CAR-T Cells in Systemic B Cell Mediated Autoimmune Disease

Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1/Phase 2
SUMMARY

The investigational product is designed to effectively combat B cells in patients with autoimmune diseases. Autologous T cells enriched with CD4/CD8 are genetically engineered using a lentiviral vector to express chimeric antigen receptors (CARs) that target the CD19 antigen on the cell surface of B cells and their precursors. During treatment, patients undergo leukapheresis, lymophodepleting chemotherapy and administration of the expanded CD19-CAR-transduced T cells.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• General:

‣ Subjects must understand and voluntarily sign an informed consent form including written consent for data protection,

⁃ Adults aged ≥ 18 years at time of consent,

⁃ Adequate renal (eGFR \> 30 ml/min/m2), liver (no Child Pugh C), heart (at worst NYHA III, EF \> 30%) and pulmonary (FV and DLCO \> 30%) function,

⁃ Male subjects unless surgically sterile, must agree to use two acceptable methods for contraception (e.g. spermicide and condom) during the trial and refrain from fathering a child starting from the time of signing the Informed Consent Form (ICF) until 12 months after dosing of the IMP,

⁃ Females of childbearing potential (FCBP) must have a negative urine pregnancy test at screening and must agree to use a highly effective contraceptive method (Pearl in-dex \<1) starting from the time of signing the ICF and for 12 months after dosing of the IMP,

⁃ Must be able to adhere to the study visit schedule and other protocol requirements,

⁃ Double vaccination against SARS-CoV-2 or SARS-CoV-2 within the last 6 months.

• SLE specific:

‣ Fulfilling the 2019 ACR/EULAR classification criteria of SLE,

⁃ Positivity of anti-dsDNA (\> 4 U/l), anti-histone (+ or more), anti-nucleosome (+ or more) or anti-Sm antibodies (+ or more),

⁃ Active disease at screening, defined as ≥ 1 organ system with a British Isles Lupus Assessment (BILAG) A score (severe disease activity) or ≥ 2 organ systems with a BILAG B score (moderate disease activity),

⁃ Insufficient response or intolerance/ contraindication to glucocorticoids and to at least 2 of the following treatments: hydroxychloroquine, mycophenolate mofetil, belimumab, methotrexate, rituximab, cyclophosphamide. Insufficient response is defined as having increased disease activity based on the definition explained in the previous bullet point.

• SSc specific:

‣ Fulfilling the 2013 ACR/EULAR classification criteria of SSc),

⁃ Positivity (+ or more) for at least one SSc-specific parameter (Scl70, RNA polymerase, Th/To, RP11/12, U3RNP autoantibodies),

⁃ Signs for fast progression including (i) disease duration ≤ 5 years (from onset of first non-Raynaud manifestation), (ii) mRSS score 10-35 at screening, (iii) elevated acute phase reactant levels (CRP ≥ 6 mg/L, ESR ≥ 28mm/h or platelet count ≥ 330 G/L), (iii) mRSS increase ≥ 3 units or involvement of one new body area or mRSS increase ≥ 2 units in one body area or ≥ 1 tendon friction rub over 6 months,

⁃ Insufficient response or intolerance/ contraindication to at least 2 of the following treatments: mycophenolate mofetil, azathioprine, nintedanib, methotrexate, rituximab. Insufficient response is defined as having increased disease activity based on the definition explained in the previous bullet point.

• DM/PM specific:

‣ Fulfilling the 2017 ACR/EULAR classification criteria for probable or definite DM or PM,

⁃ Presence of active myositis in muscle biopsy or muscle MRI and/or signs of interstitial lung disease related to DM/PM,

⁃ Positivity (+ or more) for at least one myositis-specific antibody (aminoacyl tRNA synthetases, Mi2, MDA5, SAE, SRP, ARS, HMGCR, MJ, TIF1gamma),

⁃ Muscle weakness as define by MMT \< 142 and 2 of the following criteria: VAS patients Global ≥2cm, VAS physician Global ≥ 2cm, HAQ \> 0.25, at least one muscle enzyme \> 1.3 times upper limit of normal, VAS global extra muscular activity ≥ 2cm,

⁃ Insufficient response or intolerance/ contraindication to glucocorticoids and to at least 2 of the following treatments: mycophenolate mofetil, ciclosporin A, tacrolimus, methotrexate, rituximab, intravenous immunoglobulins. Insufficient response is defined as having increased disease activity based on the definition explained in the previous bullet point.

Locations
Other Locations
Germany
Universitätsklinikum Erlangen
RECRUITING
Erlangen
Contact Information
Primary
Georg Schett, Prof. Dr. med. univ.
georg.schett@uk-erlangen.de
+49 9131 85 32093
Backup
Daniela Bohr, Dr.med
daniela.bohr@uk-erlangen.de
+49 9131 85 32093
Time Frame
Start Date: 2023-07-17
Estimated Completion Date: 2026-05-31
Participants
Target number of participants: 24
Treatments
Other: Active dose
A prospective, open-label, non-randomized, single-dose interventional basket study.~Single intravenous infusion of a freshly prepared advanced therapy medicinal product (ATMP) from autologous and expanded T cells transduced ex vivo with a CD19-CAR construct.~No control intervention (e.g. another immunosuppressive therapy). Concomitant measures: Leukapheresis and lymphodepleting therapy for conditioning.
Sponsors
Leads: Miltenyi Biomedicine GmbH

This content was sourced from clinicaltrials.gov