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Safety and Efficacy Study of OMS721 in Patients With Atypical Hemolytic Uremic Syndrome (aHUS)

Primary Purpose

Thrombotic Microangiopathies, Atypical Hemolytic Uremic Syndrome

Status
Unknown status
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
OMS721
Sponsored by
Omeros Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Thrombotic Microangiopathies focused on measuring TMA, aHUS

Eligibility Criteria

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

Inclusion Criteria:

  • Competent to provide informed consent, or if a minor, have at least one parent or legal guardian to provide informed consent with written assent from the subject.
  • Are at least 12 years old at screening (Visit 1).
  • Have a clinically diagnosis of primary atypical hemolytic uremic syndrome (aHUS), with ADAMTS13 activity greater than 5% in plasma.
  • Plasma therapy-resistant aHUS patients must have a screening platelet count less than 150,000/uL, evidence of microangiopathic hemolysis, and serum creatinine greater than upper limit of normal.
  • Plasma therapy-responsive aHUS patients must have documented history of requiring plasma therapy to prevent aHUS exacerbation and received plasma therapy at least once every 2 weeks at an unchanged frequency for at least 8 weeks before first dose of OMS721.

Exclusion Criteria:

  • Have STEC-HUS, a direct positive Coombs test, history of hematopoietic stem cell transplant, and/or HUS from an identified drug.
  • History of vitamin B12 deficiency-related HUS, systemic lupus erythematosus, and/or antiphospholipid syndrome.
  • Active cancer or history of cancer (except non-melanoma skin cancers) within 5 years of screening.
  • Have been on hemodialysis or peritoneal dialysis for greater than or equal to 12 weeks.
  • Have an active systemic bacterial or fungal infection requiring systemic antimicrobial therapy (prophylactic antimicrobial therapy administered as standard of care is allowed).
  • Baseline resting heart rate less than 45 beats per minute or greater than 115 beats per minute.
  • Baseline QTcF greater than 470 milliseconds.
  • Have malignant hypertension (diastolic blood pressure [BP] greater than 120 mm Hg with bilateral hemorrhages or "cotton-wool" exudates on funduscopic examination).
  • Have a poor prognosis with a life expectancy of less than three months in the opinion of the Investigator.
  • Are pregnant or lactating.
  • Have received treatment with an investigational drug or device within four weeks prior to screening.
  • Have abnormal liver function tests defined as ALT or AST > five times ULN.
  • Have HIV infection.
  • History of cirrhosis of the liver.
  • Have previously completed treatment in an OMS721study.

Sites / Locations

  • Omeros Investigational Site
  • Omeros Investigational SiteRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

OMS721

Arm Description

Administration of OMS721

Outcomes

Primary Outcome Measures

The effect of OMS721 as measured by platelet count change from baseline
The effect of OMS721 will be evaluated in subjects with aHUS by changes in platelet count from baseline

Secondary Outcome Measures

Safety as measured by incidences of Adverse Events, vital signs, ECG, and clinical laboratory tests
Assessment of safety of OMS721 in subjects with aHUS by incidence of Adverse Events, clinically significant vital sign abnormalities, ECG abnormalities, and clinical laboratory test abnormalities
TMA Response
Complete TMA response defined as normalization of platelet count, normalization of serum LDH, and > 25% decrease in serum creatinine by at least 2 consecutive measures over at least 4 consecutive weeks, within the initial 26-week period
TMA event-free status
No decrease in platelet count of > 25% from baseline, no plasma exchange or plasma infusion, and no initiation of new dialysis over at least 12 consecutive weeks, within the initial 26-week period
Increase in eGFR
Increase of greater than 15 ml/min/1.73 m2 in eGFR calculated by the MDRD Equation
Hematological Normalization
Normalization of platelet count and normalization of serum LDH by 2 consecutive measurements over at least 4 consecutive weeks, within the initial 26-week period
TMA Remission
Platelet count greater than or equal to 150,000/μL over at least 2 consecutive weeks, within the initial 26-week period
Incidence of antidrug antibodies (ADA)
Incidences of ADA in subjects with aHUS, administered OMS721
Change from baseline in serum creatinine
Assessment of subject's change from baseline in serum creatinine
Change from baseline in serum LDH
Assessment of subject's change from baseline in serum LDH
Change from baseline in haptoglobin
Assessment of subject's change from baseline in haptoglobin
Pharmacokinetics (PK): Trough plasma concentration, lower limit of quantification (LLOQ)
Pharmacokinetics (PK): Maximum plasma concentrations (Cmax)
Pharmacokinetics (PK): Area under time-concentration curve (AUC)
Pharmacodynamics (PD): Inhibition of C3 activity
Pharmacodynamics (PD): Inhibition of C4 activity

