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NCT01632241: EMBRACE

Efficacy and Safety of Belimumab in Black Race Patients With Systemic Lupus Erythematosus (SLE)

Completed Phase 4 Results posted Last updated 8 September 2021
What this trial tests

Phase 4 trial testing Placebo plus standard therapy in Systemic Lupus Erythematosus in 503 participants. Completed in 28 January 2019.

Timeline
19 February 2013
Primary endpoint
18 June 2018
28 January 2019

Quick facts

Lead sponsorHuman Genome Sciences Inc., a GSK Company
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment503
Start date19 February 2013
Primary completion18 June 2018
Estimated completion28 January 2019
Sites96 locations across France, Colombia, South Africa, United Kingdom, United States, Brazil

Drugs / interventions tested

Conditions studied

Sponsor

Human Genome Sciences Inc., a GSK Company — full company profile →

Who can join

18 and older, any sex, with Systemic Lupus Erythematosus. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Participants Achieving a Systemic Lupus Erythematosus Responder Index (SRI) Response Rate With the Modified Systemic Lupus Erythematosus Disease Activity Index- 2K (SLEDAI-2K) Scoring for Proteinuria at Week 52 [DB Phase] Primary · Week 52

SRI response is defined as \>=4 point reduction, from Baseline in safety of estrogen in Lupus National Assessment(SELENA)SLEDAI\[SS\] score (with modified SLEDAI-2K scoring for proteinuria \[PU\]), no worsening (increase of \<0.30 points from Baseline) in Physician's Global Assessment (PGA) and no new British Isles Lupus Assessment Group of SLE clinics(BILAG)A organ domain score \[ODS\] or 2 new BILAG B ODS compared with Baseline. Drop-outs and treatment failures were set to non-responders. Analysis performed using a logistic regression model for comparison between belimumab and placebo with c

GroupValue95% CI
Placebo (DB Phase)41.6
Belimumab 10 mg/kg (DB Phase)48.7
Percentage of Participants Achieving a SRI Response Rate With the Modified SLEDAI-2K Scoring for Proteinuria at Week 24 of OL Phase Primary · Week 24 of OL phase (Week 76)

SRI response is defined as \>=4 point reduction, from OL Baseline in SS score (with the modified SLEDAI-2K scoring for PU), no worsening (increase of \<0.30 points from OL Baseline) in PGA and no new BILAG A ODS or 2 new BILAG B ODS compared with OL Baseline. For participants switching from placebo to belimumab 10 mg/kg IV in the OL phase, Baseline was defined as the last assessment at the end of the double-blind phase (i.e. Week 52) pre-OL treatment. For participants that received belimumab 10 mg/kg IV during the double-blind phase and continued to receive belimumab 10 mg/kg IV during the OL

GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)18.8
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)73.6
Number of Participants With Non-serious Adverse Events (nSAEs) and Serious Adverse Event (SAEs) [OL Phase] Primary · Week 52 to Week 84

An adverse event (AE) is any untoward medical occurrence in a clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. SAE is defined as any untoward medical occurrence that; results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect, other situations judged by physician, is associated with liver injury and impaired liver function. Number of participants who had common nSAEs (\>

nSAEs
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)23
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)49
SAEs
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)6
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)13
Number of Participants With Severe AEs [OL Phase] Primary · Week 52 to Week 84

An AE is any untoward medical occurrence in a clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Number of participants with severe AEs have been presented. For Safety, participants that completed DB and OL phase, an additional 8 weeks follow-up was conducted (Week 84).

GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)10
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)9
Number of Participants With AEs Leading to Treatment Discontinuation [OL Phase] Primary · Week 52 to Week 84

An AE is any untoward medical occurrence in a clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Number of participants with AEs leading to treatment discontinuation have been presented. For Safety, participants that completed DB and OL phase, an additional 8 weeks follow-up was conducted (Week 84).

GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)1
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Number of Participants With Worst Toxicity Grade 3 or 4 for Hematology Parameters [OL Phase] Primary · Week 52 to Week 84

Blood samples were collected for the assessment of hematology parameters. The parameters assessed were activated partial thromboplastin time (APTT), hemoglobin, leukocytes, neutrophils, platelets and prothrombin time. Grading was assigned as mild (Grade 1), moderate (grade 2), severe (Grade 3) and potentially life-threatening (Grade 4) according to Division of Microbiology and Infectious Diseases (DMID \[Modified from DMID Adult Toxicity Tables, 2001\]) AE Severity Grading. Number of participants with worst toxicity Grade 3 or 4 for hematology parameters have been presented. For Safety, partic

APTT, Grade 3, n=93,203
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)1
APTT, Grade 4, n=93,203
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Hemoglobin, Grade 3, n=115,235
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)4
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)6
Hemoglobin, Grade 4, n=115,235
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Leukocytes, Grade 3, n=114,235
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)6
Leukocytes, Grade 4, n=114,235
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Neutrophils, Grade 3, n=114,234
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)2
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)6
Neutrophils, Grade 4, n=114,234
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)1
Number of Participants With Worst Toxicity Grade of 3 or 4 for Clinical Chemistry Parameters [OL Phase] Primary · Week 52 to Week 84

Blood samples were collected for the assessment of liver function and other chemistry parameters. The parameters assessed were alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), bilirubin, albumin, creatinine, hyperglycemia, hypoglycemia and urate. Grading was assigned as mild (Grade 1), moderate (grade 2), severe (Grade 3) and potentially life-threatening (Grade 4) according to DMID AE Severity Grading. Number of participants with worst toxicity Grade of 3 or 4 for liver function and other chemistry parameters have b

ALP, Grade 3
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
ALP, Grade 4
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
ALT, Grade 3
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
ALT, Grade 4
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
AST, Grade 3
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
AST, Grade 4
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Bilirubin, Grade 3
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Bilirubin, Grade 4
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Number of Participants With Worst Toxicity Grade of 3 or 4 for Urinalysis Parameters [OL Phase] Primary · Week 52 to Week 84

Urinalysis parameters assessed were urine protein and protein/creatinine. Urine samples were collected for the measurement of urinalysis parameters by dipstick method. Grading was assigned as mild (Grade 1), moderate (grade 2), severe (Grade 3) and potentially life-threatening (Grade 4) according to DMID AE Severity Grading. Number of participants with worst toxicity grade of 3 or 4 for urinalysis parameters have been presented. For Safety, participants that completed DB and OL phase, an additional 8 weeks follow-up was conducted (Week 84).

Protein, Grade 3, n=115, 234
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Protein, Grade 4, n=115,234
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Protein/Creatinine, Grade 3,n=112,227
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)5
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)5
Protein/Creatinine, Grade 4, n=112,227
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)3
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Number of Participants With Worst Toxicity Grade of 3 or 4 of Immunoglobulins [OL Phase] Primary · Week 52 to Week 84

Serum samples were obtained for the measurement of immunoglobulin G. Grading was assigned as mild (Grade 1), moderate (grade 2), severe (Grade 3) and potentially life threatening (Grade 4) according to DMID AE Severity Grading. Number of participants with worst toxicity grade of 3 or 4 of immunoglobulin G have been presented. For Safety, participants that completed DB and OL phase, an additional 8 weeks follow-up was conducted (Week 84).

Grade 3
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)1
Grade 4
GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)0
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)0
Percentage of Participants Achieving SRI-SS Response Rate at Week 52 [DB Phase] Secondary · Week 52

SRI is defined as \>=4 point reduction, from Baseline in SS score, no worsening (increase of \<0.30 points from Baseline) in PGA and no new BILAG A organ domain score or 2 new BILAG B organ domain scores compared with Baseline. Drop-outs and Treatment failures were set to non-responders. Analysis was performed using a logistic regression model for the comparison between belimumab and placebo with covariates treatment group, Baseline SS score (\<=9 vs. \>=10), Baseline complement levels (low C3 and/or C4 vs. no low C3 or C4) and region (US/Canada vs. Rest of World).

