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Sjogren's SyndromePhase 2TWINSS ExtnNCT04541589

Study of Safety and Tolerability of CFZ533 in Patients With Sjögren's Syndrome

A Phase 2 study testing Iscalimab in people with Sjogren's Syndrome, run by Novartis Pharmaceuticals at 62 sites in 23 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

This study will evaluate the safety and tolerability of iscalimab at two dose levels in patients with Sjögren's Syndrome, who participated in the TWINSS core study, CCFZ533B2201 (NCT03905525). Additionally, this Extension study will further explore the pharmacokinetics (PK) and efficacy of iscalimab at two dose level. Read more about this study

Who is it for?
Ages 18 to 99 years
Conditions the study is for
Sjogren's Syndrome
What is being tested?
Iscalimab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
206 participants
Where
62 sitesin 23 countries
Study dates
5 Jan 2021to 19 Aug 2024
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 99 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participants had to have participated in the TWINSS core study, CCFZ533B2201 (NCT03905525), and had to have completed the entire treatment period up to Week 48 and the follow-up period up to Week 60.
  • Signed informed consent had to be obtained prior to participation in the Extension study (i.e., before commencement of the Week 60 assessments of the core study).
  • In the judgment of the Investigator, participants had to be expected to clinically benefit from continued iscalimab therapy.

Who cannot join

  • Sjögren's Syndrome overlap syndromes where another autoimmune rheumatic disease constituted the principle illness, specifically:
  • Moderate-to-severe active systemic lupus erythematosus (SLE) with anti-dsDNA positivity and renal involvement, or other organ involvement that impeded on the ability to score ESSDAI domains
  • Active rheumatoid arthritis (RA) that impeded on the ability to score the ESSDAI articular domain
  • Systemic sclerosis
  • Any other concurrent connective tissue disease (e.g., lupus nephritis (LN), large vessel vasculitis (LVV), Sharp syndrome (mixed connective tissue disease) that was active and required immunosuppressive treatment outside the scope of this trial and would impede on Sjögren's Syndrome organ domain assessments
  • Use of other investigational drugs other than iscalimab during the core study
Show all 10Show fewer
  • Active uncontrolled viral, bacterial or other infections requiring systemic treatment at the time of enrollment, or history of recurrent clinically significant infection or of bacterial infections with encapsulated organisms
  • Pregnant or nursing (lactating) women, where pregnancy was defined as the state of a female after conception and until the termination of gestation, confirmed by a positive human Chorionic Gonadotropin (hCG) laboratory test
  • Women of child-bearing potential (WOCBP), defined as all women physiologically capable of becoming pregnant, unless they were using highly effective methods of contraception during dosing and for 14 weeks after stopping the investigational drug.
  • Missing ESSDAI (Cohort 1 and Cohort 2) or ESSPRI (Cohort 2) scores in the core study at Weeks 0 and 4 or Weeks 40 and 48.

Trial locations and contacts

62 sites in 23 countries.

