Exploring a new drug for rare immune-related inflammatory diseases

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial investigates the efficacy of Filgotinib, a JAK1 inhibitor, in treating patients with rare immune-mediated inflammatory diseases such as Behçet's disease, idiopathic inflammatory myopathy, and IgG4-related disease. The study aims to provide a more targeted and specific anti-inflammatory treatment option compared to traditional therapies that often involve long-term use of glucocorticoids and other immunosuppressants. By focusing on the role of type 1 interferon in these conditions, the trial seeks to determine if JAK-STAT inhibition can effectively reduce disease activity and improve patient outcomes. Participants will be closely monitored for their response to the treatment and any potential side effects.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age 18 years of older
* One of the following rare IMIDs:

  * Diagnosis of Behçet's disease without refractory life, organ or sight-threatening symptoms with active disease, defined as a BDCAF \>2 (new BDCAF) or \>15 (old BDCAF) or with active disease, based on clinical grounds (e.g. the need to start new or additional medication
  * Diagnosis of idiopathic inflammatory myopathy, according to diagnostic criteria:

Dermatomyositis: Dermatomyositis Classification Criteria according to the European Neuromuscular Centre guidelines 201852 or anti-synthetase syndrome: Anti- synthetase syndrome Classification Criteria according to the European Neuromuscular Centre guidelines 200353, both with active disease, defined as a CDASI score of ≥5 or abnormal levels of at least 1 of the following enzymes: creatine kinase (≥ 4× upper limit of normal \[ULN\]), aldolase (≥4 × ULN), lactate dehydrogenase (LDH ≥4 × ULN), aspartate transaminase (AST ≥4 × ULN), alanine aminotransferase (ALT ≥4 × ULN) or a MRI within the last 3 months indicative of active inflammation (e.g. edema signal pattern in affected proximal muscles) or active disease based on clinical grounds, e.g. the need to start new or additional medication

* Diagnosis of IgG4-related disease, according to 2019 ACR/EULAR guidelines, with active disease, defined as: IgG4-related disease responder index \>10 or active disease based on clinical grounds, e.g. the need to start new or additional medication

  * Refractory disease, defined as symptomatic disease that persists despite a 12-week trial of glucocorticoid therapy as well as lack of response to at least one other immunosuppressive agent such as methotrexate (MTX), mycophenolate mofetil (MMF), azathioprine (AZA) or rituximab or intolerance to standard-of-care treatment, as defined by the treating physician.
  * No evidence of active or latent or inadequately treated infection with mycobacterium tuberculosis (TB) as defined by all of the following: both a negative QuantiFERON-TB Gold (QFT-G) In-Tube test and a Mantoux tuberculin skin test performed at or within 3 months prior to screening and no signs suggestive of active TB infection as determined (and documented) by a qualified radiologist or pulmonologist as per local standard of care on a chest radiograph and no history of either untreated or inadequately treated latent or active TB infection.

Exclusion Criteria:

* Age \<18 years
* Age ≥65 years
* Life expectancy less than 6 months
* Juvenile DM, myositis overlapping with other autoimmune diseases, immune mediated necrotizing myopathy (IMNM), inclusion-body myositis or cancer-associated myositis
* End-stage IIM wherein muscle weakness is most likely due to muscle damage, rather than myositis disease activity
* Increased risk of major cardiovascular problems
* Current smoker or smoked for a long time in the past
* Pregnancy or lactation
* Previous use of other JAK inhibitors
* Use of any investigational drug within one month prior to screening or within five half-lives of the investigational agent, whichever is longer.
* Human Immunodeficiency Virus (HIV) infection
* Presence of an active infection or viral hepatitis type B or C
* History of shingles or recurrent herpes simplex infection
* Concomitant malignancies or previous malignancies within the last five years (with exception of adequately treated basal or squamous cell carcinoma of the skin)
* Increased risk of cancer
* Kidney injury with estimated glomerular filtration rate \<15mL/min/1.73m2
* Liver failure Child Pugh C
* Absolute neutrophil count \<1\*109
* Absolute leukocyte count \<0.5\*109
* Hemoglobin \<5mmol/L - Inability to comply with study and/or follow-up procedures
* Known recent substance abuse (drugs or alcohol).
* Poor tolerability of venipuncture or lack of adequate venous access for required blood sampling during the study period.
* Previous non-adherence to immunosuppressants
* Hypersensitivity to the active substance or to any of the excipients
* Rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption

Where it's running

• Amsterdam UMC
  Amsterdam, Netherlands Recruiting
• Zuyderland Medical Center
  Heerlen, Netherlands Recruiting
• Radboud university medical center
  Nijmegen, Netherlands Recruiting
• Erasmus MC
  Rotterdam, Netherlands Recruiting
• Hagaziekenhuis
  The Hague, Netherlands Recruiting
• University Medical Center
  Utrecht, Netherlands Recruiting

Study contacts

• Principal investigator: Jaap M van Laar, Prof. dr. — UMC Utrecht
• Study coordinator: Anne Karien Marijnissen, Dr
• Email: a.c.a.marijnissen@umcutrecht.nl
• Phone: +887550459

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.