IgG4 Related DiseasePhase 2NCT04918147
Elotuzumab in Immunoglobulin G4-Related Disease (IgG4-RD)
A Phase 2 study testing elotuzumab, methylprednisolone and diphenhydramine in people with IgG4 Related Disease and IgG4-RD, run by National Institute of Allergy and Infectious Diseases (NIAID) at 3 sites in United States.
Trial summary
This is a two-part multi-center clinical trial in participants with active IgG4-RD. Part 1 (Cohort 1a and Cohort 1B) is an open-label, dose escalation phase to determine the safety of elotuzumab for investigation in IgG4-RD. Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- IgG4 Related Disease, IgG4-RD
- What is being tested?
- elotuzumab, methylprednisolone and diphenhydramine
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 8 participants
- Where
- 3 sitesUnited States
- Study dates
- 13 Oct 2021to 4 Jan 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 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Individuals who meet all of the following criteria are eligible for enrollment as study participants:
- Participant must be able to understand and provide informed consent and be willing to comply with study procedures and follow up.
- Are at least 18 years of age and not older than 70 years of age at screening.
- Meet the ACR/EULAR Classification Criteria for IgG4-RD [30, 31].
- Have active disease based at screening on an IgG4-RD RI ≥4, with disease manifestations in at least two organ systems.
- May have newly-diagnosed or relapsing disease at screening. Relapsing disease is defined as IgG4-RD that has previously been in remission but is now active again.
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- May be on treatment or off treatment for IgG4-RD at the time of screening. If on treatment, must be willing to discontinue those other treatments before the baseline visit.
- No history of severe allergic reactions to monoclonal antibodies.
- Female participants of childbearing potential must have a negative pregnancy test upon study entry.
- Female participants of childbearing potential and male participants with a partner of childbearing potential must agree to consistently and correctly use FDA approved highly effective methods of birth control for the entire duration of the study and 6 months after last elotuzumab infusion.
- Immunization with one of the FDA authorized or licensed SARS-CoV-2 vaccines as per CDC recommendations at the time of informed consent is required for study entry. Vaccinations must have been completed at least 2 weeks prior to start of study therapy.
Who cannot join
- Individuals who meet any of these criteria are not eligible for enrollment as study participants:
- Presence of a condition other than IgG4-RD that (e.g., asthma) is likely to require systemic Glucocorticoids (GC) for disease control during the period of the trial.
- Malignancy within 5 years (except successfully treated in situ cervical cancer, resected squamous cell or basal cell carcinoma of the skin.)
- The following lab values as indicators of hepatic dysfunction:
- Serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) greater than three times the upper limit of normal (ULN)
- Total bilirubin > two times the ULN unless caused by Gilbert's disease. Gilbert's disease with total bilirubin > three times ULN.
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- Serum albumin < 2.5 gm/dL.
- Evidence of another uncontrolled condition which, in the judgment of the investigator, could interfere with participation in the trial according to the protocol.
- Active infection requiring hospitalization or treatment with systemic antimicrobial agents within the 30 days prior to treatment allocation/randomization.
- Prior use of rituximab or other B cell depleting agents within 9 months of enrollment unless B cells have been demonstrated to have repopulated.
- Use of any investigational agent or biologic and non-biologic DMARDs within 5 half-lives of the agent (or 6 months if the half-life is unknown) prior to enrollment.
- Any of the following laboratory tests at the Screening Visit:
- White blood cell count (WBC) < 3.0 x 103/µL.
- Absolute neutrophil count (ANC) < 1.5 x 103/µL.
- Hemoglobin < 10 g/dL.
- Platelet count < 75 x 109/L.
- Estimated glomerular filtration rate (eGFR) ≤ 45 ml/minute/1.73 m2.
- The use of supplemental oxygen at baseline.
- At or within 90 days of screening: Positive Interferon-Gamma Release Assay (IGRA). Indeterminate IGRAs must be repeated (with same or other IGRA per local policy) and shown to be negative. Alternatively, if the assay remains indeterminant, a participant must have a negative PPD. Finally, if the participant has had the Bacille Calmette-Guerin (BCG) vaccine or has some other condition complicating the interpretation of TB testing, consultation with infectious disease specialist must be obtained before receipt of the first investigational infusion.
- Participants diagnosed with latent TB are eligible but must have received appropriate prophylaxis for 30 days before their first investigational infusion.
- Medical history or serologic evidence at Screening of chronic infections including:
- Human immunodeficiency virus infection.
- Hepatitis B as indicated by surface antigen or hepatitis B core antibody positivity
- Hepatitis C as indicated by anti-hepatitis C antibody positivity; if a participant is Hepatitis C antibody positive, they will be eligible to participate in the study if he/she is negative for viral load at Screening.
