Anti-CD20 in Systemic Lupus Erythematosus

NCT ID: NCT00036491

Last Updated: 2017-11-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-01-31

Study Completion Date

2006-01-31

Brief Summary

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The purpose of this study is to determine the safety and effectiveness of rituximab (anti-CD20) in treating systemic lupus erythematosus (SLE).

White blood cells in the body called B cells give off substances that are active in promoting SLE disease. Researchers have found that anti-CD20 can block production of these substances in another disease. This study explores whether anti-CD20 will also be safe in people with SLE and whether it may be effective in treating SLE.

Detailed Description

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B cells clearly play an essential role in the pathogenesis of SLE since they produce autoantibodies. Clinical observations support the contention that intervening in the production of autoantibodies by the B lymphocyte will be effective therapy. Current approved therapy for B-cell non-Hodgkin's lymphoma includes anti-CD20. The results of anti-CD20 administration in SLE are anticipated to be similar to those in lymphoma patients. The current proposal explores the mechanisms and applicability of B-cell depletion as a potential treatment for SLE.

Participants receive 4 weekly infusions of study medication. Each participant is enrolled in the study for a total of 1 year with protocol visits weekly for the first 3 months, then every other week for the next 2 months, every month for the next 4 months, and every other month for the remaining 5 months of the study (Weeks 0, 1, 2, 3, 4, 5, 6, 7, 9, 11, 13, 15, 19, 23, 27, 31, 39, 47, and 55). Responses to exogenous antigens are measured; assessments for clinical response with SLE-disease activity score (SLEDEI) and systemic lupus activity measure (SLAM) score are performed. Participants complete a health questionnaire and a health survey and laboratory parameters are evaluated.

Conditions

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Lupus Erythematosus, Systemic

Keywords

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Systemic Lupus Erythematosus SLE B-Lymphocytes anti-CD20 rituximab

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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rituximab

375 mg/m\^2 administered intravenously

Group Type EXPERIMENTAL

Rituximab

Intervention Type DRUG

Subjects received four weekly infusions of rituximab at a dose of 375 mg/m\^2

Interventions

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Rituximab

Subjects received four weekly infusions of rituximab at a dose of 375 mg/m\^2

Intervention Type DRUG

Other Intervention Names

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Rituxan®

Eligibility Criteria

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Inclusion Criteria

People may be eligible for this study if they:

* Are 18 to 70 years of age
* Agree to use a reliable method of birth control during treatment and for 6 months after treatment ends
* Have SLE (by the American College of Rheumatology criteria)
* Have had SLE for at least 6 months prior to screening
* Have active SLE disease at the screening visit
* Have organ disease (lung, stomach, intestinal, blood, kidney, and/or heart)
* Have failed standard therapy, including at least 1 immunosuppressive agent, or have experienced side effects from an immunosuppressive agent that required discontinuation of treatment
* Meet blood, liver, and kidney laboratory values set by the protocol
* Have not taken an immunosuppressive agent for 2 weeks prior to the first treatment
* Have been on a stable dose of oral corticosteroids, if taking them, for 4 weeks before the first week's visit. Oral corticosteroids may be altered as medically necessary after enrollment.
* Have at least 1 elevated autoantibody level at screening visit.

Exclusion Criteria

People will not be eligible for this study if they:

* Are pregnant or breast-feeding
* Have heart, lung, nervous system, kidney, liver, stomach, intestinal, or other diseases that may place the patient at risk if participating in the trial
* Have cranial neuropathy (a condition affecting the head region)
* Are on blood-thinning agents to prevent blood clotting
* Have a serious skin disease
* Have a certain class of heart disease
* Have had cancer, unless surgically cured basal cell carcinoma or cervical dysplasia
* Have a long term serious infectious disease such as tuberculosis or a fungal infection that is now active, or active within 2 years of the baseline visit
* Have had HIV infection or another immunosuppressive state (chemotherapy or radiation therapy)
* Have received any experimental drug within 30 days of baseline visit
* Have received any monoclonal antibody or similar medication within 3 months of the baseline visit
* Received any intravenous, joint, or muscle injection of corticosteroids within 4 weeks of the baseline visit
* Abuse alcohol or drugs
* Are unwilling or unable to follow the protocol
* Have poor veins for receiving injections.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Autoimmunity Centers of Excellence

OTHER

Sponsor Role collaborator

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robert A. Eisenberg, MD

Role: STUDY_CHAIR

University of Pennsylvania

Locations

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University of Colorado

Denver, Colorado, United States

Site Status

University of Rochester

Rochester, New York, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Eisenberg R. Targeting B cells in SLE: the experience with rituximab treatment (anti-CD20). Endocr Metab Immune Disord Drug Targets. 2006 Dec;6(4):345-50. doi: 10.2174/187153006779025757.

Reference Type BACKGROUND
PMID: 17214580 (View on PubMed)

Sutter JA, Kwan-Morley J, Dunham J, Du YZ, Kamoun M, Albert D, Eisenberg RA, Luning Prak ET. A longitudinal analysis of SLE patients treated with rituximab (anti-CD20): factors associated with B lymphocyte recovery. Clin Immunol. 2008 Mar;126(3):282-90. doi: 10.1016/j.clim.2007.11.012. Epub 2008 Jan 15.

Reference Type BACKGROUND
PMID: 18226586 (View on PubMed)

Albert D, Dunham J, Khan S, Stansberry J, Kolasinski S, Tsai D, Pullman-Mooar S, Barnack F, Striebich C, Looney RJ, Prak ET, Kimberly R, Zhang Y, Eisenberg R. Variability in the biological response to anti-CD20 B cell depletion in systemic lupus erythaematosus. Ann Rheum Dis. 2008 Dec;67(12):1724-31. doi: 10.1136/ard.2007.083162. Epub 2008 Feb 4.

Reference Type RESULT
PMID: 18250115 (View on PubMed)

Related Links

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https://www.niaid.nih.gov

National Institute of Allergy and Infectious Diseases (NIAID)

Other Identifiers

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SACCC #ASL02

Identifier Type: OTHER

Identifier Source: secondary_id

UPenn #U1131s

Identifier Type: OTHER

Identifier Source: secondary_id

ACE Study #AC002

Identifier Type: OTHER

Identifier Source: secondary_id

DAIT AC002

Identifier Type: -

Identifier Source: org_study_id