search
Back to results

An Open-label, Multi-center Clinical Trial of Eculizumab in Adult Patients With Atypical Hemolytic-uremic Syndrome

Primary Purpose

Atypical Hemolytic-Uremic Syndrome

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Eculizumab
Sponsored by
Alexion
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atypical Hemolytic-Uremic Syndrome focused on measuring Atypical Hemolytic-Uremic Syndrome

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion:

  1. Patient must be willing and able to give written informed consent.
  2. Patient's age > 18 years.
  3. Patients exhibit thrombocytopenia, hemolysis and elevated Serum Creatinine.
  4. Patients with diagnosis of aHUS with or without an identified complement regulatory protein genetic abnormality or anti-complement factor antibody and for whom etiologies of hemolytic uremic syndrome have been ruled out as confirmed in the exclusion criteria
  5. Female patients of childbearing potential must be practicing an effective, reliable and medically approved contraceptive regimen during the entire duration of the study, including the follow-up period. At the time of the last follow-up visit, patients must agree to continue to use adequate contraception methods for up to 5 months following discontinuation of eculizumab treatment.
  6. Able and willing to comply with study procedures

Exclusion:

  1. Chronic dialysis.
  2. Prior eculizumab use or hypersensitivity to eculizumab, to murine proteins or to one of the excipients.
  3. Known familial a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13) deficiency (ADAMTS-13 <5%).
  4. Typical Hemolytic-Uremic Syndrome (HUS) (known Shiga toxin +).
  5. History of malignancy within 5 years of screening.
  6. Known human immunodeficiency virus (HIV) infection.
  7. Identified drug exposure-related hemolytic-uremic syndrome (HUS).
  8. Infection-related HUS.
  9. HUS related to bone marrow transplant (BMT).
  10. HUS related to vitamin B12 deficiency.
  11. Known Systemic Lupus Erythematosus (SLE) or antiphospholipid antibody positivity or syndrome.
  12. Patients with a confirmed diagnosis of sepsis defined as positive blood cultures within 7 days of the screening visit and not treated with antibiotics to which the organism is sensitive.
  13. Presence or suspicion of active and untreated systemic bacterial infection that, in the opinion of the Investigator confounds an accurate diagnosis of aHUS or impedes the ability to manage the aHUS disease.
  14. Pregnancy or lactation.
  15. Unresolved systemic meningococcal disease.
  16. Any medical or psychological condition that, in the opinion of the investigator, could increase the patient's risk by participating in the study or confound the outcome of the study.
  17. Patients receiving chronic intravenous immunoglobulin (IVIg) within 8 weeks or chronic Rituximab therapy within 12 weeks of screening visit.
  18. Patients receiving other immunosuppressive therapies such as steroids, mechanist target of rapamycin (mTOR) inhibitors, calcineurin inhibitors (e.g., cyclosporine or tacrolimus) are excluded unless: [1] part of an established post-transplant anti-rejection regime, or [2] patient has confirmed anti-Complement Factor Antibodies requiring immunosuppressive therapy, or [3] steroids are being used for a condition other than aHUS (example asthma).
  19. Participation in any other investigational drug trial or device trial, or procedures beginning 4 weeks prior to screening and throughout the entire trial.

Sites / Locations

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Eculizumab

Arm Description

Outcomes

Primary Outcome Measures

Percentage of Patients With Complete TMA Response
Proportion of Patients with Complete TMA response was determined and defined by normalization of hematological parameters (platelet count and LDH) and preservation of renal function (defined as < 25% increase in serum creatinine from baseline) which were sustained for at least two consecutive measurements obtained at least four weeks apart.
Percentage of Patients With Modified Complete TMA Response
Proportion of Patients with Modified Complete TMA response through 26 weeks of treatment was determined and defined by normalization of hematological parameters (platelet count and LDH) and improvement in renal function (defined as ≥ 25% reduction from the baseline value in serum creatinine, which were sustained for at least two consecutive measurements obtained at least four weeks apart.

