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LY2127399

Phase 3

Rheumatoid Arthritis | Small molecule | Immunology |Eli Lilly and Company|Last Updated: Sep 10, 2019

Success Probability

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials5
Total Enrollment1,402

FDA Designations

No designations recorded

Clinical trial landscape

LY2127399 · 12 trials · 8 indications

Phase 3 3Phase 2 6Phase 1 3
NCT01202760A Rheumatoid Arthritis Study in ParticipantsRheumatoid Arthritis
COMPLETED1,004 Analytics
NCT01205438A Study of LY2127399 in Participants With Systemic Lupus ErythematosusSystemic Lupus Erythematosus
COMPLETED1,124 Analytics
NCT01196091A Study of LY2127399 in Participants With Systemic Lupus ErythematosusSystemic Lupus Erythematosus
COMPLETED1,164 Analytics
PHASE3COMPLETED
A Rheumatoid Arthritis Study in Participants
Rheumatoid ArthritisUnlock trial analytics
PHASE3COMPLETED
A Study of LY2127399 in Participants With Systemic Lupus Erythematosus
Systemic Lupus ErythematosusUnlock trial analytics
PHASE3COMPLETED
A Study of LY2127399 in Participants With Systemic Lupus Erythematosus
Systemic Lupus ErythematosusUnlock trial analytics

Study Endpoints

Primary Endpoints

Percentage of Participants With American College of Rheumatology 20% (ACR20) Response
Up to 24 weeks

ACR20 Responder Index: Composite of clinical, laboratory, and functional measures of rheumatoid arthritis. ACR20 Responder: had \>=20% improvement from baseline in both 68 tender and 66 swollen joint counts and \>=20% improvement in at least 3 of 5 criteria: participant's and physician's global assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) (which measured participants' perceived degree of difficulty performing daily activities), joint pain, and C-reactive protein (CRP). Percentage of participants achieving ACR20 response=(number of ACR20 responders/number of participants treated)\*100. All non-responders at Week 16 as well as all participants who discontinued study treatment at any time, for any reason, were defined as non-responders starting at that timepoint and going forward, including Week 24 endpoint.

Percentage of Participants Achieving an SLE Responder Index Response at Week 52
52 weeks

Percentage of participants with a ≥ 5 point reduction from baseline in SELENA SLEDAI score, and no worsening (increase of \< 0.30 points from baseline) in PGA, and no new BILAG A organ domain score or 2 new BILAG B organ domain scores compared with baseline. SELENA SLEDAI is calculated from 24 individual descriptors across 9 organ systems; 0 indicates inactive disease and the maximum theoretical score is 105; scores \> 20 are rare. PGA is a visual analog scale scored from 0 to 3 (0=none, 1=mild, 2=moderate, 3=severe). BILAG uses a single score for each of the 9 organ domains; range is from severe (A) to no disease (E). Participants who were unable to comply with allowed concomitant medications requirements were considered non-responders, as were participants who dropped out or were missing Week 52 data.

Change From Baseline in PRA
Baseline, Weeks 8, 16, 24, 36, 52, 64 and 76

The PRA value is calculated and expressed as a percentage, which can range from 0 % to 100%. The value represents a summation of the total HLA antibody burden that the participant has and how frequently those HLA antigens appear in organ donor population. A calculated PRA of 20% means the participant has antibodies that represent an antigen frequency that exists in approximately 20% of the population.

Change From Baseline in Arcsine Transformed PRA Scores
Baseline, Weeks 8, 16, 24, 36, 52, 64 and 76

The PRA value is calculated and expressed as a percentage, which can range from 0% to 100%. The value represents a summation of the total HLA antibody burden that the participant has and how frequently those HLA antigens appear in organ donor population. A calculated PRA of 20% means the participant has antibodies that represent an antigen frequency that exists in approximately 20% of the population. PRA scores were transformed using the arcsine function, which enables a skewed distribution of data typically expressed as proportions to achieve properties closer to a normal distribution. The range of possible arcsine transformed PRA scores is 0 (when PRA = 0) to approximately 1.57 (when PRA =100). Higher scores indicate the participant has antibodies against HLA antigens that appear frequently in the organ donor population.

Number of Participants With a Change From Baseline Positive to Post-Baseline Negative in the Summation of Top 10 Highest Antibody Levels (Class I and Class II Single Antigen Reactivity Reported Separately) During Treatment and Follow-Up
Baseline through Weeks 24, 52 and 76
Total Number of Gd-Enhancing T1-Weighted MRI Lesions Per Scan Averaged During Weeks 12, 16, 20, and 24
Weeks 12, 16, 20, and 24

Lesions were measured using Gd-enhancing T1-weighted MRI scans. The number of T1-weighted lesions per scan was obtained from the number of T1-weighted lesions observed during a specified week divided by the number of scans performed that same week. To obtain the number of T1-weighted lesions per scan averaged during Weeks 12, 16, 20, and 24, the number of lesions per scan at each week was summed and then divided by the number of visits with non-missing lesion counts.