Full Information

First Posted
April 17, 2017
Last Updated
October 17, 2018
Sponsor
Omeros Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT03205995
Brief Title
Safety and Efficacy Study of OMS721 in Patients With Atypical Hemolytic Uremic Syndrome
Acronym
aHUS
Official Title
A Phase 3 Study to Evaluate the Safety and Efficacy of OMS721 for the Treatment of Atypical Hemolytic Uremic Syndrome (aHUS) in Adults and Adolescents
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Unknown status
Study Start Date
February 23, 2017 (Actual)
Primary Completion Date
February 2020 (Anticipated)
Study Completion Date
February 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Omeros Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the platelet count change from baseline and safety of OMS721 in adults and adolescents with atypical hemolytic uremic syndrome (aHUS). The study will also evaluate pharmacokinetics (PK), pharmacodynamics (PD), and anti-drug antibody response (ADA).
Detailed Description
This is a Phase 3, multicenter study of OMS721 in adults and adolescents with atypical hemolytic uremic syndrome (aHUS). The uncontrolled, open-label study will evaluate the effect of OMS721 in subjects with plasma therapy-resistant aHUS and plasma therapy-responsive aHUS. This study has four periods: Screening, Treatment Induction, Treatment Maintenance, and Follow-up. Approximate enrollment is 80 subjects. An interim analysis will be performed after 40 subjects have completed 26 weeks of treatment for potential registration.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Thrombotic Microangiopathies, Atypical Hemolytic Uremic Syndrome
Keywords
TMA, aHUS

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
80 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
OMS721
Arm Type
Experimental
Arm Description
Administration of OMS721
Intervention Type
Biological
Intervention Name(s)
OMS721
Intervention Description
Intravenous loading dose followed by daily subcutaneous injections
Primary Outcome Measure Information:
Title
The effect of OMS721 as measured by platelet count change from baseline
Description
The effect of OMS721 will be evaluated in subjects with aHUS by changes in platelet count from baseline
Time Frame
26 weeks
Secondary Outcome Measure Information:
Title
Safety as measured by incidences of Adverse Events, vital signs, ECG, and clinical laboratory tests
Description
Assessment of safety of OMS721 in subjects with aHUS by incidence of Adverse Events, clinically significant vital sign abnormalities, ECG abnormalities, and clinical laboratory test abnormalities
Time Frame
Pre-dose and up to 771 days post-dose
Title
TMA Response
Description
Complete TMA response defined as normalization of platelet count, normalization of serum LDH, and > 25% decrease in serum creatinine by at least 2 consecutive measures over at least 4 consecutive weeks, within the initial 26-week period
Time Frame
26 weeks
Title
TMA event-free status
Description
No decrease in platelet count of > 25% from baseline, no plasma exchange or plasma infusion, and no initiation of new dialysis over at least 12 consecutive weeks, within the initial 26-week period
Time Frame
26 weeks
Title
Increase in eGFR
Description
Increase of greater than 15 ml/min/1.73 m2 in eGFR calculated by the MDRD Equation
Time Frame
26 weeks
Title
Hematological Normalization
Description
Normalization of platelet count and normalization of serum LDH by 2 consecutive measurements over at least 4 consecutive weeks, within the initial 26-week period
Time Frame
26 weeks
Title
TMA Remission
Description
Platelet count greater than or equal to 150,000/μL over at least 2 consecutive weeks, within the initial 26-week period
Time Frame
26 weeks
Title
Incidence of antidrug antibodies (ADA)
Description
Incidences of ADA in subjects with aHUS, administered OMS721
Time Frame
771 days post-dose
Title
Change from baseline in serum creatinine
Description
Assessment of subject's change from baseline in serum creatinine
Time Frame
26 weeks
Title
Change from baseline in serum LDH
Description
Assessment of subject's change from baseline in serum LDH
Time Frame
26 weeks
Title
Change from baseline in haptoglobin
Description
Assessment of subject's change from baseline in haptoglobin
Time Frame
26 weeks
Title
Pharmacokinetics (PK): Trough plasma concentration, lower limit of quantification (LLOQ)
Time Frame
Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (if occurs): RT Days 1-4; Follow-Up at Day 771
Title
Pharmacokinetics (PK): Maximum plasma concentrations (Cmax)
Time Frame
Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (if occurs): RT Days 1-4; Follow-Up at Day 771
Title
Pharmacokinetics (PK): Area under time-concentration curve (AUC)
Time Frame
Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (if occurs): RT Days 1-4; Follow-Up at Day 771
Title
Pharmacodynamics (PD): Inhibition of C3 activity
Time Frame
Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (if occurs): RT Days 1-4; Follow-Up at Day 771
Title
Pharmacodynamics (PD): Inhibition of C4 activity
Time Frame
Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (if occurs): RT Days 1-4; Follow-Up at Day 771

