Summary

Eligibility
for people ages 18 years and up (full criteria)
Location
at San Francisco, California and other locations
Dates
study started
estimated completion
Principal Investigator
by Maria Dall'Era, M.D.David Wofsy, M.D.

Description

Summary

This is a multi-center double-blind placebo controlled clinical trial evaluating the efficacy of VIB4920 combined with mycophenolate mofetil (MMF) and prednisone in achieving a renal response in participants with active lupus nephritis (LN).

Official Title

A Phase 2a Randomized Placebo-Controlled Double-Blind Multicenter Trial of VIB4920 for Active Lupus Nephritis (ITN091AI)

Details

Up to 114 eligible participants with active lupus nephritis (LN) will receive induction therapy with mycophenolate mofetil (MMF) and methylprednisolone beginning at Week 0.Participants will also receive prednisone 25 mg per day beginning at Week 0 and tapered to 5 mg per day at Week 8.

Participants will be assessed at Week 8 for a renal response. Sixty-six participants with a urine protein-to-creatinine ratio (UPCR) > 0.75 will be randomized 2:1 to receive VIB4920 versus placebo at Week 10. Participants who are not eligible for randomization will complete study participation after the Week 8 study visit, and further care will be provided according to the judgment of the site investigator or treating physician.

Randomized participants will receive VIB4920 1500 mg or placebo intravenously at Weeks 10, 12, 14, 18, 22, 26, 30, and 34, and will continue MMF 2-3 g per day and prednisone 5 mg per day. The primary endpoint will be assessed at Week 38, and participants followed until Week 60.

Keywords

Lupus Nephritis, Mycophenolate mofetil, VIB4920, Nephritis

Eligibility

You can join if…

Open to people ages 18 years and up

Individuals who meet all of the following criteria are eligible for enrollment as study participants:

  1. Age 18 years or older.
  2. Classification of Systemic Lupus Erythematosus (SLE) by any of the following criteria: the 1997 update of the 1982 American College of Rheumatology (ACR) criteria, the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria, or the 2019 European League Against Rheumatism (EULAR)/ACR criteria.
  3. UPCR ≥ 1.5 based on a 24-hour urine collection at Visit -1.
  4. Renal biopsy within 12 weeks prior to Visit -1 of ISN/RPS LN with both of the following:
    1. Class III, Class IV, or Class V in combination with Class III or IV, and
    2. Modified NIH Activity Index ≥ 1.
  5. SARS-CoV-2 vaccination according to the current Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommendations.

You CAN'T join if...

  1. Inability or unwillingness to give written informed consent or comply with study protocol.
  2. Contraindication to treatment with MMF or mycophenolate sodium; or treatment with MMF or mycophenolate sodium is inappropriate in the opinion of the investigator.
  3. Treatment with a biologic agent or investigational agent within 90 days or 5 half-lives prior to Visit 0, whichever is longer. Agents authorized by the FDA for prevention or treatment of SARS-CoV-2 are not considered investigational and are not exclusionary.
  4. Rituximab or other B cell depleting agent within 6 months prior to Visit 0.
  5. Prior treatment with VIB4920.
  6. Receipt of a live attenuated vaccine within 4 weeks prior to Visit 0.
  7. Comorbidities requiring treatment with systemic corticosteroids, including those that have required 3 or more courses of systemic corticosteroids within 12 months prior to Visit 0.
  8. Current malignancy or history of malignancy, except for adequately treated basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma in situ > 12 months prior to Visit 0.
  9. End stage renal disease, defined as eGFR < 20 ml/min/1.73m2.

    10. History of transplantation. 11. The following risks for thromboembolic events:

    1. Recent or recurrent deep venous thrombosis or arterial thromboembolism.
    2. Immobilization or major surgery within 12 weeks prior to Visit 0.
    3. History of congenital or inherited deficiency of antithrombin III, protein S, or protein C.
    4. History of anti-phospholipid syndrome, according to the 2006 Sapporo classification criteria.
      1. History of a severe allergy or hypersensitivity reaction to any component of the VIB4920 formulation.
        1. Any one of the following laboratory abnormalities:
      2. Peripheral B cell count <5/μl.
      3. Neutropenia (absolute neutrophil count < 1000/mm3).
      4. Anemia (hemoglobin < 8 g/dL).
      5. Thrombocytopenia (platelets < 50,000/mm3).
      6. Aspartate aminiotransferase or alanine aminotransferase ≥ 2x upper limit of normal.
        1. Evidence of current or prior tuberculosis infection, including any of the following:
      7. Positive QuantiFERON-TB Gold or TB Gold Plus test.
      8. Positive T-SPOT.TB test.
      9. Positive purified protein derivation (PPD) tuberculin, defined as > 5mm induration.
        1. Human immunodeficiency virus (HIV) infection.
        2. Current or past hepatitis B (HBV) infection.
        3. Current or past hepatitis C virus (HCV) infection, except adequately treated HCV with documented sustained virologic response.
        4. Active bacterial, viral, fungal, or opportunistic infection.
        5. History of significant, recurrent, or chronic infection that may pose additional risks from participating in the study, in the opinion of the investigator.
        6. History of severe psychiatric condition that would interfere with the participant's ability to comply with the study protocol, in the opinion of the investigator.
        7. Current substance abuse, or history of substance abuse within 12 months prior to Visit
    5. 22. Lack of peripheral venous access. 23. Pregnancy. 24. Breastfeeding. 25. Unwillingness to use a medically acceptable form of contraception for the duration of

      the study if female of child-bearing potential or if male with a partner of child-bearing potential.

      26. Past or current medical problems or findings from physical examination or laboratory

      testing that are not listed above, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study.

Locations

  • UCSF School of Medicine: Lupus Clinic and Rheumatology Clinical Research Center accepting new patients
    San Francisco California 94143 United States
  • UCLA Medical Center: Division of Rheumatology not yet accepting patients
    Los Angeles California 90095 United States

Lead Scientists at UCSF

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Links
Immune Tolerance Network (ITN) National Institute of Allergy and Infectious Diseases (NIAID) Division of Allergy, Immunology, and Transplantation (DAIT)
ID
NCT05201469
Phase
Phase 2 Lupus Research Study
Study Type
Interventional
Participants
Expecting 114 study participants
Last Updated