- Live vaccines within 8 weeks of initiating study therapy.
- Participant is pregnant or breastfeeding, or planning a pregnancy while enrolled in the study.
- Substance use disorder, including the recurrent use of alcohol and/or drugs within the past year associated with clinically significant impairment associated with failure to meet major responsibilities at work, school, or home.
- IgG4-RD that is dominated primarily by advanced fibrotic lesions. Specifically, participants whose disease manifestations consist only of
- retroperitoneal fibrosis,
- fibrosing mediatinitis,
- sclerosing mesenteritis, or
- Riedel's thyroiditis. Participants with these disease manifestations can be included, however, only if they have disease in 2 organ systems that is not of an advanced fibrotic nature and otherwise meet the Inclusion and Exclusion Criteria.
- Evidence a SARS-CoV-2 (COVID-19) infection started within the 30 days prior to treatment allocation/randomization. Participants diagnosed with SARS-CoV-2 (COVID-19) infection more than 30 days prior to treatment allocation/randomization must have symptoms resolved and be deemed fit to participate in the trial.
Trial locations and contacts
3 sites in 1 country.
United States3 sites
Emory Healthcare
Atlanta, Georgia, 30322
Massachusetts General Hospital
Boston, Massachusetts, 02114
Mayo Clinic: Pulmonary and Critical Care Medicine
Rochester, Minnesota, 55905
About this study
This is a two-part multi-center clinical trial in participants with active IgG4-RD.
Part 1 (Cohort 1a and Cohort 1B) is an open-label, dose escalation phase to determine the safety of elotuzumab for investigation in IgG4-RD.
Read more
Part 2 (Cohort 2) is a randomized, placebo-controlled, double-blinded (masked) trial phase to compare the effects of elotuzumab and prednisone to elotuzumab placebo and prednisone in participants with IgG4 RD.
Approximately 75 participants with active IgG4-RD will be enrolled in the overall program, 12 in Part 1 and 63 in Part 2. Randomization in Part 2: 2 to 1, with approximately forty-two participants randomized to elotuzumab plus prednisone taper, and twenty-one participants randomized to placebo for elotuzumab plus prednisone taper.
The total duration of participation for each participant in this trial will be 48 weeks (11 months).
Read the detailed description
Immunoglobulin G4-Related Disease (IgG4-RD) is a chronic fibro-inflammatory condition that can affect virtually every organ system, including the pancreas, biliary tract, salivary and lacrimal glands, orbits, lungs, kidneys, meninges, pituitary gland, prostate and thyroid. It may also involve the retroperitoneum. This multi-organ immune-mediated condition, once regarded as a group of isolated, single-organ diseases, is now recognized to be an overarching, single-disease entity linked by common histopathological and immunohistochemical features.
IgG4-RD tends to afflict middle-aged to elderly individuals. Although IgG4-RD can affect a single organ at presentation, it is not uncommon for participants to present with or develop multi-organ disease. As the disease progresses, additional organs develop lesions and the cellular inflammation characterizing early disease moves toward a more fibrotic stage, causing major tissue damage, dysfunction and ultimately organ failure. It is unclear whether IgG4 itself is involved in the pathogenesis of the disease.
The goals of IgG4-RD treatment are to reduce inflammation and organ swelling and to prevent or reverse tissue fibrosis. No approved therapy exists for IgG4-RD.
This study will enroll adult participants who meet the 2019 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Classification Criteria for IgG4-RD, and who have active IgG4-RD with disease manifestations in at least two organ systems.
Primary study objectives:
- To determine the safety and tolerability of the addition of elotuzumab to prednisone in participants with IgG4-RD, and
- To compare the effect of the addition of elotuzumab versus placebo to prednisone on the IgG4-RD Responder Index (IgG4-RD RI), a measure of IgG4-RD disease activity.
- Conditions
- IgG4 Related Disease, IgG4-RD
- Being tested
- elotuzumab, placebo for elotuzumab, methylprednisolone, diphenhydramine, acetaminophen
- Keywords
- immune-mediated fibroinflammatory disease, prospective trial, safety and efficacy, IgG4-RD Responder Index (IgG4-RD RI)
- Medical subject headings
- Immunoglobulin G4-Related Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
elotuzumabDrug
Also called BMS-901608, Empliciti®
Elotuzumab is a humanized recombinant monoclonal antibody (mAb) targeted against SLAMF7, a cell surface glycoprotein.
placebo for elotuzumabDrug
Also called normal saline
The placebo for elotuzumab is 0.9% sterile normal saline for injection.