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Competent to provide informed consent, or if a minor, have at least one parent or legal guardian to provide informed consent with written assent from the subject. Are at least 12 years old at screening (Visit 1). Have a clinically diagnosis of primary atypical hemolytic uremic syndrome (aHUS), with ADAMTS13 activity greater than 5% in plasma. Plasma therapy-resistant aHUS patients must have a screening platelet count less than 150,000/uL, evidence of microangiopathic hemolysis, and serum creatinine greater than upper limit of normal. Plasma therapy-responsive aHUS patients must have documented history of requiring plasma therapy to prevent aHUS exacerbation and received plasma therapy at least once every 2 weeks at an unchanged frequency for at least 8 weeks before first dose of OMS721. Exclusion Criteria: Have STEC-HUS, a direct positive Coombs test, history of hematopoietic stem cell transplant, and/or HUS from an identified drug. History of vitamin B12 deficiency-related HUS, systemic lupus erythematosus, and/or antiphospholipid syndrome. Active cancer or history of cancer (except non-melanoma skin cancers) within 5 years of screening. Have been on hemodialysis or peritoneal dialysis for greater than or equal to 12 weeks. Have an active systemic bacterial or fungal infection requiring systemic antimicrobial therapy (prophylactic antimicrobial therapy administered as standard of care is allowed). Baseline resting heart rate less than 45 beats per minute or greater than 115 beats per minute. Baseline QTcF greater than 470 milliseconds. Have malignant hypertension (diastolic blood pressure [BP] greater than 120 mm Hg with bilateral hemorrhages or "cotton-wool" exudates on funduscopic examination). Have a poor prognosis with a life expectancy of less than three months in the opinion of the Investigator. Are pregnant or lactating. Have received treatment with an investigational drug or device within four weeks prior to screening. Have abnormal liver function tests defined as ALT or AST > five times ULN. Have HIV infection. History of cirrhosis of the liver. Have previously completed treatment in an OMS721study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Alan Lew
Phone
206-676-5000
Email
alew@omeros.com
First Name & Middle Initial & Last Name or Official Title & Degree
Andrea Kessler
Phone
206-676-0851
Email
akessler@omeros.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eckhard Leifke, M.D.
Organizational Affiliation
Omeros Corporation
Official's Role
Study Director
Facility Information:
Facility Name
Omeros Investigational Site
City
Los Angeles
State/Province
California
ZIP/Postal Code
90025
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Omeros Investigational Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60643
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No
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

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Safety and Efficacy Study of OMS721 in Patients With Atypical Hemolytic Uremic Syndrome

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