62 sites in 23 countries

United States7 sites
  • The John Hopkins Jerome L Greene Sjogren

    Baltimore, Maryland, 21224

  • Ochsner Health System

    Baton Rouge, Louisiana, 70809

  • Tufts School of Dental Medicine

    Boston, Massachusetts, 02111

  • Uni Wisconsin School Med Pub Health

    Madison, Wisconsin, 53792

  • Winthrop University Hospital

    Mineola, New York, 11501

  • Perelman School of Medicine

    Philadelphia, Pennsylvania, 19104

  • North GA Rheumatology Group PC

    Suwanee, Georgia, 30024

Other trials in United States

Russia5 sites
  • Novartis Investigative Site

    Kazan', 420097

  • Novartis Investigative Site

    Moscow, 115522

  • Novartis Investigative Site

    Saint Petersburg, 195257

  • Novartis Investigative Site

    Tomsk, 634009

  • Novartis Investigative Site

    Yekaterinburg, 620028

Other trials in Russia

Chile4 sites
  • Novartis Investigative Site

    Santiago, RM, 7500588

  • Novartis Investigative Site

    Santiago, 7500571

  • Novartis Investigative Site

    Santiago, 7500710

  • Novartis Investigative Site

    Valdivia, Los Ríos Region, 5110683

Other trials in Chile

France4 sites
  • Novartis Investigative Site

    Brest, 29200

  • Novartis Investigative Site

    Le Kremlin-Bicêtre, 94275

  • Novartis Investigative Site

    Lille, 59037

  • Novartis Investigative Site

    Strasbourg, 67000

Other trials in France

Germany4 sites
  • Novartis Investigative Site

    Bonn, 53105

  • Novartis Investigative Site

    Dresden, 01307

  • Novartis Investigative Site

    Freiburg im Breisgau, 79106

  • Novartis Investigative Site

    Würzburg, 97080

Other trials in Germany

Japan4 sites
  • Novartis Investigative Site

    Chuo Ku, Tokyo, 104 8560

  • Novartis Investigative Site

    Kurashiki, Okayama-ken, 710-0824

  • Novartis Investigative Site

    Nagoya, Aichi-ken, 457 8510

  • Novartis Investigative Site

    Sasebo, Nagasaki, 857-1195

Other trials in Japan

Brazil3 sites
  • Novartis Investigative Site

    Juiz de Fora, Minas Gerais, 36010 570

  • Novartis Investigative Site

    São Paulo, São Paulo, 01244-030

  • Novartis Investigative Site

    Vitória, Espírito Santo, 29055 450

Other trials in Brazil

Canada3 sites
  • Novartis Investigative Site

    Rimouski, Quebec, G5L 5T1

  • Novartis Investigative Site

    Toronto, Ontario, M5T 2S8

  • Novartis Investigative Site

    Trois-Rivières, Quebec, G9A 3Y2

Other trials in Canada

Israel3 sites
  • Novartis Investigative Site

    Haifa, 3104802

  • Novartis Investigative Site

    Kfar Saba, 4428164

  • Novartis Investigative Site

    Ramat Gan, 5265601

Other trials in Israel

Portugal3 sites
  • Novartis Investigative Site

    Lisbon, 1050-034

  • Novartis Investigative Site

    Lisbon, 1649 035

  • Novartis Investigative Site

    Ponte de Lima, 4990 041

Other trials in Portugal

United Kingdom3 sites
  • Novartis Investigative Site

    Birmingham, B15 2TH

  • Novartis Investigative Site

    Doncaster, DN2 5LT

  • Novartis Investigative Site

    Manchester, M13 9WL

Other trials in United Kingdom

Argentina2 sites
  • Novartis Investigative Site

    CABA, 1426

  • Novartis Investigative Site

    Ciudad Autonoma de Bs As, Buenos Aires, C1055AAF

Other trials in Argentina

Austria2 sites
  • Novartis Investigative Site

    Graz, 8036

  • Novartis Investigative Site

    Vienna, 1090

Other trials in Austria

Colombia2 sites
  • Novartis Investigative Site

    Barranquilla, Atlántico, 080002

  • Novartis Investigative Site

    Medellín, Antioquia, 050001

Other trials in Colombia

Hungary2 sites
  • Novartis Investigative Site

    Szeged, 6720

  • Novartis Investigative Site

    Székesfehérvár, Fejér, 8000

Other trials in Hungary

Italy2 sites
  • Novartis Investigative Site

    Milan, MI, 20132

  • Novartis Investigative Site

    Pisa, PI, 56124

Other trials in Italy

Netherlands2 sites
  • Novartis Investigative Site

    Groningen, 9713 GZ

  • Novartis Investigative Site

    Rotterdam, South Holland, 3015 GD

Other trials in Netherlands

Romania2 sites
  • Novartis Investigative Site

    Brasov, 500283

  • Novartis Investigative Site

    Cluj-Napoca, 400006

Other trials in Romania

Australia1 site
  • Novartis Investigative Site

    Nedlands, Western Australia, 6009

Other trials in Australia

Greece1 site
  • Novartis Investigative Site

    Athens, 115 27

Other trials in Greece

South Korea1 site
  • Novartis Investigative Site

    Seoul, Seocho Gu, 06591

Other trials in South Korea

Sweden1 site
  • Novartis Investigative Site

    Stockholm, SE, 113 65

Other trials in Sweden

Turkey (Türkiye)1 site
  • Novartis Investigative Site

    Ankara, 06500

Other trials in Turkey (Türkiye)

About this study

Official title: A TWINSS Extension Trial to Evaluate the Safety and Tolerability of CFZ533 (Iscalimab) at Two Dose Levels Administered Subcutaneously in Patients With Sjögren's Syndrome

This study will evaluate the safety and tolerability of iscalimab at two dose levels in patients with Sjögren's Syndrome, who participated in the TWINSS core study, CCFZ533B2201 (NCT03905525). Additionally, this Extension study will further explore the pharmacokinetics (PK) and efficacy of iscalimab at two dose level.

Read the detailed description

This study was a continuation of the TWINSS core study CCFZ533B2201 (NCT03905525) that offered continuation of treatment for participants who completed the core study and were deemed by the Investigator to clinically benefit from continued iscalimab therapy based upon response to therapy at the end of the treatment period of the core study. The extension study was a 48-week treatment study, with a safety follow-up period of 12 weeks, to provide additional safety and tolerability information for iscalimab.At Week 60 of the TWINSS core study, eligible participants had the option to enroll in the extension study.

Participants were classified as treatment responders or non-responder based on their European League Against Rheumatism (EULAR) Sjögren's syndrome disease activity index (ESSDAI) and EULAR Sjögren's syndrome patient reported index (ESSPRI) scores from predefined time points in the core study. In the extension study, participants were reassigned to either iscalimab 600 mg or 300 mg subcutaneously via prefilled syringes (PFS) based on their responder status and the iscalimab doses that they received in the core study

All participants enrolled in the extension study received a weekly loading regimen at the start of the treatment period for the initial 3 weeks, followed by a subcutaneous maintenance regimen (600 or 300 mg subcutaneously every 2 weeks). Injections were performed at site or at home by site staff or participant/caregiver.

