Lupus NephritisPhase 2NCT02550652
A Study to Evaluate the Safety and Efficacy of Obinutuzumab Compared With Placebo in Participants With Lupus Nephritis (LN)
A Phase 2 study testing Mycophenolate Mofetil/Mycophenolic Acid, Obinutuzumab and Methylprednisolone in people with Lupus Nephritis, run by Hoffmann-La Roche at 46 sites in 12 countries.
Trial summary
This Phase II study will compare the efficacy and safety of obinutuzumab plus mycophenolate mofetil (MMF)/mycophenolic acid (MPA) with placebo plus MMF/MPA in participants with proliferative LN. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Lupus Nephritis
- What is being tested?
- Mycophenolate Mofetil/Mycophenolic Acid, Obinutuzumab and Methylprednisolone
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 126 participants
- Where
- 46 sitesin 12 countries
- Study dates
- 13 Nov 2015to 2 Aug 2023
- Phase
- Phase 2
- 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 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Diagnosis of Systemic Lupus Erythematosus (SLE), according to current American College of Rheumatology (ACR) criteria
- Diagnosis of International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 Class III or IV LN as evidenced by renal biopsy performed within 6 months prior to or during screening. Participants may co-exhibit Class V disease in addition to either Class III or Class IV disease
- Proteinuria (urine protein to creatinine ratio) greater than (>) 1.0
- For women who are not postmenopausal (greater than or equal to [>/=] 12 months of non-therapy-induced amenorrhea) or surgically sterile (absence of ovaries and/or uterus): agreement to remain abstinent or use two adequate methods of contraception, including at least one method with a failure rate of less than (<) 1 percent (%) per year, during the treatment period and for at least 18 months after the last dose of study drug
- For men: agreement to remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of <1% per year during the treatment period and for at least 12 months after the last dose of study drug and agreement to refrain from donating sperm during this same period
Who cannot join
- Retinitis, poorly controlled seizure disorder, acute confusional state, myelitis, stroke or stroke syndrome, cerebellar ataxia, or dementia that is currently active and resulting from SLE
- Presence of rapidly progressive glomerulonephritis
- Severe renal impairment as defined by estimated Glomerular Filtration Rate (GFR) <30 milliliters per minute (mL/min) or the need for dialysis or renal transplant
- Greater than 50% of glomeruli with sclerosis on renal biopsy
- Treatment with cyclophosphamide or calcineurin inhibitors within the 3 months prior to randomization
- Unstable disease with thrombocytopenia or at high risk for developing clinically significant bleeding or organ dysfunction requiring therapies such as plasmapheresis or acute blood or platelet transfusions
Show all 12Show fewer
- History of severe allergic or anaphylactic reactions to monoclonal antibodies or known hypersensitivity to any component of the obinutuzumab infusion
- Significant or uncontrolled medical disease in any organ system not related to SLE or LN, which, in the investigator's opinion, would preclude participant participation
- Concomitant chronic conditions, excluding SLE, (e.g., asthma, Crohn's disease) that required oral or systemic steroid use in the 52 weeks prior to screening
- Previous treatment with an anti-cluster of differentiation (CD20)-targeted therapy within 12 months
- Previous treatment with a biologic B-cell-targeted therapy (other than anti-CD20) within 6 months of randomization
- Known intolerance to MMF or MPA
Trial locations and contacts
46 sites in 12 countries.
46 sites in 12 countries
United States7 sites
Emory Uni ; Division of Rheumatology
Atlanta, Georgia, 30303
Suny Downstate Medical Center; Rheumatology
Brooklyn, New York, 11203
Ohio State University; Division of Nephrology
Columbus, Ohio, 43210
North Shore - Long Island Jewish Hospital Health System; Rheumatology & Allergy- Clinical Immunology
Great Neck, New York, 11021
Univ of California, San Diego
La Jolla, California, 92093
Columbia University Medical Center
New York, New York, 10032
Stanford University Medical Center
Palo Alto, California, 94304
Mexico7 sites
Centro de Investigación de Tratamientos Innovadores de Sinaloa (CITI)
Culiacán, Sinaloa, 80000
Unidad de Investigacion en Enfermedades Cronico-Degenerativa; Reumatologia
Guadalajara, Jalisco, 44620
Centro de Estudios de Investigacion Basica Y Clinica S.C.; Reumatologia
Guadalajara, Jalisco, 44690
Unidad de Reumatologia Rehabilitacion Integral; Centro Medico Del Angel
Mexicali, Estado de Baja California, 21100
Hospital General De Mexico; Rheumatology
Mexico City, Mexico CITY (federal District), 6726
Instituto Nacional de Ciencias Médicas Y de La Nutricion Zubirán
Mexico City, Mexico CITY (federal District), Tlalpan 14000
Centro de Investigación Clínica de Morelia S.C.