GroupValue95% CI
Placebo (DB Phase)41.6
Belimumab 10 mg/kg (DB Phase)49.0
Percentage of Participants Achieving SRI-SS Response Rate With the SELENA SLEDAI for Scoring of Proteinuria at Week 24 of OL Phase Secondary · Week 24 of OL phase (Week 76)

SRI response is defined as \>=4 point reduction, from OL Baseline in SS scoring for PU, no worsening (increase of \<0.30 points from OL Baseline) in PGA and no new BILAG A ODS or 2 new BILAG B ODS compared with OL Baseline. For participants switching from placebo to belimumab 10 mg/kg IV in the open-label phase, Baseline was defined as the last assessment at the end of the double-blind phase (i.e. Week 52) pre-OL treatment. For participants that received belimumab 10 mg/kg IV during the double-blind phase and continued to receive belimumab 10 mg/kg IV during the open-label phase, Baseline was

GroupValue95% CI
Placebo to Belimumab 10 mg/kg (OL Phase)19.4
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)73.1
Time to First Severe Flare (as Measured by the Modified SLE Flare Index) up to 52 Weeks [DB Phase] Secondary · Up to 52 Weeks

Time to first severe SLE flare is defined as the number of days from treatment start date until the participant met an event (event date - treatment start date +1). Analyses of severe SLE flare was performed on modified SS SLE flare index that excludes severe flares (SF) that were triggered only by an increase in SS score to \>12 (this may only represent a modest increase in disease activity). Treatment failures were imputed as SF. For participants who died, data were censored at date of death if no SF occurred before death. Only post-Baseline SF were considered. Analysis was performed using C

GroupValue95% CI
Placebo (DB Phase)NA346 – NA
Belimumab 10 mg/kg (DB Phase)NANA – NA

Adverse events — posted to ClinicalTrials.gov

Time frame: nSAEs and SAEs were collected from the start of study treatment up to Week 52 for Double Blind phase and from Week 52 to Week 84 for the Open Label phase. Participants that completed DB and OL phase, an additional 8 weeks follow-up was conducted (Week 84).. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Placebo (DB Phase)
Serious: 31/165 (19%)
Deaths: 0/165
Belimumab 10 mg/kg (DB Phase)
Serious: 36/331 (11%)
Deaths: 2/331
Placebo to Belimumab 10 mg/kg (OL Phase)
Serious: 6/117 (5%)
Deaths: 0/117
Belimumab 10 mg/kg to Belimumab 10 mg/kg (OL Phase)
Serious: 13/242 (5%)
Deaths: 0/242

Serious adverse events (107 terms)

ReactionSystemPlacebo (DB Phase)Belimumab 10 mg/kg (DB Pha…Placebo to Belimumab 10 mg…Belimumab 10 mg/kg to Beli…
PneumoniaInfections and infestations
Systemic lupus erythematosusMusculoskeletal and connective tissue disorders
PericarditisCardiac disorders
Lupus nephritisRenal and urinary disorders
SLE arthritisMusculoskeletal and connective tissue disorders
CostochondritisMusculoskeletal and connective tissue disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
Muscular weaknessMusculoskeletal and connective tissue disorders
Non-cardiac chest painGeneral disorders
PleurisyRespiratory, thoracic and mediastinal disorders
Urinary tract infectionInfections and infestations
Abortion spontaneousPregnancy, puerperium and perinatal conditions
AsthmaRespiratory, thoracic and mediastinal disorders
CellulitisInfections and infestations
Lupus pneumonitisRespiratory, thoracic and mediastinal disorders
PyrexiaGeneral disorders
Abdominal painGastrointestinal disorders
Accidental overdoseInjury, poisoning and procedural complications
Acute kidney injuryRenal and urinary disorders
Acute myocardial infarctionCardiac disorders
Amoebic colitisInfections and infestations
AnaemiaBlood and lymphatic system disorders
AppendicitisInfections and infestations
ArthritisMusculoskeletal and connective tissue disorders
Arthritis gonococcalInfections and infestations
Other adverse events (13 terms — click to expand)

