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RecruitingNCT05863936BEAMUpdated May 18, 2023

Trial of Belimumab Combined With Multi-target Induction Therapy in Lupus Nephritis

A Phase 3 interventional study of Methylprednisolone Injectable Suspension and Belimumab Injection in Lupus Nephritis, Remission and Safety Issues, sponsored by Nanjing University School of Medicine. Recruiting at 1 site in China. Open to participants aged 14 Years to 65 Years. Per ClinicalTrials.gov, last updated 2023-05-18.

Sponsored by Nanjing University School of Medicine · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Mar 2024, 2 years 7 months ago, but the record still lists the study as recruiting.
  • Started Apr 2023; still recruiting 3 years 7 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
15
Allocation
Not applicable
Ages
14 Years to 65 Years
Sex
All
01

Study summary

The goal of this single-center, prospective clinical trial is to test the safety and efficacy of belimumab combined with multi-target therapy in the treatment of severe lupus nephritis. The main questions it aims to answer are: lupus nephritis complete remission rate at week 24, and the partial remission rate and safety assessments. Patients with severe lupus nephritis will be enrolled and received pulse methylprednisolone at a dose of 1.5 to 3.0g, followed by intravenous belimumab at a dose of 10mg per kilogram at weeks 2, 4, and 6, and every 4 weeks thereafter. Multitarget therapy will be also administered during the induction phase. Induction therapy will last for 24 weeks. Patients with severe lupus nephritis who only received multi-target therapy during the same period will be enrolled as the control group.

02

Conditions studied

  • Lupus Nephritis
  • Remission
  • Safety Issues

Browse trials for

Keywords

  • Lupus nephritis
  • B cell depletion therapy
  • Remission
03

In context

Lupus Nephritis

340 studies on the registry are indexed under Lupus Nephritis; 135 are open to participants now.

This study's planned enrollment of 15 is below the median of 48 across 242 interventional studies indexed under Lupus Nephritis.

Browse Lupus Nephritis studies →

Lead sponsor

Nanjing University School of Medicine is the lead sponsor of 39 studies on the registry; 5 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
14 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Active LN in accordance with the American College of Rheumatology (ACR) diagnostic criteria for SLE (1997), SLE-DAI>10 points (except type Ⅴ LN).
  • Patients with active lupus nephritis (type Ⅲ, Ⅳ, Ⅴ, Ⅴ+Ⅲ, Ⅴ+Ⅳ) diagnosed by light microscopy, immunofluorescence microscopy, and electron microscopy according to the ISN/RPS2003 lupus nephritis classification criteria, with pathological chronicity index (CI) less than 3 points and no TMA like changes in interstitial vessels.
  • Proteinuria ≥1.5g/24h, with or without active urinary sediment (urinary sediment red blood cell count >100/ul, or white blood cell count >5 /HP, or red blood cell cast, excluding urinary tract infection).
  • Serum creatinine \<3.0mg/dL or \<30 ml/min/1.73m\^2 (CKD-EPI formula).
  • Received methylprednisolone pulse therapy within 2 weeks before enrollment, cumulative dose 1.5-3.0g).

Exclusion criteria

Exclusion Criteria:

  • Required renal replacement therapy or received renal replacement therapy within 3 months.
  • Abnormal liver function with elevated , AST or more than 2 times the .
  • Abnormal glucose metabolism, defined as fasting blood glucose concentration ≥7.0mmol/L and/or 2-hour postprandial blood glucose concentration >11.1mmol/L.
  • Mycophenolate mofetil, cyclophosphamide, tacrolimus, cyclosporine A, and high-dose intravenous immunoglobulin (IVIG) were used in the past 12 weeks; It did not include oral hormones, azathioprine or tripterygium wilfordii polyglycosides, or intravenous low-dose MP (less than 80mg/ day), or short-term use of cyclosporine A\<2 weeks, or leflunomide \<4 weeks.
  • Known allergy to or to MMF, tacrolimus, or belimumab; Patients with active infection or intravenous antibiotic use within 1 month before admission.
  • Current or past 3 months: active , , tuberculosis, cytomegalovirus pneumonia, active fungal infection, syphilis infection or infection, etc.; Active peptic ulcer; A history of drug use and alcohol abuse; Severe malnutrition (\<16 kg/m\^2).
  • Other active diseases, such as severe life-threatening cardiovascular diseases; , or asthma requiring treatment with oral ; Bone marrow suppression caused by SLE activity was excluded: WBC\<3000/ul, \<1300/ul, and count \< 50 000/ul. Patients with active SLE who received double plasma filtration, plasma exchange or high-dose gamma globulin therapy within 4 weeks.
  • Patients with malignant hypertension.
  • Women who have fertility requirements, refuse or are lactating.
  • Other investigators considered that they were not suitable for enrollment and may have rapid disease progression or severe disease complications.
Terms in these criteria, in plain language(14)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
15 participants (estimated)