Also called Solu-Medrol®
Premedication administered intravenously, 45 to 90 minutes prior to each elotuzumab/placebo infusion, per protocol. Dosage in milligrams (mg).
diphenhydramineDrug
Also called Benadryl®
Premedication administered orally or intravenously, 45 to 90 minutes prior to each elotuzumab/placebo infusion, per protocol. Dosage in milligrams (mg).
acetaminophenDrug
Also called Tylenol®
Premedication administered orally, 45 to 90 minutes prior to each elotuzumab/placebo infusion, per protocol. Dosage in milligrams (mg).
famotidineDrug
Also called H2 blocker
Premedication administered orally or intravenously, 45 to 90 minutes prior to each elotuzumab/placebo infusion, per protocol. Dosage in milligrams (mg).
prednisoneDrug
Also called corticosteroid
Prescribed dosing with prednisone begins on the day of the first elotuzumab/placebo infusion, administered orally. The ten-week dosing taper proceeds, per protocol. Dosage in milligrams (mg).
| Study group | Role | What they receive |
|---|---|---|
| Cohort 1a: Elotuzumab-One-Month Regimen (Open-Label) + Pred Taper | Experimental | Per protocol: Six participants will receive elotuzumab on days 0,7, 14, 21, and the prescribed 10-week prednisone taper.
* Elotuzumab: 10 mg/kg administered once weekly, intravenously for 4 doses, per protocol.
* Prednisone taper (Pred Taper): Prescribed 10-week dosing taper beginning on Day 0 (baseline) that is taken orally (by mouth) daily, per protocol. Dosage in milligrams (mgs). Receives: Drug: elotuzumab; Drug: methylprednisolone; Drug: diphenhydramine; Drug: acetaminophen; Drug: famotidine; Drug: prednisone |
| Cohort 1b: Elotuzumab-Twelve-Month Regimen (Open-Label) + Pred Taper | Experimental | Per protocol: Six participants will receive elotuzumab over a 48 week period, dose of 10mg/kg IV x 1, at baseline, then at weeks 8, 16, 24, 32 and 40 (for a total of 6 doses), with the prescribed 10-week prednisone taper.
* Elotuzumab: 10 mg/kg administered as referenced above, intravenously, per protocol.
* Prednisone taper (Pred Taper): Prescribed 10-week dosing taper beginning on Day 0 (baseline) that is taken orally (by mouth) daily, per protocol. Dosage in milligrams (mgs). Receives: Drug: elotuzumab; Drug: methylprednisolone; Drug: diphenhydramine; Drug: acetaminophen; Drug: famotidine; Drug: prednisone |
| Cohort 2: Arm A- Elotuzumab (Randomized) + Pred Taper | Experimental | Safety and efficacy analyses from Cohort 1a and Cohort 1b will occur prior to initiating Cohort 2 (Randomized).
Assuming no safety signal for Cohort 1, forty-two participants will receive elotuzumab per the regimen prescribed above in Part 1B, with the prescribed 10-week prednisone taper.
* Elotuzumab: 10 mg/kg administered as referenced above, intravenously, per protocol.
* Prednisone taper (Pred Taper): Prescribed 10-week dosing taper beginning on Day 0 that is taken daily by mouth, per protocol. Dosage in milligrams (mgs). Receives: Drug: elotuzumab; Drug: methylprednisolone; Drug: diphenhydramine; Drug: acetaminophen; Drug: famotidine; Drug: prednisone |
| Cohort 2: Arm B-Placebo (Randomized) + Pred Taper | Placebo comparator | Safety and efficacy analyses from Cohort 1a and Cohort 1b will occur prior to initiating Cohort 2 (Randomized).
Twenty-one participants will receive placebo for elotuzumab on day 0, then weeks 8, 16, 24, 32 and 40, and the prescribed 10-week prednisone taper.
* Placebo for elotuzumab: Administered on same schedule as elotuzumab described in Cohort 2 Arm A: intravenously, per protocol.
* Prednisone taper (Pred Taper): Prescribed 10-week dosing taper beginning on Day 0 taken daily by mouth, per protocol. Dosage in milligrams (mgs). Receives: Drug: placebo for elotuzumab; Drug: methylprednisolone; Drug: diphenhydramine; Drug: acetaminophen; Drug: famotidine; Drug: prednisone |
What is being measured
The primary outcome is the main question the study is designed to answer.
The Percent of Participants in Each Cohort Who Experience at Least One Grade 3 or Higher Adverse Event (AE).
The severity of AEs were classified using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0
Measured: Up to Week 48 post treatment initiation
Secondary outcomes (11)
The Percent of Participants Who Experience at Least One Grade 2 or Higher Adverse Event (AE).
The severity of AEs was classified using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0.
Measured: Up to Week 48 post treatment initiation
The Percent of Participants With a Grade 3 or Higher Infection
The number of AEs classified as infections that were Grade 3 or higher. The severity of AEs was classified using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0.
