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Sjögren SyndromePhase 2TWINSSNCT03905525

Study of Safety and Efficacy of Multiple Doses of CFZ533 in Two Distinct Populations of Patients With Sjogren's Syndrome

A Phase 2 study testing CFZ533 in people with Sjögren Syndrome, run by Novartis Pharmaceuticals at 71 sites in 23 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

This study was to evaluate the safety, efficacy, pharmacokinetics (PK) and pharmacodynamics (PD) of multiple doses of CFZ533 (iscalimab) in patients with Sjögren's Syndrome (SjS). Read more about this study

Who is it for?
Ages 18 to 100 years
Conditions the study is for
Sjögren Syndrome
What is being tested?
CFZ533
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
273 participants
Where
71 sitesin 23 countries
Study dates
1 Oct 2019to 6 Jun 2023
Phase
Phase 2

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 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Both cohorts must have met all the following criteria:
  • Signed informed consent must be obtained prior to participation in the study
  • Male or female patient >= 18 years of age
  • Classification of Sjögren's Syndrome according to ACR/EULAR 2016 criteria (Shiboski et al 2016)
  • Seropositive for anti-Ro/SSA antibodies
  • Stimulated whole salivary flow rate of >= 0.1 mL/min
Show all 15Show fewer
  • Able to communicate well with the Investigator to understand and comply with the requirements of the study
  • Screening ESSDAI value >= 5 within the following 8 organ domains: constitutional, lymphadenopathy, glandular, articular, cutaneous, renal, hematologic and biologic
  • Patients with involvement of one or more of the remaining 4 domains are eligible but scores of these domains will not contribute to the assessment for eligibility for Cohort 1
  • At selected sites participating in Cohort 2, patients who based on the above criterion 7, do not qualify for Cohort 1, should be further evaluated for Cohort 2
  • Screening ESSPRI score of >= 5
  • Screening ESSDAI value < 5 within 8 domains scored for inclusion criterion #7 Cohort 1
  • Screening ESSPRI fatigue subscore >= 5 or ESSPRI dryness subscore >= 5
  • Hypergammaglobulinemia defined by IgG greater than upper limit of normal (ULN) or lymphocytopenia (less than lower limit of normal (LLN)) or hypocomplementemia (low C3, or low C4 - when considered due to disease activity and not due to genetic factors)
  • Score of >= 30 on IDEEL symptom bother questionnaire at Screening

Who cannot join

  • Sjögren's Syndrome overlap syndromes where another autoimmune rheumatic disease constitutes the principal illness
  • Use of other investigational drugs within 5 half-lives of enrollment or within 30 days whichever is longer, or longer if required by local regulations
  • Prior treatment with any of the following within 6 months prior to randomization:
  • B-cell depletors (e.g. rituximab, ianalumab) unless CD19+ B cell count have returned to ≥ 50 cells/µL
  • abatacept
  • anti-tumor necrosis factor alpha monoclonal anti-body
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  • intravenous/subcutaneous Ig; plasmapheresis; i.v. or oral cyclophosphamide
  • i.v. or oral cyclosporine A
  • any other immunosuppressants unless explicitly allowed in criterion #5
  • Use of steroids (predniso(lo)ne or equivalent corticosteroid) at dose > 10 mg/day
  • Use of steroids and synthetic DMARDS at inconsistent dose and within 3 months prior to randomization

Trial locations and contacts

71 sites in 23 countries.

