Behcet DiseasePhase 3SHIELDNCT00995709
Phase III Study in Refractory Behcet's Disease
A Phase 3 study testing AIN457 in people with Behcet Disease, run by Novartis Pharmaceuticals at 49 sites in 17 countries.
Trial summary
The purpose of this pivotal trial is to evaluate subcutaneous (SQ) AIN457 as an adjunctive therapy to reduce the rate of exacerbations of posterior uveitis or panuveitis secondary to Behçet's disease during the 24 weeks of study therapy as compared to standard of care alone. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Behcet Disease
- What is being tested?
- AIN457
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 118 participants
- Where
- 49 sitesin 17 countries
- Study dates
- Oct 2009to Jul 2010
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients with Behçet's disease and with a history of recurrent uveitis in a least one eye.
- Documented evidence of >2 recurrent exacerbations of either intermediate uveitis, posterior uveitis or panuveitis in the study eye within the past 6 months (this could include the current exacerbation for patients having an acute exacerbation at screening). Exacerbations fulfilling the study inclusion criteria must have one or more of the following recorded in the patients patients medical record for each recurrent exacerbation:
- >2+ vitreous haze with <2+ anterior chamber cell grade (intermediate or posterior uveitis) or >2+ vitreous haze with >2+ anterior chamber cell grade (panuveitis)
- presence of retinal infiltrates or vasculitis or hemorrhages
- documented >10 ETDRS letter or 2 line Snellen decrease in visual acuity attributed to ocular inflammation secondary to the recurrent exacerbation of Behçet's disease.
- Requirement for either of the following immunosuppressive therapies for at least 3 of the past 6 months for the treatment of or to prevent an exacerbation of ocular inflammation related to Behçet's disease:
Show all 10Show fewer
- Prednisone or equivalent >10 mg daily
- The need for at least >1 periocular injection or >1 intravitreal corticosteroid injection in the study eye within the past 6 months (the last injection must have not been given within 6 weeks of screening)
- Treatment with cyclosporine, tacrolimus, azathioprine, mycophenolate mofetil, mycophenolic acid or methotrexate either as monotherapy or in combination with or without steroids. (Patients treated at any time with chlorambucil or cyclophosphamide are not eligible for the study.)
- Patients not meeting the above specified criteria for immunomodulatory therapies are eligible for enrollment if they are intolerant to systemic immunomodulatory therapy as determined by the study investigator.
Who cannot join
- Subjects with infectious uveitis, uveitis due to other causes than Behçet's disease, or uveitis of unknown etiology.
- Less severe (i.e. anterior) uveitis associated with Behçet's disease.
- Ocular treatments
- Treatment with intravitreal anti-VEGF agents administered to the study eye within 3 months prior to study screening.
- Treatment with any injected or implantable corticosteroid releasing device (i.e., flucinolone acetonide implant, Retisert®) in the study eye within the last 3 years.
- Intraocular surgery or laser photocoagulation in the study eye within the last 6 weeks prior to screening except for a diagnostic vitreous or aqueous tap with a small-gauge needle.
Show all 11Show fewer
- Systemic conditions or treatments
- Treatment with any live or live-attenuated vaccine (including vaccine for varicella-zoster virus or measles) within 2 months prior to screening.
- Any systemic biologic therapy (e.g. interferon, infliximab, daclizumab, etanercept, or adalimumab) given intravenously or subcutaneously within 3 months prior to screening and no prior treatment with AIN457.
- Any prior treatment with systemic alkylating agents (cyclophosphamide, chlorambucil).
- Other protocol-defined inclusion/exclusion criteria may apply
Trial locations and contacts
49 sites in 17 countries.
