Clinical trial NCT06375005: Efficacy and Safety of Telitacicept in the Treatment of Systemic Sclerosis
Official title: The Efficacy and Safety of Telitacicept in the Treatment of Early Diffuse Cutaneous Systemic Sclerosis: a Multicenter, Open-label, Randomized Controlled Study
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE2
Conditions: Diffuse Cutaneous Systemic Sclerosis
Lead sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University
Sponsor class: OTHER
First posted: 2024-04-19
Enrollment: 38
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study is a prospective, open-label, randomized, controlled, multi-center clinical trial. The aim of this study is to investigate the efficacy and safety of Telitacicept in adults with early diffuse cutaneous systemic sclerosis (dcSSc), with Mycophenolate Mofetil (MMF) administered as a background treatment.


Eligibility criteria: Inclusion Criteria:

* Men or women aged 18-70 years old.
* Systemic sclerosis, as defined by ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) 2013 criteria.
* dcSSc (diffuse cutaneous systemic sclerosis) according to the LeRoy criteria.
* Disease duration of ≤ 18 months (defined as time from the first non-Raynaud's phenomenon manifestation).
* ≥ 10 mRSS units at the screening visit.
* Negative serum pregnancy test in a woman of childbearing potential at the screening visit.
* Ability to render informed consent in accordance with institutional guidelines.

Exclusion Criteria:

* Limited scleroderma.
* Disease duration of greater than 3 years.
* Rheumatic autoimmune disease other than SSc.
* Systemic sclerosis-like illness associated with environmental agents such as vinyl chloride, or bleomycin.
* Any prior history of renal crisis.
* Intermediate- or high-risk pulmonary arterial hypertension.
* Pulmonary disease with FVC \< 50% of predicted or DLCO (hemoglobin-corrected) \< 40% of predicted at screening or requires oxygen therapy.
* Underwent major surgery within 8 weeks prior to randomization or planned major surgery during the trial period.
* Use of immunosuppressive therapies, including methotrexate, azathioprine, hydroxychloroquine, leflunomide, tacrolimus, sirolimus, and mycophenolate mofetil within 4 weeks prior to randomization, and cyclophosphamide within 3 months prior to randomization.
* Use of other anti-fibrotic agents, including colchicine, D-penicillamine, thalidomide, nintedanib, pirfenidone, tyrosine kinase inhibitors (imatinib, nilotinib, dasatinib) within 4 weeks prior to randomization.
* Use of corticosteroids at doses exceeding the equivalent of prednisone 10 mg daily, or intravenous and intramuscular corticosteroid injections within 4 weeks prior to randomization.
* Use of Intravenous Immunoglobulin (IVIG) within 12 weeks within 4 weeks prior to randomization.
* Prior use of belimumab, rituximab, or other B-Cell depleting therapies ever.
* Use of other biologics or small molecule targeted therapies, including anakinra within 1 week prior to randomization, ixekizumab within 2 weeks prior to randomization, and infliximab, certolizumab pegol, golimumab, adalimumab, abatacept, tocilizumab within 8 weeks prior to randomization, and janus kinase inhibitors within 2 weeks prior to randomization.
* Prior use of other cell depletion therapies.
* Concurrent serious medical condition which in the opinion of the investigator makes the patient inappropriate for this study such as severe central nervous system disease，severe heart failure, arrhythmia, unstable atherosclerotic cardiovascular disease, severe GI involvement, severe hypertension or severe diabetes.
* Abnormal results in hepatitis B or hepatitis C testing indicating active or chronic infection.
* Active tuberculosis (TB) or latent TB infection.
* Seropositive for human immunodeficiency virus (HIV) or known history of HIV infection.
* Known active bacterial, viral, fungal, mycobacterial, or other infection，including major episode of infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of screening, or oral antibiotics within 2 weeks prior to screening.
* Primary or secondary immunodeficiency.
* IgA deficiency (\<10 mg/dL) or IgG deficiency (\<400 mg/dL).
* Participation in another clinical research study involving the evaluation of another investigational drug within 3 months of entry into this study.
* Any of the following at the screening visit: Hemoglobin \<8.0 g/dL; WBC \<3 x 10\^9/L; Neutrophil \<1.5 x 10\^9/L; platelets \<75 x 10\^9/L; serum ALT or AST \> 1.5 x ULN; TBil \> ULN; eGFR \< 40mL/min/1.73m\^2.
* Malignant disease within 5 years prior to screening, with the exception of excised/cured local basal or squamous cell carcinoma of the skin or carcinoma in situ of the uterine cervix;
* Immunization with a live/attenuated vaccine within 4 weeks prior to randomization.
* Pregnant or breast feeding women or women of childbearing potential not willing to use adequate contraception.
* History of allergic or anaphylactic reactions to human, humanized, or murine monoclonal antibodies.
* Immunization with a live/attenuated vaccine within 4 weeks prior to randomization.
* Patients anticipated to be non-compliant with the protocol requirements or expected not to complete the trial as planned (e.g., those with psychiatric disorders, history of alcohol abuse, drug abuse, or substance misuse).

