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A Study of PRN1008 in Patients With Pemphigus

Primary Purpose

Pemphigus

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Rilzabrutinib
Placebo
Sponsored by
Principia Biopharma, a Sanofi Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pemphigus focused on measuring Pemphigus Vulgaris (PV), Pemphigus Foliaceus (PF)

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female participants, aged 18 to 80 years old with moderate to severe, newly diagnosed or relapsing PV or PF, with a clinical presentation and histopathology consistent with PV or PF.
  • Positive circulating anti-desmoglein 1 (anti-dsg1) or 3 autoantibody titer.
  • At screening, pemphigus disease area index score of at least 9 points for relapsing participants or at least 15 points for newly diagnosed participants.
  • Adequate hematologic, hepatic, and renal function.
  • Effective means of contraception.

Exclusion Criteria:

  • Suspected paraneoplastic pemphigus and other forms of pemphigus that were not PV or PF.
  • Previous use of a Bruton tyrosine kinase inhibitor.
  • Pregnant or lactating women.
  • Electrocardiogram clinically significant abnormalities.
  • A history of malignancy of any type within 5 years before Day 1, other than surgically excised non-melanoma skin cancers or in situ cervical cancer.
  • Use of immunologic response modifiers as concomitant medication and with the washout period.
  • Use of proton pump inhibitor drugs such as omeprazole and esomeprazole within 3 days of Day 1.
  • Concomitant use of known strong-to-moderate inducers or inhibitors of cytochrome P450 3A (CYP3A) within 3 days or 5 half-lives (whichever is longer) of Day 1
  • Use of CYP3A-sensitive substrate drugs.
  • Had received any investigational drug within the 30 days before Day 1.
  • History of drug abuse within the previous 12 months.
  • Alcoholism or excessive alcohol use.
  • Any other clinically significant disease, condition or medical history that, in the opinion of the Investigator, would interfere with participant safety, trial evaluations, and/or trial procedures.

Sites / Locations

  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)
  • Central Recruiting (Principia Biopharma)

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo Then Rilzabrutinib

Rilzabrutinib Then Rilzabrutinib

Arm Description

In BT period, participants received placebo orally twice daily (BID) up to 37 weeks along with sponsor-provided corticosteroids (CS). After at least two weeks of control of disease activity (CDA; no new lesions and established lesions begin to heal), based on protocol-specified clinical criteria, investigators could decrease the CS dose to a minimum of 5 milligrams (mg) prednisone/prednisolone per day from Week 29 to Week 37. Post completion of BT period, eligible participants received rilzabrutinib 400 mg BID up to Week 61 in OLE period and those who were eligible after OLE period completion, continued the same treatment until Week 109 in LTE period according to protocol-specified criteria.

In BT period, participants received rilzabrutinib 400 mg orally BID up to 37 weeks along with sponsor-provided CS. After at least two weeks of CDA (no new lesions and established lesions begin to heal), based on protocol-specified clinical criteria, investigators could decrease the CS dose to a minimum of 5 mg prednisone/prednisolone per day from Week 29 to Week 37. Post completion of BT period, eligible participants received rilzabrutinib 400 mg BID up to Week 61 in OLE period and those who were eligible after OLE period completion, continued the same treatment until Week 109 in LTE period according to protocol-specified criteria.

Outcomes

Primary Outcome Measures

Percentage of Participants Who Achieved Complete Remission (CR) With a Corticosteroids Dose of Less Than or Equal to (<=) 10 mg/Day From Week 29 to Week 37: Pemphigus Vulgaris Participants in Modified Intent-to-Treat (PV mITT) Population
Complete remission was defined as absence of new and established lesions and was intended to mean "no disease activity" for 2 consecutive weeks, with Pemphigus Disease Area Index (PDAI) activity score =0 and CS dose <=10 mg. PDAI score weighted for number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). PDAI total score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. In this outcome measure (OM), percentage of participants who achieved CR while on a daily corticosteroids dose of <=10 mg/day were reported.
Percentage of Participants Who Achieved Complete Remission With a Corticosteroids Dose of <=10 mg/Day From Week 29 to Week 37: Modified Intent-to-Treat (mITT) Population
Complete remission was defined as absence of new and established lesions and was intended to mean "no disease activity" for 2 consecutive weeks, with PDAI activity score =0 and CS dose <=10 mg. PDAI score weighted for number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). PDAI total score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. In this OM, percentage of participants who achieved CR while on a daily corticosteroids dose of <=10 mg/day were reported.