Study blinding for the extension study was maintained until final database lock of the core study, upon which the participants and Investigators were unblinded, making it an open-label study through Week 120 (end of study visit).

Being tested
Iscalimab, Placebo
Keywords
Sjogren's Syndrome, autoimmune, ESSDAI, ESSPRI, anti-CD40, CFZ533, iscalimab, TWINSS Extension
Medical subject headings
Sjogren's Syndrome

What participants receive

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

  • IscalimabDrug

    Also called CFZ533

    Iscalimab 600 mg or 300 mg was administered subcutaneously weekly for the first 3 weeks. Subsequently, iscalimab was administered subcutaneously bi-weekly (every other week or Q2W).

  • PlaceboOther

    Placebo (1 injection of 2 ml) administered to participants in the iscalimab 300 mg arm to maintain blinding until the final database lock of the core study

Study groups in NCT04541589
Study groupRoleWhat they receive
Arm 1: Iscalimab 600 mgExperimentalParticipants received 600 mg (2 injections of 300 mg/2 mL) of iscalimab subcutaneously weekly for the initial 3 weeks as loading doses, followed by a bi-weekly maintenance regimen at 600 mg (2 injections of 300 mg/2 mL).
Receives: Drug: Iscalimab
Arm 2 - Iscalimab 300 mgExperimentalParticipants received one dose of 600 mg (2 injections of 300 mg/2 mL) of iscalimab subcutaneously on the first day of the extension study; then 300 mg weekly (1 injection of 300 mg/2 mL of iscalimab and 1 injection of 2 mL of placebo) for the next 2 weeks as loading doses. This was followed by a bi-weekly maintenance regimen of 300 mg (1 injection of 300 mg/2 mL of iscalimab and 1 injection of 2 mL of placebo). After the final database lock of the core study, participants underwent unblinding, leading to the discontinuation of placebo injections.
Receives: Drug: Iscalimab; Other: Placebo

What is being measured

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

  1. Number of Participants With Treatment-emergent Adverse Events (TEAEs)

    An AE was defined as any untoward medical occurrence (e.g., any unfavorable and unintended sign [including abnormal laboratory findings], symptom or disease) in a participant. TEAE included all AEs up to the last dose date plus 14 weeks or the end of the entire study (including the safety follow-up period), whichever occurred earlier. A patient with multiple severity ratings for an AE was only counted under the maximum rating. Additionally, a patient with multiple occurrences of an event was counted only once. The severity of AEs was assessed using the Common Terminology Criteria for Adverse Events, with the following grading system: Mild: usually transient in nature and generally not interfering with normal activities; Moderate: sufficiently discomforting to interfere with normal activities; Severe: prevented normal activities.

    A serious adverse event (SAE) was defined as any AE that required medical intervention, hospitalization, or results in death, disability, or a birth defect.

    Measured: From start of extension study up to 14 weeks after last study-drug administration or end of study (whichever occurred earlier), assessed up to approximately 60 weeks

Secondary outcomes (2)
  1. Free Iscalimab Concentration in Plasma

    Free iscalimab concentration in plasma during the treatment (Ctrough) and follow-up (up to end of study) periods. Blood sample was collected at the specified timepoints to assess the concentration of free iscalimab. The baseline assessment of this extension study (Day 1) was identical to the last timepoint (FUP3/Week 60) of the core study (CCFZ533B2201).

    Measured: Predose at Day 1, 113, 225, 337 and 421

  2. Incidence of Anti-iscalimab Antibodies in Plasma

    Number of participants with anti-iscalimab antibodies (ADA) in plasma at any time during the study. The baseline assessment of this extension study (Day 1) was identical to the last timepoint (FUP3/Week 60) of the core study (CCFZ533B2201).

    Measured: 60 weeks

Timeline

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

  1. First posted9 Sep 2020
  2. Study start5 Jan 2021
  3. Primary completion19 Aug 2024
  4. Study completion19 Aug 2024

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
Non-randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
206 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04541589
Sponsor's protocol ID
CCFZ533B2201E1
Other IDs
2020-001942-20
Acronym
TWINSS Extn
Status last verified
Oct 2025
First submitted
14 Aug 2020
Last updated
16 Oct 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing access to patient-level data and supporting clinical documents from eligible studies with qualified external researchers. Requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to protect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Iscalimab in people with Sjogren's Syndrome, run by Novartis Pharmaceuticals at 62 sites in 23 countries.

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 3 inclusion and 10 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: finished, as of the sponsor's last update on 16 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 62 sites in United States, Russia, Chile, France, Germany and 18 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. 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 29 Jun 2025). 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?

Number of Participants With Treatment-emergent Adverse Events (TEAEs) (time frame: From start of extension study up to 14 weeks after last study-drug administration or end of study (whichever occurred earlier), assessed up to approximately 60 weeks). 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 16 Oct 2025.

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