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LY2127399

Phase 3

Rheumatoid Arthritis | Monoclonal antibody | Immunology |Eli Lilly and Company|Trials Updated: Oct 8, 2019

LY2127399 development status

Highest phase Phase 3
Registered trials 21 across 2 sponsors since Mar 2006

LY2127399 target and mechanism

ModalityMonoclonal antibody

Also known as LY2127399 (Tabalumab), Tabalumab, Tabalumab Auto-Injector, Tabalumab Prefilled Syringe

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials14
Total Enrollment4,473

FDA Designations

No designations recorded

LY2127399 clinical trials

LY2127399 · 14 trials · 8 indications

Phase 3 3Phase 2 7Phase 1 4
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.

Progression Free Survival (PFS)
Baseline up to Objective Disease Progression or Death From Any Cause (assessed up to 9 months)

PFS is defined as the time from date of first dose to the first observation of disease progression or death due to any cause. If a participant does not have a complete baseline disease assessment, then the PFS time is censored at the enrollment date, regardless of whether or not objectively determined disease progression (Increase of \> 25% from lowest response in serum M component, urine M component, bone marrow plasma cell percentage, development of bone lesions) or death has been observed for the participant. If a participant is not known to have died or have objective progression as of the data inclusion cutoff date for the analysis, the PFS time is censored at the last complete objective progression-free disease assessment date.

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 One or More Drug Related Adverse Events (AEs) or Any Serious AEs
Baseline through 8 months

A summary of other non-serious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section.

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.
100 mg Tabalumab+Dexamethasone (Dex)+Bortezomib (BTZ)EXPERIMENTALTabalumab 100 milligram (mg) administered once intravenously (IV) over 30 minutes on Day 1 every 21 days for 8 cycles. Dexamethasone 20 mg administered once orally on Days 1, 2, 4, 5, 8, 9, 11 and 12 every 21 days for 8 cycles. Bortezomib 1.3 milligram per square meter (mg/m\^2) administered once subcutaneously (SQ) on Days 1, 4, 8 and 11 every 21 days for a minimum 8 cycles. All treatment may continue past 8 cycles.
300 mg Tabalumab+Dexamethasone+BortezomibEXPERIMENTALTabalumab 300 mg administered once IV over 30 minutes on Day 1 every 21 days for 8 cycles. Dexamethasone 20 mg administered orally on Days 1, 2, 4, 5, 8, 9, 11 and 12 every 21 days for a minimum 8 cycles. Bortezomib 1.3 mg/m\^2 administered once SQ on Days 1, 4, 8 and 11 every 21 days for 8 cycles. All treatment may continue past 8 cycles.
Placebo Comparator: Placebo + Dexamethasone + BortezomibPLACEBO_COMPARATORPlacebo administered once IV on Day 1 every 21 days for 8 cycles. Dexamethasone 20 mg administered once orally on Days 1, 2, 4, 5, 8, 9, 11 and 12 every 21 days for a minimum 8 cycles. Bortezomib 1.3 mg/m\^2 administered once SQ on Days 1, 4, 8 and 11 every 21 days for 8 cycles. All treatment may continue past 8 cycles.
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
100 mg Tabalumab+Bortezomib (BTZ)IV+Dexamethasone (Dex)EXPERIMENTALCohort 1. 100 mg tabalumab (LY2127399) intravenously (IV) on day 1 of each cycle, each cyle is 21 days. Bortezomib (BTZ), 1.3 milligram per square meter (mg/m\^2), IV on days 1, 4, 8, 11 of Cycle 1-8, then on days 1, 8, 15, 22 from Cycle 9 onward. Oral dexamethasone (Dex), 20 mg/day, on day of and day after BTZ.
300 mg Tabalumab+BTZ IV+DexEXPERIMENTALCohort 2. 300 mg tabalumab (LY2127399) IV on day 1 of each cycle, each cycle is 21 days. BTZ, 1.3 mg/m\^2, IV on days 1, 4, 8, 11 of Cycle 1-8, then on days 1, 8, 15, 22 from Cycle 9 onward. Oral dex, 20 mg/day, on day of and day after BTZ.
300 mg Tabalumab+BTZ SC+DexEXPERIMENTALCohort 2-SC. 300 mg tabalumab (LY2127399)IV on day 1 of each cycle, each cycle is 21 days. BTZ, 1.3 mg/m\^2, subcutaneously (SC) on days 1, 4, 8, 11 of Cycle 1-8, then on days 1, 8, 15, 22 from Cycle 9 onward. Oral dex, 20 mg/day, on day of and day after BTZ. Cohort 2-SC was added per protocol amendment in February 2013.
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 -
DexamethasoneDRUGAdministered orally
BortezomibDRUGAdministered SQ
TabalumabBIOLOGICALAdministered IV
Bortezomib IVDRUGAdministered IV
Bortezomib SCDRUGAdministered SC
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 RicoSingaporeThailandGreeceNetherlandsTurkey (Türkiye)CzechiaBelgium
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Frequently asked questions about LY2127399

What is LY2127399?

LY2127399 is an investigational small molecule developed by Eli Lilly and Company for autoimmune and inflammatory conditions. It has been studied in rheumatoid arthritis, systemic lupus erythematosus, relapsing-remitting multiple sclerosis, multiple myeloma, and chronic kidney failure. The drug is also known as tabalumab.

What is LY2127399 used for?

LY2127399 has been studied for the treatment of several conditions, including rheumatoid arthritis, systemic lupus erythematosus, relapsing-remitting multiple sclerosis, multiple myeloma, and chronic kidney failure. It is an investigational agent and is not approved for any indication.

Who makes LY2127399?

LY2127399 is developed by Eli Lilly and Company, which trades on the New York Stock Exchange under the ticker LLY. The company sponsored the clinical trials evaluating the drug in rheumatoid arthritis and systemic lupus erythematosus.

What phase is LY2127399 in?

LY2127399 has completed Phase 3 trials in rheumatoid arthritis and systemic lupus erythematosus, and Phase 1 trials in Japanese participants with rheumatoid arthritis. It is an investigational drug and has not been approved by the FDA for any indication.

What clinical trials is LY2127399 in?

LY2127399 has been evaluated in seven completed trials, including NCT01205438, a Phase 3 study in systemic lupus erythematosus with 1,124 participants, and NCT01202760, a Phase 3 rheumatoid arthritis study with 1,004 participants. Phase 1 trials NCT01253291 and NCT01253226 enrolled Japanese participants with rheumatoid arthritis.

Is LY2127399 the same as tabalumab?

Yes, LY2127399 is also known as tabalumab. Both names refer to the same investigational drug developed by Eli Lilly and Company for autoimmune and inflammatory conditions.