Morelia, Michoacán, 58070
Brazil6 sites
Hospital das Clinicas - UFMG
Belo Horizonte, Minas Gerais, 31270-901
Instituto Scribner.
Curitiba, Paraná, 80440-020
Centro Mineiro de Pesquisa - CMIP
Juiz de Fora, Minas Gerais, 36010-570
LMK Serviços Médicos S/S
Porto Alegre, Rio Grande do Sul, 90480-000
Ser Servicos Especializados Em Reumatologia
Salvador, Estado de Bahia, 40150-150
Universidade Federal de Sao Paulo - UNIFES
São Paulo, São Paulo, 04026-000
France6 sites
HOPITAL HENRI MONDOR; SERVICE DE Nephrologie
Créteil, 94010
Hopital Claude Huriez; Internal Medicine
Lille, 59037
Hopital europeen Marseille; Service de medecine interne
Marseille, 13003
Groupe Hospitalier Pitie-Salpetriere; Service de Medecine Interne Ii
Paris, 75651
Hopital Bichat Claude Bernard; Nephrologie
Paris, 75877
Hopital Rangueil; Service de Nephrologie & D'Immunologie Clinique
Toulouse, 31059
Colombia4 sites
Clinica De La Costa
Barranquilla, 080020
Hospital Universitario San Ignacio
Bogotá, 000472
Riesgo De Fractura; Rheumatology
Bogotá
Hospital Pablo Tobon Uribe
Medellín, 050034
Peru4 sites
Instituto de Ginecología y Reproducción
Lima
Centro de Investigación Delgado; Clinica Delgado
Miraflores, 15074
Centro de Investigaciones Medicas/Hospital Maria Auxiliadora
San Juán de Miraflores, 15801
Hospital Nacional Cayetano Heredia; Rheumatology
San Martín de Porres, 15102
Argentina3 sites
Cemic; Haematology
Buenos Aires, C1431FWO
CER San Juan Centro Polivalente de Asistencia e Investigacion Clinica
San Juan, J5400DIL
Organizacion Medica de Investigacion
San Nicolás, C1015ABO
Israel3 sites
Rambam Medical Center; Rheumatology
Haifa, 3109601
Beilinson Medical Center; Rheumatology
Petah Tikva, 4941492
Sheba Medical Center; Tel Hashomer
Ramat Gan, 5262100
Italy2 sites
Azienda Ospedaliera di Padova; Dipartimento di Medicina - UOC di Reumatologia
Padova, Veneto, 35128
Ospedale San Giovanni Bosco; entro di Ricerche di Immunopatologia e Documentazione su Malattie Rare
Turin, Piedmont, 10154
Spain2 sites
Hospital Clinic i Provincial; Servicio de Nefrologia
Barcelona, 08036
Hospital Regional Universitario Carlos Haya; Servicio de Reumatologia
Málaga, 29009
About this study
Official title: A Randomized, Double-Blind, Placebo-Controlled, Multi-Center Study to Evaluate the Safety and Efficacy of Obinutuzumab in Patients With ISN/RPS 2003 Class III or IV Lupus Nephritis
This Phase II study will compare the efficacy and safety of obinutuzumab plus mycophenolate mofetil (MMF)/mycophenolic acid (MPA) with placebo plus MMF/MPA in participants with proliferative LN.
- Conditions
- Lupus Nephritis
- Being tested
- Mycophenolate Mofetil/Mycophenolic Acid, Obinutuzumab, Placebo, Methylprednisolone, Prednisone
- Medical subject headings
- Lupus Nephritis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mycophenolate Mofetil/Mycophenolic AcidDrug
MMF/MPA will be administered as per schedule specified in the respective arm.
