGA.SLEDAI measures disease activity in 9 organ systems, higher scores=more severe disease activity. Each organ system measured as either absent/present within last 30 days and weighted score across systems was utilized to calculate total SLEDAI score(range:0=no symptoms to 105=presence of all defined symptoms). Improvement is defined as reduction in SLEDAI score (BILAG) Index: assessing clinical signs, symptoms,or laboratory parameters related to SLE,divided into 9 domains. Each domain can range from A=new domain activity, B=worse domain activity, C=same domain activity, D=improving domain activity to E=absence of domain activity. PGA assesses disease activity on visual analogue scale from very well(0)-very poor(10). Week 24
Secondary Percentage of Participants With 50 Percent (%) Improvement in Joints With Pain and Signs of Inflammation (Active Joints) at Week 52 The percentage of participants who achieved at least 50% improvement from baseline in number of joints with pain and signs of inflammation at Week 52 for participants with at least 4 joints with pain and signs of inflammation at baseline were reported. Week 52
Secondary Percentage of Participants Receiving Glucocorticoid at Baseline Who Achieved Change in Glucocorticoid Dose by Week 40 and Sustain That Change Through Week 52 Reduction of glucocorticoid dose was defined as a reduction in average daily oral glucocorticoid dose by at least 50% (relative to the baseline dose) or reduction of average daily oral glucocorticoid dose by at least 25% (relative to the baseline dose) so that the average daily dose was reduced to less than or equal to (<=) 7.5 milligram (mg) (prednisone or equivalent). Sustained reduction of glucocorticoid dose was defined as achieving an average daily oral glucocorticoid dose reduction between Weeks 24 and 40, and sustaining that reduction through Week 52, in those participants who, at baseline, were receiving oral glucocorticoids. Up to Week 52
Secondary Percentage of Participants With at Least a 50% Improvement in the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Activity Score at Week 52 Percentage of participants achieving at least 50% improvement in CLASI activity score at Week 52 reported in participants with a CLASI activity score of 4 or greater at baseline. The CLASI is an instrument to assess the disease activity and damage caused to the skin for cutaneous lupus erythematosus participants with or without systemic involvement. The CLASI activity score ranges from 0-70 with lower score being improved. Activity is scored based on erythema, scale/hyperkeratosis, mucous membrane involvement, acute hair loss, and non-scarring alopecia. Week 52
Secondary Percentage of Participants Receiving Glucocorticoid at Baseline Who Achieved Change in Glucocorticoid Dose by Week 40, Sustained That Change Through Week 52, and Achieved an SRI-4 Composite Response at Week 52 Percentage of participants with reduction in glucocorticoid dose by Week 40, its sustenance through Week 52, and SRI 4 composite response at Week 52 were reported. Reduction of glucocorticoid dose was defined as reduction in average daily oral glucocorticoid dose by at least 50% (relative to baseline dose) or reduction of average daily oral glucocorticoid dose by at least 25% (relative to baseline dose) so that average daily dose is reduced to <=7.5 mg (prednisone or equivalent). Sustained reduction of glucocorticoid dose was defined as achieving an average daily oral glucocorticoid dose reduction between Weeks 24 and 40, and sustaining that reduction through Week 52, in those participants who,at baseline,were receiving oral glucocorticoids. SRI-4 was defined as composite of at least 4-point improvement in SLEDAI-2K score of 0=no symptoms to 105=presence of all defined symptoms with higher scores representing increased disease activity),no worsening in BILAG and no worsening in PGA. Up to Week 52
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