Secondary Outcome Measures

Percentage of Patients With Complete Hematologic Response
Proportion of Patients with Complete Hematologic response through end of study was determined and defined by normalization of platelet count and LDH sustained for at least two consecutive measurements obtained at least four weeks apart.
Percentage of Patients With Platelet Count Normalization
Proportion of Patients with Platelet Count Normalization through 26 weeks of treatment was determined and defined as the platelet count observed to be ≥ 150 x 109/L on at least two consecutive measurements which span a period of at least four weeks
Percentage of Patients With Estimated Glomerular Filtration Rate (eGFR) Improvement
Proportion of Patients with Estimated Glomerular Filtration Rate (eGFR) Improvement was determined and defined as an increase in eGFR by ≥ 15 mL/min/1.73m^2 from baseline, sustained for at least two consecutive measurements obtained at least four weeks apart.
Platelet Count Change From Baseline to 26 Weeks
Percentage of Patients With Complete TMA Response
Proportion of Patients with Complete TMA response through end of study was determined and defined by normalization of hematological parameters (platelet count and LDH) and preservation of renal function (defined as < 25% increase in serum creatinine from baseline) which were sustained for at least two consecutive measurements obtained at least four weeks apart.
Percentage of Patients With Modified Complete TMA Response
Proportion of Patients with Modified Complete TMA response through end of study was determined and defined by normalization of hematological parameters (platelet count and LDH) and improvement in renal function (defined as ≥ 25% reduction from the baseline value in serum creatinine, which were sustained for at least two consecutive measurements obtained at least four weeks apart.
Percentage of Patients With Complete Hematologic Response
Proportion of Patients with Complete Hematologic response through end of study of treatment was determined and defined by normalization of platelet count and LDH sustained for at least two consecutive measurements obtained at least four weeks apart.
Percentage of Patients With Platelet Count Normalization
Proportion of Patients with Platelet Count Normalization through end of study of treatment was determined and defined as the platelet count observed to be ≥ 150 x 109/L on at least two consecutive measurements which span a period of at least four weeks
Percentage of Patients With Estimated Glomerular Filtration Rate (eGFR) Improvement
Proportion of Patients with Estimated Glomerular Filtration Rate (eGFR) Improvement was determined and defined as an increase in eGFR by ≥ 15 mL/min/1.73m^2 from baseline sustained for at least two consecutive measurements obtained at least four weeks apart
Platelet Count Change From Baseline to 52 Weeks

Full Information

First Posted
August 31, 2010
Last Updated
April 20, 2017
Sponsor
Alexion
search

1. Study Identification

Unique Protocol Identification Number
NCT01194973
Brief Title
An Open-label, Multi-center Clinical Trial of Eculizumab in Adult Patients With Atypical Hemolytic-uremic Syndrome
Official Title
An Open-label, Multi-center Clinical Trial of Eculizumab in Adult Patients With Atypical Hemolytic-uremic Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
April 2015
Overall Recruitment Status
Completed
Study Start Date
July 2010 (undefined)
Primary Completion Date
October 2013 (Actual)
Study Completion Date
February 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alexion

