Safety, Efficacy and Tolerability of Ianalumab Versus Placebo, Combination With SoC Therapy, in Participants With Active Lupus Nephritis

A Randomized, Double-blind, Parallel Group, Placebo-controlled, Multicenter Phase 3 Trial to Evaluate Efficacy, Safety and Tolerability of Ianalumab on Top of Standard-of-care Therapy in Participants With Active Lupus Nephritis (SIRIUS-LN).

ClinicalTrials.gov Identifier: NCT05126277

Novartis Reference Number: CVAY736K12301

Last Update: Feb 28, 2023

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All compounds are either investigational or being studied for (a) new use(s). Efficacy and safety have not been established. There is no guarantee that they will become commercially available for the use(s) under investigation. 

Study Description

This trial will evaluate efficacy, safety, and tolerability of subcutaneous (s.c.) ianalumab given every 4 weeks (q4w) or every 12 weeks (q12w) compared to placebo, in combination with SoC, in adult participants with active LN

Condition 
Lupus Nephritis
Phase 
Phase 3
Overall status 
Recruiting
Start date 
Jul 14, 2022
Completion date 
Jul 15, 2030
Gender 
All
Age(s)
18 Years and older (Adult, Older Adult)

Interventions

Drug
ianalumab s.c. q4w
ianalumab s.c. q4w in addition to SoC
Drug
ianalumab s.c. q12w
ianalumab s.c. q12w in addition to SoC
Drug
placebo s.c.
placebo s.c. q4w in addition to SoC

Eligibility Criteria

Inclusion Criteria:

Participants eligible for inclusion in this study must meet all of the following criteria:

Adult male and female participants aged 18 years or older at the time of screening
Weigh at least 35 kg at screening
Have a confirmed clinical diagnosis of SLE according to European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) Systemic Lupus Erythematosus (SLE) classification criteria
Have a positive anti-nuclear antibody (ANA) test result; ANA titer ≥ 1:80 at screening visit based on central or local laboratory result
Active LN at screening, as defined by meeting the 3 following criteria:
Renal biopsy within 6 months prior to screening period indicating ISN/RPS class III or IV active glomerulonephritis with or without co-existing class V features, or pure class V membranous LN. If no biopsy was performed within 6 months prior to screening period, a biopsy will need to be performed during the screening period after having met all other inclusion/exclusion criteria.
UPCR ≥ 1.0 g/g on 24h urine collection at Screening
eGFR ≥ 25mL/min/1.73 m2. Participants with eGFR < 30 mL/min/1.73 m2 require renal biopsy during the screening period showing sclerosis in ≤ 50% of glomeruli

Newly diagnosed participants as well as pre-treated LN participants (including refractory cases) can be included, as long as they are currently on, or willing to initiate SoC induction therapy for LN using MPA

Induction therapy, as defined by treatment including both high dose corticosteroids and MPA, should be initiated prior to or on day of randomization
Anti-malarial treatment at stable dosing prior to randomization is strongly recommended, in the absence of contraindications
Participants on azathioprine treatment at Screening must be switched to MPA prior to randomization
Receipt of at least one dose of pulse methylprednisolone i.v. (250 - 1000 mg per day up to 3000 mg cumulative dose) or equivalent for treatment of current episode of active LN within 60 days prior randomization.
Able to communicate well with the Investigator to understand and comply with the requirements of the study

Exclusion Criteria:

Participants meeting any of the following criteria are not eligible for inclusion in this study:

Severe renal impairment as defined by i.) presence of oliguria (defined as a documented urine volume < 400 mL/24 hrs) or ii.) End-Stage Renal Disease (ESRD) requiring dialysis or transplantation
Sclerosis in > 50% of glomeruli on renal biopsy
Use of other investigational drugs within 5 half-lives of enrollment, or within 30 days or until the expected pharmacodynamic effect has returned to baseline
Prior use of any B cell depleting therapy within 36 weeks prior to randomization or if therapy was administered < 36 weeks prior to randomization B cell count less than the lower limit of normal or patient's own baseline value prior to having received an earlier B cell-depleting therapy

Prior treatment with any of the following within 12 weeks prior to randomization

Belimumab, telitacicept, abatacept, TNF-α mAb, immunoglobulins (i.v./s.c.) plasmapheresis
Any other immuno-suppressants (i.v. or oral cyclophosphamide, calcineurin inhibitors, JAK inhibitors or other kinase inhibitors)
Thalidomide treatment and/or one of the following DMARDs: methotrexate or an imidazole derivative (e.g., mizoribine)
Receipt of more than 3000 mg i.v. pulse methylprednisolone (cumulative dose) within 12 weeks prior to randomization
History of major organ transplant or hematopoietic stem cell/bone marrow transplant or are due to receive transplantation

