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Atacicept

Phase 2

Lupus Erythematosus, Systemic | Small molecule | Immunology |Merck & Company, Inc.|Last Updated: Dec 30, 2016

Success Probability

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDBiomarker
Total Trials1
Total Enrollment461

FDA Designations

No designations recorded

Clinical trial landscape

Atacicept · 3 trials · 2 indications

Phase 2 3
NCT00664521Atacicept in Combination With Rituximab in Subjects With Rheumatoid Arthritis (August III)Rheumatoid Arthritis
COMPLETED27 Analytics
NCT00624338Atacicept Phase 2/3 in Generalized Systemic Lupus Erythematosus (APRIL-SLE)Lupus Erythematosus, Systemic
COMPLETED461 Analytics
NCT00595413Atacicept in Anti-Tumor Necrosis Factor Alpha-naïve Subjects With Rheumatoid Arthritis (AUGUST II)Rheumatoid Arthritis
COMPLETED311 Analytics
PHASE2COMPLETED
Atacicept in Combination With Rituximab in Subjects With Rheumatoid Arthritis (August III)
Rheumatoid ArthritisUnlock trial analytics
PHASE2COMPLETED
Atacicept Phase 2/3 in Generalized Systemic Lupus Erythematosus (APRIL-SLE)
Lupus Erythematosus, SystemicUnlock trial analytics
PHASE2COMPLETED
Atacicept in Anti-Tumor Necrosis Factor Alpha-naïve Subjects With Rheumatoid Arthritis (AUGUST II)
Rheumatoid ArthritisUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
Baseline up to Week 64

An AE was defined as any new untoward medical occurrences/worsening of pre-existing medical condition without regard to possibility of causal relationship. An SAE was defined as an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect.

Percentage of Participants With Immunoglobulin G (IgG) Level Less Than 3 Gram Per Liter (g/L)
Week 64
Percent Change From Baseline in Vital Signs and Routine Safety Lab Parameters at Week 32
Baseline, Week 32

Vital signs assessed included blood pressure (systolic and diastolic), pulse and body temperature. Routine safety lab parameters evaluated included red blood cell (RBC), hemoglobin, hematocrit, platelets, mean cellular hemoglobin (MCH), MCH concentration, MCH volume, white blood cell (WBC), lymphocytes, monocytes, eosinophils, basophils, neutrophils, gamma glutamyl transferase (GGT), alanine aminotransferase (ALT), albumin, alkaline phosphatase (AP), aspartate aminotransferase (AST), bilirubin, calcium, creatinine, glucose, potassium, total protein, sodium, uric acid, and blood urea nitrogen. Percent change from baseline was calculated as (\[Week 32 value minus baseline value\] multiplied by 100) divided by baseline value.

Percent Change From Baseline in Anti-tetanus and Anti-diphteria Immunization Titer at Week 32
Baseline, Week 32

Percent change from baseline was calculated as (\[Week 32 value minus baseline value\] multiplied by 100) divided by baseline value.

Percent Change From Baseline in Anti-pneumococcus Titer at Week 32
Baseline, Week 32

Percent change from baseline was calculated as (\[Week 32 value minus baseline value\] multiplied by 100) divided by baseline value.

Percentage of Participants Experiencing a New Flare as Defined by British Isles Lupus Assessment Group (BILAG) Score A or B
From screening up to Week 52

A flare was defined as having an adjudicated BILAG A or B score in any of the 8 organ systems during treatment, or imputed for participants who had premature treatment discontinuation. Discontinuations due to sponsor termination of the atacicept 150 mg group were not imputed as flares in this analysis. The BILAG disease activity index evaluates systemic lupus erythematosus (SLE) activity in 8 organ systems, using a separate alphabetic score (A to E) assigned to each organ system defined as follows. BILAG A: Disease sufficiently active requiring disease-modifying treatment (prednisone greater than 20 mg daily or immunosuppressants); BILAG B: Disease less active than in "A", mild reversible problems requiring only symptomatic therapy such as antimalarials, non-steroidal anti-inflammatory drugs (NSAIDs), or prednisone less than 20 mg day; BILAG C: Stable mild disease; BILAG D: System previously affected but now inactive; BILAG E: System never involved.

Percentage of Participants Achieving American College of Rheumatology 20 Response Based on C-reactive Protein (ACR20-CRP) at Week 26
Week 26

ACR20-CRP response is defined as greater than or equal to (\>=) 20 percent (%) improvement from Baseline in both tender joint counts (based on a total of 68 joints) and swollen joint counts (based on a total of 66 joints) together with \>=20% improvement from Baseline in at least 3 of the following 5 measures: 1) participant's assessment of pain; 2) participant's global assessment of disease activity; 3) physician's global assessment of disease activity; 4) participant's assessment of physical function; and 5) acute-phase marker (CRP).