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The record Primary purpose is to assess the efficacy of eculizumab in adult patients with Atypical Hemolytic- Uremic Syndrome (aHUS) to control Thrombotic Microangiopathy (TMA) as characterized by thrombocytopenia, hemolysis and renal impairment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atypical Hemolytic-Uremic Syndrome
Keywords
Atypical Hemolytic-Uremic Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Eculizumab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Eculizumab
Intervention Description
All patients received open-label eculizumab administered intravenously on the following dose schedule: Induction dose - 900 mg per week for four weeks and a dose of 1200 mg one week later; Maintenance dose - 1200 mg every two weeks. Patients who received plasma exchange or infusion during the eculizumab treatment period received a supplemental dose of 600 mg within one hour before plasma infusion or within one hour after the completion of each plasma exchange.
Primary Outcome Measure Information:
Title
Percentage of Patients With Complete TMA Response
Description
Proportion of Patients with Complete TMA response was determined and defined by normalization of hematological parameters (platelet count and LDH) and preservation of renal function (defined as < 25% increase in serum creatinine from baseline) which were sustained for at least two consecutive measurements obtained at least four weeks apart.
Time Frame
Through 26 weeks
Title
Percentage of Patients With Modified Complete TMA Response
Description
Proportion of Patients with Modified Complete TMA response through 26 weeks of treatment was determined and defined by normalization of hematological parameters (platelet count and LDH) and improvement in renal function (defined as ≥ 25% reduction from the baseline value in serum creatinine, which were sustained for at least two consecutive measurements obtained at least four weeks apart.
Time Frame
Through 26 weeks
Secondary Outcome Measure Information:
Title
Percentage of Patients With Complete Hematologic Response
Description
Proportion of Patients with Complete Hematologic response through end of study was determined and defined by normalization of platelet count and LDH sustained for at least two consecutive measurements obtained at least four weeks apart.
Time Frame
Through 26 weeks
Title
Percentage of Patients With Platelet Count Normalization
Description
Proportion of Patients with Platelet Count Normalization through 26 weeks of treatment was determined and defined as the platelet count observed to be ≥ 150 x 109/L on at least two consecutive measurements which span a period of at least four weeks
Time Frame
Through 26 weeks
Title
Percentage of Patients With Estimated Glomerular Filtration Rate (eGFR) Improvement
Description
Proportion of Patients with Estimated Glomerular Filtration Rate (eGFR) Improvement was determined and defined as an increase in eGFR by ≥ 15 mL/min/1.73m^2 from baseline, sustained for at least two consecutive measurements obtained at least four weeks apart.
Time Frame
Through 26 weeks
Title
Platelet Count Change From Baseline to 26 Weeks
Time Frame
Through 26 weeks
Title
Percentage of Patients With Complete TMA Response
Description
Proportion of Patients with Complete TMA response through end of study was determined and defined by normalization of hematological parameters (platelet count and LDH) and preservation of renal function (defined as < 25% increase in serum creatinine from baseline) which were sustained for at least two consecutive measurements obtained at least four weeks apart.
Time Frame
Through End of Study, Median Exposure 52 Weeks
Title
Percentage of Patients With Modified Complete TMA Response
Description
Proportion of Patients with Modified Complete TMA response through end of study was determined and defined by normalization of hematological parameters (platelet count and LDH) and improvement in renal function (defined as ≥ 25% reduction from the baseline value in serum creatinine, which were sustained for at least two consecutive measurements obtained at least four weeks apart.
Time Frame
Through End of Study, Median Exposure 52 Weeks
Title
Percentage of Patients With Complete Hematologic Response
Description
Proportion of Patients with Complete Hematologic response through end of study of treatment was determined and defined by normalization of platelet count and LDH sustained for at least two consecutive measurements obtained at least four weeks apart.
Time Frame
Through End of Study, Median Exposure 52 Weeks
Title
Percentage of Patients With Platelet Count Normalization
Description
Proportion of Patients with Platelet Count Normalization through end of study of treatment was determined and defined as the platelet count observed to be ≥ 150 x 109/L on at least two consecutive measurements which span a period of at least four weeks
Time Frame
Through End of Study, Median Exposure 52 Weeks
Title
Percentage of Patients With Estimated Glomerular Filtration Rate (eGFR) Improvement
Description