71 sites in 23 countries

United States8 sites
  • The John Hopkins Jerome L Greene Sjogren

    Baltimore, Maryland, 21224

  • Ochsner Health System

    Baton Rouge, Louisiana, 70809

  • Tufts School of Dental Medicine

    Boston, Massachusetts, 02111

  • Indiana Univ School of Dentistry

    Indianapolis, Indiana, 46202

  • Uni Wisconsin School Med Pub Health

    Madison, Wisconsin, 53792

  • Winthrop University Hospital

    Mineola, New York, 11501

  • Perelman School of Medicine

    Philadelphia, Pennsylvania, 19104

  • North GA Rheumatology Group PC

    Suwanee, Georgia, 30024

Other trials in United States

Russia6 sites
  • Novartis Investigative Site

    Kazan', 420097

  • Novartis Investigative Site

    Moscow, 115522

  • Novartis Investigative Site

    Orenburg, 460000

  • Novartis Investigative Site

    Saint Petersburg, 195257

  • Novartis Investigative Site

    Tomsk, 634009

  • Novartis Investigative Site

    Yekaterinburg, 620028

Other trials in Russia

Chile5 sites
  • Novartis Investigative Site

    Concepción, 6740

  • Novartis Investigative Site

    Santiago, RM, 7500588

  • Novartis Investigative Site

    Santiago, Santiago Metropolitan, 7500571

  • Novartis Investigative Site

    Santiago, Santiago Metropolitan, 7500710

  • Novartis Investigative Site

    Valdivia, Los Ríos Region, 5110683

Other trials in Chile

France5 sites
  • Novartis Investigative Site

    Brest, 29200

  • Novartis Investigative Site

    Le Kremlin-Bicêtre, 94275

  • Novartis Investigative Site

    Lille, 59037

  • Novartis Investigative Site

    Paris, 75014

  • Novartis Investigative Site

    Strasbourg, 67000

Other trials in France

Japan5 sites
  • Novartis Investigative Site

    Chuo Ku, Tokyo, 104 8560

  • Novartis Investigative Site

    Kurashiki, Okayama-ken, 710-0824

  • Novartis Investigative Site

    Nagoya, Aichi-ken, 457 8510

  • Novartis Investigative Site

    Sasebo, Nagasaki, 857-1195

  • Novartis Investigative Site

    Shinjuku-ku, Tokyo, 160 8582

Other trials in Japan

Germany4 sites
  • Novartis Investigative Site

    Bonn, 53105

  • Novartis Investigative Site

    Dresden, Saxony, 01307

  • Novartis Investigative Site

    Freiburg im Breisgau, Baden-Wurttemberg, 79106

  • Novartis Investigative Site

    Würzburg, Bavaria, 97080

Other trials in Germany

Portugal4 sites
  • Novartis Investigative Site

    Almada, 2805-267

  • Novartis Investigative Site

    Lisbon, 1050-034

  • Novartis Investigative Site

    Lisbon, 1649-035

  • Novartis Investigative Site

    Ponte de Lima, 4990 041

Other trials in Portugal

Brazil3 sites
  • Novartis Investigative Site

    Juiz de Fora, Minas Gerais, 36010 570

  • Novartis Investigative Site

    São Paulo, São Paulo, 01244-030

  • Novartis Investigative Site

    Vitória, Espírito Santo, 29055 450

Other trials in Brazil

Canada3 sites
  • Novartis Investigative Site

    Rimouski, Quebec, G5L 5T1

  • Novartis Investigative Site

    Toronto, Ontario, M5T 2S8

  • Novartis Investigative Site

    Trois-Rivières, Quebec, G9A 3Y2

Other trials in Canada

Colombia3 sites
  • Novartis Investigative Site

    Barranquilla, Atlántico, 080002

  • Novartis Investigative Site

    Cali, Valle del Cauca Department, 760012

  • Novartis Investigative Site

    Medellín, Antioquia, 050001

Other trials in Colombia

Hungary3 sites
  • Novartis Investigative Site

    Budapest, 1023