Primary outcomes:
measure: Change From Baseline in Modified Rodnan Skin Score (mRSS) at Week 48
timeFrame: Baseline, Week 48
measure: Percentage of Participants With Treatment-related Adverse Events (AEs) and Serious Adverse Events (SAEs)
timeFrame: Week 52
Secondary outcomes:
measure: Change From Baseline in Modified Rodnan Skin Score (mRSS) at Week 24
timeFrame: Baseline, Week 24
measure: Percentage of Participants Who Improved in Modified Rodnan Skin Score (mRSS) by ≥20%, ≥40%, ≥60% From Baseline to Week 24 and Week 48
timeFrame: Baseline, Week 24 and 48
measure: American College of Rheumatology Composite Response Index for Systemic Sclerosis (ACR-CRISS) and Revised ACR-CRISS at Week 24 and 48
timeFrame: Week 24 and 48
measure: Change From Baseline in Forced Vital Capacity (FVC) Percent Predicted at Week 24 and Week 48
timeFrame: Week 24 and 48
measure: Change From Baseline in Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) Percent Predicted (Corrected For Hemoglobin) at Week 24 and Week 48
timeFrame: Week 24 and 48
measure: Change From Baseline in Patient's Global Assessment at Week 24 and Week 48
timeFrame: Baseline, Week 24 and 48
measure: Change From Baseline in Physician's Global Assessment at Week 24 and Week 48
timeFrame: Baseline, Week 24 and 48
measure: Change From Baseline in Short Form-36 (SF-36) Questionnaire at Week 24 and Week 48
timeFrame: Baseline, Week 24 and 48
measure: Change From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI) Score at Week 24 and Week 48
timeFrame: Baseline, Week 24 and 48
measure: Change From Baseline in Physical Function Assessed by Scleroderma Health Assessment Questionnaire Disability Index (SHAQ-DI) at Week 24 and Week 48
timeFrame: Baseline, Week 24 and 48
measure: Change From Baseline in Tender Joint Counts at Week 24 and Week 48
timeFrame: Baseline, Week 24 and 48
measure: Change From Baseline in Swollen Joint Counts at Week 24 and Week 48
timeFrame: Baseline, Week 24 and 48
measure: Change From Baseline in Digital Ulcer Counts at Week 24 and Week 48
timeFrame: Baseline, Week 24 and 48
Other outcomes:
Locations:
city: Yangzhou
country: China
facility: Affiliated Hospital of Yangzhou University
state: Jiangsu
city: Shanghai
country: China
facility: Huashan Hospital of Fudan University
state: Shanghai
city: Hangzhou
country: China
facility: Hangzhou First People's Hospital
state: Zhejiang
city: Hangzhou
country: China
facility: Sir Run Run Shaw Hospital, Zhejiang University School Of Medicine
state: Zhejiang
city: Hangzhou
country: China
facility: The Second Affiliated Hospital of Zhejiang University School of Medicine
state: Zhejiang
city: Huzhou
country: China
facility: Changxing People's Hospital
state: Zhejiang
city: Jiaxing
country: China
facility: The First Hospital of Jiaxing
state: Zhejiang
city: Ningbo
country: China
facility: Ningbo First Hospital
state: Zhejiang
city: Wenzhou
country: China
facility: The First Affiliated Hospital of Wenzhou Medical University
state: Zhejiang
Study officials:
affiliation: Second Affiliated Hospital, School of Medicine, Zhejiang University
name: JING XUE, PhD
role: PRINCIPAL_INVESTIGATOR
References: