Non-proportional hazards (NPH) have been observed in many immuno-oncology clinical trials. Weighted log-rank tests (WLRT) with suitable weights can be used to improve the power of detecting the difference between surv...
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Background: Approximately 40% of patients with systemic lupus erythematosus (SLE) develop organ damage within the first 5 years of diagnosis due to uncontrolled disease activity and cumulative steroid exposure, result...
Background: Approximately 40% of patients with systemic lupus erythematosus (SLE) develop organ damage within the first 5 years of diagnosis due to uncontrolled disease activity and cumulative steroid exposure, resulting in a greater risk of early mortality. [1] Timely intervention with disease-modifying biologics such as belimumab (BEL) in the early stages of SLE might modify the disease course and prevent irreversible organ damage while avoiding the need for high-dose glucocorticoids (GCs) or immunosuppressants (IS). Previous studies suggested that BEL may have benefit when used earlier in the course of the disease, especially in patients with minimal or no organ damage at baseline who received BEL within 2 years of classification. [2,3] However, the use of BEL early in the treatment pathway has been limited in clinical practice, with the majority of BEL use following the failure of ≥2 IS. Objectives: Present the design of the BeEARLY (BEL in Early SLE) study, which will evaluate the efficacy and safety of BEL in adult SLE patients with early disease. Methods: In this Phase 4, prospective, open-label, single-arm, 3-year clinical study (GSK Study 219240), approximately 350 adult patients with active, autoantibody-positive, early SLE (≤2 years since diagnosis) with no organ damage and with inadequate response to initial standard therapy (ST; with/without conventional IS) will be enrolled. Key eligibility criteria are shown in Table 1 . Eligible participants will receive open-label BEL 200 mg/week subcutaneously as an add-on to their initial ST for 52 weeks (Part A), with a long-term extension of up to 104 weeks (end of study is the safety follow-up visit after Week 156; Part B). Key primary and secondary endpoints are shown in Table 2 . Participants will be required to taper the average oral GC (OGC; prednisone equivalent) dose from Week 12 to ≤7.5 mg/day by Week 26, and to ≤5 mg/day by Week 48 at the discretion of the investigator if they continue to maintain stabl
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