Immune Tolerance in Autoimmune Disease

Autoimmune diseases occur when the immune system mistakenly flags certain cells in the body as foreign invaders. The resulting attack can cause irreparable damage to critical organs and tissues. For example, in multiple sclerosis, it’s the myelin coating that insulates nerve cells; in lupus, it can be any number of organs or systems that are damaged. Currently, many of the primary methods to treat patients with autoimmune disease utilize immune suppressors, which help reduce the inflammatory attack on tissues but can put patients at higher risk for developing infections.

Immune tolerance therapies are designed to stop, or even prevent, the autoimmune disease while leaving the body's disease-fighting abilities intact. These tolerance therapies essentially reprogram the immune system, so that a short course of treatment will have long-lasting, perhaps lifelong effects. While immune tolerance therapies are mainly experimental, the Immune Tolerance Network (ITN) believes that targeted reprogramming of the immune system holds a great deal of promise to effectively treat autoimmune diseases with fewer side effects than current drugs.

Research Focus - Autoimmune Disease

The clinical heterogeneity of the more than 80 autoimmune diseases presents a significant challenge with respect to the development of therapies designed to re-establish self-tolerance. The ITN’s approach to tolerance in autoimmune diseases attempts to address these challenges through a coordinated program of clinical studies aimed at establishing proof-of-principle either in diseases where a self-antigen has been identified, the target organ is accessible for further study or the disease pathogenesis has been relatively well established.

Given the complex nature of these diseases, and following the approaches being developed in the transplant and allergy portfolios, the ITN builds on results from ongoing trials by developing combination approaches affecting humoral and cellular, as well as adaptive and innate, immune responses. This includes combinations that ablate or anergize effector responses, deviate induced responses and boost regulatory responses. Because combination therapy trials can be logistically and scientifically challenging, the ITN has adopted the use of smaller, mechanistically-based studies as a first step in evaluating promising combinations and establishing a mechanistic plan that will inform on the pathways of tolerance.

Daratumumab For Antiphospholipid Syndrome (DARE-APS)

Principal Investigator:

Doruk Erkan, MD, MPH | Hospital for Special Surgery

Jason Knight, MD, PhD | University of Michigan

A study about the safety of daratumumab in patients with antiphospholipid syndrome (APS), and its effectiveness at reducing the antiphospholipid antibodies that cause APS.

Category: 

Autoimmune Disease

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Specific Category: 

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Status: 

Active

CD40L-CD40 Pathway In Rheumatoid Arthritis (CONTROL-RA)

Principal Investigator:

William St. Clair, MD | Duke University

The goal of CONTROL-RA is to see how the experimental study drug, VIB4920, affects control of rheumatoid arthritis (RA).

Category: 

Autoimmune Disease

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Specific Category: 

Rheumatoid Arthritis

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Status: 

Active

VIB4920 for Active Lupus Nephritis (VIBRANT)

Principal Investigator:

Betty Diamond, MD | Feinstein Institute for Medical Research

David Wofsy, MD | University of California San Francisco School of Medicine

Maria Dall'Era, MD | University of California San Francisco School of Medicine

The goal of the VIBRANT trial is to determine if treating lupus nephritis with VIB4920 in addition to standard therapy is more effective than treating lupus nephritis with standard therapy alone.

Category: 

Autoimmune Disease

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Specific Category: 

Lupus

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Status: 

Active

Targeting IL-15 For The Treatment Of Vitiligo (REVEAL)

Principal Investigator:

Brett King, MD, PhD | Yale University

The REVEAL study will investigate whether the experimental study medication, AMG714, can bring back normal color to the skin in vitiligo.

Category: 

Autoimmune Disease

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Specific Category: 

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Status: 

Active

Belimumab and Rituximab for Primary Membranous Nephropathy (REBOOT)

Principal Investigator:

Patrick Nachman, MD | University of Minnesota

Ignacio Sanz, MD | Emory University

REBOOT will test whether a combination of, belimumab and rituximab, is safe and if this combination is more effective at blocking the immune attack on the kidney of patients with Primary Membranous Neuropathy (MN).

Category: 

Autoimmune Disease

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Specific Category: 

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Status: 

Active

Best Available Therapy Vs. Autologous Hematopoietic Stem Cell Transplant For MS (BEAT MS)

Principal Investigator:

Jeffrey Cohen, MD | Cleveland Clinic

George Georges, MD | Fred Hutchinson Cancer Research Center

Paolo Muraro, MD, PhD | Imperial College London

BEAT-MS is a clinical trial comparing chemotherapy followed by autologous hematopoietic stem cell transplant (AHSCT) – a type of bone marrow transplantation – to the most effective medicines regularly used to treat relapsing MS.

Category: 

Autoimmune Disease

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Specific Category: 

Multiple Sclerosis

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Status: 

Active

Evaluation Of Brentuximab Vedotin For Diffuse Cutaneous Systemic Sclerosis (BRAVOS)

Principal Investigator:

David Fox, MD | University of Michigan | Ann Arbor, MI

Dinesh Khanna, MD | University of Michigan | Ann Arbor, MI

BRAVOS is a clinical trial evaluating Brentuximab Vendotin treatment for Diffuse Cutaneous Systemic Sclerosis.

Category: 

Autoimmune Disease

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Specific Category: 

Scleroderma

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Status: 

Active

Rituximab for the Treatment of Wegener's Granulomatosis and Microscopic Polyangiitis (RAVE)

Principal Investigator:

John H. Stone | Johns Hopkins University | Baltimore, MD

Ulrich Specks | Mayo Clinic | Rochester, MN

Antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is the most common type of small blood vessel inflammation in adults. ANCA-associated vasculitis includes Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA). Rituximab is a man-made antibody used to treat certain types of cancer. The purpose of this study is to determine the effectiveness of rituximab in treating adults with WG and MPA.

Category: 

Autoimmune Disease

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Specific Category: 

Vasculitis

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Status: 

Completed

Atorvastatin (Lipitor) Therapy in Patients With Clinically Isolated Syndrome (CIS) at Risk for Multiple Sclerosis (STAYCIS)

Principal Investigator:

Scott Zamvil | University of California | San Francisco, CA

Patients who have been diagnosed with clinically isolated syndrome (CIS) often develop problems related to the central nervous system, which controls the nerves in the body. Some of these patients may later be diagnosed with multiple sclerosis (MS), a progressive disease of the nervous system. The purpose of this study is to determine if the drug atorvastatin is helpful to CIS patients.

Category: 

Autoimmune Disease

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Specific Category: 

Multiple Sclerosis

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Status: 

Completed

A Phase I Study: Safety of RG2077 (CTLA4-IgG4m) in Patients With Relapsing-Remitting Multiple Sclerosis

Principal Investigator:

Samia Khoury | Brigham & Women's Hospital | Boston, MA

Multiple sclerosis (MS) is an autoimmune disorder. In this disease, the body's immune system attacks and destroys the cells that cover and protect nerves. This study will test the safety of a new drug called RG2077 that is designed to treat MS. The study will not determine whether RG2077 is effective in treating MS, only whether it is safe to use in patients with MS.

Category: 

Autoimmune Disease

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Specific Category: 

Multiple Sclerosis

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Status: 

Completed

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