49 sites in 17 countries
Greece8 sites
Novartis Investigative Site
Athens, Greece, GR 156 69
Novartis Investigative Site
Athens, GR, 115 27
Novartis Investigative Site
Heraklion - Crete, GR, 711 10
Novartis Investigative Site
Ioannina, GR, 455 00
Novartis Investigative Site
Ioannina, 45500
Novartis Investigative Site
Larissa, Greece, GR 41110
Novartis Investigative Site
Larissa, GR, 41110
Novartis Investigative Site
Pátrai, 26500
Turkey (Türkiye)6 sites
Novartis Investigative Site
Altindag / Ankara, 06590
Novartis Investigative Site
Ankara, Turkey, 06100
Novartis Investigative Site
Ankara, Turkey, 06490
Novartis Investigative Site
Istanbul, 34093
Novartis Investigative Site
Istanbul, 34303
Novartis Investigative Site
Izmir, 35380
Germany4 sites
Novartis Investigative Site
Dessau, 06847
Novartis Investigative Site
Essen, 45147
Novartis Investigative Site
Heidelberg, 69120
Novartis Investigative Site
Münster, 48145
India4 sites
Novartis Investigative Site
Angamaly, 683572
Novartis Investigative Site
Chennai, Tamil Nadu, 600006
Novartis Investigative Site
Madurai, Tamil Nadu, 625020
Novartis Investigative Site
New Delhi, 110 029
Israel4 sites
Novartis Investigative Site
Afula, 18101
Novartis Investigative Site
Nahariya, 22100
Novartis Investigative Site
Ramat Gan, 52621
Novartis Investigative Site
Tel Aviv, 64239
Spain4 sites
Novartis Investigative Site
Barcelona, Barcelona, 08035
Novartis Investigative Site
Barcelona, Catalonia, 08028
Novartis Investigative Site
Barcelona, Catalonia, 08035
Novartis Investigative Site
Barcelona
United States3 sites
Novartis Investigative Site
Arlington, Texas, 76012
Novartis Investigative Site
Baltimore, Maryland, 21205-2005
Novartis Investigative Site
Houston, Texas, 77025
Tunisia3 sites
Novartis Investigative Site
Monastir, 5019
Novartis Investigative Site
Sfax
Novartis Investigative Site
Tunis
Italy2 sites
Novartis Investigative Site
Ancona, AN, 60126
Novartis Investigative Site
Milan, MI, 20132
Jordan2 sites
Novartis Investigative Site
Amman, 11195
Novartis Investigative Site
Irbid, 22110
South Korea2 sites
Novartis Investigative Site
Seoul, Korea, 110 744
Novartis Investigative Site
Seoul, Korea, 120-752
Switzerland2 sites
Novartis Investigative Site
Bern, 3012
Novartis Investigative Site
Lausanne, Switzerland, 1003
About this study
Official title: A 24 Week Multicenter, Randomized, Double-masked, Placebo Controlled Study to Assess the Difference in the Rate of Recurrent Exacerbations in Behçet¿s Patients With Posterior or Panuveitis Treated With AIN457 vs Placebo Adjunctive to Standard-of-care Immunosuppressive Therapy
The purpose of this pivotal trial is to evaluate subcutaneous (SQ) AIN457 as an adjunctive therapy to reduce the rate of exacerbations of posterior uveitis or panuveitis secondary to Behçet's disease during the 24 weeks of study therapy as compared to standard of care alone.
- Conditions
- Behcet Disease
- Being tested
- AIN457, Placebo
- Keywords
- Behçet's disease,, intermediate uveitis, panuveitis, posterior uveitis, uveitis
- Medical subject headings
- Behcet Syndrome, Uveitis, Intermediate, Panuveitis, Uveitis, Posterior, Uveitis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AIN457Drug
AIN457Drug
PlaceboDrug
| Study group | Role | What they receive |
|---|---|---|
| AIN457C 300 mg every 2 week dosage regimen | Experimental | AIN457 300 mg was administered in 2 subcutaneous (s.c.) injections of 150 mg each. every 2 weeks Receives: Drug: AIN457 |
| AIN457C 300 mg monthly dosage regimen | Experimental | AIN457 300 mg was administered in 2 subcutaneous (s.c.) injections of 150 mg e Receives: Drug: AIN457 |
| Placebo | Placebo comparator | Placebo was administered in 2 s.c. injections every 2 weeks Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Rate of Recurrent Ocular Exacerbations in the Study Eye During 24 Weeks by Treatment
Measured: Baseline to week 24
Rate of Recurrent Ocular Exacerbations in the Study Eye During 24 Weeks by Treatment
Patients number of occurences during a 24 week period.
Measured: 24 weeks
Secondary outcomes (4)
Change From Baseline for Composite Immunosuppressive Medication Score at Week 24 by Treatment (Full Analysis Set)
For each corticosteroid medication, dose of the corticosteroid was first converted to a prednisone-equivalent dose. To determine the prednisone equivalent dose, the corticosteroid dose was multiplied by a conversion factor. . The total prednisone equivalent dose was calculated as the sum of the prednisone equivalent doses of all corticosteroids. Consequently, the total converted prednisone equivalent dose was used to obtain the immunosuppressive score. The key secondary efficacy variable was the change in total post-baseline immunosuppressive medication score from baseline.The score is actually the prednisoone equivalents taken by patient as calculated by conversion table. A reduction in prenisone or prenisone equivalents is a positive outcome. An increase in the number of prednisone equivalents suggests that the treatment is not efficacious or that there is disease progression. A score of 0 would be the lowest ( no steriods taken) and the upper limit is indeterminate.
