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ACE-536 Extension Study - Beta Thalassemia

Primary Purpose

Beta-Thalassemia

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
ACE-536
Sponsored by
Acceleron Pharma, Inc., a wholly-owned subsidiary of Merck & Co., Inc., Rahway, NJ USA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Beta-Thalassemia

Eligibility Criteria

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

Inclusion Criteria:

  1. Completion of the treatment period in the base study A536-04.
  2. Females of child bearing potential (defined as sexually mature women who have not undergone hysterectomy or bilateral oophorectomy, or are not naturally postmenopausal ≥ 24 consecutive months) must have negative urine or blood pregnancy test prior to enrollment and use adequate birth control methods (abstinence, oral contraceptives, barrier method with spermicide, or surgical sterilization) during study participation and for 12 weeks following the last dose of ACE-536. Males must agree to use a latex condom during any sexual contact with females of child-bearing potential during study participation and for 12 weeks following the last dose of ACE-536, even if he has undergone a successful vasectomy. Patients must be counseled concerning measures to be used to prevent pregnancy and potential toxicities prior to the first dose of ACE-536.
  3. Patient is able to adhere to the study visit schedule, understand and comply with all protocol requirements.
  4. Patient understands and is able to provide written informed consent

    Patients with treatment interruption (defined as patients who complete the EOS visit for study A536-04 and are ≥ 28 days post EOS visit) must also meet the following criteria

  5. Mean hemoglobin concentration < 10.0 g/dL of 2 measurements (not influenced by RBC transfusion) (one performed within one day prior to Cycle 1 Day 1 and the other performed during the screening period [Day -28 to Day -1]) in NTD patients.
  6. Adequate folate levels or on folate therapy.
  7. Platelet count ≥ 100 x 10(9) /L and ≤ 1,000 x 10(9) /L.
  8. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 3 x upper limit of normal (ULN).
  9. Serum creatinine ≤ 1.5 x ULN.
  10. Ejection fraction ≥ 50% by Echocardiogram (ECHO) or Multi gated acquisition scan (MUGA).

Exclusion Criteria:

  1. Discontinuation/withdrawal from study A536-04 due to patient request, patient unwillingness or inability to comply with the protocol, pregnancy, use of prohibited medication (e.g., hydroxyurea), medical reason or AE, hypersensitivity reaction to the study drug, at the discretion of the sponsor, or loss to follow-up prior to completion of the treatment period.
  2. Any clinically significant pulmonary (including pulmonary hypertension), cardiovascular, endocrine, neurologic, hepatic, gastrointestinal, infectious, immunological (including clinically significant allo- or auto-immunization) or genitourinary disease considered by the investigator as not adequately controlled prior to Cycle 1 Day 1.
  3. Symptomatic splenomegaly.
  4. Splenectomy within 56 days prior to Cycle 1 Day 1.
  5. Major surgery (except splenectomy) within 28 days prior to Cycle 1 Day 1. Patients must have completely recovered from any previous surgery prior to Cycle 1 Day 1.
  6. Patients receiving or planning to receive hydroxyurea treatment. Patients must not have had hydroxyurea within 90 days of Cycle 1 Day 1.
  7. For patients with treatment interruption: Iron chelation therapy if initiated within 56 days prior to Cycle 1 Day 1.
  8. Cytotoxic agents, systemic corticosteroids, immunosuppressants, or anticoagulant therapy such as warfarin or heparin within 28 days prior to Cycle 1 Day 1 (prophylactic aspirin up to 100 mg/day and low molecular weight (LMW) heparin for superficial vein thrombosis (SVT) is permitted).
  9. Treatment with another investigational drug (including sotatercept [ACE-011]) or device, or approved therapy for investigational use ≤ 28 days prior to Cycle 1 Day 1, or if the half-life of the previous investigational product is known, within 5 times the half-life prior to Cycle 1 Day 1, whichever is longer at any time between the end of treatment of the base study A536-04 and Cycle 1 Day 1.
  10. Known positive for human immunodeficiency virus (HIV), active infectious hepatitis B (HBV) or active infectious hepatitis C (HCV).
  11. Uncontrolled hypertension defined as systolic blood pressure (SBP) ≥ 150 mm Hg or diastolic blood pressure (DBP) ≥ 100 mm Hg.
  12. Known history of thromboembolic events ≥ grade 3 according to the National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v.4.0 (current active minor version).
  13. Pregnant or lactating females.
  14. History of severe allergic or anaphylactic reactions or hypersensitivity to recombinant proteins or excipients in the investigational drug.
  15. Any other condition not specifically noted above which, in the judgment of the investigator, would preclude the patient from participating in the study.

