CD19-CART(Relma-cel) for Moderate to Severe Active Systemic Lupus Erythematosus

Systemic Lupus Erythematosus Clinical Trial

Official title:

A Phase I Dose-escalation Study Evaluate the Safety Tolerability Pharmacokinetics(PK) and Pharmacodynamics(PD) of Relma-cel in Subjects With Moderate to Severe Active Systemic Lupus Erythematosus (SLE)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05765006
• Other study ID #: JWCAR029012
• Status: Recruiting
• Phase: Phase 1
• Start date: February 24, 2023
• Est. completion date: December 30, 2025

Study information

• Verified date: March 2023
• Source: Shanghai Ming Ju Biotechnology Co., Ltd.
• Contact: medical JW
• Phone: +86 21 50464201
• Email: Relma-celMedical[@]jwtherapeutics.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a phase I, open-label, single-arm, multicenter study to asess the safety tolerability pharmacokinetics and pharmacodynamics of Relma-cel in moderate or severe active systemic lupus erythematosus (SLE) subjects in China.

Description:

This is a phase I, open-label, single-arm, multicenter study to asess the safety tolerability pharmacokinetics(PK) and pharmacodynamics(PD) of Relma-cel in moderate or severe active systemic lupus erythematosus (SLE) subjects in China.

There will be 4 dose level (15x106 CAR+ T cells as the back up dose ,25x106 CAR+ T cells as the starting dose 、50x106 CAR+ T cells and 100x106(or 150 x106CAR+ T cells）Dose escalation, to evaluate the safety、 tolerability of Relma-cel in adult subjects of SLE and determine RP2D .

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 24
• Est. completion date: December 30, 2025
• Est. primary completion date: December 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 70 Years

Eligibility

Inclusion Criteria:

1. Sign an informed consent form (ICF) voluntarily.

2. At the time of signing the ICF, you must be between 18 and 70 years old (inclusive), male or female.

3. A diagnosis of SLE according to the 1997 revised criteria of the American College of Rheumatology (ACR).

4. The history of SLE prior to screening was at least 6 months, and the disease remained active at least 2 months after the use of a stable standard SLE regimen prior to screening.

Standard treatment regimen refers to the steady use of any of the following (alone or in combination) : corticosteroids, antimalarials, non-steroidal anti-inflammatory drugs (NSAIDs), and other immunosuppressants or immunomodulators including azathioprine, Mycophenolate Mofetil, cyclophosphamide, methotrexate, leflunomide, tacrolimus, and cyclosporine.

Oral corticosteroids must meet the following requirements:

1. Prednisone (or equivalent) =7.5 mg/ day, and =30 mg/ day.

2. There is no minimum daily dose requirement for corticosteroids when used in combination with immunosuppressants.

3. At least 8 weeks of treatment prior to screening, and the dose must be kept stable for > 2 weeks.

5. Screening is positive for antinuclear antibodies, and/or anti-DS-DNA antibodies, and/or anti-Smith antibodies.

6. SELENA-SLEDAI score =8 during the screening period. Score =6 for SELENA-SLEDAI clinical symptoms (except for low complement and/or anti-DS-DNA antibodies) if low complement and/or anti-DS-DNA antibody score is present.

Exclusion Criteria:

1. Severe lupus nephritis (defined as proteinuria > 6 g/24h or serum creatinine > 2.5 mg/dL or 221 µmol/L), treatment with active nephritis with Prohibited drugs, hemodialysis, or prednisone =100 within 8 weeks prior to screening mg/d or equivalent glucocorticoid therapy =14 days.

2. Prior to screening, other lupus crises, such as active central nervous system lupus, severe hemolytic anemia, severe thrombocytopenic purpura, severe agranulocytosis, severe myocardial damage, severe lupus pneumonia or pulmonary hemorrhage, severe lupus hepatitis, and severe vasculitis.

3. Clinically significant central nervous system diseases or pathological changes not caused by lupus prior to screening, including but not limited to: cerebrovascular accident, aneurysm, epilepsy, convulsions/convulsions, aphasia, stroke, severe brain injury, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis.

4. Combined with other autoimmune diseases, systematic treatment is needed.

5. History of major organ transplantation (e.g., heart, lung, kidney, liver) or hematopoietic stem cell/bone marrow transplantation.

6. IgA deficiency was present during screening (serum IgA level < 10 mg/dL)

Related Conditions & MeSH terms

• Lupus Erythematosus, Systemic
• Systemic Lupus Erythematosus

Intervention

Biological:
• Relma-cel
CD19-targeted Chimeric AntigenReceptor (CAR) T Cells; Relma-cel be administrated at four dose level:25×106 CAR+ T cells?50×106 CAR+ T cells?100×106 CAR+ T cells/150×106 CAR+ T cells

Locations

Country	Name	City	State
China	Relma-cel Medical	Shanghai

Sponsors (1)

Lead Sponsor	Collaborator
Shanghai Ming Ju Biotechnology Co., Ltd.

Country where clinical trial is conducted

China, 

References & Publications (1)

Kaufman JL, Deak ST, Erdman W. Radionuclide scans to define patterns of occult myonecrosis. N J Med. 1986 Feb;83(2):101-3. No abstract available. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	DLT rate	The incidence of dose-limiting toxicity	3 months
Primary	determine RP2D	To determine RP2D(Phase 2 recommended dose)	3 months
Secondary	SELENA-SLEDAI (Safety of Estrogens in Systemic Lupus Erythematosus National Assessment) score; 0 to 4 is basically no disease activity; 5 to 9 is light activity; 10 to 14 is moderate activity;=15 is considered heavy activity.	SELENA-SLEDAI score taken up to 3 months after CD19 cCAR T cells infusion	3 months
Secondary	BILAG -2004(updated version of british isles lupus assessment group ) level;The BILAG 2004 index categorizes disease activity into 5 different levels from A-E.Grade A represents very active disease.	BILAG-2004 level taken up to 3 months after CD19 cCAR T cells infusion	3 months
Secondary	PGA (physician global assessment) score,The PGA scale ranges from "no disease activity" (0) to the "most severe disease activity" (3).the score is between 0 to 3.	PGA score taken up to 3 months after CD19 cCAR T cells infusion	3 months
Secondary	Autoantibody detection	Autoantibody detection up to 3 months after CD19 cCAR T cells infusion	3 months