Study arms

  • Other
    Belimumab and multi-target therapy group

    Patients with severe lupus nephritis will be enrolled and received pulse methylprednisolone at a dose of 1.5 to 3.0g, followed by intravenous belimumab at a dose of 10mg per kilogram at weeks 2, 4, and 6, and every 4 weeks thereafter. Multitarget therapy will be also administered during the induction phase. Induction therapy will last for 24 weeks.

    Drug: Methylprednisolone Injectable Suspension · Drug: Belimumab Injection · Drug: Immunosuppressive Agents

Interventions

  • Methylprednisolone pulse therapy, total dose from 1500mg to 3000mg.

    Also known as: Methylprednisolone pulse therapy

  • Belimumab at a dose of 10mg per kilogram at weeks 2, 4, and 6, and every 4 weeks for 24 weeks.

    Also known as: Beliumab induction therapy

  • 1. Mycophenolate Mofetil, oral, 1.0-1.5g per day; 2. Tacrolimus, oral, 2-4mg per day.

    Also known as: Multi-target immunosuppressive therapy

06

What researchers measure

Primary outcomes

  1. Proportion of patients with a cumulative complete response at week 24 of treatment.

    Complete response will be defined as below: 1. urinary protein less than 0.4g/24h 2. no active urinary sediment 3. serum albumin more than 3.5g/dl 4. and normal SCr.

    Time frame: 24 weeks

Secondary outcomes

  1. The proportion of patients with partial response and non-response to treatment.

    Partial response will be defined as a decrease of more than 50% of the baseline value of urinary protein and less than 3.5g/24h of urinary protein, a decrease of more than 50% of the baseline value of urinary sediment red blood cell count, and a normal or an increase of less than 30% of serum creatinine

    Time frame: 24 weeks

  2. Overall response rate at 24 weeks.

    These will include complete remission and partial remission

    Time frame: 24 weeks

  3. Improvement of clinical indicators.

    Clinical improvement of the disease was assessed using systemic lupus erythematosus disease activity index.

    Time frame: 24 weeks

  4. The changes of B cells.

    The changes of CD20 number in peripheral blood will be observed and investigated.

    Time frame: 24 weeks

07

Study locations

1 of 1 sites recruiting
  • Jiong Zhang
    Nanjing, Jiangsu 210016, China
    Recruiting
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Apr 2023 (actual). Primary completion is estimated for Mar 2024, 11 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 19, 2023
First posted
May 18, 2023
StartActual
Apr 1, 2023
Primary completionEst.
Mar 31, 2024
CompletionEst.
Dec 31, 2024
Last update
May 18, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 18, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05863936
Lead sponsor
Nanjing University School of Medicine
Responsible party
Zhi-Hong Liu, MD (Professor in Medicine, Nanjing University School of Medicine) — Principal investigator
First posted
May 18, 2023
Start date
Apr 1, 2023
Primary completion
Mar 31, 2024 (estimated)
Completion
Dec 31, 2024 (estimated)
Last update
May 18, 2023

Study contacts

Jiong Zhang, PhD
Contact
jiongzhang@live.com
86-25-80862860
Zhi-Hong Liu, MD
principal investigator · National Clinical Research Center of Kidney Diseases, Jinling Hospital

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Belimumab

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