Sites / Locations

  • Acceleron Investigative Site
  • Acceleron Investigative Site
  • Acceleron Investigative Site
  • Acceleron Investigative Site
  • Acceleron Investigative Site
  • Acceleron Investigative Site
  • Acceleron Investigative Site

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ACE-536 0.8 mg/kg once every 3 weeks SC

Arm Description

ACE-536 0.8 mg/kg once every 3 weeks by SC injection

Outcomes

Primary Outcome Measures

Long-term safety and tolerability of ACE-536 in patients with β thalassemia who were previously enrolled in study A536-04
safety and tolerability will be assessed by recording and classification of all adverse events (clinical and laboratory) reported by study investigators in all subjects who received at least one dose of study drug

Secondary Outcome Measures

Erythroid response (8-week) in non-transfusion dependent (NTD) patients
Proportion of patients with a mean hemoglobin increase ≥ 1.5 g/dL over continuous 8-week interval compared to baseline, not influenced by red blood cell (RBC) transfusion
Erythroid response (12-week) in non-transfusion dependent (NTD) patients
Proportion of patients with a mean hemoglobin increase ≥ 1.5 g/dL over continuous 12-week interval compared to baseline, not influenced by red blood cell (RBC) transfusion
Erythroid response (8-week) in transfusion dependent (TD) patients
Proportion of patients with a reduction in RBC transfusion burden by ≥ 20% over a continuous 8-week interval compared to the 8 weeks prior to the start of treatment
Erythroid response (12-week) in transfusion dependent (TD) patients
Proportion of patients with a reduction in RBC transfusion burden by ≥ 50% over a continuous 12-week interval compared to the 12 weeks prior to the start of treatment
Time to, and duration of, erythroid response
Length of time required to achieve erythroid response, and total duration of that response
Mean change from baseline in hemoglobin levels in NTD patients
Mean change in hemoglobin, not influenced by RBC transfusion
Mean % change from baseline in transfusion burden in TD patients
Mean change in transfusion burden from baseline burden
Mean change in pre-transfusion hemoglobin levels in TD patients
Mean change in pre-transfusion hemoglobin
Changes in markers of erythropoiesis
Assessment of erythropoietin levels, reticulocyte count, nucleated RBC count and solubel transferrin receptor
Changes in markers of iron metabolism
Assessment of serum iron, TIBC, serum ferritin, transferrin saturation, hepcidin and NTBI
ACE-536 pharmacokinetic profileversus time curve (AUC)
Assessment of Cmax, Tmax and area under the plasma concentration
Quality of Life assessments (exploratory)
FACT-An and SF-36 health surveys

Full Information

First Posted
October 6, 2014
Last Updated
May 17, 2021
Sponsor
Acceleron Pharma, Inc., a wholly-owned subsidiary of Merck & Co., Inc., Rahway, NJ USA
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1. Study Identification

Unique Protocol Identification Number
NCT02268409
Brief Title
ACE-536 Extension Study - Beta Thalassemia
Official Title
An Open-Label Extension Study to Evaluate the Long-Term Effects of ACE-536 in Patients With β-Thalassemia Previously Enrolled in Study A536-04
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
November 2014 (undefined)
Primary Completion Date
June 18, 2020 (Actual)
Study Completion Date
June 18, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Acceleron Pharma, Inc., a wholly-owned subsidiary of Merck & Co., Inc., Rahway, NJ USA