Measured: Up to Week 48 post treatment initiation
The Percent of Participants Who Experience a Malignancy.
The number of participants with malignancies reported as AEs. The severity of AEs was classified using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0.
Measured: Up to Week 48 post treatment initiation
The Percent of Participants Who Experience a Hepatotoxicity
Hepatotoxicity is defined as an increase in the aspartate aminotransferase (AST) or alanine aminotransferase (ALT) to elevations three times the upper limit of normal.
Measured: Up to Week 48 post treatment initiation
The Percent of Participants Who Experience a Serious Adverse Event
An adverse event (AE) is considered "serious" if, in the view of either the investigator or sponsor, it results in any of the following outcomes (21 CFR 312.32(a)):
- Death. 2. Life-threatening event: An AE is considered "life-threatening" if, in the view of either the investigator or Sponsor, its occurrence places the participant at immediate risk of death. It does not include an AE that, had it occurred in a more severe form, might have caused death. 3. Inpatient hospitalization or prolongation of existing hospitalization. 4. Persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions. 5. Congenital anomaly or birth defect. 6. Important medical events that may not result in death, be life threatening, or require hospitalization may be considered serious when, based upon appropriate medical judgment, they may jeopardize the participant and may require medical or surgical intervention to prevent one of the outcomes listed above.
Measured: Up to Week 48 post treatment initiation
The Percent of Participants Who Experience Infusion Reactions
The number of participants with infusion reactions reported as AEs. Infusion reactions are defined as any adverse reaction within 24 hours of infusion which are Grade 2 or higher events and at least possibly related to study drug. The severity of AEs was classified using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0.
Measured: Up to 24 hours post treatment infusion
The Percent of Participants That Reach the Following Threshold Levels of IgG4-Related Disease Responder Index (IgG4-RD RI) Improvement at 24 Weeks: 50% and 75%.
The IgG4-RD RI detects change in disease activity and identifies improvements/worsening in the same or different organ systems. It encompasses more than 25 organs/sites and records the following for each organ/site: (i) activity trend (through a 0-3 [normal/resolved - worsening] organ/site score); (ii) presence of symptoms due to active disease; (iii) need for urgent care; (iv) presence of damage; and (v) presence of symptoms due to damage. The final activity score at each visit is obtained by summing all organ/site scores (i) and by doubling items needing urgent care (iii). Higher scores represent greater (i.e. worse) disease activity. % improvement in the IgG4-RD RI = 100 x ( (Baseline IgG4-RD RI Activity Score - Week 24 IgG4-RD RI Activity Score) / Baseline IgG4-RD RI Activity Score). Participants who use glucocorticoids/immunosuppressants beyond that permitted by protocol, or who experience a disease flare before 24 weeks will be defined as achieving no disease response (0%).
Measured: Baseline and Week 24
Number of Participants With Disease Flares
IgG4-Related Disease flare was defined as recurrence of disease activity such that additional immunosuppressive therapy beyond the trial protocol is indicated. Such additional therapy may include glucocorticoids or alternative immunosuppressive agents. At the time of a potential disease flare, investigators documented the features of the disease flare in each involved organ, including laboratory evaluations, radiology studies, and other procedures (e.g., biopsy). Disease flares were reported as adverse events.
Measured: Up to Week 48 post treatment initiation
Change From Baseline in Physician Global Assessment
The Physician Global Assessment of the participant's current disease activity was recorded on a 100 mm linear horizontal visual analog scale, where the left hand extreme of the line is considered "Very Good" (0 mm, symptom free and no IgG4-RD symptoms) and the right hand extreme is considered "Very Bad" (100 mm, maximum IgG4-RD activity). Only active disease (as opposed to damage) is considered in the scoring. Change was calculated as the value at Week 12, 24 or 48 minus the value at Baseline.
Measured: Baseline, Weeks 12, 24 and 48
Change From Baseline in Patient Global Assessment
The Patient Global Assessment of the participant's current disease activity was recorded on a 100 mm linear horizontal visual analog scale, where the left hand extreme of the line is considered "Very Good" (0 mm, symptom free and no IgG4-RD symptoms) and the right hand extreme is considered "Very Bad" (100 mm, maximum IgG4-RD activity). Change was calculated as the value at Week 12, 24 or 48 minus the value at Baseline.
Measured: Baseline, Weeks 12, 24 and 48
Disease-Related Damage, as Measured by the Damage Section of the IgG4-Related Disease (IgG4-RD) Responder Index.
