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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05798117
Registration number
NCT05798117
Ethics application status
Date submitted
27/02/2023
Date registered
4/04/2023
Titles & IDs
Public title
An Open-label, Study to Assess Safety, Efficacy and Cellular Kinetics of YTB323 in Severe, Refractory Systemic Lupus Erythematosus
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Scientific title
An Open-label, Multi-center, Phase 1/2 Study to Assess Safety, Efficacy and Cellular Kinetics of YTB323 in Participants With Severe, Refractory Systemic Lupus Erythematosus
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Secondary ID [1]
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2022-001796-14
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Secondary ID [2]
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CYTB323G12101
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Systemic Lupus Erythematosus
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Lupus Nephritis
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Condition category
Condition code
Renal and Urogenital
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0
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Other renal and urogenital disorders
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Inflammatory and Immune System
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0
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Other inflammatory or immune system disorders
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Human Genetics and Inherited Disorders
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0
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - YTB323
Experimental: YTB323 - Single infusion of YTB323
Treatment: Drugs: YTB323
Single infusion of YTB323
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Number of participants with AEs and SAEs
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Assessment method [1]
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Long term safety follow up
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Timepoint [1]
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Day 1 to 2 years
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Secondary outcome [1]
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CAR transgene levels by quantitative polymerase chain reaction (qPCR) in blood (Maximum observed blood concentration Cmax)
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Assessment method [1]
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Blood samples will be collected to assess cellular kinetics.
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Timepoint [1]
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Pre-dose, up to 2 years
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Secondary outcome [2]
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CAR transgene levels by quantitative polymerase chain reaction (qPCR) in blood (Area under plasma concentration -time AUC)
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Assessment method [2]
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Blood samples will be collected to assess cellular kinetics.
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Timepoint [2]
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Pre-dose, up to 2 years
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Secondary outcome [3]
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CAR transgene levels by quantitative polymerase chain reaction (qPCR) in blood (Time to reach maximum concentration Tmax)
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Assessment method [3]
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Blood samples will be collected to assess cellular kinetics.
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Timepoint [3]
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Pre-dose, up to 2 years
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Secondary outcome [4]
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CAR transgene levels by quantitative polymerase chain reaction (qPCR) in blood (Terminal elimination half-life T1/2)
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Assessment method [4]
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Blood samples will be collected to assess cellular kinetics.
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Timepoint [4]
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Pre-dose, up to 2 years
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Secondary outcome [5]
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CAR transgene levels by quantitative polymerase chain reaction (qPCR) in blood (Last measurable concentration Clast)
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Assessment method [5]
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Blood samples will be collected to assess cellular kinetics.
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Timepoint [5]
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Pre-dose, up to 2 years
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Secondary outcome [6]
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CAR transgene levels by quantitative polymerase chain reaction (qPCR) in blood (Time to reach last measurable concentration Tlast)
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Assessment method [6]
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Blood samples will be collected to assess cellular kinetics.
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Timepoint [6]
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Pre-dose, up to 2 years
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Secondary outcome [7]
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Number of patients with anti-drug antibodies
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Assessment method [7]
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Blood samples will be collected to measure anti-drug antibodies against YTB323.
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Timepoint [7]
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Pre-dose, up to 2 years
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Secondary outcome [8]
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Level of T cell activation by YTB323
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Assessment method [8]
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Blood samples will be collected to measure the level of T cell activation by YTB323.
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Timepoint [8]
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Pre-dose, up to 2 years
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Secondary outcome [9]
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Number of patients infused with planned target dose
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Assessment method [9]
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Feasibility of the manufacturing process in autoimmune disorders.
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Timepoint [9]
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Day 1
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Secondary outcome [10]
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Change from pre-dose up to 2 years in the Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) score
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Assessment method [10]
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SLEDAI-2K scores are between 0 and 105, a higher score represents a higher disease activity.
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Timepoint [10]
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Pre-dose, up to 2 years
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Secondary outcome [11]
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Change from pre-dose up to 2 years in Physician's global assessment (PGA)
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Assessment method [11]
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The Physician's Global assessment is a visual analog scale from 0 to 3, 0 represents no activity and 3 represents severe disease activity.
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Timepoint [11]
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Pre-dose, up to 2 years
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Secondary outcome [12]
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Change from pre-dose up to 2 years in Lupus Low Disease Activity State (LLDAS)
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Assessment method [12]
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LLDAS is a composite measure based on: SLEDAI-2K = 4, with no activity in major organ system (renal, central nervous system, cardiopulmonary, vasculitis, and fever) and no hemolytic anemia or gastrointestinal activity, current, no new lupus disease activity compared with the previous assessment, prednisone (or its equivalent) dose = 7.5 mg/day, PGA (scale 0-3) = 1, well tolerated standard maintenance doses of immunosuppressive lupus therapy.
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Timepoint [12]
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Pre-dose, up to 2 years
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Secondary outcome [13]
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Remission rate
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Assessment method [13]
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Remission as specified by Definitions Of Remission In Systemic Lupus Erythematosus (DORIS) criteria: Clinical SLEDAI=0, PGA\<0.5 (0-3) irrespective of serology.
The patient may be on antimalarials, low-dose glucocorticoids (prednisolone =5 mg/day), and/or stable immunosuppressive therapy including biologics.