Any one of the following laboratory values at screening:

Hemoglobin levels < 8.0 g/dL (< 5 mmol/L), or < 7.0 g/dL (< 4.3 mmol/L) if related to participant's SLE such as in active hemolytic anaemia
Platelet count < 25 x 1000/µL
Absolute neutrophil count (ANC) < 0.8 x 1000/µL
Active viral, bacterial or other infections requiring systemic treatment at the time of screening, or history of recurrent clinically significant infection
History of known intolerance/hypersensitivity to MPA, oral corticosteroids, or any component of the study drug(s) or its excipients
Receipt of live/attenuated vaccine within a 4-week period prior to randomization
History of primary or secondary immunodeficiency, including a positive HIV test result
History of malignancy of any organ system (other than localized basal cell carcinoma or squamous cell carcinoma of the skin or or in-situ cervical cancer), treated or untreated, within the past 5 years, regardless of whether there is evidence of local recurrence or metastases
Any surgical, medical (e.g., uncontrolled hypertension, heart failure or diabetes), psychiatric or additional physical condition that the Investigator feels may jeopardize the participants in case of participation in this study
Chronic infection with hepatitis B (HBV) or hepatitis C (HCV). Positive serology for hepatitis B surface antigen (HBsAg) excludes the participant
Evidence of active tuberculosis (TB) infection (after anti-TB treatment, participants with history of TB may become eligible according to national local guidelines)
Pregnant or nursing (lactating) women
Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception during dosing and for 6 months after stopping of investigational medication
Sexually active male participants, who do not agree to use barrier protection during intercourse with women of child-bearing potential while taking study treatment

Other protocol -defined Inclusion/Exclusion may apply.

