A Study of DS-7011a in Patients With Systemic Lupus Erythematosus

Systemic Lupus Erythematosus Clinical Trial

Official title:

A Phase 1b/2, Double-Blind, Placebo-Controlled, Randomized, Parallel-Arm Study to Explore the Safety, Pharmacokinetics, and Proof of Biological Activity of DS-7011a in Patients With Systemic Lupus Erythematosus

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05638802
• Other study ID #: DS7011-107
• Status: Recruiting
• Phase: Phase 1/Phase 2
• Start date: June 7, 2023
• Est. completion date: March 15, 2025

Study information

• Verified date: April 2024
• Source: Daiichi Sankyo
• Contact: Contact for Clinical Trial Information Disclosure
• Phone: 908-992-6400
• Email: CTRinfo[@]dsi.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Systemic lupus erythematosus (SLE) is a systemic chronic autoimmune disease characterized by autoantibody production, inflammation, and tissue damage in multiple organs. Standard of care therapies used to treat SLE are only partially effective and have a wide range of toxicities. There is a need for more effective and safer therapies for patients with SLE.

Description:

This Phase 1b/2 study will initially explore the safety, tolerability, pharmacokinetics, pharmacodynamics, immunogenicity, and efficacy of DS-7011a in patients with SLE. DS-7011a is an anti-Toll-like receptor 7 (TLR7) antagonistic monoclonal antibody developed for the treatment of SLE.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 24
• Est. completion date: March 15, 2025
• Est. primary completion date: March 15, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Male and female participants must be of 18 years or more with definite SLE for at least 6 months prior to Screening, defined according to the 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for SLE, including documented history of positivity for antinuclear antibody (titer =1:80).

• Body mass index (BMI) =18 kg/m^2 and body weight =45 kg.

• Presence of active CLE (acute, subacute, and chronic cutaneous lupus), with active skin involvement and a CLASI-A score of 4 or higher at the time of screening and randomization as recognized by 2 adjudicators, ie, the investigator in the periphery at the site and a centrally located arbiter contracted ad hoc (in case of disagreement between these 2 adjudicators, a third adjudicator, also centrally located and contracted ad hoc, will solve the disagreement and provide a final decision), despite adequate use of conventional therapies (either topical corticosteroids or antimalarial agents used for at least 12 weeks prior to Screening) or because of the requirement to discontinue these therapies due to side effects or poor tolerability.

• Participants must be willing to have skin tape harvests collected from the affected skin area (skin tape stripping done on the target lesion).

• Participants must agree not to participate in any other investigational study during the study Treatment Period and for 3 months after the last dose of study drug.

• Participants must give written informed consent to participation in the study prior to Screening.

• Participants must be vaccinated against COVID-19

Exclusion Criteria:

• Active lupus nephritis (LN) on induction therapy, or induction therapy completed within 12 weeks prior to Screening (stable maintenance therapy with mycophenolate or azathioprine allowed).

• Active neuropsychiatric SLE, including, but not limited to, the following: seizure, new or worsening impaired level of consciousness, psychosis, delirium or confusional state, aseptic meningitis, ascending or transverse myelitis, chorea, cerebellar ataxia, mononeuritis multiplex, or demyelinating syndromes.

• Primary diagnosis of autoimmune or rheumatic disease other than SLE (secondary Sjögren's syndrome or autoimmune thyroiditis are not exclusionary) or drug-induced lupus.

• History of chronic, recurrent (3 or more of the same type of infection in 1 year) or recent serious infection, including viral infections, as determined by the investigator, or requiring anti-infective treatment within 12 weeks prior to Screening.

• History of severe herpes infection or signs of herpes or varicella zoster viral infection within 12 weeks prior to Screening.

• Positive COVID-19 molecular test at Screening or symptoms suggestive of SARS-CoV-2 infection or close contact with an individual with SARS-CoV-2 infection within 2 weeks prior to randomization.

• History of malignant disease within the 2 years before Screening or ongoing at the time of Screening, except basal cell carcinomas and squamous cell carcinomas of the skin, or completely excised carcinoma in situ of the cervix

• Chronic kidney disease with significant proteinuria (ie, >2 g/24 h or urine protein to creatinine ratio >200 mg/g) or decreased renal function (estimated glomerular filtration rate [eGFR] <30 mL/min).

• New York Heart Association class III or IV congestive heart failure.

• Concomitant disease or condition that could interfere with, or treatment of which might interfere with, the conduct of the study, or that would, in the opinion of the investigator, pose an unacceptable risk to the participant in this study.

• History or positive test result for human immunodeficiency virus at Screening.

• Active hepatitis B virus (HBV) infection determined at Screening as positive test result for hepatitis B surface antigen.

• Active hepatitis C virus (HCV) infection determined at Screening as HCV ribonucleic acid (RNA) above the limit of detection in subjects with positive HCV antibody titer.

• History of, or ongoing, active tuberculosis (TB) or untreated latent TB infection (LTBI) at Screening. Participants with documented previously completed appropriate LTBI treatment and without evidence of re-exposure will not be required to be tested.

• Any other significant condition that according to the investigator's judgment would prevent compliance with study protocol and full study participation.

• Participants must not be participating in another investigational study or have participated in an investigational study within the past 30 days prior to randomization (Day 1).

• History of or current inflammatory skin disease other than SLE that in the opinion of the investigator could interfere with the inflammatory skin assessments and confound the disease activity assessments.

• History of any non-SLE disease that had required treatment with oral or parenteral corticosteroids for more than a total of 2 weeks within the last 24 weeks prior to randomization

Related Conditions & MeSH terms

• Lupus Erythematosus, Systemic
• Systemic Lupus Erythematosus

Intervention

Drug:
• DS-7011a
20 mg/kg intravenous dose to be administered every 4 weeks at baseline (Day 1), Day 29, and Day 57
• Placebo
Saline intravenous solution administered every 4 weeks at baseline (Day 1), Day 29, and Day 57

Locations

Country	Name	City	State
United States	Pinnacle Research Group LLC	Anniston	Alabama
United States	Oakland Hills Dermatology	Auburn Hills	Michigan
United States	Joint & Muscle Research Institute	Charlotte	North Carolina
United States	Precision Comprehensive Clinical Research Solutions	Colleyville	Texas
United States	Metroplex Clinical Research Center, LLC	Dallas	Texas
United States	The University of Kansas Medical Center	Kansas City	Kansas
United States	Trinity Health Center Medical Arts	Minot	North Dakota
United States	Arkansas Research Trials	North Little Rock	Arkansas
United States	Office of Tory P. Sullivan, M.D. - North Miami Beach	North Miami Beach	Florida
United States	MediSearch Clinical Trials	Saint Joseph	Missouri
United States	West Broward Rheumatology Associates	Tamarac	Florida
United States	Revival Research Institute, LLC	Troy	Michigan

Sponsors (1)

Lead Sponsor	Collaborator
Daiichi Sankyo

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of Participants with Treatment-emergent Adverse Events Following Administration with DS-7011a in Participants With Systemic Lupus Erythematosus		Screening up to Week 24
Secondary	Pharmacokinetic Parameter Area Under the Concentration Curve Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus		Day 1 (at predose and at end of infusion), Day 2 (24 hours after administration), Day 8 (1 week after administration), Days 29 and 57 (at predose and at end of infusion), and Days 85 and 113
Secondary	Pharmacokinetic Parameter Maximum Concentration Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus		Day 1 (at predose and at end of infusion), Day 2 (24 hours after administration), Day 8 (1 week after administration), Days 29 and 57 (at predose and at end of infusion), and Days 85 and 113
Secondary	Pharmacokinetic Parameter Minimum Concentration Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus		Day 1 (at predose and at end of infusion), Day 2 (24 hours after administration), Day 8 (1 week after administration), Days 29 and 57 (at predose and at end of infusion), and Days 85 and 113
Secondary	Change From Baseline in Cutaneous Lupus Area and Severity Index Activity Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus		Screening up to Week 16
Secondary	Change From Baseline in Cutaneous Lupus Activity Investigator Global Assessment Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus		Screening up to Week 16
Secondary	Change From Baseline in SLE Disease Activity Index 2000 Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus		Screening up to Week 16
Secondary	Change From Baseline in Clinician's Global Impression of Change Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus		Screening up to Week 16
Secondary	Change From Baseline in Patient's Global Impression of Change Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus		Screening up to Week 16
Secondary	Change From Baseline in Autoantibodies Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus	Autoantibodies, including antinuclear, anti-dsDNA, anti-Smith [Sm], and antiribonucleoprotein [RNP] antibodies, will be assessed.	Screening up to Week 16
Secondary	Change From Baseline in Complement Factors Following Administration of DS-7011a in Participants With Systemic Lupus Erythematosus	Complement factors, such as C3 and C4, will be assessed.	Screening up to Week 16