Overview

Efficacy and Safety Study of Sirukumab in Patients With Giant Cell Arteritis

Status:
Terminated
Trial end date:
2018-03-21
Target enrollment:
0
Participant gender:
All
Summary
Sirukumab is a fully human anti-interleukin-6 (IL-6) immunoglobulin G1-kappa with a high affinity and specificity for binding to the human IL-6 molecule that may have therapeutic benefit in the treatment of giant cell arteritis (GCA) by interruption of multiple pathogenic pathways. Sirukumab inhibits IL-6-mediated signal transducer and activator of transcription 3 (STAT3) phosphorylation, resulting in the inhibition of the biological effect of IL-6. This study will evaluate the efficacy and safety of sirukumab to characterize the benefit-to-risk profile of sirukumab in the treatment of active GCA. The study will be conducted in 2 distinct parts (Part A and Part B) and consists of the following phases: Screening phase, Part A: 52-week double-blind treatment phase, Part B: 104-week extension phase with the option to receive open-label sirukumab based on disease status and a 16-week follow-up phase if applicable. Approximately 204 subjects with a diagnosis of GCA and active disease within 6 weeks of baseline will be randomized into Part A, the 52-week double-blind treatment phase, to receive one of two doses of sirukumab or placebo, each in addition to a pre-specified prednisone taper. The efficacy and safety of sirukumab in sustaining remission will be assessed at Week 52. Subjects completing Part A of the study will be eligible to enter Part B, the 104-week extension phase, designed to investigate the long-term maintenance of remission and safety following cessation of sirukumab treatment and to assess long-term corticosteroid use. Subjects with active GCA at the end of Part A or those with new onset of GCA flare during the first 52 weeks of Part B will be eligible to receive open-label sirukumab. Subjects will need to have follow-up safety evaluations for at least 16 weeks after receiving the last dose of study drug, applicable only for those who are withdrawn prematurely from the study or whose open-label sirukumab treatment in Part B completes after Week 88.
Phase:
Phase 3
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
GlaxoSmithKline
Treatments:
Antibodies, Monoclonal
Prednisone
Criteria
Inclusion Criteria:

- Diagnosis of GCA defined by the following Revised GCA Diagnosis Criteria:

Age >=50 years. History of ESR >=50 millimeter/hour (mm/hour) or CRP >=2.45
milligram/deciliter(mg/dL).

Presence of at least one of the following: Unequivocal cranial symptoms of GCA; Unequivocal
symptoms of polymyalgia rheumatic (PMR).

Presence of at least one of the following: Temporal artery biopsy revealing features of
GCA; Evidence of large-vessel vasculitis by angiography or cross-sectional imaging.

- Active GCA within 6 weeks of Randomization (Baseline) where active disease is defined
by an ESR >=30 mm/hr or CRP >=1 mg/dL AND the presence of at least one of the
following:

Unequivocal cranial symptoms of GCA; Unequivocal symptoms of PMR; Other features judged by
the clinician investigator to be consistent with GCA or PMR flares.

- At screening, receiving or able to receive prednisone 20-60 mg/day for the treatment
of active GCA.

- Clinically stable GCA disease at baseline such that the subject is able to safely
participate in the blinded prednisone taper regimen in the opinion of the
investigator.

- Practicing acceptable methods of birth control if a female of child-bearing potential.

- No evidence of active or latent infection with Mycobacterium tuberculosis (TB).

Exclusion Criteria:

- Are pregnant or breastfeeding.

- Recent (within the past 12 weeks) or planned major surgery that would impact on study
procedures or assessments.

- Organ transplantation recipients (except corneas within 3 months prior to baseline
visit).

- Had prior treatment with any of the following:

Systemic immunosuppressives) within 4 weeks of baseline; Biologic agents targeted at
reducing tumor necrosis factor-alpha (TNF-alpha) within 2-8 weeks of baseline, depending on
the agent; Any prior use of tocilizumab or other anti-IL-6 agents; B-cell depleting agents
(eg, rituximab) within 12 months prior to baseline or longer if B cell counts have not
returned to normal range or baseline levels; Cytotoxic drugs such as cyclophosphamide,
chlorambucil, nitrogen mustard, or other alkylating agents within 4 weeks of baseline;
Abatacept within 8 weeks of baseline; Tofacitinib within 4 weeks of baseline; Methotrexate
use within 2 weeks of baseline.

Methylprednisolone > 100 mg/day intravenous (IV) (or equivalent) within 8 weeks of
baseline.

- History of severe allergic reactions to monoclonal antibodies, human proteins, or
excipients.

- Evidence of serious concomitant disease, which in the opinion of the investigator
makes them unsuitable for participation in the study.

- Major ischemic event, unrelated to GCA, within 12 weeks of screening.

- Marked baseline prolongation of corrected QT (QTc) interval >= 450 milliseconds (msec)
(QTc by Bazett's formula [QTcB ]or QTc by Fridericia's formula [QTcF] ), history of
Torsade de Pointes, family history of long QT syndrome, history of second or third
degree heart block.

- Current liver disease that could interfere with the trial

- History of or current active diverticulitis, inflammatory bowel disease, or other
symptomatic gastrointestinal tract condition that might predispose to bowel
perforation.

- History of known demyelinating diseases such as multiple sclerosis or optic neuritis.

- Active infections, or history of recurrent infections or have required management of
acute or chronic infections, as follows:

Currently on any suppressive therapy for a chronic infection, history or suspicion of
chronic infection, hospitalization for treatment of infection within 60 days of the
baseline visit, or use of parenteral (IV) or intra-muscular [IM]) antimicrobials within 60
days of baseline or oral antimicrobials within 30 days of baseline

- Primary or secondary immunodeficiency or any other autoimmune disease.

- Human immunodeficiency virus (HIV) infection, hepatitis C or hepatitis B infection

- Live virus or bacterial vaccination within 3 months before the first administration of
study drug