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Lupus NephritisPhase 2TULIP-LN1NCT02547922

Safety and Efficacy of Two Doses of Anifrolumab Compared to Placebo in Adult Subjects With Active Proliferative Lupus Nephritis

A Phase 2 study testing Anifrolumab in people with Lupus Nephritis, run by AstraZeneca at 80 sites in 17 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to evaluate the efficacy and safety of an intravenous treatment regimen of two doses of anifrolumab versus placebo in adult subjects with active proliferative lupus nephritis (LN). Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Lupus Nephritis
What is being tested?
Anifrolumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
147 participants
Where
80 sitesin 17 countries
Study dates
4 Nov 2015to 18 Jan 2021
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Main Inclusion Criteria:

  1. Age 18 through 70 years at the time of screening
  2. Fulfils at least 4 of the 11 criteria of the revised 1982 ACR classification criteria for SLE, at least one of which must be:
  3. Positive antinuclear antibody (ANA) test (1:40 or higher) or
  4. Elevated anti-dsDNA antibodies at screening (reported as equivocal or positive results), as per the centrallaboratory; or
  5. Anti-Smith antibody at screening elevated to above normal (ie, positive or equivocal results) as per the central laboratory
  6. Class III (±Class V) or Class IV (±Class V) LN according to the World Health Organisation (WHO) or 2003 ISN/RPS classification based on a renal biopsy obtained within 12 weeks prior to signing the ICF or during the screening period:
  7. Urine protein to creatinine ratio >1 gm/gm (113.17 mg/mmol), obtained on a 24-hour urine collection at screening
  8. Estimated glomerular filtration rate ≥35 mL/min/1.73 m2
  9. Must not have active or latent TB on either chest radiograph or by Quantiferon gold test
  10. Women of childbearing potential must have a negative serum beta-hCG test at screening and negative urine pregnancy test prior to the first dose of sponsor-provided MMF.

Main Exclusion Criteria:

  1. Receipt of any investigational product (small molecule or biologic) or commercially available biologic agent within four weeks or 5 half lives prior to signing of the ICF, whichever is greater
  2. Pure Class V membranous LN on a renal biopsy obtained within 12 weeks prior to signing ICF or during the screening period
  3. Known intolerance to ≤1.0 gm/day of MMF
  4. History of dialysis within 12 months prior to signing the ICF or expected need for renal replacement therapy (dialysis or renal transplant) within a 6 month period after enrolment
  5. Subjects, who at the time of signing the ICF, received any of the following immunosuppressive therapies after their qualifying biopsy
  6. Oral corticosteroids >0.5 mg/kg/day for more than 8 weeks or
  7. Oral or IV pulse methylprednisolone >3.0 gm (cumulative dose) or
  8. IV cyclophosphamide >2 pulses of high-dose (≥0.5 gm/m2) or >4 doses of low dose (500 mg every 2 weeks) or
  9. Average MMF >2.5 gm/day (>1800 mg/day of enteric-coated mycophenolate sodium) for more than 8 weeks or
  10. Tacrolimus >4 mg/day for more than 8 weeks
  11. Major surgery within 8 weeks before signing the ICF or major surgery planned during the study period
  12. History of any non-SLE disease that has required treatment with oral or parenteral corticosteroids for more than a total of 2 weeks within the last 24 weeks prior to signing the ICF
  13. Confirmed positive test for hepatitis B or hepatitis C
  14. Any severe herpes infection at any time prior to randomization
  15. Opportunistic infection requiring hospitalisation or parenteral antimicrobial treatment within 3 years prior to randomization (vaginal, oral and skin candidiasis is not an exclusionreason).
  16. History of cancer, apart from:
  17. Squamous or basal cell carcinoma of the skin that has been successfully treated
  18. Cervical cancer in situ that has been successfully treated
  19. Concurrent enrolment in another clinical study with an IP within 4 weeks prior to ICF signing or within 5 half-lives of the IP used in that clinical study, whichever is longer.
  20. During screening (within 30 days before Day 1 [Week 0 visit]), any of the following:
  21. Aspartate transaminase (AST) >2.5×upper limit of normal (ULN)
  22. Alanine transaminase (ALT) >2.5×ULN
  23. Total bilirubin >ULN (unless due to Gilbert's syndrome [based on Investigator's judgement])
  24. Glycosylated haemoglobin (HbA1c) >8% (or >0.08) at screening (diabetic subjects only)
  25. Neutrophil count <1x103/μL (or <1.0 GI/L)
  26. Platelet count <25x103/μL (or <25 GI/L)
  27. Haemoglobin <8 g/dL (or <80 g/L).

Trial locations and contacts

80 sites in 17 countries.

