AzTrials
AzTrials

Lupus Erythematosus, SystemicPhase 4NCT03543839

Trial of Belimumab in Early Lupus

A Phase 4 study testing Belimumab in people with Lupus Erythematosus, Systemic and Lupus Erythematosus, run by Northwell Health at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This two year study will evaluate the effects of giving belimumab (Benlysta) to patients with Early Lupus. Early lupus is a diagnosis of lupus within 2 years. Subjects will be randomized to receive belimumab or placebo during the first year. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Belimumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
30 participants
Where
1 siteUnited States
Study dates
15 Sep 2020to Mar 2029
Phase
Phase 4
Are there results?
Not yet: the study is under way

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis of SLE per current ACR classification criteria
  • Date of SLE diagnosis within 2 years of screening
  • ANA positive (with a titer ≥ 80)
  • anti-ds DNA antibody positive
  • Mild to moderate disease activity define by a SLEDAI-2K ≥4
  • Stable corticosteroid dose in the 4 weeks prior to screening ≤ 30mg/day.
Show all 11Show fewer
  • If on methotrexate, dose must be stable for 4 weeks
  • Concomitant treatment with hydroxychloroquine unless documented inability to tolerate
  • Able and willing to give written informed consent and comply with the requirements of the study protocol
  • Negative serum pregnancy test (for women of child bearing potential)
  • Men and women of reproductive potential must agree to use an acceptable method of birth control during treatment and for 16 weeks after completion of treatment

Who cannot join

  • Previous exposure to disease modifying drugs such as azathioprine, mycophenolate mofetil, cyclophosphamide, or cyclosporine.
  • Previous exposure to biologic therapies including rituximab, belimumab or other agents that have been investigated for SLE.
  • Active renal or nervous system disease or disease activity fulfilling BILAG A criteria
  • Use of high dose steroids (>0.5 mg/kg/ day) within the 4 weeks prior to screening
  • Expectation (by the investigator) that the subject will require treatment with a disease modifying drug within the first 52 weeks of the study
  • Hemoglobin: < 8.0 gm/dL
Show all 34Show fewer
  • Platelets: < 50,000/mm
  • ANC < 1.0 x 103/mm
  • AST or ALT >2.5 x Upper Limit of Normal unless related to primary disease.
  • Creatinine clearance ≤ 25ml/min per 1.73 m2
  • Positive Hepatitis B or C serology (Hep B Surface antigen, Hep B core Ab or Hepatitis C antibody)
  • History of positive HIV (HIV conducted during screening if applicable)
  • Treatment with any investigational agent within 4 weeks of screening or 5 half-lives of the investigational drug (whichever is longer)
  • Receipt of a live vaccine within 30 days prior to baseline or concurrently with belimumab
  • Have a history of an anaphylactic reaction to parenteral administration of contrast agents, human or murine proteins or monoclonal antibodies
  • Currently on any suppressive therapy for a chronic infection (such as tuberculosis, pneumocystis, cytomegalovirus, herpes simplex virus, herpes zoster and atypical mycobacteria)
  • Hospitalization for treatment of infection within 60 days of Day 0.
  • Use of parenteral (IV or IM) antibiotics (antibacterials, antivirals, anti-fungals, or anti parasitic agents) within 60 days of Day 0
  • History of serious recurrent or chronic infection
  • Lack of peripheral venous access
  • History of drug, alcohol, or chemical abuse within 365 days prior to Day 0
  • Pregnancy (a negative serum pregnancy test must be obtained for all women of childbearing potential at screening; a urine pregnancy test must be negative < 7 days prior to first dose and monthly)
  • Lactation
  • History of psychiatric disorder that would interfere with normal participation in this protocol
  • Significant cardiac or pulmonary disease (including obstructive pulmonary disease)
  • Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the patient at high risk from treatment complications
  • History of malignant neoplasm within the last 5 years with the exception of adequately treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix
  • Evidence of serious suicide risk including any history of suicidal behaviour in the last 6 months and/or any suicidal ideation in the last 2 months or who in the investigator's judgment, pose a significant suicide risk
  • History of a primary immunodeficiency
  • Have a significant IgG deficiency (IgG level < 400 mg/dL)
  • Have an IgA deficiency (IgA level < 10 mg/dL)
  • Have any other clinically significant abnormal laboratory value in the opinion of the investigator
  • Comorbidities requiring corticosteroid therapy, including those which have required two or more courses of systemic courses of systemic corticosteroids within the previous 12 months
  • Inability to comply with study and follow-up procedures

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Sanita Kandasami, BS contact

516 562-2401

skandasami@northwell.edu

Cynthia Aranow, MD contact

516 562-3845

caranow@northwell.edu

United States1 site, 1 recruiting
  • Feinstein Institute

    Manhasset, New York, 11030

    Sanita Kandasami, 516-562-2401, skandasami@northwell.edu

    Cynthia Aranow, M.D.

