The purpose of this study is evaluating the efficacy and safety of SC antifrolumab in adult patients with moderate -to-severe SLE despite receiving standard therapy
This is a Phase 3, multicentre, multinational, randomised, double-blind, placebo-controlled study to evaluate the efficacy and safety of a subcutaneous treatment regimen of anifrolumab versus placebo in participants with moderately to severely active, autoantibody-positive systemic lupus erythematosus (SLE) while receiving standard of care (SOC) treatment. Participants must be taking either 1 or any combination of the following: oral glucocorticoids, antimalarial, and/or immunosuppressants. The study will be performed in adult participants of 18 to 70 years of age. Approximately 360 participants receiving SOC treatment will be randomised in a 1:1 ratio to receive a fixed subcutaneous dose of anifrolumab or placebo administered once weekly via an accessorized prefilled syringe and with the primary endpoint evaluated at Week 52. Subjects who complete Week 52 may enter into open-label extension (OLE). All patients who enter the OLE Period will receive a fixed subcutaneous dose of anifrolumab for up to 52 weeks. Study intervention will be administered SC via an accessorised prefilled syringe (aPFS).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
367
Patients will have IP administered or will self-administer IP under supervision by site staff at Week 0 and Week 1 and, for patients participating in the OLE period, at Week 52. For weekly doses coinciding with subsequent on-site visits, patients will also have IP administered or will self-administer IP under supervision by site staff, and in addition will receive a set of kits (including back-up kits) for at-home administration.
Solution for injection in aPFS
British Isles Lupus Assessment Group-based Composite Lupus Assessment (BICLA) response
BICLA response is a composite binary endpoint whereby responders are defined by meeting all of the following criteria: * Improvement from baseline in disease activity as measured by BILAG-2004. Improvement is defined as a reduction of all baseline BILAG-2004 A to B/C/D and baseline BILAG-2004 B to C/D and no BILAG-2004 worsening in other organ systems, where worsening is defined as ≥ 1 new BILAG-2004 A or ≥ 2 new BILAG 2004 B. * No worsening from baseline in SLEDAI-2K, where worsening is defined as an increase from baseline of \> 0 points in SLEDAI-2K. * No worsening from baseline in the patient's lupus disease activity, where worsening is defined as an increase ≥ 0.30 points on a 3-point PGA VAS.
Time frame: At week 52
Time to first BICLA response sustained through Week 52
Time from first dose to first BICLA response that is consecutively maintained through Week 52
Time frame: Baseline through to Week 52
BICLA response with maintained low (or reduced) use of oral corticosteroid (OCS)
Response is defined by being a BICLA responder at Week 52 and having maintained low (or reduced) OCS use through Week 52. Maintained OCS use is defined as follows: * If baseline OCS ≥ 10 mg/day an OCS dose of ≤ 7.5 mg/day prednisone or equivalent must be achieved by Week 40 and an OCS dose ≤ 7.5 mg/day prednisone or equivalent must be maintained from Week 40 to Week 52. * If baseline OCS \< 10 mg/day, OCS dose at Week 40 must be less than or equal to OCS dose at baseline, with no increase from Week 40 OCS dose between Week 40 and Week 52.
Time frame: At week 52
Time to flare
Flare defined as either 1 or more BILAG 2004 A or 2 or more BILAG 2004 B compared to previous visit
Time frame: Baseline through to Week 52
Maintained oral corticosteroid (OCS) reduction among patients with baseline OCS ≥10 mg/day.
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Research Site
Birmingham, Alabama, United States
Research Site
Paradise Valley, Arizona, United States
Research Site
Phoenix, Arizona, United States
Research Site
El Cajon, California, United States
Research Site
Fullerton, California, United States
Research Site
Hemet, California, United States
Research Site
La Mesa, California, United States
Research Site
Los Angeles, California, United States
Research Site
Menifee, California, United States
Research Site
Upland, California, United States
...and 130 more locations
Achieving maintained OCS reduction through Week 52 is defined by meeting all of the following criteria: * Achieve an OCS dose of ≤ 7.5 mg/day prednisone or equivalent by Week 40 * Maintain an OCS dose ≤ 7.5 mg/day prednisone or equivalent from Week 40 to Week 52 * No discontinuation of investigational product * No use of restricted medications beyond the protocol allowed threshold before assessment
Time frame: At week 52
Annualized flare rate
Flare defined as either 1 or more BILAG 2004 or 2 or more BILAG2004 B compared to previous visit
Time frame: Baseline through to Week 52
SRI4
Proportion of patients achieving a SRI of ≥ 4 (SRI\[4\]) response at Week 52, defined by meeting all of the following criteria: Reduction from baseline of ≥ 4 points in the SLEDAI-2K No new organ systems affected as defined by 1 or more BILAG-2004 A or 2 or more BILAG 2004 B items compared to baseline using BILAG-2004 No worsening from baseline in the patients' lupus disease activity, where worsening is defined by an increase ≥ 0.30 points on a 3-point PGA VAS.
Time frame: At week 52