A Study to Evaluate the Treatment Outcomes of Subcutaneous Anifrolumab in Immunosuppressant-naïve and Biologic-naïve Systemic Lupus Erythematosus
Multinational, Interventional, 52-week, Open-label, Single-arm Study to Evaluate the Treatment Outcomes of Anifrolumab 120 mg Subcutaneous Once Weekly in Immunosuppressant-naïve and Biologic-naïve Systemic Lupus Erythematosus (SUNFLOWER)
Who can join
As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.
- Age
- 18 Years to 70 Years
- Sex
- All sexes
- Healthy volunteers
- Not accepted
- Compensation
- Not stated
Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.
What to expect
No one can promise a trial will help you personally — that is what the research is trying to find out.
What participation involves
- Visits mentioned: 2 visits
- Time periods mentioned: 69 weeks, 35 days, 12 weeks
Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.
Show the study's own words
- "In this study, approximately 275 participants will be enrolled and the study duration will be up to approximately 69 weeks, including: A Screening Period lasting up to 35 days and A 52-week treatment period."
- "Between week 5 and week 40, participants taking \>5 mg/day GC dose at study entry will attempt a protocolized taper to 5 mg/day over 12 weeks."
- "Participants achieving DORIS remission for 2 consecutive visits will attempt complete withdrawal of GC following a 12-week tapering regimen."
- Compensation
- Not stated
- Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
- Participants are monitored closely by the research team throughout the study.
- Some participants may receive access to an investigational treatment, which is still being studied.
- Your participation helps researchers learn whether this approach could help future patients.
About this study
In plain language
The SUNFLOWER study looks at how well weekly anifrolumab shots under the skin help adults with lupus that is not well controlled. The medicine is added to antimalarial treatment, with or without steroids, for people who have never used other immune-suppressing drugs or biologic medicines. The study also looks at whether people whose lupus becomes inactive can slowly stop long-term steroids.
The purpose of the SUNFLOWER study is to describe clinical outcomes, including DORIS remission, achieved following the initiation of anifrolumab 120 mg SC once weekly (QW) as add-on therapy to an anti-malarial, with or without GC; in patients not in LLDAS at enrolment. Patients will be naïve to any prior conventional immunosuppressant including prior biologic therapy at enrolment. The study will also employ a tapering protocol for a systematic approach to GC tapering, seeking to understand better the proportion of patients in remission who can successfully withdraw chronic GC completely.
Compensation is read from the study's own description and may be missing — always confirm with the study team.
Eligibility
Who can join
- Be 18 to 70 years old and weigh at least 40 kg (about 88 pounds).
- Have systemic lupus erythematosus (SLE) confirmed by a rheumatologist, a doctor who treats lupus and joint diseases.
- Have a positive blood test for lupus-related antibodies at screening.
- Take an antimalarial medicine, with or without steroid pills, as your usual lupus treatment.
- Have a lupus activity score of at least 4, or a lower score while taking at least 7.5 mg of steroids daily, measured as prednisone.
- Have no active infection, past tuberculosis (TB), or major health findings unrelated to lupus.
- Have a normal HPV test within the past 2 years. Females must have a negative pregnancy test at screening.
- Be able to complete all study visits, tests, and questionnaires, and agree not to use other experimental treatments.
Who can't join
- Have severe active lupus affecting the brain, nerves, or kidneys that the study's usual treatment cannot control; certain other autoimmune diseases; or serious blood vessel swelling not caused by lupus.
- Have certain serious blood-clotting conditions, a serious clot or unexplained pregnancy loss in the past year, or 3 or more unexplained pregnancy losses in a row.
- Have recent suicidal thoughts or behavior, repeated suicidal behavior in your lifetime, or current or recent alcohol or drug abuse.
- Have certain serious, repeated, or long-lasting infections; HIV; hepatitis B; severe or repeated shingles; a weakened immune system; or a removed spleen.
- Have cancer or a history of cancer, except certain successfully treated skin cancers or very early cervical cancer.
- Have used lupus treatments other than antimalarials or steroids; certain recent vaccines or experimental treatments; blood products other than albumin; or another study treatment. Serious allergies to the study medicine or certain protein-based medicines also rule people out.
