Lupus nephritis (LN) is a serious complication of systemic lupus erythematosus (SLE) characterized by inflammation of the kidneys.1 Living with LN can be very challenging, with available treatments often having side effects2 and limited ability to adequately prevent disease flare.3 

Therefore, more treatment options are needed. That’s why we’re conducting the SIRIUS-LN clinical trial to see if an investigational drug is safe and effective.

About LN

  • Lupus nephritis is a severe complication of SLE characterised by inflammation of the kidneys.
  • Signs and symptoms of LN can include blood or protein in the urine (known as ‘hematuria’ and ‘proteinuria’), weight gain, high blood pressure, and swelling (known as ‘edema’).4
  • It can affect between 25-50% of SLE patients at onset and may increase up to 60% during the course of the disease.5
  • Like other autoimmune diseases, it’s unclear exactly what causes LN.

What will taking part involve?

If you are eligible and choose to take part in the SIRIUS-LN trial, some assessments will be carried out to make sure that the trial is right for you.

You’ll spend a total of up to 5 years in the trial. The duration of each period of the trial is detailed below.

We’ll carry out some assessments to make sure the study is right for you.

You’ll receive either the investigational drug and/or a placebo every 4 weeks. Your trial doctor will explain this in more detail, should you take part. You’ll continue to receive your standard of care (a treatment generally recommended by medical experts) regardless of whether you receive the investigational drug or placebo.

We’ll continue to monitor your health after you stop taking your assigned trial treatment.

You may also have the opportunity to participate in an extension period before going into the follow-up period after consulting with your doctor.

See if you’re eligible

How is the investigational drug thought to work?

  • B cells are a type of white blood cell and are central to the immune system. They produce antibodies that circulate around the body, seeking and attacking foreign cells such as bacteria and viruses.
  • However, in people with autoimmune diseases, these B cells mistakenly attack the healthy cells instead, causing the damage and inflammation seen in conditions such as LN.
  • B cell activating factor (BAFF) is a protein that supports B cell activity. Although the specific cause of LN is still not known, it’s thought that people with LN have increased B cell activity together with high levels of BAFF.
  • The investigational drug in the SIRIUS-LN trial has a dual mechanism of action – it aims to deplete B cells while also potentially blocking BAFF receptor-mediated activation of B cells. In this way, it’s hoped that the investigational drug will limit the damaging effects of B cell activity that cause the symptoms of LN.

Who can take part?

Trial eligibility Yes checkbox in blue square icon

 

To take part in the SIRIUS-LN trial, in addition to other criteria, potential participants must:

  • Be aged 18 years or older
  • Have a diagnosis of SLE
  • Have active LN as shown by a biopsy, urine test, and blood test
  • Weigh at least 77 lbs

 

Trial Eligibility No cross mark in blue square icon

 

In addition to other criteria, potential participants must not:

  • Be pregnant or nursing (or plan to become pregnant or nurse during the trial)
  • Have any other severe kidney impairment (e.g. end-stage kidney disease requiring dialysis)

For the full eligibility criteria of SIRIUS-LN, please visit:

Participation in clinical trials is completely voluntary and you are free to leave at any time without any change to your usual healthcare.

How will each participant’s health be monitored?

Participants will need to visit the trial clinic regularly. This is so that we can administer their assigned trial treatment and monitor their general health and LN with assessments such as:

Stethoscope Icon
Physical examinations
Blood tests, blue syringe icon
Blood samples
Urine tests, blue test tube icon
Urine samples
Skin prick testing, blue microscope icon
LN assessments
Questionnaires, blue writing on sheet icon
Questionnaires
Vital signs, blue heart icon
Vital signs
Mature woman patient in doctors office

What is a clinical trial?

Every year, hundreds of thousands of people take part in clinical trials (also known as clinical studies). These are carefully controlled scientific investigations that help to improve the practice of medicine all around the world. They help us discover:

  • Alternative ways to diagnose conditions
  • Alternative ways to treat conditions
  • Alternative ways to track the progress of conditions

Different types of clinical trials

Clinical trials help us answer scientific questions, but different types of trials help us do this in different ways. For example:

Female doctor taking the blood pressure of a male clinical trial participant.

Interventional trials

Participants are asked to change their care somehow. For example, they may be asked to take an investigational drug or change their diet. The SIRIUS- LN trial is interventional.

A female healthcare professional sits at a computer as she and two male healthcare professionals review the information on a screen.

Observational trials

Participants are asked to continue their usual healthcare regimen while healthcare professionals monitor their condition. For example, the level of a certain substance (e.g., an antibody) in the blood could be monitored.

Frequently asked questions

We’ve compiled answers to some of the most common questions about clinical trials, as well as any specific questions related to this particular clinical trial.

About the SIRIUS-LN clinical trial

You’ll be randomly assigned to receive either the investigational drug or placebo. Your trial doctor will explain this in more detail, should you take part.

This trial is ‘double-blind’. This means that neither you nor the trial team at the clinic will know whether you’ll receive the investigational drug or the placebo. Using a placebo helps us to be sure any changes seen are due to the investigational drug alone and not some other factor.

Both the investigational drug and placebo will be given as subcutaneous (under the skin) injections into either your arm, abdomen or thigh, every 4 weeks for up to 144 weeks (33 months). You’ll receive two injections at every visit and the injection sites on your body will be rotated. The trial team will make sure you’re as comfortable as possible during administration of the investigational drug.

Benefits to taking part in this clinical trial include frequent health assessments.

Risks to taking part in this clinical trial include:

  • The investigational drug may have unknown side effects
  • The investigational drug may not work for you

Your LN may stay the same, not respond, or get worse.

At every stage of the trial, your health and well-being are the top priority. Therefore, if you have a flare during the trial, the trial doctor will take immediate action to ensure you receive appropriate medical care and treatment.

It’s really important that you stick to the visit schedule so that we can closely monitor your health and give you your trial treatment.

However, we do understand that plans can suddenly change. Therefore, if you can’t make a visit, or you miss one, please contact the trial team as soon as possible. They can then reschedule your appointment.

Other questions about clinical trials

A placebo is a ‘dummy drug’ that looks just like the investigational drug and is given the same way; however, it contains no active medicine. Using a placebo helps us to understand if any changes seen are due to the investigational drug and not some other factor. But that doesn’t mean people in the placebo group receive no care. In this trial placebo will be given on top of your standard of care LN treatment. The health of every participant will be closely monitored throughout their participation in a trial.

Participation in clinical trials is voluntary. This means that you are under no obligation to take part and you are free to leave at any time without penalty. However, we would encourage all potential participants to stay in a trial for its duration, if possible.

No. You do not need medical insurance to take part in this clinical trial.

Every clinical trial is designed to be as safe as possible for participants and must be reviewed by regulatory boards (such as the US Food and Drug Administration) before it can begin. It is the job of these boards to protect the safety and rights of a trial’s participants. They do this by reviewing the trial’s protocol. A protocol is a plan that explains the need for the trial, what participants will need to do, and how their health will be monitored.

Risks to taking part in this clinical trial include:

  • The investigational drug may have unknown side effects
  • The investigational drug may not work for you

Before a person can be enrolled into a clinical trial, they must meet eligibility criteria specific to that trial.

Many clinical trials are ‘randomized’ and ‘double-blind’. Randomized means a participant will be allocated to a study treatment group by chance, like the flip of a coin. Double-blind means that neither the participant nor the trial team will know which group the participant is in until after the trial is complete. This is to ensure that any effects seen are due to the investigational drug alone. Some clinical trials offer ‘open-label’ treatment. This means participants and the trial doctor will know that they are receiving the investigational drug. If you pass the pre-screener, the trial coordinator at the clinical trial site will be able to provide you with more information.

References:

  1. Qi, S., Chen, Q., Xu, D., Xie, N., & Dai, Y. (2018). Clinical application of protein biomarkers in lupus erythematosus and lupus nephritis. Lupus, 27(10), 1582-1590.
  2. Schwartz N, Goilav B, Putterman C. The pathogenesis, diagnosis and treatment of lupus nephritis. Curr Opin Rheumatol; 2014;26:502–9.
  3. Appel GB, Contreras G, Dooley MA, et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol. 2009;20:1103–12.
  4. National Kidney Foundation [Internet]. Lupus and kidney disease (lupus nephritis). [cited 2023 Apr 11]. Available from: https://www.kidney.org/atoz/content/lupus
  5. Anders HJ, Saxena R, Zhao MH, et al. Lupus nephritis. Nat Rev Dis Primers; 2020;6:7.