    Recruiting

Other trials in United States

About this study

Official title: Pilot Trial of Belimumab in Early Lupus

This two year study will evaluate the effects of giving belimumab (Benlysta) to patients with Early Lupus. Early lupus is a diagnosis of lupus within 2 years. Subjects will be randomized to receive belimumab or placebo during the first year. During the second year, subjects who were randomized to belimumab will be rerandomized to continue to receive belimumab or to receive placebo. The study will look at clinical effects as well as effects on the immune system.

Read the detailed description

This protocol proposes that early treatment of Systemic Lupus Erythematous (SLE) may prevent tissue damage and may even lead to long-term remission of disease. This concept is supported by reports of SLE-associated autoimmunity that are detected serologically many years prior to any constitutional symptoms or specific tissue inflammation and immune dysregulation precedes the development of clinically apparent SLE. Belimumab (Benlysta) is an FDA approved medication and is a monoclonal antibody directed against B cell-activating factor (BAFF)/ B Lymphocyte Stimulator (BLyS). B cells maturing in environments with high BAFF levels are more likely to be autoreactive B cells. This is a double-blind placebo controlled trial of belimumab, in patients with early lupus, ie lupus diagnosed within 2 years. Thirty subjects will be randomized (2:1) to receive subcutaneous belimumab weekly or placebo. After a year of treatment, subjects receiving belimumab will be rerandomized (1:1) to receive belimumab or placebo. The primary outcome is B cell autoreactivity. Clinical efficacy including disease activity, flares, attainment of low disease activity or remission as well as surrogate cardiovascular biomarkers will also be assessed.

Being tested
Belimumab, Belimumab/Placebo, Placebo
Keywords
lupus, early lupus, belimumab, autoreactivity
Medical subject headings
Lupus Erythematosus, Systemic

What participants receive

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

  • BelimumabBiological

    Subjects in this arm will receive 200mg belimumab subcutaneously weekly for 2 years

  • Belimumab/PlaceboBiological

    Subjects in this arm will receive weekly subcutaneous injections of 200mg belimumab for 1 year and then placebo subcutaneous injections for 1 year.

  • PlaceboOther

    Subjects in this arm will receive weekly subcutaneous injections of placebo for 2 years

Study groups in NCT03543839
Study groupRoleWhat they receive
BelimumabActive comparatorSubjects in this arm will receive 200mg belimumab for self administration subcutaneously weekly for 2 years
Receives: Biological: Belimumab
Belimumab/PlaceboExperimentalSubjects in this arm will receive 200mg belimumab for self administration subcutaneously weekly for 1 year and then placebo injections subcutaneously for 1 year.
Receives: Biological: Belimumab/Placebo
PlaceboPlacebo comparatorSubjects in this arm will receive placebo for self administration subcutaneously weekly for 2 years
Receives: Other: Placebo

What is being measured

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

  1. Frequency of anergic autoreactive naïve B cells

    The frequency of autoreactive B cells in the naïve subset will be identified by flow cytometry.

    Measured: Assessment at year 1

Secondary outcomes (35)
  1. Frequency of anergic autoreactive naïve B cells

    The frequency of autoreactive B cells in the naïve subset will be identified by flow cytometry.

    Measured: Assessment at year 2

  2. Frequency of autoreactivity in transitional B cells

    The frequency of autoreactive B cells in the transitional B cell subset will be identified by flow cytometry.

    Measured: Year 1

  3. Frequency of autoreactivity in transitional B cells

    The frequency of autoreactive B cells in the transitional B cell subset will be identified by flow cytometry.

    Measured: Year 2

  4. Time to reconstitution of B cell subsets in subjects in belimumab/placebo arm randomized to receive placebo after 1 year of belimumab therapy

    B cell numbers decrease following belimumab; the time for B cell reconstituion will be determined

    Measured: Year 2

  5. SRI (SLE Response Index) modified

    Systemic lupus response index

    Measured: Year 1

  6. SRI modified

    Systemic lupus response index

    Measured: Year 2

  7. Low lupus disease activity state (LLDAS)

    LLDAS as defined by the Asia-Pacific Lupus Association

    Measured: Year 1

  8. Low lupus disease activity state

    LLDAS as defined by the Asia-Pacific Lupus Association

    Measured: Year 2

  9. Remission

    Remission defined by DORIS (Definition of Remission in SLE)

    Measured: Year 1

  10. Remission

    Remission defined by DORIS (Definition of Remission in SLE)