Number of Participants Who Had Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
Baseline through Week 52 (up to 48 weeks of treatment or ED and follow-up through Week 52)

A TEAE started on or after the date and time of the first dose of study drug administered in this study, or started prior to the study drug administration but worsened after the study drug started. Clinically significant events were defined as SAEs and other non-serious adverse events (AEs). A summary of SAEs and other non-serious AEs is located in the Reported Adverse Events module. Participants were on treatment up to 48 weeks. If a participant completed 48 weeks of treatment, the post-study treatment follow-up started at the next visit, 4 weeks later (Week 52). If a participant discontinued treatment early \[early discontinuation (ED)\], the post-study treatment follow-up started immediately afterwards. Baseline was defined as Week 0 in this study \[which is equivalent to Week 24 of the participant's prior study: Study H9B-MC-BCDG (NCT00689728) or Study H9B-MC-BCDH (NCT00785928)\].

Number of Participants With Planned Laboratory Evaluations (Including Hematology, Clinical Chemistry, and Urinalysis) Reported as AEs
Baseline through Week 112

For each planned laboratory evaluation, the range of values to be reported as AEs, regardless of causality, was pre-specified. A summary of SAEs and other non-serious AEs regardless of causality is located in the Reported Adverse Events module. Baseline was defined as Week 0 in this study \[which is equivalent to Week 24 of the participant's prior study: Study H9B-MC-BCDG (NCT00689728) or Study H9B-MC-BCDH (NCT00785928)\].

Percentage of Participants Who Achieved American College of Rheumatology (ACR) 50 Response up to 24 Weeks
Up to week 24

ACR50 Responder Index is a composite of clinical, laboratory, and functional measures in rheumatoid arthritis. An ACR50 Responder is defined as a participant with \>50% improvement from baseline in both tender and swollen joint counts and in at least 3 of the following 5 criteria: physician global assessment, participant global assessment, functional ability measure (Health Assessment Questionnaire-Disability Index which measures participants' perceived degree of difficulty when performing various daily activities), visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein.

Percentage of Participants Achieving American College of Rheumatology (ACR)50 Response at Week 16
16 weeks

ACR50 Responder Index is a composite of clinical, laboratory, and functional measures in rheumatoid arthritis. ACR50 Responder is defined as a participant with greater than 50% improvement from baseline in both tender and swollen joint counts and in at least 3 of the following 5 criteria: physician global assessment, patient global assessment, functional ability measure (Health Assessment Questionnaire-Disability Index which measures participants' perceived degree of difficulty when performing various daily activities), visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein.

Percentage of Participants Achieving American College of Rheumatology 20% Response (ACR20) (Effectiveness of LY2127399 in Treating Rheumatoid Arthritis Using the ACR20 Scale)
Week 16

ACR Responder Index is a Composite of clinical, laboratory, and functional measures of rheumatoid arthritis (RA). ACR20 Responders: had ≥20% improvement from baseline in both tender and swollen joint counts and ≥20% improvement in at least 3 of 5 criteria: participant's and physician's global assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) (which measured participants' perceived degree of difficulty performing daily activities), visual analog pain scale, and erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP).

Pharmacokinetic (PK)/Pharmacodynamic (PD)modeling of LY2127399 to determine a Phase 2 dose
2 years
Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
Baseline up to 72 weeks

Included are the number of participants who experienced SAEs and treatment-emergent other non-SAEs. A summary of SAEs and other non-SAEs, regardless of causality, is located in the Reported Adverse Events (AEs) module.

Number of Participants With Adverse Events (AEs) [Clinically Significant Effects]
Baseline through study completion (up to Week 32 plus up to 12 weeks for B cell monitoring)

Clinically significant effects are defined as serious AEs (SAEs) and other non-serious AEs regardless of causality. A summary of SAEs and other non-serious AEs regardless of causality is located in the Reported Adverse Events module.