ObinutuzumabDrug
Also called Gazyva, GA101, RO5072759
Obinutuzumab will be administered as per schedule specified in the respective arm.
PlaceboOther
Placebo matching to obinutuzumab will be administered as per schedule specified in the respective arm.
Methylprednisolone IV will be administered as per schedule specified in the respective arm.
PrednisoneDrug
Prednisone will be administered as per schedule specified in the respective arm.
| Study group | Role | What they receive |
|---|---|---|
| Obinutuzumab | Experimental | Participants will receive obinutuzumab 1000 milligrams (mg) intravenous (IV) infusion on Days 1, 15, 168, and 182 along with MMF/MPA at a starting dose of 1500 mg/day (or equivalent) administered orally in 2 or 3 divided doses. MMF/MPA dose will be up titrated to a target dose of 2.0 - 2.5 grams per day (g/day) (or equivalent). Investigators, at their discretion, may use MPA as a substitute for MMF, with a 360 mg dose being equivalent to a 500 mg dose of MMF. During screening or at randomization, if clinically indicated, participants may receive 750-1000 mg methylprednisolone IV once daily for up to 3 days to treat underlying LN clinical activity. Participants will receive 0.5 mg/kg oral prednisone, tapering this prednisone dose, per protocol, starting on Day 16 and reducing the prednisone dosage to 7.5 mg/day by Week 12. Receives: Drug: Mycophenolate Mofetil/Mycophenolic Acid; Drug: Obinutuzumab; Drug: Methylprednisolone; Drug: Prednisone |
| Placebo | Placebo comparator | Participants will receive placebo matching to obinutuzumab IV infusion on Days 1, 15, 168, and 182 along with MMF/MPA at a starting dose of 1500 mg/day (or equivalent) administered orally in 2 or 3 divided doses. MMF/MPA dose will be up titrated to a target dose of 2.0 - 2.5 g/day (or equivalent). Investigators, at their discretion, may use MPA as a substitute for MMF, with a 360 mg dose being equivalent to a 500 mg dose of MMF. During screening or at randomization, if clinically indicated, participants may receive 750-1000 mg methylprednisolone IV once daily for up to 3 days to treat underlying LN clinical activity. Participants will receive 0.5 mg/kg oral prednisone, tapering this prednisone dose, per protocol, starting on Day 16 and reducing the prednisone dosage to 7.5 mg/day by Week 12. Receives: Drug: Mycophenolate Mofetil/Mycophenolic Acid; Other: Placebo; Drug: Methylprednisolone; Drug: Prednisone |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants Who Achieve Protocol Defined Complete Renal Response (CRR) at Week 52
Percentage of participants with normalization of serum creatinine, inactive urinary sediment (as evidenced by < 10 red blood cells (RBCs)/high-power field (HPF) and the absence of red cell casts) and urinary protein to creatinine ratio < 0.5. Normalization of serum creatinine is defined as serum creatinine ≤ the upper limit of normal (ULN) range of central laboratory values if baseline (Day 1) serum creatinine is above the ULN or serum creatinine ≤ 15% above baseline and ≤ the ULN range of central laboratory values if baseline (Day 1) serum creatinine is above the ULN range of central laboratory values.
Measured: From baseline to Week 52
Secondary outcomes (21)
Percentage of Participants Who Achieve Protocol Defined Overall Response (OR) at Week 52
OR includes both CRR and partial renal response (PRR). CRR as defined in the primary outcome measure above. PRR defined as 50% improvement in urine protein:creatinine ratio, with one of following conditions met: 1. If baseline urine protein:creatinine ratio is ≤ 3.0, then urine protein:creatinine ratio of <1.0. 2. If baseline protein:creatinine ratio is > 3.0, then urine protein:creatinine ratio of <3.0, serum creatinine ≤15% above baseline value, and no urinary red cell casts and either RBCs/HPF ≤50% above baseline or <10 RBCs/HPF.
