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VasculitisPhase 2TRIBECANCT04629144

Efficacy and Safety of Belimumab in the Treatment of Non-infectious Active Cryoglobulinemia Vasculitis Compared to Placebo. TRIBECA STUDY (Treatment nd BElimumab in Cryoglobulinemia Associated Vasculitis)

A Phase 2 study testing Belimumab in people with Vasculitis and Cryoglobulinemia, run by Assistance Publique - Hôpitaux de Paris at 20 sites in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

Cryoglobulinemia vasculitis (CV) is a systemic immune-mediated small vessel vasculitis. Rituximab proved effective on main vasculitis signs, with a complete clinical response of 65%. However, CV relapse is noted in up to 40% of patients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Vasculitis, Cryoglobulinemia
What is being tested?
Belimumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
48 participants
Where
20 sitesFrance
Study dates
20 Oct 2021to 20 Oct 2025
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • The eligibility criteria will be checked at the inclusion/randomization visit. Patients meeting the following criteria may be included in the study:
  • Age > 18 years
  • Written inform consent
  • Active mixed cryoglobulinemia vasculitis, at initiation of rituximab, define by a. a clinically active vasculitis with skin, joint, renal, peripheral nerve, central neurological, digestive, pulmonary and/or cardiac involvement , b. history of positive cryoglobulinemia and/or positive Rheumatoid factor associated with low C4 complement level , and/or a monoclonal component (IgM Kappa) and/or a histologal proof of vasculitis in the affected organs
  • Affiliated to National French social security system
  • Having received Rituximab as induction therapy within 6 weeks (1 to 4 infusions, dose at the discretion of the investigator)
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  • Female subjects of childbearing potential must have a negative serum or urinary pregnancy test at inclusion visit, and confirmed monthly while in study, out to at least 92 days (5 half lives) post last dose.
  • For subjects with reproductive potential (male or female), a willingness to use contraceptive measures adequate to prevent the subject or the subject's partner from becoming pregnant during the study from 2 weeks prior to administration of the 1st dose of study agent until 92 days after the last dose of study agent. Therefore the subjects agree to 1 of the following:
  • Complete abstinence from intercourse from 2 weeks prior to administration of the 1st dose of study agent until 92 days after the last dose of study agent (Sexual inactivity by abstinence must be consistent with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g. calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception) OR
  • Consistent and correct use of 1 of the following acceptable methods of birth control for 1 month prior to the start of the study agent, during the study, and 92 days after the last dose of study agent o Oral contraceptive, either combined or progestogen alone o Injectable progestogen o Implants of levonorgestrel or etonogestrel o Estrogenic vaginal ring o Percutaneous contraceptive patches o Intrauterine device (IUD) or intrauterine system (IUS) with <1% failure rate as stated in the product label
  • o Male partner sterilization (vasectomy with documentation of azoospermia) prior to the female subject's entry into the study, and this male is the sole partner for that subject. For this definition, "documented" refers to the outcome of the investigator's/designee's medical examination of the subject or review of the subject's medical history for study eligibility, as obtained via a verbal interview with the subject or from the subject's medical records
  • Double barrier method: condom and occlusive cap (diaphragm or cervical/vault caps) plus spermicidal agent (foam/gel/film/cream/suppository) These allowed methods of contraception are only effective when used consistently, correctly and in accordance with the product label. The investigator is responsible for ensuring subjects understand how to properly use these methods of contraception.
  • HIV negative serology ; negative HBs Ag test and HBc Ab test; HCV negative serology or negative HCV RNA if positive HCV serology within 3 months before inclusion:
  • o In case of negative AgHBs and positive HBc Ab test, HBV DNA test must be negative; AND Hepatitis B surveillance should be started (monthly HBsAg and HBV DNA testing for the duration of the study treatment and at least every 12 weeks after treatment is discontinued for the duration of study treatment. In addition, antiviral prophylaxis should be started before the first administration of the study treatment and continued until 12 months after completion of study treatment; HCV negative serology or negative HCV RNA if positive HCV serology within 3 months before inclusion
  • neutrophils (ANC) >1x109/L