Secondary Endpoints

Percentage of Participants Achieving American College of Rheumatology 20 Response Based on C-reactive Protein (ACR20-CRP), ACR50-CRP and ACR70-CRP at Week 32
Week 32
Change From Baseline in Disease Activity Score in 28 Joints (DAS28) Based on CRP (DAS28-CRP) at Week 32
Baseline, Week 32
Median Percentage Change From Baseline in Levels of Total, Mature and Memory B Cells
Baseline, Week 3, 7, 12, 16, 26 and 32
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Rituximab Plus AtaciceptEXPERIMENTALRituximab will be administered as an intravenous infusion at a dose of 1000 mg at Weeks 1 and 3, followed by atacicept 150 mg subcutaneously once a week from Week 7 to 32.
Rituximab Plus PlaceboPLACEBO_COMPARATORRituximab will be administered as an intravenous infusion at a dose of 1000 mg at Weeks 1 and 3, followed by placebo matched to atacicept subcutaneously once a week from Week 7 to 32.
Atacicept 75 mgEXPERIMENTAL -
Atacicept 150 mgEXPERIMENTAL -
PlaceboPLACEBO_COMPARATOR -
Atacicept 150 mg with loading doseEXPERIMENTAL -
Atacicept 150 mg without loading doseEXPERIMENTAL -
AdalimumabACTIVE_COMPARATOR -

Interventions

NameTypeDescription
RituximabBIOLOGICALRituximab will be administered as an intravenous infusion at a dose of 1000 mg at Weeks 1 and 3.
AtaciceptDRUGAtacicept will be administered at a dose of 150 mg subcutaneously once a week from Week 7 to 32.
Placebo matched to ataciceptDRUGPlacebo matched to atacicept will be administered subcutaneously once a week from Week 7 to 32.
Atacicept 75 mgDRUG75 milligram (mg) atacicept injection will be administered subcutaneously twice weekly during initial loading period for 4 weeks followed by once weekly during maintenance period for subsequent 48 weeks.
Atacicept 150 mgDRUG150 mg atacicept injection will be administered subcutaneously twice weekly during initial loading period for 4 weeks followed by once weekly during maintenance period for subsequent 48 weeks.
Placebo ComparatorOTHERPlacebo matched to atacicept injection will be administered subcutaneously twice weekly during initial loading period for 4 weeks followed by once weekly during maintenance period for subsequent 48 weeks.
Atacicept: with loading doseDRUGAtacicept will be administered subcutaneously at a dose of 150 milligram (mg) twice a week for initial 4 weeks as loading dose, followed by 150 mg once a week for subsequent 21 weeks.
AdalimumabBIOLOGICALAdalimumab (Humira®) will be administered subcutaneously at a dose of 40 mg every other week for 25 weeks.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites8

Inclusion Criteria: * Male and female subjects * Greater than and equal to (\>=) 18 years of age at the time of Informed Consent * Who have rheumatoid arthritis satisfying American College of Rheumatology (ACR) criteria with a disease history of at least 12 months * Subjects must have active diseas...

Countries:FranceNetherlandsSwedenUnited KingdomUnited StatesArgentinaAustraliaAustriaBulgariaCroatiaCzechiaGermanyGreeceIndiaIsraelLatviaLebanonLithuaniaMalaysiaMexicoPhilippinesPolandRussiaSerbiaSouth AfricaSouth KoreaSpainSwitzerlandTaiwanUkraine
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Frequently asked questions about Atacicept

What is Atacicept used for?

Atacicept is an investigational immunology drug being developed for systemic lupus erythematosus and rheumatoid arthritis. It is a small molecule being studied in Phase 2 clinical trials. Atacicept is not approved by the FDA and remains in clinical development for these autoimmune conditions.

Who makes Atacicept?

Atacicept is being developed by Merck & Company, Inc., which trades under the ticker MRK. The company is conducting clinical trials of Atacicept for systemic lupus erythematosus and rheumatoid arthritis. Merck is responsible for the drug's development program.

What phase is Atacicept in?

Atacicept is in Phase 2 clinical development for systemic lupus erythematosus and rheumatoid arthritis. It is an investigational drug and has not been approved by the FDA. All completed trials for Atacicept are Phase 2 studies, and the drug remains under clinical investigation.

What clinical trials is Atacicept in?

Atacicept has completed three clinical trials. NCT00595413 studied Atacicept in rheumatoid arthritis patients with 311 participants. NCT00624338 studied Atacicept in systemic lupus erythematosus with 461 participants. NCT00664521 studied Atacicept in combination with rituximab in rheumatoid arthritis with 27 participants.

Is Atacicept the same as APRIL-SLE?

No, APRIL-SLE is the name of a clinical trial, not an alternative name for Atacicept. The trial NCT00624338, titled "Atacicept Phase 2/3 in Generalized Systemic Lupus Erythematosus (APRIL-SLE)", studied Atacicept in patients with systemic lupus erythematosus. Atacicept is the drug being tested in that trial.