80 sites in 17 countries

United States17 sites
  • Research Site

    Aurora, Colorado, 80045

  • Research Site

    Boston, Massachusetts, 02118

  • Research Site

    Columbus, Ohio, 43210

  • Research Site

    DeBary, Florida, 32713

  • Research Site

    Glendale, Arizona, 85306

  • Research Site

    Great Neck, New York, 11021

  • Research Site

    La Jolla, California, 92037-0706

  • Research Site

    Los Angeles, California, 90095-1670

  • Research Site

    Memphis, Tennessee, 38119

  • Research Site

    New Hyde Park, New York, 11042

  • Research Site

    New York, New York, 10016

  • Research Site

    New York, New York, 10029

  • Research Site

    Newark, New Jersey, 07103-2499

  • Research Site

    Oklahoma City, Oklahoma, 73104

  • Research Site

    Phoenix, Arizona, 85032

  • Research Site

    The Bronx, New York, 10457

  • Research Site

    Thousand Oaks, California, 91360

Other trials in United States

Peru9 sites
  • Research Site

    Arequipa, AREQUIPA54

  • Research Site

    Lima, L14

  • Research Site

    Lima, L34

  • Research Site

    Lima, LIMA 01

  • Research Site

    Lima, LIMA 31

  • Research Site

    Lima, LIMA 32

  • Research Site

    Lima, LIMA 33

  • Research Site

    Lima, Lima-1

  • Research Site

    Lima

Other trials in Peru

Taiwan6 sites
  • Research Site

    Changhua, 50006

  • Research Site

    Kaohsiung City, 80756

  • Research Site

    Taichung, 40447

  • Research Site

    Taichung, 40705

  • Research Site

    Taipei, 100

  • Research Site

    Taoyuan City, 333

Other trials in Taiwan

France5 sites
  • Research Site

    Bordeaux, 33076

  • Research Site

    Marseille, 13005

  • Research Site

    Paris, 75013

  • Research Site

    Strasbourg, 67098

  • Research Site

    Toulouse, 31059

Other trials in France

Mexico5 sites
  • Research Site

    Chihuahua City, 31000

  • Research Site

    Guadalajara, 44160

  • Research Site

    Guadalajara, 44280

  • Research Site

    México, 14080

  • Research Site

    San Luis Potosí City, 78213

Other trials in Mexico

Australia4 sites
  • Research Site

    Adelaide, 5000

  • Research Site

    Clayton, VIC 3168

  • Research Site

    Parkville, 3050

  • Research Site

    Westmead, 2145

Other trials in Australia

Belgium4 sites
  • Research Site

    Brussels, 1070

  • Research Site

    Brussels, 1200

  • Research Site

    Leuven, 3000

  • Research Site

    Liège, B-4000

Other trials in Belgium

Hungary4 sites
  • Research Site

    Budapest, 1097

  • Research Site

    Debrecen, 4032

  • Research Site

    Kaposvár, 7400

  • Research Site

    Szeged, 6725

Other trials in Hungary

Italy4 sites
  • Research Site

    Milan, 20132

  • Research Site

    Padova, 35128

  • Research Site

    Pisa, 56126

  • Research Site

    Reggio Emilia, 42100

Other trials in Italy

Serbia4 sites
  • Research Site

    Belgrade, 11000

  • Research Site

    Belgrade, 1100

  • Research Site

    Niš, 18000

  • Research Site

    Novi Sad, 21000

Other trials in Serbia

South Korea4 sites
  • Research Site

    Gwangju, 501-757

  • Research Site

    Seoul, 05505

  • Research Site

    Seoul, 150-713

  • Research Site

    Suwon, 16499

Other trials in South Korea

Argentina3 sites
  • Research Site

    Buenos Aires, C1015ABO

  • Research Site

    Córdoba, 5016

  • Research Site

    Rosario, S2000PBJ

Other trials in Argentina

Poland3 sites
  • Research Site

    Krakow, 31-066

  • Research Site

    Lodz, 92-213

  • Research Site

    Warsaw, 02-637

Other trials in Poland

Russia3 sites
  • Research Site

    Orenburg, 460018

  • Research Site

    Saint Petersburg, 197022

  • Research Site

    Saint Petersburg, 197089

Other trials in Russia

Germany2 sites
  • Research Site

    Berlin, 10117

  • Research Site

    Kiel, 24105

Other trials in Germany

Spain2 sites
  • Research Site

    Barcelona, 08035

  • Research Site

    Barcelona, 08036

Other trials in Spain

United Kingdom1 site
  • Research Site

    London, E1 1BB

Other trials in United Kingdom

About this study

Official title: A Multicentre, Randomised, Double-blind, Placebo-controlled, Phase 2 Study Evaluating the Efficacy and Safety of Anifrolumab in Adult Subjects With Active Proliferative Lupus Nephritis

The purpose of this study is to evaluate the efficacy and safety of an intravenous treatment regimen of two doses of anifrolumab versus placebo in adult subjects with active proliferative lupus nephritis (LN).

Read the detailed description

This is a Phase 2, multicentre, multinational, randomised, double-blind, placebo-controlled study to evaluate the efficacy and safety of two intravenous (IV) treatment regimens of anifrolumab versus placebo while taking standard of care (SOC) treatment with mycophenolate mofetil (MMF) and corticosteroids in adult subjects with active proliferative lupus nephritis (LN).