Measured: 24 weeks
To Determine the Effect of AIN457 on Macular Edema and Visual Acuity in Patients With Posterior Segment Uveitis Secondary to Behçet's Disease as Determined by Optical Coherence Tomography.
Optical coherence tomography (OCT) is amedical imaging technique that uses light to capture micrometer-resolution, three-dimensional images from within optical scattering media (e.g., biological tissue). OCT is based on low-coherence interferometry, typically employing near-infrared light. The use of relatively long wavelength light allows it to penetrate into the scattering medium. OCT is a noninvasive procedure that uses optical interferometry to visualize the structures within the retina. Following dilation of the pupil, a light source operating at 850nm provides probe illumination which is split and detected with and without the refraction of the retinal tissues. Cross-sectional imaging is accomplished in 1.3 second by acquiring a sequence of interferometric A-scans. A false color tomogram of optical reflectivity is produced by the computer. Central foveal thickness will be the primary variable derived from OCT. A increase in thickness could translate to disease progression.
Measured: baseline, and wk 24 (end of study)
To Establish the Impact of AIN457 on Quality of Life of Posterior Segment Uveitis Patients Secondary to Behçet's Disease Refractory to Systemic Immunomodulatory Therapy as Measured by National Eye Institute Visual Function Questionaire-25 and Euroqol.
The VFQ-25 is a reliable and valid 25-item version of the 51-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). It is especially useful in settings such as clinical trials, where interview length is a critical consideration. Scores range from 0 to 100, with higher scores indicating better visual function.
Measured: screening, and wk 24 (end of study)
To Observe the Effect of AIN457 on the Systemic Non-ocular Manifestations of Behçet's Disease in Patients With Posterior Segment Uveitis Requiring Systemic Immunosuppression as Measured by the Bechet's Disease Current Activity Form.
The BDCAF scores oral and genital ulceration, skin, joint and gastrointestinal involvement, presence of fatigue and headache according to the duration of symptoms. The presence and type of large-vessel and central nervous system (CNS) involvement are documented. Eye activity was deemed present if there was a history of blurring of vision or if the eye was painful or red. . The BDCAF score was calculated by adding the score of each index and ranged between 0 and 12 A reduction in score signifies a lessening of the disease.
Measured: baseline and wk 24 (end of study)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Oct 2009 (estimated)
- Study startOct 2009
- Primary completionJul 2010
- Study completionJul 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Behcet DiseaseStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 118 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00995709
- Sponsor's protocol ID
- CAIN457C2303
- Other IDs
- 2009-011237-27, 2009
- Acronym
- SHIELD
- Status last verified
- Aug 2015
- First submitted
- 13 Oct 2009
- Last updated
- 31 Aug 2015
- Results posted
- Yes, on ClinicalTrials.gov
Publications
Dick AD, Tugal-Tutkun I, Foster S, Zierhut M, Melissa Liew SH, Bezlyak V, Androudi S. Secukinumab in the treatment of noninfectious uveitis: results of three randomized, controlled clinical trials. Ophthalmology. 2013 Apr;120(4):777-87. doi: 10.1016/j.ophtha.2012.09.040. Epub 2013 Jan 3.
PubMed 23290985
Study at a glance
From the registry record, last updated by the sponsor on 31 Aug 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A 24 Week Multicenter, Randomized, Double-masked, Placebo Controlled Study to Assess the Difference in the Rate of Recurrent Exacerbations in Behçet¿s Patients With Posterior or Panuveitis Treated With AIN457 vs Placebo Adjunctive to Standard-of-care Immunosuppressive Therapy
- ClinicalTrials.gov ID
- NCT00995709
- Acronym / sponsor ID
- SHIELD / CAIN457C2303
- Conditions
- Behcet Disease
- Keywords
- Behçet's disease,, intermediate uveitis, panuveitis, posterior uveitis, uveitis
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 118 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- Oct 2009
- Primary completion
- Jul 2010 (actual)
- Study completion
- Jul 2010 (actual)
- First posted
- 15 Oct 2009 (estimated)
- Results
- Posted 31 Aug 2015
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this pivotal trial is to evaluate subcutaneous (SQ) AIN457 as an adjunctive therapy to reduce the rate of exacerbations of posterior uveitis or panuveitis secondary to Behçet's disease during the 24 weeks of study therapy as compared to standard of care alone.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| AIN457C 300 mg every 2 week dosage regimen | Experimental | Drug: AIN457AIN457 300 mg was administered in 2 subcutaneous (s.c.) injections of 150 mg each. every 2 weeks |
| AIN457C 300 mg monthly dosage regimen | Experimental | Drug: AIN457AIN457 300 mg was administered in 2 subcutaneous (s.c.) injections of 150 mg e |
| Placebo | Placebo comparator | Drug: PlaceboPlacebo was administered in 2 s.c. injections every 2 weeks |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Patients with Behçet's disease and with a history of recurrent uveitis in a least one eye.