Who cannot join

  • Subjects will be not included from the study if they meet any of the following criteria:
  • Patient with a vasculitis unrelated to cryoglobulinemia
  • Patient with non active cryoglobulinemia vasculitis, at initiation of rituximab. Patients with mixed inactive vasculitis following rituximab administration may be included.
  • Excluded concomitant medications:
  • 365 days Prior to Investigational Medicinal Product (Belimumab or placebo):: Any biologic investigational agent (e.g., abetimus sodium, anti CD40L antibody, BG9588/ IDEC 131) Investigational agent applies to any drug not approved for sale in the country in which it is being used
  • 180 Days Prior to Investigational Medicinal Product (Belimumab or placebo):: Intravenous cyclophosphamide
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  • 30 Days Prior to Investigational Medicinal Product (Belimumab or placebo): (or 5 half lives, whichever is greater) Any non-biologic investigational agent Investigational agent applies to any drug not approved for sale in the country in which it is being use
  • Live vaccines within 30 days prior to baseline or concurrently with Investigational Medicinal Product (Belimumab or placebo)
  • Have a history of malignant neoplasm within the last 5 years, other than carcinoma in situ of the cervix or excised basal cell, squamous cell carcinoma of the skin and low grade hemopathy with no indication for a specific treatment
  • Have evidence of serious suicide risk including any history of suicidal behaviour in the last 6 months and/or any suicidal ideation in the last 2 months or who in the investigator's judgment, pose a significant suicide risk
  • Have a Progressive multifocal leukoencephalopathy
  • Have a history of a primary immunodeficiency
  • 9. Have a history of major organ transplant or hematopoietic stem cell/marrow transplant or renal transplant
  • 10. Infection history:
  • Currently on any suppressive therapy for a chronic infection (such as tuberculosis, pneumocystis, cytomegalovirus
  • Infection requiring hospitalization and/or use of parenteral (IV or IM) antibiotics (antibacterials, antivirals, anti-fungals, or anti-parasitic agents) within 60 days of the inclusion visit.
  • 11. Have current drug or alcohol abuse or dependence, or a history of drug or alcohol abuse or dependence within 365 days prior to the inclusion visit
  • 12. Have a historically positive HIV test according to results obtained within 3 months prior to inclusion visit
  • 13. Hepatitis status according to results obtained within 3 month prior to inclusion visit :
  • Positive test for hepatitis B RNA
  • Positive test for Hepatitis C RNA
  • 14. Have a history of a hypersensitivity or an anaphylactic reaction to parenteral administration of Belimumab, corticosteroids or any excipients of the treatments administered during the study
  • 15. If Women of Child Bearing Potential (WCBP) are included please see special instructions in Inclusion criteria
  • 16. Pregnant or breast feeding women
  • 17. Have any intercurrent significant medical or psychiatric illness that the investigator considers would make the candidate unsuitable for the study
  • 18. Patients under legal protection or unable to consent
  • 19. Participation to another interventional study

Trial locations and contacts

20 sites in 1 country.

David Saadoun, MD PhD contact

142499742 ext. 33

david.saadoun@aphp.fr

Jérôme Lambert, MD PhD contact

142499742 ext. +33

jerome.lambert@u-paris.fr

20 sites in 1 country

France20 sites, 20 recruiting
  • CH Blois

    Blois

    Bertrand Lioger, MD

    Recruiting
  • CHU (Haut-Lévêque)

    Bordeaux

    Estibaliz Lazaro, MD

    Recruiting
  • CHU Caen

    Caen

    Achille Aouba, MD

    Recruiting
  • Hopital Henri Mondor

    Créteil

    Marc Michel, MD

    Not yet recruiting
  • Hopital Bicetre

    Le Kremlin-Bicêtre

    Xavier Mariette, MD

    Recruiting
  • CHU Lille

    Lille

    Eric Hachulla, MD

    Recruiting
  • CHU La Conception

    Marseille

    Gilles Kaplanski, MD

    Recruiting
  • CHU Nantes

    Nantes

    Antoine Neel, MD

    Recruiting
  • CH Nimes

    Nîmes

    Olivier Moranne, MD

    Recruiting
  • Hopital de La Pitié Salpetriere AP-HP

    Paris

    David Saadoun, MD PhD

    Recruiting
  • Hopital Européen Georges Pompidou

    Paris

    Alexandre Karras, MD

    Recruiting
  • Hopital Necker

    Paris

    Aurélie Hummel, MD

    Recruiting
  • Hopital Saint Antoine

    Paris

    Arsene Mekinian, MD

    Recruiting
  • Hopital Saint Louis

    Paris

    Baptiste Hervier, MD

    Recruiting
  • Hopital Tenon

    Paris

    Jean-Jacques Boffa, MD

    Recruiting
  • CHU Starsbourg

    Strasbourg

    Jacques Eric Gottenberg, MD

    Recruiting
  • Hopital Foch

    Suresnes

    Felix Ackermann, MD

    Recruiting
  • CHU Toulouse

    Toulouse

    Stanislas Faguer, MD

    Recruiting
  • CHU Tours

    Tours

    Alexandra Audemard, MD

    Recruiting
  • CHU Valenciennes

    Valenciennes

    Thomas Quemeneur, MD

    Recruiting

Other trials in France

About this study

Official title: Multicenter Randomized Double-blind Study Comparing the Efficacy and Safety of Belimumab in the Treatment of Non-infectious Active Cryoglobulinemia Vasculitis Compared to Placebo. TRIBECA STUDY (Treatment nd BElimumab in Cryoglobulinemia Associated Vasculitis)