  • Novartis Investigative Site

    Szeged, 6720

  • Novartis Investigative Site

    Székesfehérvár, Fejér, 8000

Other trials in Hungary

Israel3 sites
  • Novartis Investigative Site

    Haifa, 3104802

  • Novartis Investigative Site

    Kfar Saba, 4428164

  • Novartis Investigative Site

    Ramat Gan, 5265601

Other trials in Israel

Italy3 sites
  • Novartis Investigative Site

    Milan, MI, 20132

  • Novartis Investigative Site

    Pisa, PI, 56126

  • Novartis Investigative Site

    Udine, UD, 33100

Other trials in Italy

United Kingdom3 sites
  • Novartis Investigative Site

    Birmingham, B15 2TH

  • Novartis Investigative Site

    Doncaster, DN2 5LT

  • Novartis Investigative Site

    Manchester, M13 9WL

Other trials in United Kingdom

Argentina2 sites
  • Novartis Investigative Site

    Buenos Aires, C1055AAF

  • Novartis Investigative Site

    CABA, 1426

Other trials in Argentina

Austria2 sites
  • Novartis Investigative Site

    Graz, 8036

  • Novartis Investigative Site

    Vienna, 1090

Other trials in Austria

Netherlands2 sites
  • Novartis Investigative Site

    Groningen, 9713 GZ

  • Novartis Investigative Site

    Rotterdam, South Holland, 3015 GD

Other trials in Netherlands

Romania2 sites
  • Novartis Investigative Site

    Brasov, 500283

  • Novartis Investigative Site

    Cluj-Napoca, 400006

Other trials in Romania

Australia1 site
  • Novartis Investigative Site

    Nedlands, Western Australia, 6009

Other trials in Australia

Greece1 site
  • Novartis Investigative Site

    Athens, 115 27

Other trials in Greece

South Korea1 site
  • Novartis Investigative Site

    Seoul, Seocho Gu, 06591

Other trials in South Korea

Sweden1 site
  • Novartis Investigative Site

    Stockholm, SE, 113 65

Other trials in Sweden

Turkey (Türkiye)1 site
  • Novartis Investigative Site

    Ankara, Yenimahalle, 06500

Other trials in Turkey (Türkiye)

About this study

Official title: A 48-week, 6-arm, Randomized, Double-blind, Placebo-controlled Multicenter Trial to Assess the Safety and Efficacy of Multiple CFZ533 Doses Administered Subcutaneously in Two Distinct Populations of Patients With Sjogren's Syndrome (TWINSS)

This study was to evaluate the safety, efficacy, pharmacokinetics (PK) and pharmacodynamics (PD) of multiple doses of CFZ533 (iscalimab) in patients with Sjögren's Syndrome (SjS).

Read the detailed description

This study consisted of a 6-week screening, 2 treatment periods of 24 weeks each, and a follow-up period of 12 weeks. In Periods 1 and 2, thirteen (13) treatment administration visits were planned, including a weekly loading regimen (2 visits) at the start of each treatment period. One administration equaled to two subcutaneous (s.c.) injections.

This study included two distinct cohorts termed Cohort 1 and Cohort 2.

  • Cohort 1: subjects with moderate-to-severe systemic and symptomatic disease involvement.
  • Cohort 2: subjects with low systemic disease involvement but high symptom burden.
Being tested
CFZ533, Placebo
Keywords
Sjögren Syndrome (SjS), sicca syndrome, dryness, fatigue, autoimmune disease, European League Against Rheumatism (EULAR), EULAR Sjögren syndrome disease activity index (ESSDAI), EULAR Sjögren syndrome patient reported index (ESSPRI), monoclonal antibody, anti-CD40, iscalimab (CFZ533), TWINSS
Medical subject headings
Sjogren's Syndrome, Fatigue, Autoimmune Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CFZ533Drug

