For Healthcare Professionals

Evaluate Efficacy, Safety and Tolerability, PK and PD of Emapalumab in Children and Adults With MAS in Still's or SLE

clipboard-pencil

About the study

The purpose of this study is to assess the safety, tolerability and efficacy of emapalumab in children and adults with macrophage activation syndrome (sHLH/MAS) in Still's disease (including systemic juvenile idiopathic arthritis and adult onset Still's disease) or with sHLH/MAS in systemic lupus erythematous, resenting an inadequate response to high dose glucocorticoid treatment.
user-3

Who can take part

You may be eligible to participate in the study if you meet the following criteria:

INCLUSION CRITERIA

Inclusion criteria Run-in phase in all cohorts

  1. Informed consent provided by the subject or by the subject s' legally authorized representative(s) with the assent of subjects who are legally capable of providing it, as required by local law.
  2. Male and female subjects aged between 6 months and 80 years of age at the time of diagnosis of MAS.
  3. MAS defined as per the criteria defined below for each cohort and requiring treatment with GCs.

Interventional phase in all cohorts

  1. Informed consent provided by the subject or by the subject's legally authorized representative(s) with the assent of subjects who are legally capable of providing it, as as required by local law.
  2. Male and female subjects aged between 6 months and 80 years of age at the time of diagnosis of active MAS.
  3. Subjects who have shown an inadequate response to high dose intravenous (i.v.) GCs administered for at least 3 days according to local standard clinical practice, including but not limited to pulses of 30 mg/kg PDN on 3 consecutive days. High i.v. GCs dose is recommended not to be lower than 2 mg/kg/ day PDN equivalent (or at least 60 mg/day in pediatric subjects of 30 kg or more, and at least 1g/day in adult MAS subjects). In case of rapid worsening of the subject's condition and/or laboratory parameters, as per Investigator judgment, inclusion may occur within less than 3 days from starting high dose GCs.

Diagnosis of active MAS confirmed by the treating rheumatologist, having ascertained the followings:

a. Febrile subjects presenting with ferritin > 684 ng/mL. b. and any 2 of: i. Platelet count ≤ 181 x109/L ii. AST-level > 48 U/L iii. Triglycerides > 156 mg/dL iv. Fibrinogen level ≤ 360 mg/dL

Female subjects of child-bearing potential willing to use highly effective methods of contraception from study drug initiation to 6 months after the last dose of study drug.

Specific inclusion criteria to Cohort 1 and Cohort 2

Cohort 1:

  1. Confirmed sJIA diagnosis. For subjects presenting with MAS in the context of the onset of sJIA, high presumption of sJIA will suffice for eligibility.
  2. Confirmed diagnosis of AOSD as per Yamaguchi criteria.

Cohort 2:

Confirmed diagnosis of SLE as per SLICC'12 criteria.

EXCLUSION CRITERIA

Exclusion criteria

  1. Primary HLH documented by either the presence of a known causative genetic mutation or abnormal perforin expression and CD107a degranulation assay as described with primary hemophagocytic lymphohistiocytosis or by the presence of family history.
  2. Confirmed malignancy. Note: subjects with a suspected malignancy should have mononuclear cells typed by flow cytometry and/or tissue biopsy, as applicable, to rule out malignancy.
  3. Treatment with canakinumab, JAK inhibitors, TNF inhibitors and tocilizumab at the time of emapalumab initiation.
  4. Ongoing treatment with anakinra at a dose above 4 mg/kg at time of emapalumab initiation.
  5. Subjects treated with etoposide for MAS in the last 1 month.
  6. Clinically active mycobacteria (typical and atypical), Histoplasma Capsulatum, or Salmonella infections.
  7. Evidence of leishmania infections.
  8. Evidence of latent tuberculosis.
  9. History of hypersensitivity or allergy to any component of the study drug.
  10. Receipt of a Bacillus Calmette-Guerin (BCG) vaccine within 12 weeks prior to screening.
  11. Receipt of a live or attenuated live (other than BCG) vaccine within 4 weeks prior to screening.
  12. Pregnancy or lactating female subjects.
pin location

Study Locations

Enter your ZIP code/Postal code/PIN code to locate study sites near you:

How to Apply


Contact the study center to learn if this study is a good match for you.

Study’s details


Contition

Macrophage Activation Syndrome,Secondary Hemophagocytic Lymphohistiocytosis,Still Disease,Systemic Lupus Erythematosus,SJIA,AOSD,MAS

Age (in years)

6 - 80

Phase

Phase 3

Participants needed

41

Est. Completion Date

Sep 30, 2025

Treatment type

Interventional


Sponsor

Swedish Orphan Biovitrum

ClinicalTrials.gov identifier

NCT05001737

Study number

NI-0501-14

Understanding Clinical Trials


Get answers to your questions about clinical trials.What is a clinical research?What does taking part in clinical trials involve?What should I ask the trial doctor?
Vector

Interested?

Sign up to save your favorites, 
receive newsletters, resources, and alerts 
about clinical trials related to your conditions of interest.