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To assess the safety tolerability pharmacokinetics and pharmacodynamics of Relma-cel in moderate or severe active systemic lupus erythematosus (SLE) subjects in China.
For phase I to evaluate the safety and tolerability of Relma-cel in moderate to severe active systemic lupus erythematosus (SLE) and determine the Phase II Recommended Dose (RP2D). For phase II to evaluation of the efficacy of Relma-cel (treatment group) in moderate to severe active SLE using the Low Disease Activity State of Lupus (LLDAS) under Phase II Recommended Dose (RP2D) compared to conventional therapy combined with or without biologics (control group).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Relma-cel | Experimental | Evaluate the safety and tolerability of Relma-cel in moderate to severe active systemic lupus erythematosus (SLE) and determine the Phase II Recommended Dose (RP2D) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Relma-cel | Drug | CD19-targeted Chimeric AntigenReceptor (CAR) T Cells |
|
| Measure | Description | Time Frame |
|---|---|---|
| DLT rate | The incidence of dose-limiting toxicity | 6months |
| determine RP2D | To determine RP2D(Phase 2 recommended dose) | 6months |
| Measure | Description | Time Frame |
|---|---|---|
| SELENA-SLEDAI | 0 to 4 is basically no disease activity;5 to 9 is light activity;10 to 14 is moderate activity;≥15 is considered heavy activity. | 3 months after CD19 cCAR T cells infusion |
| BILAG -2004 |
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Inclusion Criteria:
Oral corticosteroids must meet the following requirements:
5. Positive antinuclear antibody, and/or anti-dsDNA antibody, and/or anti-Smith antibody at screening.
6. SELENA-2k score ≥7 points during the screening period. 7. Active organ involvement during screening period. 8. No active infection (e.g., pneumonia, tuberculosis) within 2 weeks prior to screening period.
9. Vascular access is sufficient for leukapheresis. 10. Adequate organ function:
11. Fertile women (defined as all women biologically capable of becoming pregnant) must consent to the use of a highly effective contraceptive method for contraception from at least 28 days before the start of lymphodepleting and 2 years after infusion of Relma-cel (including the duration of the dose-interrupted study treatment). Men whose partners are fertile must agree to use an effective barrier method of contraception from the start of lymphodepleting until 2 year after Relma-cel infusion and should not donate semen or sperm throughout the study period.
12. Fertile women must test negative for serum beta human chorionic gonadotropin (β-hCG) at the time of screening and within 48 hours before the first day of lymphodepleting treatment.
Exclusion Criteria:
Subjects who meet any of the following exclusion criteria should not be included in this study
1) Active hepatitis B. However, hepatitis B surface antigen (HBsAg) positive and/or anti-hepatitis B core antibody (HBcAb) positive, and HBV DNA below the lower limit of the central reference value are eligible for inclusion in this study, and investigators need to provide preventive antiviral therapy to participants as appropriate.
2) Hepatitis C or human immunodeficiency virus (HIV) or syphilis infection. 7. A history of any of the following cardiovascular diseases in the 6 months prior to screening: Class III or IV heart failure as defined by the New York Heart Association (NYHA), myocardial infarction, unstable angina, uncontrolled or symptomatic atrial arrhythmia, any ventricular arrhythmia, or other clinically significant heart disease.
8. Use any other clinical study drugs within 1 month before screening. However, if the research treatment is ineffective or the disease relapses, and at least 3 half-life period have been passed before screening, enrollment is allowed.
9. Previously received CAR-T cell or other genetically modified T cell therapies.
10. There was a history of ≥grade 2 bleeding within 30 days prior to screening, or long-term treatment with anticoagulants (such as warfarin, low molecular weight heparin, or factor Xa inhibitors).
11. Plasma exchange, plasma separation or hemodialysis were performed within 14 days before leukapheresis.
12. Use any live vaccine against infectious diseases within 1 month prior to screening.
13. Known life-threatening allergic reactions, hypersensitivities, or intolerances to Relma-cel or their excipients, including DMSO.
14. A history or evidence of suicidal thoughts in the 6 months before signing the ICF, or any suicidal behavior in the 12 months prior, or is considered by the investigator there is a significant risk of suicide.
15. Malignant tumor within 2 years before signing the ICF. Exceptions include non-melanoma skin cancer after radical treatment, localized prostate cancer, biopsy-confirmed cervical carcinoma in situ or squamous intraepithelial lesions detected by cervical smear, and completely resected breast carcinoma in situ.
16. Pregnant or lactating women. 17. Other situations in which the investigator determines that the subject has poor compliance or is unwilling or unable to comply with the study protocol.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| JW Medical | Contact | 021-50464201 | Relma-celMedical@jwtherapeutics.com | |
| Yue Dong | Contact | 01069154127 | dongyue@pumch.cn |
| Name | Affiliation | Role |
|---|---|---|
| xiaofeng zeng | Peking Union Medical College Hospital | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36109639 | Result | Mackensen A, Muller F, Mougiakakos D, Boltz S, Wilhelm A, Aigner M, Volkl S, Simon D, Kleyer A, Munoz L, Kretschmann S, Kharboutli S, Gary R, Reimann H, Rosler W, Uderhardt S, Bang H, Herrmann M, Ekici AB, Buettner C, Habenicht KM, Winkler TH, Kronke G, Schett G. Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus. Nat Med. 2022 Oct;28(10):2124-2132. doi: 10.1038/s41591-022-02017-5. Epub 2022 Sep 15. |
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| ID | Term |
|---|---|
| D008180 | Lupus Erythematosus, Systemic |
| ID | Term |
|---|---|
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| C000718412 | relmacabtagene autoleucel |
| D000305 | Adrenal Cortex Hormones |
| D007166 | Immunosuppressive Agents |
| D001688 | Biological Products |
| ID | Term |
|---|---|
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D007155 | Immunologic Factors |
| D045505 | Physiological Effects of Drugs |
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The BILAG 2004 index categorizes disease activity into 5 different levels from A-E.Grade A represents very active disease.
| 3 months after CD19 cCAR T cells infusion |
| PGA (physician global assessment) score | The PGA scale ranges from "no disease activity" (0) to the "most severe disease activity" (3).the score is between 0 to 3. | 3 months after CD19 cCAR T cells infusion |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D045424 | Complex Mixtures |