Measured: From baseline to Week 52
Time to OR Over 52 Weeks
OR includes both CRR and partial renal response(PRR). CRR as defined in the primary outcome measure above. PRR defined as 50% improvement in upcr, with one of these conditions met: 1. If baseline upcr is ≤3.0, then upcr of <1.0. 2. If baseline pcr is > 3.0, then upcr of <3.0, serum creatinine ≤15% above baseline value, and no urinary red cell casts and either RBCs/HPF ≤50% above baseline or <10 RBCs/HPF. Percentage of participants with response at various time points were measured using Kaplan Meier method.
Measured: From baseline to Week 52
Percentage of Participants Who Achieve Protocol Defined Partial Renal Response (PRR) at Week 52
PRR defined as serum creatinine ≤15% above baseline value, no urinary red cell casts and either RBCs/HPF ≤ 50% above baseline or < 10 RBCs/HPF, 50% improvement in urine protein:creatinine ratio, with one of following conditions met: 1. If baseline urine protein:creatinine ratio is ≤ 3.0, then a urine protein:creatinine ratio of < 1.0. 2. If baseline protein:creatinine ratio is > 3.0, then a urine protein:creatinine ratio of < 3.0.
Measured: Week 52
Percentage of Participants Who Achieve Protocol Defined CRR at Week 24
CRR defined as normalization of serum creatinine, inactive urinary sediment (as evidenced by < 10 red blood cells (RBCs)/high-power field (HPF) and the absence of red cell casts) and urinary protein to creatinine ratio < 0.5. Normalization of serum creatinine is defined as serum creatinine ≤ the upper limit of normal (ULN) range of central laboratory values if baseline (Day 1) serum creatinine is above the ULN or serum creatinine ≤ 15% above baseline and ≤ the ULN range of central laboratory values if baseline (Day 1) serum creatinine is ≤ the ULN range of central laboratory values.
Measured: Week 24
Time to CRR Over 52 Weeks
CRR included normalization of serum creatinine, inactive urinary sediment (as evidenced by < 10 RBCs/HPF and the absence of red cell casts) and urinary protein to creatinine ratio < 0.5. Normalization of serum creatinine is defined as serum creatinine ≤ the ULN range of central laboratory values if baseline serum creatinine is above the ULN or serum creatinine ≤ 15% above baseline and ≤ the ULN range of central laboratory values if baseline (Day 1) serum creatinine is ≤ the ULN range of central laboratory values. Percentage of participants with response at various time points were measured using Kaplan Meier method.
Measured: From Baseline to Week 52
Change From Baseline in Anti-Double Stranded Deoxyribonucleic Acid (Anti-dsDNA) Antibody Levels at Week 52
Anti-dsDNA antibodies are a group of anti-nuclear autoantibodies targeting double stranded DNA.
Measured: Baseline and Week 52
Change From Baseline in Complement Component 3 (C3) Levels at Week 52
Complement C3 is a blood test that reflects activation of complement pathway associated with immune deposition in certain autoimmune diseases.
Measured: Baseline and Week 52
Change From Baseline in C4 Levels at Week 52
Complement C4 is a blood test that reflects activation of complement pathway associated with immune deposition in certain autoimmune diseases.
Measured: Baseline, Week 52
Percentage of Participants Who Achieve Protocol Defined Modified CRR (mCRR1) at Week 52
mCRR1 has got two components only, i.e. serum Creatinine and urinary protein to creatinine ratio. mCRR1 is defined by attainment of normalization of serum creatinine as evidenced by 1.) serum creatinine ≤ the ULN range of central laboratory values if baseline (Day 1) serum creatinine is above the ULN or serum creatinine ≤15% above baseline and ≤ the ULN range of central laboratory values if baseline (Day 1) serum creatinine ≤ the ULN range of central laboratory values and 2.) Urinary protein to creatinine ratio <0.5.
Measured: Week 52
Percentage of Participants Who Achieve Protocol Defined Second mCRR (mCRR2) at Week 52
mCRR2 is defined by normalization of serum creatinine, inactive urinary sediment (as evidenced by < 10 RBCs/HPF and the absence of red cell casts), and urinary protein to creatinine ratio <0.5. Normalization of serum creatinine as evidenced by the following: Serum creatinine ≤15% above baseline if baseline (Day 1) serum creatinine is above the normal range of the central laboratory values or ≤ the ULN range of central laboratory values if baseline (Day 1) serum creatinine is ≤ the ULN range of central laboratory values.