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Timepoint [13]
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Up to 2 years
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Secondary outcome [14]
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Change from pre-dose up to 2 years in Urinary protein creatinine ratio (UPCR)
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Assessment method [14]
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Change in the value of UPCR.
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Timepoint [14]
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Pre-dose, up to 2 years
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Secondary outcome [15]
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Incidence of Complete renal response (CRR)
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Assessment method [15]
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Number of participants who achieved CRR.
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Timepoint [15]
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Up to 2 years
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Eligibility
Key inclusion criteria
* Signed informed consent
* Adequate renal, hepatic, cardiac, hematological and pulmonary function
* Men and women with SLE, aged =18 years and =65 years at screening, fulfilling the 2019 European League Against Rheumatism EULAR/ACR classification criteria for SLE.
* Patient must be positive for at least one of the following autoantibodies at screening: antinuclear antibodies (ANA) at a titer of =1:80, or anti dsDNA (above the ULN); or anti-Sm (above the ULN)
* Active (severe) disease as defined by SLEDAI-2K = 8 (not including the SLEDAI-2K domains of lupus headache, cerebrovascular accident, organic brain syndrome) and at least one of the following significant SLE related organ involvements:
* Renal
* At least moderate or severe peri/myocarditis
* At least moderate or severe pleuritis or other lung involvement
* Vasculitis
* Failure to respond to two or more standard immunosuppressive therapies (including one of mycophenolate or cyclophosphamide), unless contraindicated or having experienced documented adverse events or intolerance related to such immunosuppressive drugs not allowing their further use, in combination with glucocorticoids and failure to respond to at least one biological agent (unless contraindicated, the patient deemed ineligible by the Investigator or not available in a country).
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Clinically significant active, opportunistic, chronic or recurrent infection confirmed by clinical evidence, imaging, or positive laboratory tests (e.g., blood cultures, PCR for DNA/RNA, such as COVID-19 etc.) one month prior to or during screening. Patients who have had at least one severe infection that required prolonged hospitalization in the intensive care setting within 5 years prior to screening and/or at least one severe infection that required prolonged hospitalization within one year prior to screening.
* Uncontrolled diabetes mellitus, lung diseases or any other illness that are not related to SLE that in the opinion of the Investigator would jeopardize the ability of the patient to tolerate lymphodepletion and CD19 CAR-T cell therapy
* Prior history of malignancy except for localized basal cell or squamous skin cancer. Other malignancies for which the patient is judged to be cured by local surgical therapy, such as head and neck cancer, or stage I breast cancer will be considered on an individual basis
* Any patients requiring medications prohibited by the protocol
* Any psychiatric condition or disability making compliance with treatment or informed consent impossible
* Prior treatment with anti-CD19 therapy, adoptive T cell therapy or any prior gene therapy product (e.g. CAR-T cell therapy)
* History of bone marrow/hematopoietic stem cell or solid organ transplantation
* Female participants who are pregnant or breastfeeding, or intending to conceive during the course of the study
* Women of childbearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using a highly effective method of contraception starting from the time of enrollment to at least 12 months after the YTB323 infusion and until CAR-T cells are no longer present by qPCR on two consecutive tests
* Sexually active males unwilling to use a condom during intercourse from the time enrollment for at least 12 months after the YTB323 infusion and until CAR-T cells are no longer present by qPCR on two consecutive tests
* Any acute, severe lupus related flare during screening that needs immediate treatment and/or makes the immunosuppressive washout impossible; thus, makes the patient ineligible for CD19 CAR-T therapy as judged by the Investigator, such as acute central nervous system (CNS) lupus (e.g. psychosis, epilepsy) or catastrophic antiphospholipid syndrome
* Significant, likely irreversible organ damage related to SLE, e.g. end stage renal disease, that in the opinion of the Investigator renders CD19 CAR-T cell therapy would be unlikely to benefit the patient
* B cell aplasia
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
28/02/2023
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
9/10/2026
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Actual
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Sample size
Target
24
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Novartis Investigative Site - Clayton
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Recruitment postcode(s) [1]
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3168 - Clayton
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Alabama
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Country [2]
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United States of America
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State/province [2]
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Missouri
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Country [3]
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France
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State/province [3]
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Lille
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Country [4]
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France
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State/province [4]
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Paris 13
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Country [5]
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France
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State/province [5]
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Pessac Cedex
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Country [6]
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France
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State/province [6]
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Strasbourg
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Country [7]
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Germany
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State/province [7]
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Freiburg
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Country [8]
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Germany
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State/province [8]
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Mainz
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Country [9]
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Spain
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State/province [9]
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Catalunya
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Country [10]
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Spain
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State/province [10]
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Madrid
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Country [11]
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Switzerland
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State/province [11]
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Bern
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Country [12]
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Switzerland
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State/province [12]
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Lausanne
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Novartis Pharmaceuticals
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The study is intended to assess safety, efficacy and cellular kinetics of YTB323 treatment in participants with severe refractory systemic lupus erythematosus.
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Trial website
https://clinicaltrials.gov/study/NCT05798117
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Novartis Pharmaceuticals
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Address
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Novartis Pharmaceutical
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Novartis Pharmaceuticals
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Address
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Country
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Phone
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1-888-669-6682
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect 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
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05798117