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NCT02428309

Autologous Polyclonal Tregs for Lupus

Terminated Phase 1 Results posted Last updated 12 November 2019
What this trial tests

Phase 1 trial testing Ex vivo Expanded Human Autologous Polyclonal Regulatory T Cells in Lupus Erythematosus, Cutaneous in 1 participant. Terminated before completion.

Timeline
27 August 2015
Primary endpoint
2 September 2016
3 October 2018

Quick facts

Lead sponsorNational Institute of Allergy and Infectious Diseases (NIAID)
PhasePhase 1
StatusTerminated
Study typeINTERVENTIONAL
Allocationnon randomized
Designsequential
Maskingnone
Primary purposetreatment
Enrollment1
Start date27 August 2015
Primary completion2 September 2016
Estimated completion3 October 2018
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

National Institute of Allergy and Infectious Diseases (NIAID)

Who can join

Adults 18 to 60, any sex, with Lupus Erythematosus, Cutaneous or Lupus Erythematosus, Discoid. 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.

Number of Significant Adverse Events (AEs) Through Week 48 Primary · From time of signed informed consent to Week 48

A significant adverse event is any related National Cancer Institute's Common Terminology Criteria for Adverse Events, Version 4.0 Grade 3 or higher AE or any related serious adverse event. Related is defined as being possibly, probably, or definitely related to the ex vivo expanded autologous PolyTregs, as determined by the safety review committee.

GroupValue95% CI
Dose 1 (1x10^8)0
Number of Significant Adverse Events (AEs) Through Week 152 Secondary · From time of signed informed consent to Week 152

A significant adverse event is any related National Cancer Institute's Common Terminology Criteria for Adverse Events, Version 4.0 Grade 3 or higher AE or any related serious adverse event. Related is defined as being possibly, probably, or definitely related to the ex vivo expanded autologous PolyTregs, as determined by the safety review committee.

GroupValue95% CI
Dose 1 (1x10^8)0
Number of Grade 3 or Higher Adverse Events (AEs) Through Week 152 Secondary · From time of signed informed consent to Week 152

Adverse events (AEs) Grade 3 or higher were graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events, Version 4.0.

GroupValue95% CI
Dose 1 (1x10^8)1
Number of Infection-Related Adverse Events (AEs) Through Week 152 Secondary · From time of signed informed consent to Week 152

If the adverse event was believed to be caused by a viral, bacterial, or fungal organism, regardless of whether it was treated with antibiotics or not, then it was classified as infection-related.

GroupValue95% CI
Dose 1 (1x10^8)0
Number of Lupus Flares Through Week 152 by Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) and Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) Criteria Secondary · From time of signed informed consent to Week 152

An activity score increase of ≥4 CLASI points defines a flare. A mild/moderate flare includes at least one of the following SELENA-SLEDAI criteria: Increase in the SLEDAI Score of ≥3 points, new or worse discoid, photosensitive, profundus, cutaneous vasculitis, bullous lupus, nasopharyngeal ulcers, pleuritic, pericarditis, arthritis, fever attributable to SLE; increase in prednisone (\<0.5 mg/kg/day); added NSAID or Plaquenil; increase in PhGA (\<2.5 \[on a 3.0 indexed VAS scale\]). A severe flare includes at least one of the following SELENA-SLEDAI criteria: Increase of \>12 in the SLEDAI Sco

No.of lupus flares (CLASI)
GroupValue95% CI
Dose 1 (1x10^8)0
No. of lupus flares (SELENA-SLEDAI)
GroupValue95% CI
Dose 1 (1x10^8)1
Number Infusion-Related Adverse Events (AEs) Within 24 Hours of Infusion Secondary · From time of infusion to 24 hours post infusion

Any infusion-related adverse events Grade 1 or higher within 24 hours of polyclonal Treg infusion. This study graded the severity of adverse events according to the National Cancer Institute's Common Terminology Criteria for Adverse Events, Version 4.0.

GroupValue95% CI
Dose 1 (1x10^8)0
Change From Baseline: Alkaline Phosphatase (ALK), Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST) Secondary · Baseline (Visit 0) and Weeks 4, 12, 48, and 152

Change=Post Baseline value minus Baseline value. A positive difference reflects an increased laboratory parameter value over time; a negative difference reflects a decreased laboratory parameter value over time. Normal laboratory values are based on subject age, gender, and the specific laboratory methods that were used to determine the lab values.