An assessment of damage caused by IgG4-RD in each affected organ is part of the Responder Index. The IgG4-RD RI encompasses more than 25 organs/sites and records the following set of information for each organ/site: (i) activity trend (through a 0-3 [normal/resolved - worsening] organ/site score); (ii) presence of symptoms due to active disease; (iii) need for urgent care; (iv) presence of damage; and (v) presence of symptoms due to damage. Activity and damage are considered separately from the standpoint of scoring, because only disease activity can be expected to respond to treatment. Damage is defined as organ dysfunction that has occurred as a result of IgG4-RD and is considered permanent. The total damage score at each visit is defined as the total number of damaged organs and can range from 0 (no damage) to more than 26 (severe damage).
Measured: Screening and Week 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jun 2021
- Study start13 Oct 2021
- Primary completion4 Jan 2024
- Study completion4 Jan 2024
Why it stopped: The study was terminated early based on disease flare/lack of efficacy in the early phase of the trial.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for IgG4 Related DiseaseStudies of the same condition, open and under way.
- More trials run by National Institute of Allergy and Infectious Diseases (NIAID)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Sequential
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 8 participants (actual)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Collaborators
- Autoimmunity Centers of Excellence, Bristol-Myers Squibb, Rho Federal Systems Division, Inc.
- Responsible party
- Sponsor
- Investigators
- John H. Stone, MD, MPH, Study chair, Massachusetts General Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04918147
- Sponsor's protocol ID
- DAIT AIG01
- Other IDs
- UM1AI144298, NIAID CRMS ID#: 38708
- Status last verified
- Jan 2026
- First submitted
- 4 Jun 2021
- Last updated
- 5 Feb 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: The plan is to share data upon completion of the study in: Immunology Database and Analysis Portal (ImmPort), a long-term archive of clinical and mechanistic data from DAIT-funded grants and contracts.
Publications
Wallace ZS, Naden RP, Chari S, Choi HK, Della-Torre E, Dicaire JF, Hart PA, Inoue D, Kawano M, Khosroshahi A, Lanzillotta M, Okazaki K, Perugino CA, Sharma A, Saeki T, Schleinitz N, Takahashi N, Umehara H, Zen Y, Stone JH; Members of the ACR/EULAR IgG4-RD Classification Criteria Working Group. The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease. Ann Rheum Dis. 2020 Jan;79(1):77-87. doi: 10.1136/annrheumdis-2019-216561. Epub 2019 Dec 3.
PubMed 31796497Khosroshahi A, Wallace ZS, Crowe JL, Akamizu T, Azumi A, Carruthers MN, Chari ST, Della-Torre E, Frulloni L, Goto H, Hart PA, Kamisawa T, Kawa S, Kawano M, Kim MH, Kodama Y, Kubota K, Lerch MM, Lohr M, Masaki Y, Matsui S, Mimori T, Nakamura S, Nakazawa T, Ohara H, Okazaki K, Ryu JH, Saeki T, Schleinitz N, Shimatsu A, Shimosegawa T, Takahashi H, Takahira M, Tanaka A, Topazian M, Umehara H, Webster GJ, Witzig TE, Yamamoto M, Zhang W, Chiba T, Stone JH; Second International Symposium on IgG4-Related Disease. International Consensus Guidance Statement on the Management and Treatment of IgG4-Related Disease. Arthritis Rheumatol. 2015 Jul;67(7):1688-99. doi: 10.1002/art.39132. No abstract available.
PubMed 25809420
Study at a glance
From the registry record, last updated by the sponsor on 5 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Elotuzumab in Immunoglobulin G4-Related Disease (IgG4-RD)
- ClinicalTrials.gov ID
- NCT04918147
- Acronym / sponsor ID
- DAIT AIG01
- Conditions
- IgG4 Related Disease, IgG4-RD
- Keywords
- immune-mediated fibroinflammatory disease, prospective trial, safety and efficacy, IgG4-RD Responder Index (IgG4-RD RI)
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: The study was terminated early based on disease flare/lack of efficacy in the early phase of the trial.
- Enrolment
- 8 participants (actual)
- Lead sponsor
- National Institute of Allergy and Infectious Diseases (NIAID)US National Institutes of Health
- Collaborators
- Autoimmunity Centers of Excellence, Bristol-Myers Squibb, Rho Federal Systems Division, Inc.
- Study start
- 13 Oct 2021 (actual)
- Primary completion
- 4 Jan 2024 (actual)
- Study completion
- 4 Jan 2024 (actual)
- First posted
- 8 Jun 2021 (actual)
- Results
- Posted 25 Feb 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a two-part multi-center clinical trial in participants with active IgG4-RD.
Part 1 (Cohort 1a and Cohort 1B) is an open-label, dose escalation phase to determine the safety of elotuzumab for investigation in IgG4-RD.
Part 2 (Cohort 2) is a randomized, placebo-controlled, double-blinded (masked) trial phase to compare the effects of elotuzumab and prednisone to elotuzumab placebo and prednisone in participants with IgG4 RD.