    Also called iscalimab

    Biological

  • PlaceboOther

    liquid placebo for injections

Study groups in NCT03905525
Study groupRoleWhat they receive
Cohort 1 / Arm AExperimental3 weekly subcutaneous (s.c.) loading doses of iscalimab were 600 mg on Weeks 0, 1 and 2. From Week 2 and up to Week 46 (last dose), iscalimab was administered s.c. bi-weekly at 600 mg. To maintain blinding in Period 2, placebo was administered at Week 25.
Receives: Drug: CFZ533
Cohort 1 / Arm BExperimental3 weekly subcutaneous (s.c.) loading doses of iscalimab were 600 mg on Week 0, and 300 mg on Week 1 and Week 2. From Week 2 and up to Week 46 (last dose), iscalimab was administered s.c. bi-weekly at 300 mg. To maintain blinding in Period 2, placebo was administered at Week 25.
Receives: Drug: CFZ533
Cohort 1 / Arm CExperimental3 weekly subcutaneous (s.c.) loading doses of iscalimab were 600 mg on Week 0, and 150 mg on Week 1 and Week 2. From Week 2 and up to Week 46 (last dose), iscalimab was administered s.c. bi-weekly at 150 mg. To maintain blinding in Period 2, placebo was administered at Week 25.
Receives: Drug: CFZ533
Cohort 1 / Arm D (Period 1)Placebo comparatorPlacebo treatment is administered subcutaneous (s.c.) weekly for the first 3 doses, then bi-weekly from Week 2 to Week 22 in Period 1.
Receives: Other: Placebo
Cohort 1 / Arm D1 (Period 2)ExperimentalPeriod 2: 3 weekly subcutaneous (s.c.) loading doses of 600 mg iscalimab on Week 24, 25 and 26. After Week 26 and up to Week 46 (last dose), iscalimab was administered bi-weekly at 600 mg.
Receives: Drug: CFZ533
Cohort 2 / Arm EExperimental3 weekly subcutaneous (s.c.) loading doses of iscalimab were 600 mg on Week 0, 1 and 2. From Week 2 and up to Week 46 (last dose), iscalimab was administered s.c. bi-weekly at 600 mg. To maintain blinding in Period 2, placebo was administered at Week 25.
Receives: Drug: CFZ533
Cohort 2 / Arm F (Period 1)Placebo comparatorPlacebo treatment was administered subcutaneous (s.c.) weekly for the first 3 doses, then bi-weekly from Week 2 to Week 22 in Period 1.
Receives: Other: Placebo
Cohort 2 / Arm F1 (Period 2)ExperimentalPeriod 2: 3 weekly subcutaneous (s.c.) loading doses of iscalimab: 600 mg on Week 24, and 300 mg on Week 25 and Week 26. After Week 26, iscalimab was administered s.c. bi-weekly at 300 mg.
Receives: Drug: CFZ533

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Cohort 1: Change in EULAR Sjögren Syndrome Disease Activity Index (ESSDAI) Score From Baseline at 24 Weeks as Compared to Placebo

    ESSDAI is a validated disease outcome measure for SjS that contains 12 organ-specific domains contributing to disease activity. For each domain, features of disease activity are scored in 3 or 4 levels according to their severity. These scores are then summed across the 12 domains in a weighted manner to provide the total score. The domains (weights) are as follows: constitutional (3), lymphadenopathy (4), glandular (2), articular (2), cutaneous (3), pulmonary (5), renal (5), muscular (6), peripheral nervous system (PNS) (5), central nervous system (CNS) (5), hematological (2) and biological (1). The total score may vary between 0-123. It is considered low activity an ESSDAI < 5; moderate activity 5-13, and high activity if ESSDAI is >= 14.

    Measured: Baseline, Week 24

  2. Cohort 2: Change in EULAR Sjögren Syndrome Patient Reported Index (ESSPRI) Score From Baseline at 24 Weeks as Compared to Placebo.

    The ESSPRI is a self-evaluation index for measuring symptoms including pain, fatigue and dryness. Each symptom was measured with a single 0 (no symptoms) to 10 (severe symptoms) numerical scale and the final ESSPRI score is calculated by averaging these domains with a maximum severity score of 10.

    Measured: Baseline, Week 24

Secondary outcomes (19)
  1. Cohort 1: Change From Baseline in ESSPRI at Week 24

    The ESSPRI is a self-evaluation index for measuring symptoms including pain, fatigue and dryness. Each symptom was measured with a single 0 (no symptoms) to 10 (severe symptoms) numerical scale and the final ESSPRI score is calculated by averaging these domains with a maximum severity score of 10.

    Measured: Baseline, Week 24

  2. Cohort 1: Change From Baseline in Score of Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Questionnaire at Week 24

    The FACIT F (Functional Assessment of Chronic Illness Therapy-Fatigue) is a validated 13 item patient reported outcome measure assessing fatigue and its impact on daily functioning over the past 7 days, with total scores ranging from 0 to 52, where higher scores indicate less fatigue.

