UMIN-CTR Clinical Trial

BACK TOP
UMIN-CTR English Home Glossary (Simple) FAQ Search clinical trials

Name:
UMIN ID:

Recruitment status Preinitiation
Unique ID issued by UMIN UMIN000031259
Receipt No. R000035689
Scientific Title Glucocorticoid-tapering aimed maintenance therapy in patients with systemic lupus erythematosus
Date of disclosure of the study information 2018/03/01
Last modified on 2018/02/12

* This page includes information on clinical trials registered in UMIN clinical trial registed system.
* We don't aim to advertise certain products or treatments


Basic information
Public title Glucocorticoid-tapering aimed maintenance therapy in patients with systemic lupus erythematosus
Acronym BLISS-POST
Scientific Title Glucocorticoid-tapering aimed maintenance therapy in patients with systemic lupus erythematosus
Scientific Title:Acronym BLISS-POST
Region
Japan

Condition
Condition systemic lupus erythematosus
Classification by specialty
Clinical immunology
Classification by malignancy Others
Genomic information NO

Objectives
Narrative objectives1 This study is a clinical trial aiming to taper and discontinue glucocorticoid (GC) using belimumab in patients with systemic lupus erythematosus (SLE) and low disease activity. Following induction therapy, at least 3 years of immunosuppressive maintenance treatment is recommended to optimize outcomes and lupus maintenance treatment should aim for the lowest glucocorticoid dosage needed to control disease, and if possible.
On the other hand, accumulated evidence indicates the good safety and efficacy profile of belimumab in SLE for the maintenance therapy. Also, belimumab reduces serum soluble BAFF concentrations and thereby allows autoimmune B cells to undergo apoptosis, preventing escape and proliferation of new or existing autoimmune B-cell clones. We, therefore, have hypothesized that by the use of belimumab, the tapering of GC in patients with maintenance phase of SLE.
Within this context, this study is conducted with the goal of discontinuation of GC using belimumab for the maintenance phase of SLE treatments. In addition, peripheral blood immune phenotype, biomarkers, and autoantibodies will be evaluated to identify patients who will be able to withdraw GC. The result of study will not only reveal the appropriate treatment for lupus SLE patients after achieving remission, but also contribute to improvement of economic problems including reduction of medical expenses. If this study worked well, enormous benefit and flexibilitiy would be brought to many patients with SLE and other autoimmune diseases who are treated with GC.
Basic objectives2 Efficacy
Basic objectives -Others
Trial characteristics_1
Trial characteristics_2
Developmental phase

Assessment
Primary outcomes Proportion of subjects who achieve glucocorticoid free [Time Frame: Week 52]
Key secondary outcomes Secondary endpoints
1) Score of SELENA-SLEDAI [Time Frame: Week 24 and 52]
2) Mean changes from baseline in Physician's Global Assessment (PGA) using visual analogue scale (VAS) [Time Frame: Week 24 and 52]
3) Mean dose of glucocorticoids (Last Observation Carried Forward)
4) Annualized flare rate with flare defined as SELENA - SLEDAI score > 4 points [Time Frame: Week 52]

Exploratory endpoints
1) The mean duration, subjects achieve 50% dose reduction of glucocorticoid [Time Frame: Week 52]
2) The immunophenotype of peripheral blood by flow cytometric analysis [Time Frame: Week 52]
3) The differences of immunophenotype, biomarkers, and autoantibodies between the patients who could achieve glucocorticoid free and the patients who could not achieve glucocorticoid free [Time Frame: Week 52]

Base
Study type Observational

Study design
Basic design
Randomization
Randomization unit
Blinding
Control
Stratification
Dynamic allocation
Institution consideration
Blocking
Concealment

Intervention
No. of arms
Purpose of intervention
Type of intervention
Interventions/Control_1
Interventions/Control_2
Interventions/Control_3
Interventions/Control_4
Interventions/Control_5
Interventions/Control_6
Interventions/Control_7
Interventions/Control_8
Interventions/Control_9
Interventions/Control_10