Conditions
Lupus Nephritis
Being tested
Anifrolumab, Placebo
Keywords
lupus, nephritis, randomized, placebo, anifrolumab, safety, efficacy, adult
Medical subject headings
Lupus Nephritis, Nephritis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AnifrolumabBiological

    Administration every 4 week from Week 0 to Week 100 in addition to SOC which will continue until Week 112

  • PlaceboDrug

    Administration every 4 week from Week 0 to Week 100 in addition to SOC which will continue until Week 112

Study groups in NCT02547922
Study groupRoleWhat they receive
Anifrolumab - Lower DoseExperimentalAnifrolumab - Lower Dose
Receives: Biological: Anifrolumab
Anifrolumab - Higher DoseExperimentalAnifrolumab - Higher Dose
Receives: Biological: Anifrolumab
PlaceboPlacebo comparatorPlacebo IV Q4W plus SOC
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline in 24-hour Urine Protein to Creatinine Ratio (UPCR)

    To evaluate the efficacy of anifrolumab plus SOC (combination of mycophenolate mofetil and corticosteroids) compared with placebo plus SOC in subjects with active proliferative lupus nephritis (LN).

    Geometric mean ratio of 24-hour UPCR at week 52 over baseline. Values <1 indicate improvement from baseline.

    Measured: From Week 1 (Baseline) up to Week 52

Secondary outcomes (1)
  1. Proportion of Subjects Achieving the Composite Endpoint Complete Renal Response (CRR)

    CRR was defined as meeting all of the following:

    • Estimated glomerular filtration rate (eGFR) is ≥60 mL/min/1.73 m^2 or no confirmed decrease of eGFR from baseline of ≥20%
    • 24-hour UPCR ≤ 0.7 mg/mg
    • No discontinuation of investigational product (IP) or use of restricted medication beyond the protocol allowed threshold before assessment
    • eGFR was based on Modification of Diet in Renal Disease (MDRD) formula. Subjects treated with restricted medication beyond the protocol allowed threshold, or discontinuing study treatment for other reasons, were regarded as non-responders.

    Measured: Week 52

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Sep 2015 (estimated)
  2. Study start4 Nov 2015
  3. Primary completion26 Nov 2019
  4. Study completion18 Jan 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
147 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02547922
Sponsor's protocol ID
D3461C00007
Acronym
TULIP-LN1
Status last verified
Oct 2021
First submitted
31 Aug 2015
Last updated
24 Nov 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment:

Publications

  • Almquist J, Chia YL, Tummala R, Bertagnolli L, Jayne D, Tang W, Lindholm C. Anifrolumab Dose Regimen Selection for a Phase 3 Trial in Lupus Nephritis. Clin Pharmacol Ther. 2026 Aug;120(2):429-439. doi: 10.1002/cpt.70307. Epub 2026 May 22.

    PubMed 42175562
  • Fava A, Petri M, Gavin PG, Csomor E, Brohawn PZ, Muthas D, Platt A, Lindholm C, Ferrari N. Anifrolumab Treatment Leads to Rapid Reduction in Urinary Biomarkers of Intrarenal Inflammation in Lupus Nephritis: Results From the Phase 2 Randomized Trial. Arthritis Rheumatol. 2026 Aug;78(8):1692-1699. doi: 10.1002/art.70089. Epub 2026 Mar 16.

    PubMed 41663906
  • Brunner HI, Cody EM, Devarajan P, Huang B, Chen C, Sinibaldi D, Ramaswamy M, Knagenhjelm J, Jones F, Brohawn PZ, Tummala R, Lindholm C, White WI. The Renal Activity Index for Lupus Identifies Active Renal Disease and Treatment Response in Adult Patients With Systemic Lupus Erythematosus and Lupus Nephritis. Arthritis Care Res (Hoboken). 2026 Jun;78(6):723-732. doi: 10.1002/acr.25684. Epub 2026 Feb 23.

    PubMed 41144892
  • Jayne D, Rovin B, Mysler E, Furie R, Houssiau F, Trasieva T, Knagenhjelm J, Schwetje E, Tang W, Tummala R, Lindholm C. Anifrolumab in lupus nephritis: results from second-year extension of a randomised phase II trial. Lupus Sci Med. 2023 Aug;10(2):e000910. doi: 10.1136/lupus-2023-000910.

    PubMed 37607780
  • Jayne D, Rovin B, Mysler EF, Furie RA, Houssiau FA, Trasieva T, Knagenhjelm J, Schwetje E, Chia YL, Tummala R, Lindholm C. Phase II randomised trial of type I interferon inhibitor anifrolumab in patients with active lupus nephritis. Ann Rheum Dis. 2022 Apr;81(4):496-506. doi: 10.1136/annrheumdis-2021-221478. Epub 2022 Feb 10.

    PubMed 35144924

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Anifrolumab in people with Lupus Nephritis, run by AstraZeneca at 80 sites in 17 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Nov 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 80 sites in United States, Peru, Taiwan, France, Mexico and 12 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 24 Nov 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline in 24-hour Urine Protein to Creatinine Ratio (UPCR) (time frame: From Week 1 (Baseline) up to Week 52). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02547922, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Nov 2021.

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