    Measured: Baseline, 24 weeks

  3. Cohort 1: Change From Baseline in Physician Global Assessment (PhGA) at Week 24

    Physician's global assessment (PhGA) of disease activity was performed using a Visual Analog Scale (VAS) - an unnumbered 100 mm horizontal line ranging from "no disease activity" (score 0) to "maximal disease activity" (score 100). The assessment of patient's condition on the day is made by placing a vertical mark across the line.

    Measured: Baseline, 24 weeks

  4. Cohort 2: Change From Baseline in Score of Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Questionnaire at Week 24

    The FACIT F (Functional Assessment of Chronic Illness Therapy-Fatigue) is a validated 13 item patient reported outcome measure assessing fatigue and its impact on daily functioning over the past 7 days, with total scores ranging from 0 to 52, where higher scores indicate less fatigue.

    Measured: Baseline, 24 weeks

  5. Cohort 2: Change From Baseline in Physician Global Assessment (PhGA) at Week 24

    Physician's global assessment (PhGA) of disease activity was performed using a Visual Analog Scale (VAS) - an unnumbered 100 mm horizontal line ranging from "no disease activity" (score 0) to "maximal disease activity" (score 100). The assessment of patient's condition on the day is made by placing a vertical mark across the line.

    Measured: Baseline, 24 weeks

  6. Cohort 2: Change From Baseline in ESSDAI at Week 24

    ESSDAI is a validated disease outcome measure for SjS that contains 12 organ-specific domains contributing to disease activity. For each domain, features of disease activity are scored in 3 or 4 levels according to their severity. These scores are then summed across the 12 domains in a weighted manner to provide the total score. The domains (weights) are as follows: constitutional (3), lymphadenopathy (4), glandular (2), articular (2), cutaneous (3), pulmonary (5), renal (5), muscular (6), peripheral nervous system (PNS) (5), central nervous system (CNS) (5), hematological (2) and biological (1). The final score may vary between 0-123. It is considered low activity an ESSDAI < 5; moderate activity 5-13, and high activity if ESSDAI is >= 14.

    Measured: Baseline, week 24

  7. Cohort 2: Proportion of Subjects With at Least 12 Points Improvement Measured by Score of Impact of Dry Eye on Everyday Life (IDEEL) Questionnaire Symptom Bother Module at Week 24.

    The Impact of Dry Eye on Everyday Life (IDEEL) questionnaire is a comprehensive dry eye specific questionnaire to evaluate treatment satisfaction, symptom-related bother and impact on daily life in a population with dry eye. This study only utilized the Dry Eye Symptom-Bother module.

    The Dry Eye Symptom-Bother module of IDEEL is composed of a single dimension (20 items). A 4-point Likert-like scale is used: from "not at all" to "very much". Patients could also answer "I did not have this symptom / Not applicable". One item is scored on a 5-point Likert-like scale from "none of the time" to "all of the time". The range for the symptom-bother score is 0 to 100, with higher scores indicating greater symptom bother.

    Measured: Baseline, Week 24

  8. Cohort 1: Incidence of Adverse Events (AEs), Serious Adverse Events (SAEs) up to Week 24

    The distribution of adverse events in Treatment Period 1 was done via the analysis of frequencies for treatment emergent Adverse Event (TEAEs), Serious Adverse Event (TESAEs) and Deaths due to AEs, through the monitoring of relevant clinical and laboratory safety parameters.

    Analyses of data in the Safety Set (SAF) up to Week 24 (Period 1) is presented by actual treatment during Period 1, with data from separate cohort for the CFZ533 600mg and for the Placebo groups: CFZ533 600 mg, CFZ533 300 mg, CFZ533 150 mg and placebo.

    Measured: Up to Week 24

  9. Cohort 1: Incidence of Adverse Events (AEs), Serious Adverse Events (SAEs) in All Study Periods

    The distribution of adverse events was done via the analysis of frequencies for treatment emergent Adverse Event (TEAEs), Serious Adverse Event (TESAEs) and Deaths due to AEs, through the monitoring of relevant clinical and laboratory safety parameters.

    Analyses of data in the Safety Set (SAF) for period 2/3 or overall study is presented by actual treatment sequence during periods 1 and 2, where the CFZ533 600 mg - CFZ533 600 mg sequence included data from patients in separate cohort. CFZ533 600 mg 24 Weeks arm includes only patients from Placebo - CFZ533 600 mg arm, who took at least one CFZ533 600 mg dose in Period 2 (Patients who received Placebo in Period 1 and discontinued before Week 24 are not included). CFZ533 600 mg 48 Weeks arm includes all subjects from CFZ533 600 mg - CFZ533 600 mg arm, and subjects from CFZ533 150 mg - CFZ533 150 mg and CFZ533 300 mg - CFZ533 300 mg arms but only took the first or the first two loading dose(s) in period 1.

    Measured: up to 14 weeks following the last dose of study treatment, up to maximum Week 60

  10. Cohort 2: Incidence of Adverse Events (AEs), Serious Adverse Events (SAEs) up to Week 24

    The distribution of adverse events was done via the analysis of frequencies for treatment emergent Adverse Event (TEAEs), Serious Adverse Event (TESAEs) and Deaths due to AEs, through the monitoring of relevant clinical and laboratory safety parameters.

    Analyses of data in the Safety Set (SAF) up to Week 24 (Period 1) is presented by actual treatment during Period 1, with data from separate cohort for the CFZ533 600mg and for the Placebo groups: CFZ533 600 mg and placebo.

    Measured: Up to Week 24

  11. Cohort 2: Incidence of Adverse Events (AEs), Serious Adverse Events (SAEs) in All Study Periods

    The distribution of adverse events was done via the analysis of frequencies for treatment emergent Adverse Event (TEAEs), Serious Adverse Event (TESAEs) and Deaths due to AEs, through the monitoring of relevant clinical and laboratory safety parameters.

    Analyses of data in the Safety Set (SAF) for period 2/3 or overall study is presented by actual treatment sequence during periods 1 and 2, where the CFZ533 600 mg - CFZ533 600 mg sequence included data from patients in separate cohort. CFZ533 300 mg 24 Weeks includes only patients from Placebo - CFZ533 300 mg arm, who received Placebo in Period 1, and either took CFZ533 600 mg loading dose + at least two CFZ533 300 mg subsequent doses in Period 2 or missed CFZ533 600 mg loading dose and took at least one CFZ533 300 mg dose in Period 2 (Patients who received Placebo in Period 1 and discontinued before Week24 are not included). CFZ533 600 mg 48 Weeks arm includes all subjects from CFZ533 600 mg - CFZ533 600 mg arm.

    Measured: up to 14 weeks following the last dose of study treatment, up to maximum Week 60

  12. Cohort 1: Change From Baseline in Serum Free Light Kappa (FLCκ) Chains Levels

    Serum samples for free light kappa (FLCκ) chains were collected and analyzed.

    Measured: Baseline, Week 4, Week 12, Week 24 (End Treatment Period 1), Week 32, Week 40, Week 48 (End Treatment Period 2), FUP2 (Week 56), FUP 3 (Week 60)

  13. Cohort 2: Change From Baseline in Serum Free Light Kappa (FLCκ) Chains Levels

    Serum samples for free light kappa (FLCκ) chains were collected and analyzed.

    Measured: Baseline, Week 4, Week 12, Week 24 (End Treatment Period 1), Week 32, Week 40, Week 48 (End Treatment Period 2), FUP2 (Week 56), FUP 3 (Week 60)

  14. Cohort 1: Change From Baseline in Immunoglobulin G (IgG) Levels

    Plasma samples for Immunoglobulin G (IgG) were collected and analyzed.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (End Treatment Period 1), Week 28, Week 32, Week 40, Week 48 (End Treatment Period 2), FUP1 (Week 52), FUP2 (Week 56), FUP 3 (Week 60)