Eligibility
Age-lower limit
18 years-old <=
Age-upper limit

Not applicable
Gender Male and Female
Key inclusion criteria a) Diagnosed as SLE by American College of Rheumatology (ACR) classification criteria.
b) Patients who have low disease activity (SELENA-SLEDAI < 4 points)
c) Receipt of low dose GC (no more than prednisolone equivalent 10 mg) over 30 days
d) Receipt of HCQ and/or other immunosuppressive drug such as Azathioprine and MMF over 30 days.
Key exclusion criteria a) Patients who contraindicated by package insert of BLM.
b) Receipt of B cell depleted therapy (biologic agent) within 1 year.
c) Receipt of cyclophosphamide (Endoxan) within 6 months.
d) Receipt of high dose GC (prednisolone equivalent 1mg/kg) within 6 months.
e) Receipt of plasma exchange within 6 months.
f) Have developed clinical evidence of significant, unstable or uncontrolled, acute or chronic diseases not due to SLE (i.e., cardiovascular, pulmonary, hematologic, gastrointestinal, hepatic, renal, neurological, malignancy or infectious diseases).
g) Have developed any other medical diseases (e.g., cardiopulmonary), laboratory abnormalities, or conditions (e.g., poor venous access) that in the opinion of the principal investigator, makes the subject unstable for the study.
Target sample size 100

Research contact person
Name of lead principal investigator
1st name
Middle name
Last name Yoshiya Tanaka
Organization School of Medicine, University of Occupational and Environmental Health, Japan
Division name First Department of Internal Medicine
Zip code
Address 1-1, Iseigaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
TEL 093-603-1611
Email tanaka@med.uoeh-u.ac.jp

Public contact
Name of contact person
1st name
Middle name
Last name Satoshi Kubo
Organization School of Medicine, University of Occupational and Environmental Health, Japan
Division name First Department of Internal Medicine
Zip code
Address 1-1, Iseigaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
TEL 093-603-1611
Homepage URL
Email kubosato@med.uoeh-u.ac.jp

Sponsor
Institute First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Institute
Department

Funding Source
Organization Self funding
Organization
Division
Category of Funding Organization Self funding
Nationality of Funding Organization

Other related organizations
Co-sponsor
Name of secondary funder(s)

IRB Contact (For public release)
Organization
Address
Tel
Email

Secondary IDs
Secondary IDs NO
Study ID_1
Org. issuing International ID_1
Study ID_2
Org. issuing International ID_2
IND to MHLW

Institutions
Institutions

Other administrative information
Date of disclosure of the study information
2018 Year 03 Month 01 Day

Related information
URL releasing protocol
Publication of results Unpublished

Result
URL related to results and publications
Number of participants that the trial has enrolled
Results
Results date posted
Results Delayed
Results Delay Reason
Date of the first journal publication of results
Baseline Characteristics
Participant flow
Adverse events
Outcome measures
Plan to share IPD
IPD sharing Plan description

Progress
Recruitment status Preinitiation
Date of protocol fixation
2018 Year 01 Month 01 Day
Date of IRB
Anticipated trial start date
2018 Year 03 Month 01 Day
Last follow-up date
Date of closure to data entry
Date trial data considered complete
Date analysis concluded

Other
Other related information Every patient will start belimumab (intravenous) in addition to each current therapy. Then, concomitant GC will be reduced by half at week 8. At week 16, the dose of GC will be reduced by quarter. Thereafter, the patients will withdraw the concomitant GC at week 24 (For details of the test, see the figure below).

The disease activity will be evaluated regularly. The disease activity will be evaluated regularly. If the disease activity exacerbates (SELENA - SLEDAI score > 4 points) or judges that the attending doctor should stop the trial, the patients be withdrawn this clinical trial immediately. In that case, the dose of GC will be restored. However, further increase and addition of other medicines are also possible at the discretion of the attending physician.

In this study, immunophenotype of peripheral blood will be analysed by flow cytometry at baseline, week 24, and week 52.

Management information
Registered date
2018 Year 02 Month 12 Day
Last modified on
2018 Year 02 Month 12 Day


Link to view the page
URL(English) https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000035689

Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name


Contact us.