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A Phase 2, Adaptive, Randomized, Open-label, Assessor-blinded Active-controlled Study to Evaluate the Efficacy and Safety of Rapcabtagene Autoleucel Versus Standard of Care in Patients Suffering From Systemic Lupus Erythematosus (SLE) With Active, Refractory Lupus Nephritis (LN).


Description

The purpose of this study is to evaluate the efficacy and safety of rapcabtagene autoleucel (administered once following lymphodepletion) versus Standard of Care (SOC) in patients with systemic lupus erythematosus (SLE) with active, refractory lupus nephritis (LN).This is a Phase 2, adaptive, two-year, randomized, assessor-blinded, active controlled study: * Part A: Participants suffering from systemic lupus erythematosus (SLE) with active, refractory LN will be randomized to Regimen 1, Regimen 2, or SOC. * Part B: Participants suffering from SLE with active, refractory LN will be randomized to the selected regimen from Part A or SOC. The study will consist of two periods: * A screening period lasting up to 6 weeks, and * A randomized treatment period and primary follow-up period lasting up to 104 weeks. After end of study (EOS), participants who received rapcabtagene autoleucel infusion will enter a long-term follow-up (LTFU) period lasting up to 15 years after rapcabtagene autole

Trial Eligibility

Key Inclusion Criteria: * Men and women with SLE, aged \>= 18 years and =\< 65 years at screening, fulfilling the 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for SLE at screening. * Participant must be positive for at least one of the following autoantibodies at screening: antinuclear antibodies (ANA) at a titer of \>= 1:80 (on HEp-2 cells or an equivalent positive test), or anti-dsDNA (above the ULN); or anti-Sm (above the ULN) as determined by a central laboratory. * Active lupus nephritis without signs of significant chronicity * SLEDAI-2K Criteria at screening: SLEDAI-2K score \>= 6 points (Gladman et al 2002, Touma et al 2011), excluding points attributed to "fever", "lupus headache", "alopecia", and "organic brain syndrome". * Inadequate response at screening to at least two LN treatment regimens Key Exclusion Criteria: * Any acute, severe lupus related-flare at screening that needs immediate treatment other than pulse GCs and/or makes the immunosuppressive washout impossible and, thus, makes the participant ineligible for CD19 CAR-T therapy * Inadequate organ function during screening and prior to randomization * History or current diagnosis of ECG or cardiac abnormalities indicating significant risk of safety for participants prior to randomization * Human immunodeficiency virus (HIV) positivity at screening. * Acute or chronic infection with hepatitis B (HBV) or hepatitis C (HCV) at screening. * Evidence of active or latent tuberculosis. * Grade 2 or higher thromboembolic event in the past 4 weeks prior to screening. * Vaccination (including with live attenuated vaccines) not completed at least 6 weeks prior to randomization. Other protocol-defined inclusion/exclusion criteria may apply.

Study Info

Organization

Novartis


Primary Outcome

Part A and Part B: Percentage of participants achieving clinical response at Week 52.


Outcome Timeframe Week 52

NCTID NCT06581198

Phases PHASE2

Primary Purpose TREATMENT

Start Date 2024-09-04

Completion Date 2029-05-30

Enrollment Target 144

Interventions

BIOLOGICAL rapcabtagene autoleucel Regimen 1

BIOLOGICAL rapcabtagene autoleucel Regimen 2

OTHER Standard of Care

Locations Recruiting

Northwestern University

United States, Illinois, Chicago


University Of Iowa

United States, Iowa, Iowa City


Boston Medical Center

United States, Massachusetts, Boston


Novartis Investigative Site

Singapore, Singapore


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