Proportion of Patients with Estimated Glomerular Filtration Rate (eGFR) Improvement was determined and defined as an increase in eGFR by ≥ 15 mL/min/1.73m^2 from baseline sustained for at least two consecutive measurements obtained at least four weeks apart
Time Frame
Through End of Study, Median Exposure 52 Weeks
Title
Platelet Count Change From Baseline to 52 Weeks
Time Frame
Through 52 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion: Patient must be willing and able to give written informed consent. Patient's age > 18 years. Patients exhibit thrombocytopenia, hemolysis and elevated Serum Creatinine. Patients with diagnosis of aHUS with or without an identified complement regulatory protein genetic abnormality or anti-complement factor antibody and for whom etiologies of hemolytic uremic syndrome have been ruled out as confirmed in the exclusion criteria Female patients of childbearing potential must be practicing an effective, reliable and medically approved contraceptive regimen during the entire duration of the study, including the follow-up period. At the time of the last follow-up visit, patients must agree to continue to use adequate contraception methods for up to 5 months following discontinuation of eculizumab treatment. Able and willing to comply with study procedures Exclusion: Chronic dialysis. Prior eculizumab use or hypersensitivity to eculizumab, to murine proteins or to one of the excipients. Known familial a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13) deficiency (ADAMTS-13 <5%). Typical Hemolytic-Uremic Syndrome (HUS) (known Shiga toxin +). History of malignancy within 5 years of screening. Known human immunodeficiency virus (HIV) infection. Identified drug exposure-related hemolytic-uremic syndrome (HUS). Infection-related HUS. HUS related to bone marrow transplant (BMT). HUS related to vitamin B12 deficiency. Known Systemic Lupus Erythematosus (SLE) or antiphospholipid antibody positivity or syndrome. Patients with a confirmed diagnosis of sepsis defined as positive blood cultures within 7 days of the screening visit and not treated with antibiotics to which the organism is sensitive. Presence or suspicion of active and untreated systemic bacterial infection that, in the opinion of the Investigator confounds an accurate diagnosis of aHUS or impedes the ability to manage the aHUS disease. Pregnancy or lactation. Unresolved systemic meningococcal disease. Any medical or psychological condition that, in the opinion of the investigator, could increase the patient's risk by participating in the study or confound the outcome of the study. Patients receiving chronic intravenous immunoglobulin (IVIg) within 8 weeks or chronic Rituximab therapy within 12 weeks of screening visit. Patients receiving other immunosuppressive therapies such as steroids, mechanist target of rapamycin (mTOR) inhibitors, calcineurin inhibitors (e.g., cyclosporine or tacrolimus) are excluded unless: [1] part of an established post-transplant anti-rejection regime, or [2] patient has confirmed anti-Complement Factor Antibodies requiring immunosuppressive therapy, or [3] steroids are being used for a condition other than aHUS (example asthma). Participation in any other investigational drug trial or device trial, or procedures beginning 4 weeks prior to screening and throughout the entire trial.
Facility Information:
City
Burlington
State/Province
Massachusetts
ZIP/Postal Code
01805
Country
United States
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
City
Liège
ZIP/Postal Code
4020
Country
Belgium
City
Caen
ZIP/Postal Code
14033
Country
France
City
Lille
ZIP/Postal Code
59037
Country
France
City
Nantes
ZIP/Postal Code
44093
Country
France
City
Nice
ZIP/Postal Code
6000
Country
France
City
Paris
ZIP/Postal Code
75743
Country
France
City
Paris
ZIP/Postal Code
75970
Country
France
City
Toulouse
ZIP/Postal Code
31059
Country
France
City
Tours
ZIP/Postal Code
37044
Country
France
City
Essen
ZIP/Postal Code
45147
Country
Germany
City
Hannover
ZIP/Postal Code
30625
Country
Germany
City
Bergamo
ZIP/Postal Code
24127
Country
Italy
City
Firenze
ZIP/Postal Code
50134
Country
Italy
City
Barcelona
ZIP/Postal Code
14004
Country
Spain
City
Cordoba
ZIP/Postal Code
14004
Country
Spain
City
Exeter
Country
United Kingdom
City
London
Country
United Kingdom
City
Newcastle
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
33783815
Citation
Pugh D, O'Sullivan ED, Duthie FA, Masson P, Kavanagh D. Interventions for atypical haemolytic uraemic syndrome. Cochrane Database Syst Rev. 2021 Mar 23;3(3):CD012862. doi: 10.1002/14651858.CD012862.pub2.
Results Reference
derived
PubMed Identifier
25833956
Citation
Cofiell R, Kukreja A, Bedard K, Yan Y, Mickle AP, Ogawa M, Bedrosian CL, Faas SJ. Eculizumab reduces complement activation, inflammation, endothelial damage, thrombosis, and renal injury markers in aHUS. Blood. 2015 May 21;125(21):3253-62. doi: 10.1182/blood-2014-09-600411. Epub 2015 Apr 1.
Results Reference
derived

Learn more about this trial

An Open-label, Multi-center Clinical Trial of Eculizumab in Adult Patients With Atypical Hemolytic-uremic Syndrome

We'll reach out to this number within 24 hrs