Approximately 75 participants with active IgG4-RD will be enrolled in the overall program, 12 in Part 1 and 63 in Part 2. Randomization in Part 2: 2 to 1, with approximately forty-two participants randomized to elotuzumab plus prednisone taper, and twenty-one participants randomized to placebo for elotuzumab plus prednisone taper.
The total duration of participation for each participant in this trial will be 48 weeks (11 months).
Detailed description
Immunoglobulin G4-Related Disease (IgG4-RD) is a chronic fibro-inflammatory condition that can affect virtually every organ system, including the pancreas, biliary tract, salivary and lacrimal glands, orbits, lungs, kidneys, meninges, pituitary gland, prostate and thyroid. It may also involve the retroperitoneum. This multi-organ immune-mediated condition, once regarded as a group of isolated, single-organ diseases, is now recognized to be an overarching, single-disease entity linked by common histopathological and immunohistochemical features.
IgG4-RD tends to afflict middle-aged to elderly individuals. Although IgG4-RD can affect a single organ at presentation, it is not uncommon for participants to present with or develop multi-organ disease. As the disease progresses, additional organs develop lesions and the cellular inflammation characterizing early disease moves toward a more fibrotic stage, causing major tissue damage, dysfunction and ultimately organ failure. It is unclear whether IgG4 itself is involved in the pathogenesis of the disease.
The goals of IgG4-RD treatment are to reduce inflammation and organ swelling and to prevent or reverse tissue fibrosis. No approved therapy exists for IgG4-RD.
This study will enroll adult participants who meet the 2019 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Classification Criteria for IgG4-RD, and who have active IgG4-RD with disease manifestations in at least two organ systems.
Primary study objectives:
- To determine the safety and tolerability of the addition of elotuzumab to prednisone in participants with IgG4-RD, and
- To compare the effect of the addition of elotuzumab versus placebo to prednisone on the IgG4-RD Responder Index (IgG4-RD RI), a measure of IgG4-RD disease activity.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Cohort 1a: Elotuzumab-One-Month Regimen (Open-Label) + Pred Taper | Experimental | Drug: elotuzumab, Drug: methylprednisolone, Drug: diphenhydramine, Drug: acetaminophen, Drug: famotidine, Drug: prednisonePer protocol: Six participants will receive elotuzumab on days 0,7, 14, 21, and the prescribed 10-week prednisone taper. * Elotuzumab: 10 mg/kg administered once weekly, intravenously for 4 doses, per protocol. * Prednisone taper (Pred Taper): Prescribed 10-week dosing taper beginning on Day 0 (baseline) that is taken orally (by mouth) daily, per protocol. Dosage in milligrams (mgs). |
| Cohort 1b: Elotuzumab-Twelve-Month Regimen (Open-Label) + Pred Taper | Experimental | Drug: elotuzumab, Drug: methylprednisolone, Drug: diphenhydramine, Drug: acetaminophen, Drug: famotidine, Drug: prednisonePer protocol: Six participants will receive elotuzumab over a 48 week period, dose of 10mg/kg IV x 1, at baseline, then at weeks 8, 16, 24, 32 and 40 (for a total of 6 doses), with the prescribed 10-week prednisone taper. * Elotuzumab: 10 mg/kg administered as referenced above, intravenously, per protocol. * Prednisone taper (Pred Taper): Prescribed 10-week dosing taper beginning on Day 0 (baseline) that is taken orally (by mouth) daily, per protocol. Dosage in milligrams (mgs). |
| Cohort 2: Arm A- Elotuzumab (Randomized) + Pred Taper | Experimental | Drug: elotuzumab, Drug: methylprednisolone, Drug: diphenhydramine, Drug: acetaminophen, Drug: famotidine, Drug: prednisoneSafety and efficacy analyses from Cohort 1a and Cohort 1b will occur prior to initiating Cohort 2 (Randomized). Assuming no safety signal for Cohort 1, forty-two participants will receive elotuzumab per the regimen prescribed above in Part 1B, with the prescribed 10-week prednisone taper. * Elotuzumab: 10 mg/kg administered as referenced above, intravenously, per protocol. * Prednisone taper (Pred Taper): Prescribed 10-week dosing taper beginning on Day 0 that is taken daily by mouth, per protocol. Dosage in milligrams (mgs). |
| Cohort 2: Arm B-Placebo (Randomized) + Pred Taper | Placebo comparator | Drug: placebo for elotuzumab, Drug: methylprednisolone, Drug: diphenhydramine, Drug: acetaminophen, Drug: famotidine, Drug: prednisoneSafety and efficacy analyses from Cohort 1a and Cohort 1b will occur prior to initiating Cohort 2 (Randomized). Twenty-one participants will receive placebo for elotuzumab on day 0, then weeks 8, 16, 24, 32 and 40, and the prescribed 10-week prednisone taper. * Placebo for elotuzumab: Administered on same schedule as elotuzumab described in Cohort 2 Arm A: intravenously, per protocol. * Prednisone taper (Pred Taper): Prescribed 10-week dosing taper beginning on Day 0 taken daily by mouth, per protocol. Dosage in milligrams (mgs). |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Individuals who meet all of the following criteria are eligible for enrollment as study participants:
- Participant must be able to understand and provide informed consent and be willing to comply with study procedures and follow up.