Alkaline Phosphatase (ALK) at Week 4
GroupValue95% CI
Dose 1 (1x10^8)-9± NA
Alkaline Phosphatase (ALK) at Week 12
GroupValue95% CI
Dose 1 (1x10^8)4± NA
Alkaline Phosphatase (ALK) at Week 48
GroupValue95% CI
Dose 1 (1x10^8)4± NA
Alkaline Phosphatase (ALK) at Week 152
GroupValue95% CI
Dose 1 (1x10^8)-2± NA
Alanine Aminotransferase (ALT) at Week 4
GroupValue95% CI
Dose 1 (1x10^8)-1± NA
Alanine Aminotransferase (ALT) at Week 12
GroupValue95% CI
Dose 1 (1x10^8)-3± NA
Alanine Aminotransferase (ALT) at Week 48
GroupValue95% CI
Dose 1 (1x10^8)-1± NA
Alanine Aminotransferase (ALT) at Week 152
GroupValue95% CI
Dose 1 (1x10^8)-1± NA
Change From Baseline in g/dL: Albumin, Hemoglobin Secondary · Baseline (Visit 0) and Weeks 4, 12, 48, and 152

Change=Post Baseline value minus Baseline value. A positive difference reflects an increased laboratory parameter value over time; a negative difference reflects a decreased laboratory parameter value over time. Normal laboratory values depend on a subject age, gender, and the specific laboratory methods that were used to determine the lab values.

Albumin at Week 4
GroupValue95% CI
Dose 1 (1x10^8)NA± NA
Albumin at Week 12
GroupValue95% CI
Dose 1 (1x10^8)0.4± NA
Albumin at Week 48
GroupValue95% CI
Dose 1 (1x10^8)0.2± NA
Albumin at Week 152
GroupValue95% CI
Dose 1 (1x10^8)0.2± NA
Hemoglobin at Week 4
GroupValue95% CI
Dose 1 (1x10^8)1.6± NA
Hemoglobin at Week 12
GroupValue95% CI
Dose 1 (1x10^8)1.5± NA
Hemoglobin at Week 48
GroupValue95% CI
Dose 1 (1x10^8)1.3± NA
Hemoglobin at Week 152
GroupValue95% CI
Dose 1 (1x10^8)1.0± NA
Change From Baseline in mg/dL: Total Bilirubin, Creatinine Secondary · Baseline (Visit 0) and Weeks 4, 12, 48, and 152

Change=Post Baseline value minus Baseline value. A positive difference reflects an increased laboratory parameter value over time; a negative difference reflects a decreased laboratory parameter value over time. Normal laboratory values depend on a subject age, gender, and the specific laboratory methods that were used to determine the lab values.

Total Bilirubin at Week 4
GroupValue95% CI
Dose 1 (1x10^8)0.1± NA
Total Bilirubin at Week 12
GroupValue95% CI
Dose 1 (1x10^8)-0.2± NA
Total Bilirubin at Week 48
GroupValue95% CI
Dose 1 (1x10^8)0.0± NA
Total Bilirubin at Week 152
GroupValue95% CI
Dose 1 (1x10^8)-0.2± NA
Creatinine at Week 4
GroupValue95% CI
Dose 1 (1x10^8)0.1± NA
Creatinine at Week 12
GroupValue95% CI
Dose 1 (1x10^8)0.0± NA
Creatinine at Week 48
GroupValue95% CI
Dose 1 (1x10^8)0.1± NA
Creatinine at Week 152
GroupValue95% CI
Dose 1 (1x10^8)0.1± NA
Change From Baseline in mmol/L: Potassium, Sodium, Chloride Secondary · Baseline (Visit 0) and Weeks 4, 12, 48, and 152

Change=Post Baseline value minus Baseline value. A positive difference reflects an increased laboratory parameter value over time; a negative difference reflects a decreased laboratory parameter value over time. Normal laboratory values depend on a subject age, gender, and the specific laboratory methods that were used to determine the lab values.

Total Potassium at Week 4
GroupValue95% CI
Dose 1 (1x10^8)-0.2± NA
Total Potassium at Week 12
GroupValue95% CI
Dose 1 (1x10^8)-0.4± NA
Total Potassium at Week 48
GroupValue95% CI
Dose 1 (1x10^8)-0.3± NA
Total Potassium at Week 152
GroupValue95% CI
Dose 1 (1x10^8)-0.7± NA
Sodium at Week 4
GroupValue95% CI
Dose 1 (1x10^8)4± NA
Sodium at Week 12
GroupValue95% CI
Dose 1 (1x10^8)2± NA
Sodium at Week 48
GroupValue95% CI
Dose 1 (1x10^8)3± NA
Sodium at Week 152
GroupValue95% CI
Dose 1 (1x10^8)5± NA
Change From Baseline in Cell Counts: White Blood Cells (WBC), Total Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils, Platelets Secondary · Baseline (Visit 0) and Weeks 4, 12, 48, and 152

Change=Post Baseline value minus Baseline value. A positive difference reflects an increased laboratory parameter value over time; a negative difference reflects a decreased laboratory parameter value over time. Normal laboratory values depend on a subject age, gender, and the specific laboratory methods that were used to determine the lab values.

White Blood Cells (WBC) at Week 4
GroupValue95% CI
Dose 1 (1x10^8)0.8± NA
White Blood Cells (WBC) at Week 12
GroupValue95% CI
Dose 1 (1x10^8)1.3± NA
White Blood Cells (WBC) at Week 48
GroupValue95% CI
Dose 1 (1x10^8)1.2± NA
White Blood Cells (WBC) at Week 152
GroupValue95% CI
Dose 1 (1x10^8)1.1± NA
Total Neutrophils at Week 4
GroupValue95% CI
Dose 1 (1x10^8)0.6± NA
Total Neutrophils at Week 12
GroupValue95% CI
Dose 1 (1x10^8)0.9± NA
Total Neutrophils at Week 48
GroupValue95% CI
Dose 1 (1x10^8)0.9± NA
Total Neutrophils at Week 152
GroupValue95% CI
Dose 1 (1x10^8)0.8± NA
Change From Baseline Red Blood Cell Count Secondary · Baseline (Visit 0) and Weeks 4, 12, 48, and 152

Change=Post Baseline value minus Baseline value. A positive difference reflects an increased laboratory parameter value over time; a negative difference reflects a decreased laboratory parameter value over time. Normal laboratory values depend on a subject age, gender, and the specific laboratory methods that were used to determine the lab values.

Red Blood Cell Count at Week 4
GroupValue95% CI
Dose 1 (1x10^8)0.6± NA
Red Blood Cell Count at Week 12
GroupValue95% CI
Dose 1 (1x10^8)0.7± NA
Red Blood Cell Count at Week 48
GroupValue95% CI
Dose 1 (1x10^8)0.6± NA
Red Blood Cell Count at Week 152
GroupValue95% CI
Dose 1 (1x10^8)0.9± NA

Adverse events — posted to ClinicalTrials.gov

Time frame: From time of signed informed consent to Week 48.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Dose 1 (1x10^8)
Serious: 1/1 (100%)
Deaths: 0/1

Serious adverse events (1 terms)

ReactionSystemDose 1 (1x10^8)
Neuropathy peripheralNervous system disorders
Other adverse events (4 terms — click to expand)

ReactionSystemDose 1 (1x10^8)
PericarditisCardiac disorders
Oedema peripheralGeneral disorders
HypokalaemiaMetabolism and nutrition disorders
Cutaneous lupus erythematosusSkin and subcutaneous tissue disorders

Most-reported serious reactions: Neuropathy peripheral.

Data from ClinicalTrials.gov NCT02428309 adverse events section.

Sponsor's own description

The primary purpose of this Phase 1 study is to evaluate the safety, tolerability, and effect of 3 different doses of Treg therapy in adults with skin (cutaneous) involvement of their lupus. Targeting cutaneous disease offers the ability to control background therapy, readily detect clinical effects, and perform research analyses not only in blood but also skin. Safety, disease activity, and mechanism of Tregs will be evaluated. The intent is to support dose selection for a future larger efficacy trial in lupus.

Publications & conference data

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

  1. Next-generation regulatory T cell therapy.
    Ferreira LMR, Muller YD, Bluestone JA, Tang Q. · · 2019 · cited 385× · PMID 31541224 · DOI 10.1038/s41573-019-0041-4
  2. Past, Present, and Future of Regulatory T Cell Therapy in Transplantation and Autoimmunity.
    Romano M, Fanelli G, Albany CJ, Giganti G, et al · · 2019 · cited 375× · PMID 30804926 · DOI 10.3389/fimmu.2019.00043
  3. Treg Enhancing Therapies to Treat Autoimmune Diseases.
    Eggenhuizen PJ, Ng BH, Ooi JD. · · 2020 · cited 167× · PMID 32977677 · DOI 10.3390/ijms21197015
  4. Regulatory T cells (Tregs) and their therapeutic potential against autoimmune disorders - Advances and challenges.
    Goswami TK, Singh M, Dhawan M, Mitra S, et al · · 2022 · cited 153× · PMID 35240914 · DOI 10.1080/21645515.2022.2035117
  5. Adoptive Treg Cell Therapy in a Patient With Systemic Lupus Erythematosus.
    Dall'Era M, Pauli ML, Remedios K, Taravati K, et al · · 2019 · cited 123× · PMID 30277008 · DOI 10.1002/art.40737
  6. Therapeutic induction of antigen-specific immune tolerance.
    Kenison JE, Stevens NA, Quintana FJ. · · 2024 · cited 94× · PMID 38086932 · DOI 10.1038/s41577-023-00970-x
  7. Opportunities for Treg cell therapy for the treatment of human disease.
    Bluestone JA, McKenzie BS, Beilke J, Ramsdell F. · · 2023 · cited 90× · PMID 37153574 · DOI 10.3389/fimmu.2023.1166135
  8. IL233, A Novel IL-2 and IL-33 Hybrid Cytokine, Ameliorates Renal Injury.
    Stremska ME, Jose S, Sabapathy V, Huang L, et al · · 2017 · cited 82× · PMID 28539382 · DOI 10.1681/asn.2016121272

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