Phase 2
N=10
Zanubrutinib in Patients With IgG4-Related Disease
IgG4 Related Disease
Bottom Line
View on ClinicalTrials.gov: NCT04602598 ↗Enrolled (actual)
10
Serious AEs
10.0%
Results posted
Apr 2026
Primary outcome: Primary: Volume of the Submandibular Glands on PET-MRI — 12.7; 9.34; -3.37 cm^3 — p=< 0.001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Zanubrutinib 80 MG (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Matthew C. Baker
- Primary completion
- Feb 2025
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Volume of the Submandibular Glands on PET-MRI |
12.7; 9.34; -3.37 | < 0.001 sig |
| PRIMARY Volume of the Lacrimal Glands on PET-MRI |
2.59; 1.17; -1.42 | < 0.001 sig |
| SECONDARY FDG Avidity (SUVmax) of the Submandibular Glands on PET |
5.33; 3.42; -1.91; 3.27; -2.06 | 0.03 sig |
| SECONDARY FDG Avidity (SUVmax) of the Lacrimal Glands on PET |
5.52; 3.37; -2.15; 3.23; -2.29 | 0.008 sig |
| SECONDARY Change in Total Metabolic Lesion Volume (tMLV) of Lacrimal Glands, Submandibular Glands, Parotid Glands, and Lymph Notes on PET |
24.3; 5.19; -19.2; 3.64; -20.7 | 0.04 sig |
| SECONDARY Change in Total Lesion Glycolysis (TLG) of Submandibular and/or Lacrimal Glands on PET |
103; 16.1; -86.7; 11.2; -91.6 | 0.04 sig |
| SECONDARY Change in Submandibular Glands on MRI |
1.13; 1.25; 0.125; 1.38; 0.250; 1.00 | 0.3 |
| SECONDARY Change in Parotid Glands on MRI |
2.13; 1.63; -0.500; 1.63; -0.500; 1.13 | 0.03 sig |
| SECONDARY Change in Lacrimal Glands on MRI |
2.13; 2.50; 0.375; 2.69; 0.563 | 0.02 sig |
| SECONDARY Change in the Volume of the Parotid Glands on PET/MRI |
44.6; 39.6; -5.07; 38; -6.66 | < 0.001 sig |
| SECONDARY Change in the Volume of the Submandibular Glands on PET/MRI |
12.7; 10.0; -2.69 | < 0.001 sig |
| SECONDARY Change in the Volume of the Lacrimal Glands on PET/MRI |
2.59; 1.50; -1.09 | < 0.001 sig |
| SECONDARY Change in Serum IgG4 Level |
643; 342; -301; 226; -413 | 0.008 sig |
| SECONDARY Change in Plasmablast Count |
17.8; 0.175; -17.6; 0.213; -19.6 | 0.008 sig |
| SECONDARY Change in Absolute Regulatory B Cell Count |
3.03; 0.538; -2.49; 0.450; -2.58 | — |
| SECONDARY Change in the IgG4-RD Responder Index |
6.63; 2.38; -4.25; 2.00; -4.63 | 0.02 sig |
| SECONDARY Proportion of Patients With no Disease Flares |
7 | — |
| SECONDARY Change in Total Salivary Grey Scale Ultrasound Score (TUS) |
5.3; 4.4; -0.88; 3.5; -1.75 | 0.1 |
| SECONDARY Change in Highest Score Among the Salivary Glands for the Grey Scale Ultrasound Score (HSUS) |
2.3; 1.9; -0.38; 1.6; -0.63 | 0.1 |
| SECONDARY Change in Glandular Inflammation Total Ultrasound Score (iTUS) |
7.4; 6.4; -1.00; 5.3; -2.13 | 0.2 |
| SECONDARY Change in Highest Score Among the Salivary Glands for the Glandular Inflammation Ultrasound Score (iHSUS) |
2.4; 2.1; -0.25; 1.8; -0.63 | 0.3 |
| SECONDARY Change in Physician Global Assessment of Disease |
68.4; 21.4; -47.0; 17.4; -51.0 | 0.02 sig |
| SECONDARY Change in Patient Global Assessment of Disease |
52.4; 38.4; -14.0; 31.0; -21.4 | 0.2 |
| SECONDARY Change in VAS for Ocular Symptoms - Dryness |