Secondary Endpoints

Percentage of Participants With American College of Rheumatology 50% (ACR50) and 70% (ACR70) Responses
Up to 24 weeks
Mean Percent Improvement in American College of Rheumatology Percent Improvement (ACR-N)
Up to 24 weeks
Change From Baseline to 24 Weeks in Tender Joint Count (68 Joint Count)
Baseline, up to 24 weeks
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
120 mg LY2127399EXPERIMENTALLY2127399: 120 milligrams (mg), subcutaneous (SC) injection, every 4 weeks for 24 weeks. Participants received a 240-mg (2 SC injections of 120 mg each) loading dose of LY2127399 when initiating treatment. During the Treatment Period, for blinding purposes, participants alternated injections of LY2127399 and injections of Placebo every 2 weeks. After 16 weeks, non-responders received 90 mg of LY2127399 every 2 weeks for the rest of the 24-week Treatment Period.
90 mg LY2127399EXPERIMENTALLY2127399: 90 milligrams (mg), subcutaneous (SC) injection, every 2 weeks for 24 weeks. Participants received a 180-mg (2 SC injections of 90 mg each) loading dose of LY2127399 when initiating treatment. After 16 weeks, non-responders continued to receive 90 mg of LY2127399 every 2 weeks for the rest of the 24-week Treatment Period.
PlaceboPLACEBO_COMPARATORPlacebo: subcutaneous (SC) injection, every 2 weeks for 24 weeks. Participants received a loading dose of 2 SC injections of Placebo when initiating treatment. After 16 weeks, non-responders received 90 milligrams (mg) of LY2127399 every 2 weeks for the rest of the 24-week Treatment Period.
LY2127399 every 2 weeksEXPERIMENTAL -
LY2127399 every 4 weeksEXPERIMENTALDuring the Treatment Period, for blinding purposes, participants will alternate injections of LY2127399 and injections of placebo every 2 weeks.
LY2127399 every 4 wksEXPERIMENTALDuring the Treatment Period, for blinding purposes, patients will alternate injections of LY2127399 and injections of placebo every 2 weeks.
LY2127399EXPERIMENTAL -
4 mg LY2127399 / 4 weeksEXPERIMENTALInjection: 6 doses, one every 4 weeks for 24 weeks.
40 mg LY2127399 / 4 weeksEXPERIMENTALInjection: 6 doses, one every 4 weeks for 24 weeks.
120 mg LY2127399 / 4 weeksEXPERIMENTALInjection: 6 doses, one every 4 weeks for 24 weeks.
4 mg LY2127399 / 12 weeksEXPERIMENTALDrug: LY2127399 Injection: 2 doses, one every 12 weeks for 24 weeks. Drug: Placebo Injection: Every 4 weeks for 24 weeks (except Week 0 and Week 12).
120 mg LY2127399 / 12 weeksEXPERIMENTALDrug: LY2127399 Injection: 2 doses, one every 12 weeks for 24 weeks. Drug: Placebo Injection: Every 4 weeks for 24 weeks (except Week 0 and Week 12).
12 mg LY2127399 / 4 weeksEXPERIMENTALInjection: 6 doses, one every 4 weeks for 24 weeks.
1 mg LY2127399EXPERIMENTAL -
3 mg LY2127399EXPERIMENTAL -
10 mg LY2127399EXPERIMENTAL -
30 mg LY2127399EXPERIMENTAL -
60 mg LY2127399EXPERIMENTAL -
30 milligram (mg) LY2127399EXPERIMENTALDouble-blind Treatment: 30 mg LY2127399 administered as a single intravenous (IV) infusion over 30 minutes at 0, 3, and 6 weeks. Rescue: At Week 16 primary endpoint, participants without at least 20% improvement in either tender or swollen joint counts based on 28 joints, could receive an additional (unblinded) 30 minute infusion of LY2127399 80 mg or remain on initial randomized treatment up to Week 24. Follow-up: Optional visits beyond Week 24, if needed, to assess safety including B cell count recovery.
80 mg LY2127399EXPERIMENTALDouble-blind Treatment: 80 mg LY2127399 administered as a single IV infusion over 30 minutes at 0, 3, and 6 weeks. Rescue: At Week 16 primary endpoint, participants without at least 20% improvement in either tender or swollen joint counts based on 28 joints, could receive an additional (unblinded) 30 minute infusion of LY2127399 80 mg or remain on initial randomized treatment up to Week 24. Follow-up: Optional visits beyond Week 24, if needed, to assess safety including B cell count recovery.
AEXPERIMENTAL -
BPLACEBO_COMPARATOR -
Dose Escalation Phase(Part A):EXPERIMENTAL1,10, 30, 100 or 300 mg of LY2127399 IV on day 1 of specific 21 day cycles and 1.3 mg/m2 Bortezomib IV on days 1, 4, 8, and 11 of each 21 day cycle
Dose Confirmation Phase (Part B1):EXPERIMENTALDose determined by PK/PD modeling, LY2127399 IV on day 2 of Cycle 1 and on day 1 of specific cycles and 1.3 mg/m2 Bortezomib IV on days 1, 4, 8, and 11 of each cycle
Dose Confirmation Phase (Part B2):EXPERIMENTALDose determined by PK/PD modeling, LY2127399 IV on day 1 of specific cycles and 1.3 mg/m2 Bortezomib IV on days 1, 4, 8, and 11 of specific cycles
30mg/120 mg LY2127399EXPERIMENTALParticipants in the 30 milligrams (mg) every 4 weeks arm of the lead-in study will receive 30 mg every 4 weeks until the safety of the 120 mg every 4 weeks dose is confirmed in the lead-in study.
30 milligrams (mg) TabalumabEXPERIMENTAL30 mg tabalumab every 4 weeks (Q4W) for 20 weeks (6 doses of study drug)
60 mg TabalumabEXPERIMENTAL60 mg tabalumab Q4W for 20 weeks (6 doses of study drug)
120 mg TabalumabEXPERIMENTAL120 mg tabalumab Q4W for 20 weeks (6 doses of study drug)
Placebo Q4WPLACEBO_COMPARATORQ4W for 20 weeks
120 mg once every 2 weeks (Q2W) TabalumabEXPERIMENTALInitial loading dose of 240 mg tabalumab followed by 120 mg Q2W for 20 weeks (10 doses of study drug)
Placebo Q2WPLACEBO_COMPARATORQ2W for 20 weeks