Secondary Outcome Measures

Cumulative Oral Corticosteroid Dose From Baseline to Week 37: PV mITT Population
The cumulative dose (in milligrams) of sponsor-provided oral CS (prednisone or prednisolone) received by the participants during the BT period was calculated from Baseline to Week 37 and is reported in this OM.
Cumulative Oral Corticosteroid Dose From Baseline to Week 37: mITT Population
The cumulative dose (in milligrams) of sponsor-provided oral CS (prednisone or prednisolone) received by the participants during the BT period was calculated from Baseline to Week 37 and is reported in this OM.
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Week 37: PV mITT Population
Cumulative duration (in days) of CR post first CS dose of <= 10 mg/day from Baseline to Week 37 was analyzed with a zero-inflated negative binomial model with terms of treatment group and disease history, and an offset based on the number of days on blinded treatment period and were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Week 37: mITT Population
Cumulative duration (in days) of CR post first CS dose of <= 10 mg/day from Baseline to Week 37 was analyzed with a zero-inflated negative binomial model with terms of treatment group and disease history, and an offset based on the number of days on blinded treatment period and were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Time to First Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Week 37: PV mITT Population
Time to first CR was the time (in days) to achieve CR while on CS dose of <=10 mg/day. Complete remission was defined as the absence of new and established lesions to the "no disease activity". Kaplan-Meier method was used for the analysis.
Time to First Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Week 37: mITT Population
Time to first CR was the time (in days) to achieve CR while on CS dose of <=10 mg/day. Complete remission was defined as the absence of new and established lesions to the "no disease activity". Kaplan-Meier method was used for the analysis.
Percentage of Participants Who Achieved Complete Remission With a Corticosteroids Dose of <=5 mg/Day From Week 29 to Week 37: PV mITT Population
Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity". In this OM, percentage of participants who achieved CR while on a daily corticosteroids dose of <=5 mg/day were reported.
Percentage of Participants Who Achieved Complete Remission With a Corticosteroids Dose of <=5 mg/Day From Week 29 to Week 37: mITT Population
Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity". In this OM, percentage of participants who achieved CR while on a daily corticosteroids dose of <=5 mg/day were reported.
Percentage of Participants Who Had Pemphigus Disease Area Index (PDAI) Score <3 With a Corticosteroids Dose <=10 mg/Day From Week 29 to Week 37: PV mITT Population
PDAI is specific cutaneous and mucosal disease activity assessment performed by investigator based on evaluation of lesions in well-defined anatomical locations. The score weighted for the number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). Thus, PDAI total activity score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. In this OM, participants with PDAI score <3 while on a CS dose of <=10 mg/day were reported.
Percentage of Participants Who Had Pemphigus Disease Area Index Score <3 With a Corticosteroids Dose <=10 mg/Day From Week 29 to Week 37: mITT Population
PDAI is specific cutaneous and mucosal disease activity assessment performed by investigator based on evaluation of lesions in well-defined anatomical locations. The score weighted for the number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). Thus, PDAI total activity score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. In this OM, participants with PDAI score <3 while on a CS dose of <=10 mg/day were reported.
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Weeks 61 and 109: PV mITT Population
Cumulative duration (in days) of CR post all doses of CS <=10 mg/day during Baseline to Week 61 and Baseline to Week 109 were reported in this OM. Complete remission was defined as the absence of new and established lesions to the "no disease activity".
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Weeks 61 and 109: mITT Population
Cumulative duration (in days) of CR post all doses of CS <=10 mg/day during Baseline to Week 61 and Baseline to Week 109 were reported in this OM. Complete remission was defined as the absence of new and established lesions to the "no disease activity".
Cumulative Duration of Complete Remission With a Corticosteroids Dose = 0 mg/Day From Baseline to Weeks 61 and 109: PV mITT Population
Cumulative duration (in days) of CR post all doses of CS =0 mg/day during Baseline to Week 61 and Baseline to Week 109 were reported in this OM. Complete remission was defined as the absence of new and established lesions to the "no disease activity".
Cumulative Duration of Complete Remission With a Corticosteroids Dose = 0 mg/Day From Baseline to Weeks 61 and 109: mITT Population
Cumulative duration (in days) of CR post all doses of CS dose = 0 mg/day during Baseline to Week 61 and Baseline to Week 109 were reported in this OM. Complete remission was defined as the absence of new and established lesions to the "no disease activity".
Glucocorticoid Toxicity Index (GTI) - Cumulative Worsening Score (CWS) and Aggregate Improvement Score (AIS) at Week 37: PV mITT Population