- Documented evidence of >2 recurrent exacerbations of either intermediate uveitis, posterior uveitis or panuveitis in the study eye within the past 6 months (this could include the current exacerbation for patients having an acute exacerbation at screening). Exacerbations fulfilling the study inclusion criteria must have one or more of the following recorded in the patients patients medical record for each recurrent exacerbation:
- Requirement for either of the following immunosuppressive therapies for at least 3 of the past 6 months for the treatment of or to prevent an exacerbation of ocular inflammation related to Behçet's disease:
- Patients not meeting the above specified criteria for immunomodulatory therapies are eligible for enrollment if they are intolerant to systemic immunomodulatory therapy as determined by the study investigator.
Key exclusion criteria (11 listed)
- Subjects with infectious uveitis, uveitis due to other causes than Behçet's disease, or uveitis of unknown etiology.
- Less severe (i.e. anterior) uveitis associated with Behçet's disease.
- Ocular treatments
- Treatment with intravitreal anti-VEGF agents administered to the study eye within 3 months prior to study screening.
- Treatment with any injected or implantable corticosteroid releasing device (i.e., flucinolone acetonide implant, Retisert®) in the study eye within the last 3 years.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AIN457 | Drug | AIN457C 300 mg every 2 week dosage regimen |
| AIN457 | Drug | AIN457C 300 mg monthly dosage regimen |
| Placebo | Drug | Placebo |
Primary outcome
Rate of Recurrent Ocular Exacerbations in the Study Eye During 24 Weeks by Treatment
Time frame: Baseline to week 24
Rate of Recurrent Ocular Exacerbations in the Study Eye During 24 Weeks by Treatment
Time frame: 24 weeks
Patients number of occurences during a 24 week period.
4 secondary outcomes
Change From Baseline for Composite Immunosuppressive Medication Score at Week 24 by Treatment (Full Analysis Set)
Time frame: 24 weeks
To Determine the Effect of AIN457 on Macular Edema and Visual Acuity in Patients With Posterior Segment Uveitis Secondary to Behçet's Disease as Determined by Optical Coherence Tomography.
Time frame: baseline, and wk 24 (end of study)
To Establish the Impact of AIN457 on Quality of Life of Posterior Segment Uveitis Patients Secondary to Behçet's Disease Refractory to Systemic Immunomodulatory Therapy as Measured by National Eye Institute Visual Function Questionaire-25 and Euroqol.
Time frame: screening, and wk 24 (end of study)
To Observe the Effect of AIN457 on the Systemic Non-ocular Manifestations of Behçet's Disease in Patients With Posterior Segment Uveitis Requiring Systemic Immunosuppression as Measured by the Bechet's Disease Current Activity Form.
Time frame: baseline and wk 24 (end of study)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Aug 2015.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 23290985Dick AD, Tugal-Tutkun I, Foster S, Zierhut M, Melissa Liew SH, Bezlyak V, Androudi S. Secukinumab in the treatment of noninfectious uveitis: results of three randomized, controlled clinical trials. Ophthalmology. 2013 Apr;120(4):777-87. doi: 10.1016/j.ophtha.2012.09.040. Epub 2013 Jan 3.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Novartis Pharmaceuticals study director
Novartis Pharmaceuticals
49 sites in 17 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing AIN457 in people with Behcet Disease, run by Novartis Pharmaceuticals at 49 sites in 17 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 31 Aug 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 49 sites in Greece, Turkey (Türkiye), Germany, India, Israel and 12 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 31 Aug 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Rate of Recurrent Ocular Exacerbations in the Study Eye During 24 Weeks by Treatment (time frame: Baseline to week 24). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00995709, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Aug 2015.