Measured: Week 52
Percentage of Participants Who Achieve Protocol Defined Third mCRR (mCRR3) at Week 52
mCRR3 is defined by normalization of serum creatine as evidenced by serum creatinine ≤ the ULN range of central laboratory values and urinary protein to creatinine ratio < 0.5.
Measured: Week 52
Percentage of Participants With Adverse Events (AEs)
An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events. AEs, including AEs of Special Interest were reported based on the national cancer institute common terminology criteria for AEs, Version 4.0 (NCI-CTCAE, v4.0). Reported are the number of subjects with AEs, Grade 3-5 AEs, and Serious Adverse Events (SAEs), Infections and Serious infections. The AEs reported do not include events after the receipt of rescue medications.
Measured: From baseline to approximately 7 years and 8 months
Percentage of Participants With Adverse Events of Special Interest: Infusion Related Reactions, Grade 3 or Higher Infections, Drug-related Neutropenia and Drug-related Thrombocytopenia
Infusion related reaction is defined as any event reported within 24 hours of infusion and thought to be causally related to the investigational agent by the investigator. Grade 3 or higher infections include all events of Grade 3 to 5 under the SOC of infections and infestations. Drug-related neutropenia is defined as events in the Roche AE Grouped Term (AEGT) "Neutropenia and associated complications" and thought to be causally related to the investigational agent by the investigator. Drug-related thrombocytopenia is defined as events in the Standard MedDRA Query (SMQ) "Haematopoietic Thrombocytopenia narrow" and thought to be causally related to the investigational agent by the investigator.
Measured: From baseline to approximately 7 years and 8 months
Percentage of Participants With Anti-Drug Antibody (ADA) to Obinutuzumab
Antibodies are a blood protein produced in response to and counteracting a specific antigen.
Measured: From baseline to approximately 7 years and 8 months
Percent Change From Baseline in Circulating CD19-Positive B-Cell Levels
CD19+ B cell is a B-lymphocyte with a transmembrane protein that is encoded by the gene CD19.
Measured: Baseline, Week 2, Week 4, Week 12, Week 24, Week 52, Week 104, B Cell Follow-Up (Bcfu) at months 6, 12, 18, 24, 30, 36, 42 and 48
Maximum Observed Plasma Concentration (Cmax) of Obinutuzumab
Measured: Week 0, Week 24, Week 52
Area Under the Plasma Concentration Versus Time Curve (AUC) of Obinutuzumab
Measured: Baseline to Week 52
Systemic Clearance of Obinutuzumab
Measured: Day 0, Week 24, Week 52
Volume of Distribution Under Steady State (Vss) of Obinutuzumab
Measured: Day 0, Week 24, Week 52
Terminal Plasma Half-Life (t1/2) of Obinutuzumab
Measured: Day 0, Week 24, Week 52
Change From Baseline of Participant's Global Assessment of Disease Activity Visual Analog Scale (VAS) Score
Each VAS had a range from 0-100 with higher scores indicating greater symptom impact on global health status.
Measured: Baseline (Day 1), Weeks 4, 12, 24, 36, 52
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Sep 2015 (estimated)
- Study start13 Nov 2015
- Primary completion15 Jan 2019
- Study completion2 Aug 2023
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 (3)Papers the sponsor has linked to this study.
- Other trials for Lupus NephritisStudies of the same condition, open and under way.
- More trials run by Hoffmann-La RocheThe 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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 126 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hoffmann-La Roche
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Trials, Study director, Hoffmann-La Roche
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02550652
- Sponsor's protocol ID
- WA29748
- Other IDs
- 2015-002022-39, 2015
- Status last verified
- Jul 2024
- First submitted
- 14 Sep 2015
- Last updated
- 27 Aug 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Individual data sharing
- No: Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.clinicalstudydatarequest.com). Further details on Roche's criteria for eligible studies are available here (https://clinicalstudydatarequest.com/Study-Sponsors/Study-Sponsors-Roche.aspx). For further details on Roche's Global Policy on Sharing of Clinical Study Information and how to request access to related clinical study documents, see here (https://www.roche.com/research\_and\_development/who\_we\_are\_how\_we\_work/clinical\_trials/our\_commitment\_to\_data\_sharing.htm).