47.6; 31.9; -15.8; 21.5; -26.1 | 0.2 |
| SECONDARY Change in VAS for Dryness Symptoms |
47.6; 31.9; -15.8; 21.5; -26.1 | 0.2 |
| SECONDARY Change in FACIT-F Fatigue Score |
38.9; 41.6; 2.75; 43.3; 4.38 | 0.9 |
| SECONDARY Change in RAND Short Form-36 |
85.6; 78.8; -6.88; 78.1; -7.50 | 0.8 |
| SECONDARY Change in C3 Lab |
116; 114; 1.86; 121; 6.43 | 0.5 |
| SECONDARY Change in C4 Lab |
28.6; 31.5; 2.88; 31.0; 2.00 | 0.6 |
| SECONDARY Change in Total IgG Lab |
1610; 1240; -368; 1200; -395 | 0.008 sig |
| SECONDARY Change in IgE Lab |
562; 1230; 672; 1280; 544 | 0.3 |
| SECONDARY Change in IgG1 Lab |
572; 491; -80.8; 505; -71.2 | 0.02 sig |
| SECONDARY Change in ESR Lab |
20.4; 9.00; -11.4; 8.75; -12.9 | 0.06 |
| SECONDARY Change in CRP Lab |
0.313; 0.313; 0; 0.300; -0.0143 | 1 |
| SECONDARY Incidence of Safety Parameters Including Adverse Events |
10; 2; 8; 1; 1; 0 | — |
| SECONDARY Incidence of Safety Parameters Including Abnormal Laboratory Results |
2 | — |
Summary
The aim of this clinical trial is to evaluate the safety and efficacy of zanubrutinib in treating patients with IgG4-related disease
Eligibility Criteria
Inclusion Criteria
- Men or women aged 18 to 85, inclusive, at the time of initial screening
- Have histopathologically confirmed IgG4-RD in the submandibular gland and/or the lacrimal gland confirmed by international consensus pathology criteria
- Presence of a lymphoplasmacytic infiltrate with 10 IgG4+ plasma cells per high-power field and/or an IgG4+/IgG+ plasma cell ratio of 40%
- All women must test negative for pregnancy and agree to use a reliable method of birth control
- No current treatment with immunosuppressive medications other than prednisone 40mg daily (or other glucocorticoid equivalent) with stable dosing for 28 days
Exclusion Criteria
- Unstable prescribed dose of glucocorticoids within 28 days prior to baseline
- Any treatment with a synthetic DMARD including but not limited to hydroxychloroquine, methotrexate, leflunomide, or sulfasalazine within 28 days prior to baseline
- Any treatment with a cytotoxic or immunosuppressive drug including but not limited to cyclophosphamide, mycophenolic acid, azathioprine, cyclosporine, sirolimus, or tacrolimus within 28 days prior to baseline
- Any treatment with a BTK inhibitor within 6 months before baseline
- Any treatment with a JAK inhibitor within 28 days prior to baseline
- Use of biologic agents including infliximab, abatacept, or tocilizumab within 56 days prior to baseline
- Use of a B cell depleting therapy (such as rituximab) within 12 months prior to baseline
- A history of, or current, inflammatory or autoimmune disease (that could affect the interpretation of safety or efficacy outcomes) other than IgG4-related disease
- Evidence of active tuberculosis, HIV, or hepatitis B or C infection
- History of cancer other than non-melanoma skin cancer, cervical dysplasia or carcinoma in situ (cured >1 year), prostate cancer (cured >5 years), or colon cancer (cured >5 years)
Data sourced from ClinicalTrials.gov (NCT04602598). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.