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Study A536-06 is an open-label extension study for patients previously enrolled in study A536-04 (ClinicalTrials.gov Identifier NCT01749540), to evaluate the long-term safety and tolerability of ACE-536 in adult patients with beta-thalassemia.
Detailed Description
Study A536-06 is an open-label extension study for patients previously enrolled in study A536-04 (ClinicalTrials.gov Identifier NCT01749540), to evaluate the safety,tolerability and pharmacodynamic effects of up to 24 months of ACE-536 treatment in adult patients with beta-thalassemia previously treated with ACE-536 for up to 3 months in study A536-04. The starting dose level in A536-06 will be 0.8 mg/kg by subcutaneous (SC) injection once every 3 weeks. Dose titration/modification rules will be followed for individual patients and will be based upon safety and efficacy data collected during the course of treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Beta-Thalassemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
ACE-536 0.8 mg/kg once every 3 weeks SC
Arm Type
Experimental
Arm Description
ACE-536 0.8 mg/kg once every 3 weeks by SC injection
Intervention Type
Drug
Intervention Name(s)
ACE-536
Other Intervention Name(s)
luspatercept
Intervention Description
ACE-536 0.8 mg/kg once every 3 weeks by SC injection
Primary Outcome Measure Information:
Title
Long-term safety and tolerability of ACE-536 in patients with β thalassemia who were previously enrolled in study A536-04
Description
safety and tolerability will be assessed by recording and classification of all adverse events (clinical and laboratory) reported by study investigators in all subjects who received at least one dose of study drug
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Secondary Outcome Measure Information:
Title
Erythroid response (8-week) in non-transfusion dependent (NTD) patients
Description
Proportion of patients with a mean hemoglobin increase ≥ 1.5 g/dL over continuous 8-week interval compared to baseline, not influenced by red blood cell (RBC) transfusion
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
Erythroid response (12-week) in non-transfusion dependent (NTD) patients
Description
Proportion of patients with a mean hemoglobin increase ≥ 1.5 g/dL over continuous 12-week interval compared to baseline, not influenced by red blood cell (RBC) transfusion
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
Erythroid response (8-week) in transfusion dependent (TD) patients
Description
Proportion of patients with a reduction in RBC transfusion burden by ≥ 20% over a continuous 8-week interval compared to the 8 weeks prior to the start of treatment
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
Erythroid response (12-week) in transfusion dependent (TD) patients
Description
Proportion of patients with a reduction in RBC transfusion burden by ≥ 50% over a continuous 12-week interval compared to the 12 weeks prior to the start of treatment
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
Time to, and duration of, erythroid response
Description
Length of time required to achieve erythroid response, and total duration of that response
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
Mean change from baseline in hemoglobin levels in NTD patients
Description
Mean change in hemoglobin, not influenced by RBC transfusion
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730
Title
Mean % change from baseline in transfusion burden in TD patients
Description
Mean change in transfusion burden from baseline burden
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
Mean change in pre-transfusion hemoglobin levels in TD patients
Description
Mean change in pre-transfusion hemoglobin
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
Changes in markers of erythropoiesis
Description
Assessment of erythropoietin levels, reticulocyte count, nucleated RBC count and solubel transferrin receptor
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
Changes in markers of iron metabolism
Description
Assessment of serum iron, TIBC, serum ferritin, transferrin saturation, hepcidin and NTBI
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
ACE-536 pharmacokinetic profileversus time curve (AUC)
Description
Assessment of Cmax, Tmax and area under the plasma concentration
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)
Title
Quality of Life assessments (exploratory)
Description
FACT-An and SF-36 health surveys
Time Frame