Study Locations

United States
Novartis Investigative Site
Recruiting
Lawrenceville, 30044
Georgia
United States
Novartis Investigative Site
Recruiting
Kansas City, 66160
Kansas
United States
Novartis Investigative Site
Recruiting
Detroit, 48201
Michigan
United States
Novartis Investigative Site
Recruiting
Fairfax, 22033
Virginia
United States
Brazil
Novartis Investigative Site
Recruiting
Salvador, 40150 150
BA
Brazil
Novartis Investigative Site
Recruiting
Vitoria, 29055 450
ES
Brazil
Novartis Investigative Site
Recruiting
Curitiba, 80440-020
PR
Brazil
Novartis Investigative Site
Recruiting
Porto Alegre, 90035-003
RS
Brazil
Chile
Novartis Investigative Site
Recruiting
Santiago, 7500922
RM
Chile
China
Novartis Investigative Site
Recruiting
Guangzhou, 510000
Guangdong
China
Novartis Investigative Site
Recruiting
Guangzhou, 51000
Guangdong
China
Novartis Investigative Site
Recruiting
Guangzhou, 510280
Guangdong
China
Novartis Investigative Site
Recruiting
Shantou, 515041
Guangdong
China
Novartis Investigative Site
Recruiting
Shenzhen, 518037
Guangdong
China
Novartis Investigative Site
Recruiting
Zhanjing, 524000
Guangong
China
Novartis Investigative Site
Recruiting
Haikou, 570311
Hainan
China
Novartis Investigative Site
Recruiting
Nanchang, 330006
Jiangxi
China
Novartis Investigative Site
Recruiting
Binzhou, 256603
Shandong
China
Novartis Investigative Site
Recruiting
Chengdu, 610041
Sichuan
China
Novartis Investigative Site
Recruiting
Beijing, 100034
-
China
Novartis Investigative Site
Recruiting
Guang Zhou, 510080
-
China
Czech Republic
Novartis Investigative Site
Recruiting
Olomouc, 779 00
Czech Republic
Czech Republic
Novartis Investigative Site
Recruiting
Prague 2, 128 50
-
Czech Republic
Germany
Novartis Investigative Site
Recruiting
Regensburg, 93053
Bavaria
Germany
Novartis Investigative Site
Recruiting
Aachen, 52074
-
Germany
Novartis Investigative Site
Recruiting
Herne, 44625
-
Germany
Novartis Investigative Site
Recruiting
Muenster, 48149
-
Germany
Hungary
Novartis Investigative Site
Recruiting
Budapest, 1097
-
Hungary
Novartis Investigative Site
Recruiting
Debrecen, 4032
-
Hungary
Novartis Investigative Site
Recruiting
Kaposvar, 7400
-
Hungary
Korea, Republic of
Novartis Investigative Site
Recruiting
Bundang Gu, 13620
Gyeonggi Do
Korea, Republic of
Novartis Investigative Site
Recruiting
Suwon si, 16499
Gyeonggi Do
Korea, Republic of
Novartis Investigative Site
Recruiting
Daejeon, 35015
Korea
Korea, Republic of
Novartis Investigative Site
Recruiting
Seoul, 05505
Korea
Korea, Republic of
Novartis Investigative Site
Recruiting
Busan, 602 715
-
Korea, Republic of
Novartis Investigative Site
Recruiting
Daegu, 705 718
-
Korea, Republic of
Novartis Investigative Site
Recruiting
Gwangju, 61469
-
Korea, Republic of
Novartis Investigative Site
Recruiting
Seoul, 03722
-
Korea, Republic of
Novartis Investigative Site
Recruiting
Seoul, 04763
-
Korea, Republic of
Novartis Investigative Site
Recruiting
Seoul, 05030
-
Korea, Republic of
Novartis Investigative Site
Recruiting
Seoul, 06591
-
Korea, Republic of
Malaysia
Novartis Investigative Site
Recruiting
Sibu, 96000
Sarawak
Malaysia
Novartis Investigative Site
Recruiting
Kuala Terengganu, 20400
Terengganu
Malaysia
Novartis Investigative Site
Recruiting
Kuala Lumpur, 50589
-
Malaysia
Mexico
Novartis Investigative Site
Recruiting
Leon, 37160
Guanajuato
Mexico
Novartis Investigative Site
Recruiting
Monterrey, 64440
Nuevo Leon
Mexico
Novartis Investigative Site
Recruiting
Oaxaca, 68020
-
Mexico
Novartis Investigative Site
Recruiting
Queretaro, 76000
-
Mexico
Novartis Investigative Site
Recruiting
Queretaro, 76070
-
Mexico
Romania
Novartis Investigative Site
Recruiting
Oradea, 410619
Jud. Bihor
Romania
Novartis Investigative Site
Recruiting
Ramnicu Valcea, 240672
Valcea
Romania
Novartis Investigative Site
Recruiting
Bucharest, 022328
-
Romania
Novartis Investigative Site
Recruiting
Cluj Napoca, 400006
-
Romania
Novartis Investigative Site
Recruiting
Timisoara, 300736
-
Romania
Singapore
Novartis Investigative Site
Recruiting
Singapore, 169608
-
Singapore
Novartis Investigative Site
Recruiting
Singapore, 308433
-
Singapore
Spain
Novartis Investigative Site
Recruiting
Barcelona, 08003
Catalunya
Spain
Novartis Investigative Site
Recruiting
Valencia, 46017
Comunidad Valenciana
Spain
Novartis Investigative Site
Recruiting
El Palmar, 30120
Murcia
Spain
Novartis Investigative Site
Recruiting
La Laguna, 38320
Santa Cruz De Tenerife
Spain
Novartis Investigative Site
Recruiting
Madrid, 28040
-
Spain
Novartis Investigative Site
Recruiting
Madrid, 28041
-
Spain
Taiwan
Novartis Investigative Site
Recruiting
Kaohsiung City, 83301
-
Taiwan
Novartis Investigative Site
Recruiting
Taichung, 40447
-
Taiwan
Novartis Investigative Site
Recruiting
Taichung, 407
-
Taiwan
Novartis Investigative Site
Recruiting
Taipei, 11217
-
Taiwan
Thailand
Novartis Investigative Site
Recruiting
Hat Yai, 90110
Songkla
Thailand
Novartis Investigative Site
Recruiting
Bangkok, 10330
-
Thailand
Novartis Investigative Site
Recruiting
Bangkok, 10400
-
Thailand
Novartis Investigative Site
Recruiting
Bangkok, 10700
-
Thailand
Novartis Investigative Site
Recruiting
Chiang Mai, 50200
-
Thailand
United Kingdom
Novartis Investigative Site
Recruiting
Bradford, BD9 6RJ
West Yorkshire
United Kingdom

Contacts

Name: 
Novartis Pharmaceuticals
Phone: 
Name: 
Novartis Pharmaceuticals
Phone: 

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Call 1-888-669-6682 or email [email protected]