Publications
Rovin BH, Furie RA, Ross Terres JA, Giang S, Schindler T, Turchetta A, Garg JP, Pendergraft WF 3rd, Malvar A. Kidney Outcomes and Preservation of Kidney Function With Obinutuzumab in Patients With Lupus Nephritis: A Post Hoc Analysis of the NOBILITY Trial. Arthritis Rheumatol. 2024 Feb;76(2):247-254. doi: 10.1002/art.42734. Epub 2023 Nov 10.
PubMed 37947366Furie RA, Aroca G, Cascino MD, Garg JP, Rovin BH, Alvarez A, Fragoso-Loyo H, Zuta-Santillan E, Schindler T, Brunetta P, Looney CM, Hassan I, Malvar A. B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis: a randomised, double-blind, placebo-controlled trial. Ann Rheum Dis. 2022 Jan;81(1):100-107. doi: 10.1136/annrheumdis-2021-220920. Epub 2021 Oct 6.
PubMed 34615636Dossier C, Hogan J. Response to Majeranowski. Pediatr Nephrol. 2021 Jun;36(6):1653. doi: 10.1007/s00467-021-04982-4. Epub 2021 Mar 10. No abstract available.
PubMed 33693991
Study at a glance
From the registry record, last updated by the sponsor on 27 Aug 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-Blind, Placebo-Controlled, Multi-Center Study to Evaluate the Safety and Efficacy of Obinutuzumab in Patients With ISN/RPS 2003 Class III or IV Lupus Nephritis
- ClinicalTrials.gov ID
- NCT02550652
- Acronym / sponsor ID
- WA29748
- Conditions
- Lupus Nephritis
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 126 participants (actual)
- Lead sponsor
- Hoffmann-La RocheIndustry (pharma, biotech, devices)
- Study start
- 13 Nov 2015 (actual)
- Primary completion
- 15 Jan 2019 (actual)
- Study completion
- 2 Aug 2023 (actual)
- First posted
- 15 Sep 2015 (estimated)
- Results
- Posted 26 Feb 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This Phase II study will compare the efficacy and safety of obinutuzumab plus mycophenolate mofetil (MMF)/mycophenolic acid (MPA) with placebo plus MMF/MPA in participants with proliferative LN.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Obinutuzumab | Experimental | Drug: Mycophenolate Mofetil/Mycophenolic Acid, Drug: Obinutuzumab, Drug: Methylprednisolone, Drug: PrednisoneParticipants will receive obinutuzumab 1000 milligrams (mg) intravenous (IV) infusion on Days 1, 15, 168, and 182 along with MMF/MPA at a starting dose of 1500 mg/day (or equivalent) administered orally in 2 or 3 divided doses. MMF/MPA dose will be up titrated to a target dose of 2.0 - 2.5 grams per day (g/day) (or equivalent). Investigators, at their discretion, may use MPA as a substitute for MMF, with a 360 mg dose being equivalent to a 500 mg dose of MMF. During screening or at randomization, if clinically indicated, participants may receive 750-1000 mg methylprednisolone IV once daily for up to 3 days to treat underlying LN clinical activity. Participants will receive 0.5 mg/kg oral prednisone, tapering this prednisone dose, per protocol, starting on Day 16 and reducing the prednisone dosage to 7.5 mg/day by Week 12. |
| Placebo | Placebo comparator | Drug: Mycophenolate Mofetil/Mycophenolic Acid, Other: Placebo, Drug: Methylprednisolone, Drug: PrednisoneParticipants will receive placebo matching to obinutuzumab IV infusion on Days 1, 15, 168, and 182 along with MMF/MPA at a starting dose of 1500 mg/day (or equivalent) administered orally in 2 or 3 divided doses. MMF/MPA dose will be up titrated to a target dose of 2.0 - 2.5 g/day (or equivalent). Investigators, at their discretion, may use MPA as a substitute for MMF, with a 360 mg dose being equivalent to a 500 mg dose of MMF. During screening or at randomization, if clinically indicated, participants may receive 750-1000 mg methylprednisolone IV once daily for up to 3 days to treat underlying LN clinical activity. Participants will receive 0.5 mg/kg oral prednisone, tapering this prednisone dose, per protocol, starting on Day 16 and reducing the prednisone dosage to 7.5 mg/day by Week 12. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Diagnosis of Systemic Lupus Erythematosus (SLE), according to current American College of Rheumatology (ACR) criteria