  15. Cohort 2: Change From Baseline in Immunoglobulin G (IgG) Levels

    Plasma samples for Immunoglobulin G (IgG) were collected and analyzed.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (End Treatment Period 1), Week 28, Week 32, Week 40, Week 48 (End Treatment Period 2), FUP1 (Week 52), FUP2 (Week 56), FUP 3 (Week 60)

  16. Cohort 1: Change From Baseline in Immunoglobulin M (IgM) Levels

    Plasma samples for Immunoglobulin M (IgM) were collected and analyzed.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (End Treatment Period 1), Week 28, Week 32, Week 40, Week 48 (End Treatment Period 2), FUP1 (Week 52), FUP2 (Week 56), FUP 3 (Week 60)

  17. Cohort 2: Change From Baseline in Immunoglobulin M (IgM) Levels

    Plasma samples for Immunoglobulin M (IgM) were collected and analyzed.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (End Treatment Period 1), Week 28, Week 32, Week 40, Week 48 (End Treatment Period 2), FUP1 (Week 52), FUP2 (Week 56), FUP 3 (Week 60)

  18. Cohort 1: Change From Baseline in Plasma CXCL-13 Levels

    Plasma samples for Chemokine (C-X-C motif) ligand 13 (CXCL13), also known as B lymphocyte chemoattractant (BLC) or B cell-attracting chemokine 1 (BCA-1) were collected and analyzed.

    Measured: Baseline, Week 4, Week 12, Week 24 (End Treatment Period 1), Week 32, Week 48 (End Treatment Period 2), FUP 3 (Week 60)

  19. Cohort 2: Change From Baseline in Plasma CXCL-13 Levels

    Plasma samples for Chemokine (C-X-C motif) ligand 13 (CXCL13), also known as B lymphocyte chemoattractant (BLC) or B cell-attracting chemokine 1 (BCA-1) were collected and analyzed.

    Measured: Baseline, Week 4, Week 12, Week 24 (End Treatment Period 1), Week 32, Week 48 (End Treatment Period 2), FUP 3 (Week 60)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Apr 2019
  2. Study start1 Oct 2019
  3. Primary completion28 Sep 2022
  4. Study completion6 Jun 2023

Resources

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
Model description
Patients were screened and enrolled into one of the 2 study Cohorts: Cohort 1: At baseline subjects were randomized in ratio 1:1:1:1 into one of three CFZ533 (iscalimab) arms (A, B or C) or to placebo (Arm D). After completion of 24 weeks of treatment (Period 1) placebo patients (Arm D) will be switched to active treatment (Arm D1) for the subsequent 24 weeks (Period 2). Cohort 2: At baseline subjects were randomized in ratio 1:1 to iscalimab (Arm E) or to placebo (Arm F). After completion of 24 weeks of treatment (Period 1), placebo patients (Arm F) will be switched to iscalimab active treatment (Arm F1) for the subsequent 24 weeks (Period 2). All patients treated with iscalimab (Arms A,B,C,and E) in Period 1 continued the same study treatment in Period 2.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
273 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03905525
Sponsor's protocol ID
CCFZ533B2201
Other IDs
2018-004476-35, 2018
Acronym
TWINSS
Status last verified
Apr 2026
First submitted
25 Mar 2019
Last updated
18 May 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing access to patient-level data and supporting clinical documents from eligible studies with qualified external researchers. Requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to protect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Publications

  • Fisher BA, Mariette X, Papas A, Grader-Beck T, Bootsma H, Ng WF, van Daele PLA, Finzel S, Noaiseh G, Elgueta S, Hermann J, McCoy SS, Akpek E, Bookman A, Sopala M, Montecchi-Palmer M, Luo WL, Scheurer C, Hueber W; TWINSS study group. Safety and efficacy of subcutaneous iscalimab (CFZ533) in two distinct populations of patients with Sjogren's disease (TWINSS): week 24 results of a randomised, double-blind, placebo-controlled, phase 2b dose-ranging study. Lancet. 2024 Aug 10;404(10452):540-553. doi: 10.1016/S0140-6736(24)01211-X. Epub 2024 Jul 31.

    PubMed 39096929

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