- Be pregnant, breastfeeding, or planning pregnancy or breastfeeding during the study or within 16 weeks after the last dose. A pregnancy, birth, or pregnancy loss within 4 weeks before consent also rules people out.
- Have certain abnormal lab tests, another illness likely to need added steroids, recent or planned major surgery, or another condition that could make the study unsafe or affect its results.
Simplified for readability. The official criteria below are what the study team uses.
Official eligibility criteria
Inclusion Criteria: 1. Males or females aged 18 to 70 years of age. 2. Participants who have a diagnosis of SLE confirmed by a rheumatologist. 3. ANA-positive per the Central Lab at screening: (a) ANA (b) Anti-dsDNA (c) Anti-Smith (anti-Sm) 4. Must be on the standard therapy regimen: antimalarials with or without OCSs 5. Must have at screening and baseline: 1. Clinical SLEDAI-2K ≥ 4 points OR 2. Clinical SLEDAI-2K \< 4 with GC dose ≥ 7.5 mg/day (prednisone equivalent) 6. Should have no evidence of current active infection, (e.g., pneumonia, tuberculosis \[TB\]) or previous TB 7. Should have no evidence of malignancy; and clinically significant abnormalities (unless due to SLE). 8. No medical history or signs or symptoms of active TB prior to or during Screening. 9. Body weight ≥ 40.0 kg 10. Negative pregnancy test for females during screening 11. Normal HPV test result within 2 years prior to Week 0 (Day 1). 12. Willing and able to participate in all required study evaluations and procedures including completion of PROs. 13. Willing to not use any other forms of experimental treatment during the study. Exclusion Criteria: 1. Subjects with history of, or current diagnosis of, a clinically significant non-SLE related vasculitis syndrome. 2. Subjects with antiphospholipid antibody syndrome on stable anticoagulant therapy at an effective dose (e.g., if on warfarin, an international normalized ratio \[INR\] target 2 to 3 or as appropriate for the clinical situation) are only allowed if this is not the sole or the predominant feature of their SLE. 3. Subjects with a serious thrombotic event (e.g., pulmonary embolism stroke, deep vein thrombosis) or unexplained pregnancy loss within 1 year before the screening visit are excluded. 4. Subjects with a history of catastrophic antiphospholipid syndrome or saddle embolism. 5. Subjects with a history of 3 or more unexplained consecutive pregnancy losses. 6. History or evidence of suicidal ideation within the past 6 months; or any suicidal behavior within the past 12 months or recurrent suicidal behavior in the lifetime of the participant based on an assessment with the Columbia Suicide Severity Rating Scale (C SSRS) at Screening. 7. Active severe or unstable neuropsychiatric SLE including, but not limited to aseptic meningitis, cerebral vasculitis, myelopathy, demyelination syndromes (ascending, transverse, acute inflammatory demyelinating polyradiculopathy), acute confusional state, impaired level of consciousness, psychosis, acute stroke or stroke syndrome, cranial neuropathy, status epilepticus, cerebellar ataxia, lupus headache and mononeuritis multiplex, where, protocol-specified standard therapy is insufficient. 8. Active severe SLE-driven renal disease where, protocol-specified standard therapy is insufficient. 9. Current diagnosis of, catastrophic antiphospholipid syndrome (APS). 10. History of recurrent infection requiring hospitalization and IV antibiotics (e.g., 3 or more of the same type of infection over the previous 52 weeks). 11. Known History of a primary immunodeficiency, splenectomy, or any underlying condition that predisposes the participant to infection, or a positive result for HIV at Screening. 12. Confirmed positive test for hepatitis B. 13. Any clinical cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection that has not completely resolved within 12 weeks prior to signing the ICF. 14. Opportunistic infection requiring hospitalization or IV antimicrobial treatment within 3 years of Week 0 (Day 1). 15. Clinically significant chronic infection (e.g., osteomyelitis, bronchiectasis, etc.) within 8 weeks prior to signing the ICF (chronic nail infections are allowed). 