- Diagnosis of International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 Class III or IV LN as evidenced by renal biopsy performed within 6 months prior to or during screening. Participants may co-exhibit Class V disease in addition to either Class III or Class IV disease
- Proteinuria (urine protein to creatinine ratio) greater than (>) 1.0
- For women who are not postmenopausal (greater than or equal to [>/=] 12 months of non-therapy-induced amenorrhea) or surgically sterile (absence of ovaries and/or uterus): agreement to remain abstinent or use two adequate methods of contraception, including at least one method with a failure rate of less than (<) 1 percent (%) per year, during the treatment period and for at least 18 months after the last dose of study drug
- For men: agreement to remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of <1% per year during the treatment period and for at least 12 months after the last dose of study drug and agreement to refrain from donating sperm during this same period
Key exclusion criteria (12 listed)
- Retinitis, poorly controlled seizure disorder, acute confusional state, myelitis, stroke or stroke syndrome, cerebellar ataxia, or dementia that is currently active and resulting from SLE
- Presence of rapidly progressive glomerulonephritis
- Severe renal impairment as defined by estimated Glomerular Filtration Rate (GFR) <30 milliliters per minute (mL/min) or the need for dialysis or renal transplant
- Greater than 50% of glomeruli with sclerosis on renal biopsy
- Treatment with cyclophosphamide or calcineurin inhibitors within the 3 months prior to randomization
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 |
|---|---|---|
| Mycophenolate Mofetil/Mycophenolic AcidMMF/MPA will be administered as per schedule specified in the respective arm. | Drug | Obinutuzumab, Placebo |
| ObinutuzumabAlso: Gazyva, GA101, RO5072759Obinutuzumab will be administered as per schedule specified in the respective arm. | Drug | Obinutuzumab |
| PlaceboPlacebo matching to obinutuzumab will be administered as per schedule specified in the respective arm. | Other | Placebo |
| MethylprednisoloneMethylprednisolone IV will be administered as per schedule specified in the respective arm. | Drug | Obinutuzumab, Placebo |
| PrednisonePrednisone will be administered as per schedule specified in the respective arm. | Drug | Obinutuzumab, Placebo |
Primary outcome
Percentage of Participants Who Achieve Protocol Defined Complete Renal Response (CRR) at Week 52
Time frame: From baseline to Week 52
Percentage of participants with normalization of serum creatinine, inactive urinary sediment (as evidenced by < 10 red blood cells (RBCs)/high-power field (HPF) and the absence of red cell casts) and urinary protein to creatinine ratio < 0.5. Normalization of serum creatinine is defined as serum creatinine ≤ the upper limit of normal (ULN) range of central laboratory values if baseline (Day 1) serum creatinine is above the ULN or serum creatinine ≤ 15% above baseline and ≤ the ULN range of central laboratory values if baseline (Day 1) serum creatinine is above the ULN range of central laboratory values.