ReactionSystemPlacebo (DB Phase)Belimumab 10 mg/kg (DB Pha…Placebo to Belimumab 10 mg…Belimumab 10 mg/kg to Beli…
Upper respiratory tract infectionInfections and infestations
Urinary tract infectionInfections and infestations
HeadacheNervous system disorders
DiarrhoeaGastrointestinal disorders
InfluenzaInfections and infestations
SinusitisInfections and infestations
VomitingGastrointestinal disorders
NauseaGastrointestinal disorders
InsomniaPsychiatric disorders
CoughRespiratory, thoracic and mediastinal disorders
HypertensionVascular disorders
Back painMusculoskeletal and connective tissue disorders
DepressionPsychiatric disorders

Most-reported serious reactions: Pneumonia, Systemic lupus erythematosus, Pericarditis, Lupus nephritis, SLE arthritis, Costochondritis, Dyspnoea, Muscular weakness.

Data from ClinicalTrials.gov NCT01632241 adverse events section.

Sponsor's own description

The purpose of this study is to evaluate the efficacy, safety, and tolerability of belimumab in adult patients of black race with systemic lupus erythematosus (SLE; lupus).

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. The BAFF/APRIL system: emerging functions beyond B cell biology and autoimmunity.
    Vincent FB, Saulep-Easton D, Figgett WA, Fairfax KA, et al · · 2013 · cited 333× · PMID 23684423 · DOI 10.1016/j.cytogfr.2013.04.003
  2. Phase III/IV, Randomized, Fifty-Two-Week Study of the Efficacy and Safety of Belimumab in Patients of Black African Ancestry With Systemic Lupus Erythematosus.
    Ginzler E, Guedes Barbosa LS, D'Cruz D, Furie R, et al · · 2022 · cited 80× · PMID 34164944 · DOI 10.1002/art.41900
  3. B-cell targeted therapeutics in clinical development.
    Blüml S, McKeever K, Ettinger R, Smolen J, et al · · 2013 · cited 74× · PMID 23566679 · DOI 10.1186/ar3906
  4. A critical review of clinical trials in systemic lupus erythematosus.
    Mahieu MA, Strand V, Simon LS, Lipsky PE, et al · · 2016 · cited 57× · PMID 27497257 · DOI 10.1177/0961203316652492
  5. Systemic lupus erythematosus biomarkers: the challenging quest.
    Arriens C, Wren JD, Munroe ME, Mohan C. · · 2017 · cited 52× · PMID 28013203 · DOI 10.1093/rheumatology/kew407
  6. Research and therapeutics-traditional and emerging therapies in systemic lupus erythematosus.
    Davis LS, Reimold AM. · · 2017 · cited 37× · PMID 28375452 · DOI 10.1093/rheumatology/kew417
  7. Current and emerging treatment options for ANCA-associated vasculitis: potential role of belimumab and other BAFF/APRIL targeting agents.
    Lenert A, Lenert P. · · 2015 · cited 28× · PMID 25609919 · DOI 10.2147/dddt.s67264
  8. Belimumab in systemic lupus erythematosus (SLE): evidence-to-date and clinical usefulness.
    Guerreiro Castro S, Isenberg DA. · · 2017 · cited 26× · PMID 28344669 · DOI 10.1177/1759720x17690474

Verify or expand the search:

Other trials of Belimumab 10 mg/kg plus standard therapy

Trials testing the same drug.

Other recruiting trials for Systemic Lupus Erythematosus

Currently open trials in the same condition.

Other Human Genome Sciences Inc., a GSK Company trials

Trials by the same sponsor.

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Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT01632241.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing