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NCT02953821

Acthar Gel for Active Systemic Lupus Erythematosus (SLE)

Completed Phase 4 Results posted Last updated 20 August 2020
What this trial tests

Phase 4 trial testing Acthar Gel in Lupus Erythematosus, Systemic in 172 participants. Completed in 25 October 2019.

Timeline
16 December 2016
Primary endpoint
31 July 2019
25 October 2019

Quick facts

Lead sponsorMallinckrodt
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment172
Start date16 December 2016
Primary completion31 July 2019
Estimated completion25 October 2019
Sites39 locations across Peru, Chile, Mexico, Argentina, United States

Drugs / interventions tested

Conditions studied

Sponsor

Mallinckrodt — full company profile →

Who can join

18 and older, any sex, with Lupus Erythematosus, Systemic. 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.

Physician's Global Assessment (PGA) Primary · Baseline, Week 16, Week 24

PGA is a 100 mm visual analogue scale where higher scores indicate more severe disease activity. Lower scores indicate improvement.

Baseline
GroupValue95% CI
Placebo Gel58.8± 15.81
Acthar Gel60.6± 16.69
Week 16
GroupValue95% CI
Placebo Gel33.2± 18.77
Acthar Gel30.2± 14.89
Week 24
GroupValue95% CI
Placebo Gel26.9± 17.76
Acthar Gel25.5± 17.22
British Isles Lupus Assessment Group 2004 (BILAG 2004) Primary · Baseline, Week 16, Week 24

BILAG records disease activity occurring over the past 4 weeks, and is used to determine whether different course of treatment is required. The BILAG-2004 index covers 97 signs/symptoms across 9 organ systems. Each question is answered as 0-not present, 1-improving, 2-same, 3-worse, or 4-new. The BILAG-2004 index categorizes disease activity in each organ system into five different levels from A to E. Grade A represents very active disease, Grade B represents moderate disease activity, Grade C indicates mild stable disease, and grade D implies no disease activity, but suggests the organ syste

Baseline
GroupValue95% CI
Placebo Gel18.2± 5.15
Acthar Gel18.0± 5.45
Week 16
GroupValue95% CI
Placebo Gel9.7± 6.57
Acthar Gel7.7± 5.91
Week 24
GroupValue95% CI
Placebo Gel8.0± 6.21
Acthar Gel6.9± 5.87
Number of Participants With at Least a 4 Point Change From Baseline in Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) Primary · Week 16, Week 24

The SLEDAI-2K is a modified version of a composite score based on the presence or absence of clinical signs, clinical symptoms, and immunologic laboratory results taken within 10 days of the evaluations. Each of the descriptors has a weighted score and the total score of SLEDAI-2K is the sum of all 24 descriptor scores. The total SLEDAI-2K score falls between 0 and 105, with higher scores representing higher disease activity. Decrease from baseline indicates improvement.

Week 16
GroupValue95% CI
Placebo Gel40
Acthar Gel41
Week 24
GroupValue95% CI
Placebo Gel46
Acthar Gel44
Number of Participants With Severe Flare, Based on the SELENA Flare Index (SFI) at Week 16 Secondary · Week 16

Among some adults, having a period of SLE symptoms-called flares-may happen every so often, sometimes even years apart, and go away at other times-called remission. The SFI categorizes SLE flares as mild, moderate or severe.

GroupValue95% CI
Placebo Gel3
Acthar Gel0
Mean Cutaneous Lupus Erythematosus Disease Area and Severity Score- Activity (CLASI) Total Activity Score Secondary · at Baseline and Weeks 4, 8, and 16

The CLASI total activity score reflects ongoing inflammation that can be treated, with points given for the presence of erythema, scale, mucous membrane lesions, recent hair loss, and inflammatory alopecia. Mild, moderate, and severe disease correspond with CLASI activity score ranges of 0 to 9, 10 to 20, and 21 to 70, respectively. Higher scores indicate more disease activity, lower scores indicate improvement.

Baseline
GroupValue95% CI
Placebo Gel7.1± 6.53
Acthar Gel7.9± 7.48
Week 4
GroupValue95% CI
Placebo Gel5.8± 5.57
Acthar Gel5.6± 5.30
Week 8
GroupValue95% CI
Placebo Gel5.0± 5.19
Acthar Gel5.0± 5.41
Week 12
GroupValue95% CI
Placebo Gel4.5± 5.41
Acthar Gel4.0± 4.08
Week 16
GroupValue95% CI
Placebo Gel3.8± 4.36
Acthar Gel3.4± 3.77
Mean Number of Swollen or Tender Joints on the 28-Joint Count Secondary · at Baseline and at Weeks 4, 8, 12 and 16

The 28 Joint Count includes assessment of swelling and tenderness in the shoulders, elbows, wrists, metacarpophalangeal joints, proximal interphalangeal joints and knees. The investigator counts how many of the 28 joints are swollen or tender at the given week.

Baseline
GroupValue95% CI
Placebo Gel7.2± 4.98
Acthar Gel8.2± 5.85
Week 4
GroupValue95% CI
Placebo Gel4.9± 4.77
Acthar Gel4.2± 4.24
Week 8
GroupValue95% CI
Placebo Gel3.8± 4.97
Acthar Gel2.9± 3.42
Week 12
GroupValue95% CI
Placebo Gel2.9± 4.40
Acthar Gel2.3± 3.00
Week 16
GroupValue95% CI
Placebo Gel2.8± 3.67
Acthar Gel1.9± 3.20
Number of Participants With Decrease in Prednisone Dose to < 7.5 mg/Day at Week 20 and Week 24 Secondary · Week 20, Week 24
Week 20
GroupValue95% CI
Placebo Gel5
Acthar Gel3
Week 24
GroupValue95% CI
Placebo Gel6
Acthar Gel4

Adverse events — posted to ClinicalTrials.gov

Time frame: 24 Weeks. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Placebo Gel
Serious: 8/86 (9%)
Deaths: 1/86
Acthar Gel
Serious: 4/86 (5%)
Deaths: 0/86

Serious adverse events (11 terms)

ReactionSystemPlacebo GelActhar Gel
Systemic lupus erythematosusMusculoskeletal and connective tissue disorders
ThrombocytopeniaBlood and lymphatic system disorders
AppendicitisInfections and infestations
GastroenteritisInfections and infestations
Herpes zosterInfections and infestations
PeritonitisInfections and infestations
PneumoniaInfections and infestations
PyelonephritisInfections and infestations
Soft tissue infectionInfections and infestations
Drug abusePsychiatric disorders
Nephrotic syndromeRenal and urinary disorders
Other adverse events (6 terms — click to expand)

ReactionSystemPlacebo GelActhar Gel
Urinary tract infectionInfections and infestations
Upper respiratory tract infectionInfections and infestations
InsomniaPsychiatric disorders
NasopharyngitisInfections and infestations
HeadacheNervous system disorders
HypertensionVascular disorders

Most-reported serious reactions: Systemic lupus erythematosus, Thrombocytopenia, Appendicitis, Gastroenteritis, Herpes zoster, Peritonitis, Pneumonia, Pyelonephritis.

Data from ClinicalTrials.gov NCT02953821 adverse events section.

Sponsor's own description

This trial is to study Acthar Gel in participants with active systemic lupus erythematosus (SLE). The doctor will assign eligible patients to one of two groups (like flipping a coin). Participants will receive the treatment assigned to their group for 24 weeks: * Acthar Gel * Placebo Gel, which looks like Acthar Gel, but has no medicine in it. The doctor or his staff will take measurements and ask questions to: * see how well the gel is working * see how safe it is for patients with SLE

Publications & conference data

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

  1. Interventions for cutaneous disease in systemic lupus erythematosus.
    Hannon CW, McCourt C, Lima HC, Chen S, et al · · 2021 · cited 26× · PMID 33687069 · DOI 10.1002/14651858.cd007478.pub2
  2. Repository Corticotropin Injection for Persistently Active Systemic Lupus Erythematosus: Results from a Phase 4, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial.
    Askanase AD, Zhao E, Zhu J, Bilyk R, et al · · 2020 · cited 15× · PMID 32996096 · DOI 10.1007/s40744-020-00236-1
  3. Repository corticotropin injection in patients with persistently active SLE requiring corticosteroids: post hoc analysis of results from a two-part, 52-week pilot study.
    Furie RA, Mitrane M, Zhao E, Becker PM. · · 2017 · cited 14× · PMID 29344387 · DOI 10.1136/lupus-2017-000240
  4. Treatment with Repository Corticotropin Injection in Patients with Rheumatoid Arthritis, Systemic Lupus Erythematosus, and Dermatomyositis/Polymyositis.
    Ho-Mahler N, Turner B, Eaddy M, Hanke ML, et al · · 2020 · cited 11× · PMID 32110122 · DOI 10.2147/oarrr.s231667
  5. Patient-Reported Outcomes from a Phase 4, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of Repository Corticotropin Injection (Acthar<sup>®</sup> Gel) for Persistently Active Systemic Lupus Erythematosus.
    Askanase AD, Wan GJ, Panaccio MP, Zhao E, et al · · 2021 · cited 9× · PMID 33687687 · DOI 10.1007/s40744-021-00294-z
  6. Acthar Gel (repository corticotropin injection) for persistently active SLE: study design and baseline characteristics from a multicentre, randomised, double-blind, placebo-controlled trial.
    Askanase AD, Zhao E, Zhu J, Connolly-Strong E, et al · · 2020 · cited 6× · PMID 32399253 · DOI 10.1136/lupus-2020-000383
  7. Post Hoc Biomarker Analyses from a Phase 4, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of Repository Corticotropin Injection (Acthar® Gel) for Persistently Active Systemic Lupus Erythematosus.
    Askanase AD, Wright D, Zhao E, Zhu J, et al · · 2021 · cited 5× · PMID 34478124 · DOI 10.1007/s40744-021-00351-7

Verify or expand the search:

Other trials of Acthar Gel

Trials testing the same drug.

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Trials by the same sponsor.

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