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.
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
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- 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
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
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
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
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
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
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
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
Canada3 sites
Novartis Investigative Site
Rimouski, Quebec, G5L 5T1
Novartis Investigative Site
Toronto, Ontario, M5T 2S8
Novartis Investigative Site
Trois-Rivières, Quebec, G9A 3Y2
Colombia3 sites
Novartis Investigative Site
Barranquilla, Atlántico, 080002
Novartis Investigative Site
Cali, Valle del Cauca Department, 760012
Novartis Investigative Site
Medellín, Antioquia, 050001
Hungary3 sites
Novartis Investigative Site
Budapest, 1023
Novartis Investigative Site
Szeged, 6720
Novartis Investigative Site
Székesfehérvár, Fejér, 8000
Israel3 sites
Novartis Investigative Site
Haifa, 3104802
Novartis Investigative Site
Kfar Saba, 4428164
Novartis Investigative Site
Ramat Gan, 5265601
Italy3 sites
Novartis Investigative Site
Milan, MI, 20132
Novartis Investigative Site
Pisa, PI, 56126
Novartis Investigative Site
Udine, UD, 33100
United Kingdom3 sites
Novartis Investigative Site
Birmingham, B15 2TH
Novartis Investigative Site
Doncaster, DN2 5LT
Novartis Investigative Site
Manchester, M13 9WL
Argentina2 sites
Novartis Investigative Site
Buenos Aires, C1055AAF
Novartis Investigative Site
CABA, 1426
Austria2 sites
Novartis Investigative Site
Graz, 8036
Novartis Investigative Site
Vienna, 1090
Netherlands2 sites
Novartis Investigative Site
Groningen, 9713 GZ
Novartis Investigative Site
Rotterdam, South Holland, 3015 GD
Romania2 sites
Novartis Investigative Site
Brasov, 500283
Novartis Investigative Site
Cluj-Napoca, 400006
Australia1 site
Novartis Investigative Site
Nedlands, Western Australia, 6009
Turkey (Türkiye)1 site
Novartis Investigative Site
Ankara, Yenimahalle, 06500
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.
- Conditions
- Sjögren Syndrome
- 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 group | Role | What they receive |
|---|---|---|
| Cohort 1 / Arm A | Experimental | 3 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 B | Experimental | 3 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 C | Experimental | 3 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 comparator | Placebo 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) | Experimental | Period 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 E | Experimental | 3 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 comparator | Placebo 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) | Experimental | Period 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.
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
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)
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
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
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
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
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
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
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
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
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
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
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
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)
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)
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)
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)
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)
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)
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)
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.
- First posted5 Apr 2019
- Study start1 Oct 2019
- Primary completion28 Sep 2022
- Study completion6 Jun 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 (1)Papers the sponsor has linked to this study.
- Other trials for Sjögren SyndromeStudies 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 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)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Study Director Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
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
- Results posted
- Yes, on ClinicalTrials.gov
- 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