21 secondary outcomes
Percentage of Participants Who Achieve Protocol Defined Overall Response (OR) at Week 52
Time frame: From baseline to Week 52
Time to OR Over 52 Weeks
Time frame: From baseline to Week 52
Percentage of Participants Who Achieve Protocol Defined Partial Renal Response (PRR) at Week 52
Time frame: Week 52
Percentage of Participants Who Achieve Protocol Defined CRR at Week 24
Time frame: Week 24
Time to CRR Over 52 Weeks
Time frame: From Baseline to Week 52
Change From Baseline in Anti-Double Stranded Deoxyribonucleic Acid (Anti-dsDNA) Antibody Levels at Week 52
Time frame: Baseline and Week 52
Change From Baseline in Complement Component 3 (C3) Levels at Week 52
Time frame: Baseline and Week 52
Change From Baseline in C4 Levels at Week 52
Time frame: Baseline, Week 52
Percentage of Participants Who Achieve Protocol Defined Modified CRR (mCRR1) at Week 52
Time frame: Week 52
Percentage of Participants Who Achieve Protocol Defined Second mCRR (mCRR2) at Week 52
Time frame: Week 52
Percentage of Participants Who Achieve Protocol Defined Third mCRR (mCRR3) at Week 52
Time frame: Week 52
Percentage of Participants With Adverse Events (AEs)
Time frame: From baseline to approximately 7 years and 8 months
Percentage of Participants With Adverse Events of Special Interest: Infusion Related Reactions, Grade 3 or Higher Infections, Drug-related Neutropenia and Drug-related Thrombocytopenia
Time frame: From baseline to approximately 7 years and 8 months
Percentage of Participants With Anti-Drug Antibody (ADA) to Obinutuzumab
Time frame: From baseline to approximately 7 years and 8 months
Percent Change From Baseline in Circulating CD19-Positive B-Cell Levels
Time frame: Baseline, Week 2, Week 4, Week 12, Week 24, Week 52, Week 104, B Cell Follow-Up (Bcfu) at months 6, 12, 18, 24, 30, 36, 42 and 48
Maximum Observed Plasma Concentration (Cmax) of Obinutuzumab
Time frame: Week 0, Week 24, Week 52
Area Under the Plasma Concentration Versus Time Curve (AUC) of Obinutuzumab
Time frame: Baseline to Week 52
Systemic Clearance of Obinutuzumab
Time frame: Day 0, Week 24, Week 52
Volume of Distribution Under Steady State (Vss) of Obinutuzumab
Time frame: Day 0, Week 24, Week 52
Terminal Plasma Half-Life (t1/2) of Obinutuzumab
Time frame: Day 0, Week 24, Week 52
Change From Baseline of Participant's Global Assessment of Disease Activity Visual Analog Scale (VAS) Score
Time frame: Baseline (Day 1), Weeks 4, 12, 24, 36, 52
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Aug 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 37947366Rovin BH, Furie RA, Ross Terres JA, Giang S, Schindler T, Turchetta A, Garg JP, Pendergraft WF 3rd, Malvar A. Kidney Outcomes and Preservation of Kidney Function With Obinutuzumab in Patients With Lupus Nephritis: A Post Hoc Analysis of the NOBILITY Trial. Arthritis Rheumatol. 2024 Feb;76(2):247-254. doi: 10.1002/art.42734. Epub 2023 Nov 10.
- Derived from this study: PubMed 34615636Furie RA, Aroca G, Cascino MD, Garg JP, Rovin BH, Alvarez A, Fragoso-Loyo H, Zuta-Santillan E, Schindler T, Brunetta P, Looney CM, Hassan I, Malvar A. B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis: a randomised, double-blind, placebo-controlled trial. Ann Rheum Dis. 2022 Jan;81(1):100-107. doi: 10.1136/annrheumdis-2021-220920. Epub 2021 Oct 6.
- Derived from this study: PubMed 33693991Dossier C, Hogan J. Response to Majeranowski. Pediatr Nephrol. 2021 Jun;36(6):1653. doi: 10.1007/s00467-021-04982-4. Epub 2021 Mar 10. No abstract available.
- Individual participant dataSharing planned: No. Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.clinicalstudydatarequest.com). Further details on Roche's criteria for eligible studies are available here (https://clinicalstudydatarequest.com/Study-Sponsors/Study-Sponsors-Roche.aspx). For further details on Roche's Global Policy on Sharing of Clinical Study Information and how to request access to related clinical study documents, see here (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).
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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.
Clinical Trials study director
Hoffmann-La Roche
46 sites in 12 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Mycophenolate Mofetil/Mycophenolic Acid, Obinutuzumab and Methylprednisolone in people with Lupus Nephritis, run by Hoffmann-La Roche at 46 sites in 12 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 5 inclusion and 12 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 27 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 46 sites in United States, Mexico, Brazil, France, Colombia and 7 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 26 Feb 2020). 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?
Percentage of Participants Who Achieve Protocol Defined Complete Renal Response (CRR) at Week 52 (time frame: From baseline to Week 52). 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 NCT02550652, which also lists 3 linked publications.
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 27 Aug 2024.