Interventions

NameTypeDescription
LY2127399DRUG -
PlaceboDRUG -
Placebo every 2 weeksDRUGAdministered via subcutaneous injection for 52 weeks. A matching loading dose will also be administered at the first dose.
Placebo every 4 weeksDRUGAdministered via subcutaneous injection for 52 weeks.
Standard of CareDRUG -
LY2127399 (Tabalumab)DRUGAdministered subcutaneously
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites213

Inclusion Criteria: * Diagnosis of Rheumatoid Arthritis (RA) of more than 6 months and less than 15 years * Global Assessment of Disease Activity visual analog scale (VAS) greater than or equal to 20/100 millimeters (mm) * If on one or more conventional disease-modifying anti-rheumatic Drugs (DMARD...

Countries:United StatesArgentinaAustraliaBulgariaColombiaCroatiaHungaryIndiaJapanLithuaniaMalaysiaMexicoNew ZealandPolandRomaniaRussiaSlovakiaSouth AfricaSouth KoreaSri LankaTaiwanUkraineBrazilCanadaEcuadorFranceIsraelLatviaSerbiaSpainTunisiaUnited KingdomAustriaBelarusChileEgyptGermanyGuatemalaItalyNorth MacedoniaPeruPhilippinesPuerto RicoSingaporeThailandCzechiaBelgium
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Frequently asked questions about LY2127399

What is LY2127399 used for?

LY2127399 is an investigational monoclonal antibody being studied for multiple autoimmune and inflammatory conditions, including rheumatoid arthritis, systemic lupus erythematosus, relapsing-remitting multiple sclerosis, chronic kidney failure, and multiple myeloma. It is developed by Eli Lilly and Company and is currently in Phase 2 clinical development.

What does LY2127399 target?

LY2127399 is a monoclonal antibody that targets B-cell activating factor (BAFF), a cytokine involved in the survival and maturation of B cells. By inhibiting BAFF, LY2127399 aims to reduce abnormal B-cell activity implicated in autoimmune diseases like systemic lupus erythematosus and rheumatoid arthritis.

Who makes LY2127399?

LY2127399 is developed by Eli Lilly and Company, a pharmaceutical company traded on the New York Stock Exchange under the ticker symbol LLY. The drug is an investigational monoclonal antibody in Phase 2 clinical development for multiple indications, including systemic lupus erythematosus and rheumatoid arthritis.

What phase is LY2127399 in?

LY2127399 is in Phase 2 clinical development. It has completed five clinical trials, including two Phase 3 studies in systemic lupus erythematosus, but it is not yet approved by the FDA. The drug remains investigational and is being studied for conditions such as rheumatoid arthritis and lupus.

What clinical trials is LY2127399 in?

LY2127399 has been studied in several completed clinical trials, including NCT00308282 and NCT00689728 for rheumatoid arthritis, and NCT01196091 and NCT01205438 for systemic lupus erythematosus. These trials were placebo-controlled and double-blind, with a total enrollment of over 2,200 participants across multiple countries.

Is LY2127399 the same as tabalumab?

LY2127399 is also known as tabalumab, a monoclonal antibody targeting BAFF. It is being developed by Eli Lilly and Company for autoimmune diseases. In clinical trials, it has been evaluated for rheumatoid arthritis and systemic lupus erythematosus, among other conditions, but it is not yet approved.