- Are at least 18 years of age and not older than 70 years of age at screening.
- Meet the ACR/EULAR Classification Criteria for IgG4-RD [30, 31].
- Have active disease based at screening on an IgG4-RD RI ≥4, with disease manifestations in at least two organ systems.
Key exclusion criteria (33 listed)
- Individuals who meet any of these criteria are not eligible for enrollment as study participants:
- Presence of a condition other than IgG4-RD that (e.g., asthma) is likely to require systemic Glucocorticoids (GC) for disease control during the period of the trial.
- Malignancy within 5 years (except successfully treated in situ cervical cancer, resected squamous cell or basal cell carcinoma of the skin.)
- The following lab values as indicators of hepatic dysfunction:
- Evidence of another uncontrolled condition which, in the judgment of the investigator, could interfere with participation in the trial according to the protocol.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| elotuzumabAlso: BMS-901608, Empliciti®Elotuzumab is a humanized recombinant monoclonal antibody (mAb) targeted against SLAMF7, a cell surface glycoprotein. | Drug | Cohort 1a: Elotuzumab-One-Month Regimen (Open-Label) + Pred Taper, Cohort 1b: Elotuzumab-Twelve-Month Regimen (Open-Label) + Pred Taper, Cohort 2: Arm A- Elotuzumab (Randomized) + Pred Taper |
| placebo for elotuzumabAlso: normal salineThe placebo for elotuzumab is 0.9% sterile normal saline for injection. | Drug | Cohort 2: Arm B-Placebo (Randomized) + Pred Taper |
| methylprednisoloneAlso: Solu-Medrol®Premedication administered intravenously, 45 to 90 minutes prior to each elotuzumab/placebo infusion, per protocol. Dosage in milligrams (mg). | Drug | Cohort 1a: Elotuzumab-One-Month Regimen (Open-Label) + Pred Taper, Cohort 1b: Elotuzumab-Twelve-Month Regimen (Open-Label) + Pred Taper, Cohort 2: Arm A- Elotuzumab (Randomized) + Pred Taper, Cohort 2: Arm B-Placebo (Randomized) + Pred Taper |
| diphenhydramineAlso: Benadryl®Premedication administered orally or intravenously, 45 to 90 minutes prior to each elotuzumab/placebo infusion, per protocol. Dosage in milligrams (mg). | Drug | Cohort 1a: Elotuzumab-One-Month Regimen (Open-Label) + Pred Taper, Cohort 1b: Elotuzumab-Twelve-Month Regimen (Open-Label) + Pred Taper, Cohort 2: Arm A- Elotuzumab (Randomized) + Pred Taper, Cohort 2: Arm B-Placebo (Randomized) + Pred Taper |
| acetaminophenAlso: Tylenol®Premedication administered orally, 45 to 90 minutes prior to each elotuzumab/placebo infusion, per protocol. Dosage in milligrams (mg). | Drug | Cohort 1a: Elotuzumab-One-Month Regimen (Open-Label) + Pred Taper, Cohort 1b: Elotuzumab-Twelve-Month Regimen (Open-Label) + Pred Taper, Cohort 2: Arm A- Elotuzumab (Randomized) + Pred Taper, Cohort 2: Arm B-Placebo (Randomized) + Pred Taper |
| famotidineAlso: H2 blockerPremedication administered orally or intravenously, 45 to 90 minutes prior to each elotuzumab/placebo infusion, per protocol. Dosage in milligrams (mg). | Drug | Cohort 1a: Elotuzumab-One-Month Regimen (Open-Label) + Pred Taper, Cohort 1b: Elotuzumab-Twelve-Month Regimen (Open-Label) + Pred Taper, Cohort 2: Arm A- Elotuzumab (Randomized) + Pred Taper, Cohort 2: Arm B-Placebo (Randomized) + Pred Taper |
| prednisoneAlso: corticosteroidPrescribed dosing with prednisone begins on the day of the first elotuzumab/placebo infusion, administered orally. The ten-week dosing taper proceeds, per protocol. Dosage in milligrams (mg). | Drug | Cohort 1a: Elotuzumab-One-Month Regimen (Open-Label) + Pred Taper, Cohort 1b: Elotuzumab-Twelve-Month Regimen (Open-Label) + Pred Taper, Cohort 2: Arm A- Elotuzumab (Randomized) + Pred Taper, Cohort 2: Arm B-Placebo (Randomized) + Pred Taper |
Primary outcome
The Percent of Participants in Each Cohort Who Experience at Least One Grade 3 or Higher Adverse Event (AE).