16. Severe HZ or recurrent HZ. 17. Malignancy. History of cancer, apart from: (a) Squamous or basal cell carcinoma of the skin treated with documented success of curative therapy ≥ 3 months prior to Week 0 (Day 1). (a) Cervical cancer in situ treated with apparent success with curative therapy ≥ 1 year prior to Week 0 (Day 1). 18. Received any SLE-related therapies other than antimalarials and GCs. 19. History of allergy or reaction to any component of the study intervention formulation or history of anaphylaxis to any human gamma globulin therapy. 20. History of an anaphylactic reaction to human proteins or mAbs. 21. Received any live or attenuated vaccine within 8 weeks prior to signing the ICF. 22. Blood transfusion or receipt of blood products except albumin. 23. Received more than 2 investigational products for the SLE since time of diagnosis. 24. Received any investigational product (small molecule or biologic agent) within 4 weeks or 5 half-lives prior to signing of the ICF, whichever is greater. 25. Concurrent enrollment in another clinical study with a study intervention. 26. Subjects with any abnormal lab result as specified in the protocol. 27. Subjects with other autoimmune diseases (e.g., multiple sclerosis, psoriasis, IBD, etc.). 28. Subjects with SLE overlap syndromes such as scleroderma and mixed connective tissue disease. 29. Subject with non-SLE concomitant illness, as determined by medical judgment, who is likely to require additional systemic glucocorticosteroid therapy during the study (e.g., asthma). 30. Any condition would interfere with treatment outcomes of the study intervention or put participant at safety risk. 31. Lactating, breastfeeding, or pregnant females or females who intend to become pregnant or begin breastfeeding anytime from initiation of Screening until 16 weeks following last dose of study intervention. 32. Spontaneous or induced abortion, still or live birth, or pregnancy ≤ 4 weeks prior to signing the ICF. 33. Current alcohol, drug or chemical abuse, or a history of such abuse within 1 year before Week 0 (Day 1). 34. Major surgery within 8 weeks before signing the ICF or elective major surgery planned during the study period.
Study sites (31)
AL
- Research Site · Anniston, AL 36207More trials in Anniston
- Research Site · Birmingham, AL 35233More trials in Birmingham
AZ
- Research Site · Phoenix, AZ 85032More trials in Phoenix
- Research Site · Tucson, AZ 85748More trials in Tucson
CA
- Research Site · Fontana, CA 92335More trials in Fontana
- Research Site · La Jolla, CA 92037More trials in La Jolla
- Research Site · La Palma, CA 90623More trials in La Palma
- Research Site · Menifee, CA 92586More trials in Menifee
- Research Site · San Leandro, CA 94578More trials in San Leandro
- Research Site · Temecula, CA 92592More trials in Temecula
FL
- Research Site · Brandon, FL 33511More trials in Brandon
- Research Site · Miami, FL 33136More trials in Miami
- Research Site · Miami, FL 33145More trials in Miami
- Research Site · Miami, FL 33180More trials in Miami
IL
- Research Site · Willowbrook, IL 60527More trials in Willowbrook
IN
- Research Site · New Albany, IN 47150More trials in New Albany
LA
- Research Site · Lake Charles, LA 70605More trials in Lake Charles
MD
- Research Site · Silver Spring, MD 20904More trials in Silver Spring
MO
- Research Site · Kansas City, MO 64151More trials in Kansas City
NJ
- Research Site · West Long Branch, NJ 07764More trials in West Long Branch
OK
- Research Site · Oklahoma City, OK 73104More trials in Oklahoma City
- Research Site · Oklahoma City, OK 73116More trials in Oklahoma City
TN
- Research Site · Memphis, TN 38104More trials in Memphis
- Research Site · Memphis, TN 38119More trials in Memphis
TX
- Research Site · Austin, TX 78745More trials in Austin
- Research Site · Baytown, TX 77521More trials in Baytown
- Research Site · Colleyville, TX 76034More trials in Colleyville
- Research Site · Edinburg, TX 78550More trials in Edinburg
- Research Site · Houston, TX 77054More trials in Houston
- Research Site · Sugar Land, TX 77479More trials in Sugar Land
WA
- Research Site · Spokane, WA 99204More trials in Spokane