From first dose (Study Day 1) to end of treatment (Study Day 730)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Completion of the treatment period in the base study A536-04. Females of child bearing potential (defined as sexually mature women who have not undergone hysterectomy or bilateral oophorectomy, or are not naturally postmenopausal ≥ 24 consecutive months) must have negative urine or blood pregnancy test prior to enrollment and use adequate birth control methods (abstinence, oral contraceptives, barrier method with spermicide, or surgical sterilization) during study participation and for 12 weeks following the last dose of ACE-536. Males must agree to use a latex condom during any sexual contact with females of child-bearing potential during study participation and for 12 weeks following the last dose of ACE-536, even if he has undergone a successful vasectomy. Patients must be counseled concerning measures to be used to prevent pregnancy and potential toxicities prior to the first dose of ACE-536. Patient is able to adhere to the study visit schedule, understand and comply with all protocol requirements. Patient understands and is able to provide written informed consent Patients with treatment interruption (defined as patients who complete the EOS visit for study A536-04 and are ≥ 28 days post EOS visit) must also meet the following criteria Mean hemoglobin concentration < 10.0 g/dL of 2 measurements (not influenced by RBC transfusion) (one performed within one day prior to Cycle 1 Day 1 and the other performed during the screening period [Day -28 to Day -1]) in NTD patients. Adequate folate levels or on folate therapy. Platelet count ≥ 100 x 10(9) /L and ≤ 1,000 x 10(9) /L. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 3 x upper limit of normal (ULN). Serum creatinine ≤ 1.5 x ULN. Ejection fraction ≥ 50% by Echocardiogram (ECHO) or Multi gated acquisition scan (MUGA). Exclusion Criteria: Discontinuation/withdrawal from study A536-04 due to patient request, patient unwillingness or inability to comply with the protocol, pregnancy, use of prohibited medication (e.g., hydroxyurea), medical reason or AE, hypersensitivity reaction to the study drug, at the discretion of the sponsor, or loss to follow-up prior to completion of the treatment period. Any clinically significant pulmonary (including pulmonary hypertension), cardiovascular, endocrine, neurologic, hepatic, gastrointestinal, infectious, immunological (including clinically significant allo- or auto-immunization) or genitourinary disease considered by the investigator as not adequately controlled prior to Cycle 1 Day 1. Symptomatic splenomegaly. Splenectomy within 56 days prior to Cycle 1 Day 1. Major surgery (except splenectomy) within 28 days prior to Cycle 1 Day 1. Patients must have completely recovered from any previous surgery prior to Cycle 1 Day 1. Patients receiving or planning to receive hydroxyurea treatment. Patients must not have had hydroxyurea within 90 days of Cycle 1 Day 1. For patients with treatment interruption: Iron chelation therapy if initiated within 56 days prior to Cycle 1 Day 1. Cytotoxic agents, systemic corticosteroids, immunosuppressants, or anticoagulant therapy such as warfarin or heparin within 28 days prior to Cycle 1 Day 1 (prophylactic aspirin up to 100 mg/day and low molecular weight (LMW) heparin for superficial vein thrombosis (SVT) is permitted). Treatment with another investigational drug (including sotatercept [ACE-011]) or device, or approved therapy for investigational use ≤ 28 days prior to Cycle 1 Day 1, or if the half-life of the previous investigational product is known, within 5 times the half-life prior to Cycle 1 Day 1, whichever is longer at any time between the end of treatment of the base study A536-04 and Cycle 1 Day 1. Known positive for human immunodeficiency virus (HIV), active infectious hepatitis B (HBV) or active infectious hepatitis C (HCV). Uncontrolled hypertension defined as systolic blood pressure (SBP) ≥ 150 mm Hg or diastolic blood pressure (DBP) ≥ 100 mm Hg. Known history of thromboembolic events ≥ grade 3 according to the National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v.4.0 (current active minor version). Pregnant or lactating females. History of severe allergic or anaphylactic reactions or hypersensitivity to recombinant proteins or excipients in the investigational drug. Any other condition not specifically noted above which, in the judgment of the investigator, would preclude the patient from participating in the study.
Facility Information:
Facility Name
Acceleron Investigative Site
City
Athens
Country
Greece
Facility Name
Acceleron Investigative Site
City
Brindisi
Country
Italy
Facility Name
Acceleron Investigative Site
City
Catania
Country
Italy
Facility Name
Acceleron Investigative Site
City
Ferrara
Country
Italy
Facility Name
Acceleron Investigative Site
City
Modena
Country
Italy
Facility Name
Acceleron Investigative Site
City
Naples
Country
Italy
Facility Name
Acceleron Investigative Site
City
Turin
Country
Italy

12. IPD Sharing Statement

Citations:
PubMed Identifier
30617198
Citation
Piga A, Perrotta S, Gamberini MR, Voskaridou E, Melpignano A, Filosa A, Caruso V, Pietrangelo A, Longo F, Tartaglione I, Borgna-Pignatti C, Zhang X, Laadem A, Sherman ML, Attie KM. Luspatercept improves hemoglobin levels and blood transfusion requirements in a study of patients with beta-thalassemia. Blood. 2019 Mar 21;133(12):1279-1289. doi: 10.1182/blood-2018-10-879247. Epub 2019 Jan 7.
Results Reference
derived
Links:
URL
https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-001281-94/results
Description
A536-06 Results Posting

Learn more about this trial

ACE-536 Extension Study - Beta Thalassemia

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