Time frame: Up to Week 48 post treatment initiation
The severity of AEs were classified using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0
11 secondary outcomes
The Percent of Participants Who Experience at Least One Grade 2 or Higher Adverse Event (AE).
Time frame: Up to Week 48 post treatment initiation
The Percent of Participants With a Grade 3 or Higher Infection
Time frame: Up to Week 48 post treatment initiation
The Percent of Participants Who Experience a Malignancy.
Time frame: Up to Week 48 post treatment initiation
The Percent of Participants Who Experience a Hepatotoxicity
Time frame: Up to Week 48 post treatment initiation
The Percent of Participants Who Experience a Serious Adverse Event
Time frame: Up to Week 48 post treatment initiation
The Percent of Participants Who Experience Infusion Reactions
Time frame: Up to 24 hours post treatment infusion
The Percent of Participants That Reach the Following Threshold Levels of IgG4-Related Disease Responder Index (IgG4-RD RI) Improvement at 24 Weeks: 50% and 75%.
Time frame: Baseline and Week 24
Number of Participants With Disease Flares
Time frame: Up to Week 48 post treatment initiation
Change From Baseline in Physician Global Assessment
Time frame: Baseline, Weeks 12, 24 and 48
Change From Baseline in Patient Global Assessment
Time frame: Baseline, Weeks 12, 24 and 48
Disease-Related Damage, as Measured by the Damage Section of the IgG4-Related Disease (IgG4-RD) Responder Index.
Time frame: Screening and Week 24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Feb 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 31796497Wallace ZS, Naden RP, Chari S, Choi HK, Della-Torre E, Dicaire JF, Hart PA, Inoue D, Kawano M, Khosroshahi A, Lanzillotta M, Okazaki K, Perugino CA, Sharma A, Saeki T, Schleinitz N, Takahashi N, Umehara H, Zen Y, Stone JH; Members of the ACR/EULAR IgG4-RD Classification Criteria Working Group. The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease. Ann Rheum Dis. 2020 Jan;79(1):77-87. doi: 10.1136/annrheumdis-2019-216561. Epub 2019 Dec 3.
- Background: PubMed 25809420Khosroshahi A, Wallace ZS, Crowe JL, Akamizu T, Azumi A, Carruthers MN, Chari ST, Della-Torre E, Frulloni L, Goto H, Hart PA, Kamisawa T, Kawa S, Kawano M, Kim MH, Kodama Y, Kubota K, Lerch MM, Lohr M, Masaki Y, Matsui S, Mimori T, Nakamura S, Nakazawa T, Ohara H, Okazaki K, Ryu JH, Saeki T, Schleinitz N, Shimatsu A, Shimosegawa T, Takahashi H, Takahira M, Tanaka A, Topazian M, Umehara H, Webster GJ, Witzig TE, Yamamoto M, Zhang W, Chiba T, Stone JH; Second International Symposium on IgG4-Related Disease. International Consensus Guidance Statement on the Management and Treatment of IgG4-Related Disease. Arthritis Rheumatol. 2015 Jul;67(7):1688-99. doi: 10.1002/art.39132. No abstract available.
- Autoimmunity Centers of Excellence (ACE)Link provided by the sponsor.
- Division of Allergy, Immunology, and Transplantation (DAIT)Link provided by the sponsor.
- National Institute of Allergy and Infectious Diseases (NIAID)Link provided by the sponsor.
- Individual participant dataSharing planned: Yes. The plan is to share data upon completion of the study in: Immunology Database and Analysis Portal (ImmPort), a long-term archive of clinical and mechanistic data from DAIT-funded grants and contracts.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
John H. Stone, MD, MPH study chair
Massachusetts General Hospital
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing elotuzumab, methylprednisolone and diphenhydramine in people with IgG4 Related Disease and IgG4-RD, run by National Institute of Allergy and Infectious Diseases (NIAID) at 3 sites 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 33 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: stopped early, as of the sponsor's last update on 5 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites 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 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 25 Feb 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?
The Percent of Participants in Each Cohort Who Experience at Least One Grade 3 or Higher Adverse Event (AE). (time frame: Up to Week 48 post treatment initiation). 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 NCT04918147, which also lists 2 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 5 Feb 2026.