Cryoglobulinemia vasculitis (CV) is a systemic immune-mediated small vessel vasculitis. Rituximab proved effective on main vasculitis signs, with a complete clinical response of 65%. However, CV relapse is noted in up to 40% of patients. Following rituximab, serum Blys concentration significantly increased and may favor relapses. Tribeca is a multicentre randomized controled study comparing safety and efficacy of belimumab to placebo in non infectious cryoglobulinemia vasculitis.

Being tested
Belimumab, Placebo
Keywords
Belimumab, Vasculitis, Cryoglobulinemia, Non-infectious
Medical subject headings
Vasculitis, Cryoglobulinemia

What participants receive

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

  • BelimumabDrug

    Belimumab administered subcutaneously 200mg weekly from week 1 to week 24.

    Both arms will have the same corticosteroid tapering scheme, with an initial dose of 30 mg/day. The following schedule of reduction of prednisone will apply to both groups as long as the disease is inactive:

    • 30 mg/day week (W)0-W2,
    • 20 mg/day W2-W4
    • 15 mg/day W4-W6,
    • 10 mg/day W6-W8,
    • 5 mg/day W8-W10

    Between W10-W12 the strategy for stopping glucocorticoids is left to the investigator's discretion.

    Stopping glucocorticoid therapy at W12. At each step, the prednisone dose will be reduced only in the absence of signs of vasculitis activity.

  • PlaceboDrug

    Both arms will have the same corticosteroid tapering scheme, with an initial dose of 30 mg/day. The following schedule of reduction of prednisone will apply to both groups as long as the disease is inactive:

    • 30 mg/day week (W)0-W2,
    • 20 mg/day W2-W4
    • 15 mg/day W4-W6,
    • 10 mg/day W6-W8,
    • 5 mg/day W8-W10

    Between W10-W12 the strategy for stopping glucocorticoids is left to the investigator's discretion.

    Stopping glucocorticoid therapy at W12. At each step, the prednisone dose will be reduced only in the absence of signs of vasculitis activity.

Study groups in NCT04629144
Study groupRoleWhat they receive
BelimumabExperimentalBelimumab administered subcutaneously 200mg weekly from week 1 to week 24.
Receives: Drug: Belimumab
PlaceboPlacebo comparatorPlacebo of Belimumab administered subcutaneously weekly from week 1 to week 24.
Receives: Drug: Placebo

What is being measured

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

  1. Complete clinical response rate at week 25 with corticosteroid withdrawal at week 12

    Complete clinical response is defined by remission of all affected organs involved at baseline and the absence of clinical relapse.

    • Skin and articular remissions
    • Renal remission
    • Neurological remission
    • Digestive remission
    • Cardiac remission
    • Central nervous system remission
    • Pulmonary remission

    Measured: Week 25

Secondary outcomes (28)
  1. Safety W25

    Frequency and severity of adverse clinical events

    Measured: Week 25

  2. Safety W48

    Frequency and severity of adverse clinical events

    Measured: Week 48

  3. Response W13

    The complete clinical response is defined by the remission of all affected organs involved at baseline and the absence of clinical relapse.

    Partial clinical response The partial clinical response is defined by the improvement and / or remission of more than half of the organ involvement present at baseline and the absence of clinical relapse.

    No clinical response Patients with no clinical response at W4 will be defined by worsening of ulcers or cutaneous necrosis, worsening peripheral neurological involvement or by persistence of active renal involvement defined by persistence of proteinuria> 1.5 g / 24h or proteinuria/creatinuria <150 mg/mmol).

    Measured: Week 13

  4. Response W25

    The complete clinical response is defined by the remission of all affected organs involved at baseline and the absence of clinical relapse.

    Partial clinical response The partial clinical response is defined by the improvement and / or remission of more than half of the organ involvement present at baseline and the absence of clinical relapse.

    No clinical response Patients with no clinical response at W4 will be defined by worsening of ulcers or cutaneous necrosis, worsening peripheral neurological involvement or by persistence of active renal involvement defined by persistence of proteinuria> 1.5 g / 24h or proteinuria/creatinuria <150 mg/mmol).

    Measured: Week 25

  5. Response W48

    The complete clinical response is defined by the remission of all affected organs involved at baseline and the absence of clinical relapse.

    Partial clinical response The partial clinical response is defined by the improvement and / or remission of more than half of the organ involvement present at baseline and the absence of clinical relapse.