    Measured: Year 2

  11. Flare of lupus disease

    Lupus flare will be measure using the SELENA-SLEDAI (Safety of Estrogens in Lupus Erythematosus National Assessment --Systemic Lupus Erythematosus Disease Activity Index) flare instrument or British Isles Lupus Assessment Group (BILAG) disease activity index

    Measured: Through year 2

  12. New Classification Criteria for SLE.

    Accumulation of new American College of Rheumatology (ACR) Classification criteria or Systemic Lupus International Cooperative Clinics (SLICC) criteria

    Measured: Through year 2

  13. Serologies

    Changes in titers of anti-DNA antibody levels

    Measured: Through year 2

  14. Complement levels

    Changes in measures of C3 and C4 (mg/dL)

    Measured: Through year 2

  15. Complement levels

    Changes in measures of C3, C4 (mg/dL)

    Measured: Through year 2

  16. Serum immunoglobulin levels

    Change from baseline of serum IgG, IgM and IgA (mg/dL)

    Measured: Through year 2

  17. Damage

    Damage accrual assessed using a SLE damage index

    Measured: Through year 2

  18. Cardiovascular biomarkers

    IgM phosphocholine antibody titers and proinflammatory HDL

    Measured: Through year 2

  19. Safety and tolerability (adverse events)

    All adverse events and serious adverse events will be collected

    Measured: Through year 2

  20. Frequency of autoreactivity in CD27+, IgD+ memory B cells

    The frequency of autoreactive B cells in the CD27+, IgD+ B cell subset will be identified by flow cytometry.

    Measured: Year 1

  21. Frequency of autoreactivity in CD27+, IgD+ memory B cells

    The frequency of autoreactive B cells in the CD27+, IgD+ B cell subset will be identified by flow cytometry.

    Measured: Year 2

  22. Frequency of autoreactivity in CD27+, IgD- B cells

    The frequency of autoreactive B cells in the CD27+, IgD- B cell subset will be identified by flow cytometry.

    Measured: Year 1

  23. Frequency of autoreactivity in CD27+, IgD- B cells

    The frequency of autoreactive B cells in the CD27+, IgD- B cell subset will be identified by flow cytometry.

    Measured: Year 2

  24. Frequency of autoreactivity in CD27-, IgD- B cells

    The frequency of autoreactive B cells in the CD27-, IgD- B cell subset will be identified by flow cytometry.

    Measured: Year 1

  25. Frequency of autoreactivity in CD27-, IgD- B cells

    The frequency of autoreactive B cells in the CD27-, IgD- B cell subset will be identified by flow cytometry.

    Measured: Year 2

  26. The absolute numbers of transitional B cells

    The number of transitional B cells will be determined by flow cytometry.

    Measured: Year 1

  27. The absolute numbers of transitional B cells

    The number of transitional B cells will be determined by flow cytometry.

    Measured: Year 2

  28. The absolute numbers of naïve B cells

    The number of transitional B cells will be determined by flow cytometry.

    Measured: Year 1

  29. The absolute numbers of naïve B cells

    The number of naïve B cells will be determined by flow cytometry.

    Measured: Year 2

  30. The absolute numbers of memory B cells

    The number of memory B cells will be determined by flow cytometry.

    Measured: Year 1

  31. The absolute numbers of memory B cells

    The number of memory B cells will be determined by flow cytometry.

    Measured: Year 2

  32. The absolute number of plasmablasts

    The number of plasmablasts will be determined by flow cytometry.

    Measured: Year 1

  33. The absolute number of plasmablasts

    The number of plasmablasts will be determined by flow cytometry.

    Measured: Year 2

  34. The absolute number of plasma cells

    The number of plasma cells will be determined by flow cytometry.

    Measured: Year 1

  35. The absolute number of plasma cells

    The number of plasma cells will be determined by flow cytometry.

    Measured: Year 2

Timeline

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

  1. First posted1 Jun 2018
  2. Study start15 Sep 2020
  3. Primary completionSep 2028 (estimated)
  4. Study completionMar 2029 (estimated)

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
This is not a true cross-over study. Subjects are randomized to receive true drug or placebo in the initial phase and then those patients who were randomized to receive belimumab will be rerandomized to receive either study drug or placebo. Subjects randomized at baseline to receive placebo continue to receive placebo through the study.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03543839
Sponsor's protocol ID
17-0861
Status last verified
Jun 2026
First submitted
12 Apr 2018
Last updated
12 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Belimumab in people with Lupus Erythematosus, Systemic and Lupus Erythematosus, run by Northwell Health at 1 site in United States.

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

Who may be eligible to take part?

The sponsor lists 11 inclusion and 34 exclusion criteria. 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: looking for participants now, as of the sponsor's last update on 12 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Sanita Kandasami, BS (516 562-2401, skandasami@northwell.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Frequency of anergic autoreactive naïve B cells (time frame: Assessment at year 1). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 12 Jun 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in