Enteric-coated Mycophenolate Sodium Versus Azathioprine for the Extra-renal Lupus Manifestations
Status:
Completed
Trial end date:
2015-12-01
Target enrollment:
Participant gender:
Summary
Azathioprine is still considered the treatment of choice for the non-renal manifestations of
systemic lupus erythematosus (SLE) with an estimated efficacy of 45%.Recently, several
studies have demonstrated the efficacy of mycophenolate mofetil/enteric-coated mycophenolate
sodium in those cases, but so far, no controlled, randomized comparative study between the
two drugs has been conducted. The aim is to perform a randomized, controlled, phase III/IV
study comparing enteric-coated mycophenolate (ECMs) with azathioprine for induction and
maintenance therapy of the non-renal manifestations of SLE. Methods: Patients with non-renal
SLE flares (SLEDAI≥6 and/or BILAG o 2B refractory to full doses of hydroxychloroquine and
prednisolone (≥10 mg/d) or with relapsing flares will be included. Patients will be
stratified according the flare severity (moderate (SLEDAI<12)-severe (SLEDAI≥12)) and
randomized (1:1) into two groups of treatment, EMCs (2gr/d) or AZA (2-2.5mg/kg/d) according
to TMPT levels for 6 months. Dose will be progressively tapered based on clinical response up
to completing a year of treatment. The main aim is the percentage of complete remission
achieved ((SLEDAI <4 and/or absence of any BILAG A o B) at week 12 and 24 for moderate and
severe flares, respectively. Secondary objectives include evaluating the reduction in the
steroid requirement, number of flares post-treatment, effect on the biological parameters,
and impact on quality of life, damage and drug safety. To detect a 20% difference between the
two drugs with a 80% statistical power (0.05 alpha error), considering a follow up loss of
20%, a total of 240 patients is required.
Phase:
Phase 4
Details
Lead Sponsor:
Hospital Universitari Vall d'Hebron Research Institute