    No clinical response Patients with no clinical response at W4 will be defined by worsening of ulcers or cutaneous necrosis, worsening peripheral neurological involvement or by persistence of active renal involvement defined by persistence of proteinuria> 1.5 g / 24h or proteinuria/creatinuria <150 mg/mmol).

    Measured: Week 48

  6. Rate of cryoglobulinemia clearance W13

    cryoglobulinemia clearance

    Measured: Week 13

  7. Rate of cryoglobulinemia clearance W25

    cryoglobulinemia clearance

    Measured: Week 25

  8. Rate of cryoglobulinemia clearance W48

    cryoglobulinemia clearance

    Measured: Week 48

  9. rheumatoid factor activity W13

    negativation of rheumatoid factor activity

    Measured: Week 13

  10. rheumatoid factor activity W25

    negativation of rheumatoid factor activity

    Measured: Week 25

  11. rheumatoid factor activity W48

    negativation of rheumatoid factor activity

    Measured: Week 48

  12. C4 complement level W13

    normalization of C4 complement level

    Measured: Week 13

  13. C4 complement level W25

    normalization of C4 complement level

    Measured: Week 25

  14. C4 complement level W48

    normalization of C4 complement level

    Measured: Week 48

  15. Early failures

    Rate of early failures (non clinical response at W5) Patients with no clinical response at W4 will be defined by worsening of ulcers or cutaneous necrosis, worsening peripheral neurological involvement or by persistence of active renal involvement defined by persistence of proteinuria> 1.5 g / 24h or proteinuria/creatinuria <150 mg/mmol,).

    Measured: Week 5

  16. Clinical relapse rate W48

    Relapse is defined as de novo appearance or recurrence of a manifestation of cryoglobulinemia vasculitis

    Measured: Week 48

  17. Prednisone W25

    Cumulative dose of prednisone

    Measured: Week 25

  18. Prednisone W48

    Cumulative dose of prednisone

    Measured: Week 48

  19. Gammaglobulin

    Measured: Baseline

  20. Gammaglobulin

    Measured: Week 48

  21. CD19+

    Measured: Baseline

  22. CD19+

    Measured: Week 48

  23. Quality of life W25

    Quality of life score SF-36. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability. To calculate the scores it is necessary to purchase special software for the commercial version, but no special software is needed for the RAND-36 version. Pricing depends on the number of scores that the researcher needs to calculate.

    The eight sections are:

    vitality physical functioning bodily pain general health perceptions physical role functioning emotional role functioning social role functioning mental health

    Measured: Week 25

  24. Quality of life W48

    Quality of life score SF-36. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability. To calculate the scores it is necessary to purchase special software for the commercial version, but no special software is needed for the RAND-36 version. Pricing depends on the number of scores that the researcher needs to calculate.

    The eight sections are:

    vitality physical functioning bodily pain general health perceptions physical role functioning emotional role functioning social role functioning mental health

    Measured: Week 48

  25. Infections

    Rate of infections

    Measured: Week 48

  26. BVAS activity W13

    BVAS activity score as defined in Flossmann, Oliver, et al. "Development of comprehensive disease assessment in systemic vasculitis." Postgraduate medical journal 84.989 (2008): 143-152.

    Measured: Week 13

  27. BVAS activity W25

    BVAS activity score as defined in Flossmann, Oliver, et al. "Development of comprehensive disease assessment in systemic vasculitis." Postgraduate medical journal 84.989 (2008): 143-152.

    Measured: Week 25

  28. BVAS activity W48

    BVAS activity score as defined in Flossmann, Oliver, et al. "Development of comprehensive disease assessment in systemic vasculitis." Postgraduate medical journal 84.989 (2008): 143-152.

    Measured: Week 48

Timeline

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

  1. First posted16 Nov 2020
  2. Study start20 Oct 2021
  3. Primary completion20 Apr 2025 (estimated)
  4. Study completion20 Oct 2025 (estimated)

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
Masking
Double blind
Who is masked
Participant, Care provider
Enrolment
48 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04629144
Sponsor's protocol ID
APHP180351
Acronym
TRIBECA
Status last verified
Jun 2024
First submitted
9 Nov 2020
Last updated
26 Jun 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Belimumab in people with Vasculitis and Cryoglobulinemia, run by Assistance Publique - Hôpitaux de Paris at 20 sites in France.

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 15 inclusion and 27 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: status not confirmed, as of the sponsor's last update on 26 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in France. 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact David Saadoun, MD PhD (142499742 ext. 33, david.saadoun@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Complete clinical response rate at week 25 with corticosteroid withdrawal at week 12 (time frame: Week 25). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 26 Jun 2024.

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