GTI assessed glucocorticoid (GC) related morbidity and GC-sparing ability of other therapies; composed of 2 components: Composite GTI and specific list. Composite GTI had 9 domains and specific list had 23 items (11 domains), used as complementary tool to C-GTI. Composite GTI score:sum of 9 domain-specific scores at each visit and cumulative GTI score:sum of composite GTI scores across each visit. 2 cumulative GTI scores: CWS and AIS at Week 37 reported in this OM. CWS assessed cumulative GC toxicity regardless of whether toxicity had lasting effects/was transient. AIS assessed new therapy effectiveness in decreasing any Baseline GC toxicity over time. CWS composite score range: 0 to 439 and AIS composite score range: -346 to 439. In CWS and AIS, minimum score=least toxicity and maximum score=most toxicity. Least square (LS) mean and standard error (SE) from analysis of covariance model using treatment, disease history as fixed effects and Baseline GTI score and CS dose as covariates.
Glucocorticoid Toxicity Index - Cumulative Worsening Score and Aggregate Improvement Score at Week 37: mITT Population
GTI assessed GC related morbidity and GC-sparing ability of other therapies; composed of 2 components: Composite GTI and specific list. Composite GTI contained 9 domains and specific list contained of 23 items (11 domains), used as complementary tool to C-GTI. Composite GTI score: sum of 9 domain-specific scores at each visit and cumulative GTI score: sum of composite GTI scores across each visit. Two cumulative GTI scores: CWS and AIS at Week 37 were reported in this OM. CWS assessed cumulative GC toxicity regardless of whether toxicity had lasting effects/was transient. AIS assessed new therapy effectiveness in decreasing any Baseline GC toxicity over time. CWS composite score ranged from 0 to 439 and AIS composite score ranged from -346 to 439. For CWS and AIS, minimum score = least toxicity and maximum score = most toxicity. LS mean and SE from analysis of covariance model using treatment, disease history as fixed effects and Baseline GTI score and CS dose as covariates.
Change From Baseline in Pemphigus Disease Area Index Score at Weeks 5, 13, 25, 37, 61, and 109: PV mITT Population
PDAI is specific cutaneous and mucosal disease activity assessment performed by investigator based on evaluation of lesions in well-defined anatomical locations. The score weighted for the number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). Thus, PDAI total activity score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. PDAI activity score was measured independently of the CS dose administered in the participants.
Change From Baseline in Pemphigus Disease Area Index Score at Weeks 5, 13, 25, 37, 61, and 109: mITT Population
PDAI is specific cutaneous and mucosal disease activity assessment performed by investigator based on evaluation of lesions in well-defined anatomical locations. The score weighted for the number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). Thus, PDAI total activity score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. PDAI activity score was measured independently of the CS dose administered in the participants.
Change From Baseline in Autoimmune Bullous Disease Quality of Life (ABQOL) Score at Weeks 5, 13, 25, 37, 61, and 109: PV mITT Population
ABQOL, a 17-item questionnaire is a valid and reliable tool to assess quality of life in participants with autoimmune blistering diseases. Each question score ranged from 0 to 3 points, 0 = never, 1 = occasionally, 2 = sometimes and 3 = all the time, where higher score = poor QOL. The total ABQoL score was calculated by summing the score of each question and it ranged from 0 to 51, where higher score = more QOL impairment.
Change From Baseline in Autoimmune Bullous Disease Quality of Life Score at Weeks 5, 13, 25, 37, 61, and 109: mITT Population
ABQOL, a 17-item questionnaire is a valid and reliable tool to assess quality of life in participants with autoimmune blistering diseases. Each question score ranged from 0 to 3 points, 0 = never, 1 = occasionally, 2 = sometimes and 3 = all the time, where higher score = poor QOL. The total ABQoL score was calculated by summing the score of each question and it ranged from 0 to 51, where higher score = more QOL impairment.
Percentage of Participants With Autoimmune Bullous Disease Quality of Life Score of Zero at Weeks 5, 13, 25, 37, 61, and 109: PV mITT Population
ABQOL, a 17-item questionnaire is a valid and reliable tool to assess quality of life in participants with autoimmune blistering diseases. Each question score ranged from 0 to 3 points, 0 = never, 1 = occasionally, 2 = sometimes and 3 = all the time, where higher score = poor QOL. The total ABQoL score was calculated by summing the score of each question and it ranged from 0 to 51, where higher score = more QOL impairment. Percentage of participants with ABQOL score of '0' were reported in this outcome measure.
Percentage of Participants With Autoimmune Bullous Disease Quality of Life Score of Zero at Weeks 5, 13, 25, 37, 61, and 109: mITT Population
ABQOL, a 17-item questionnaire is a valid and reliable tool to assess quality of life in participants with autoimmune blistering diseases. Each question score ranged from 0 to 3 points, 0 = never, 1 = occasionally, 2 = sometimes and 3 = all the time, where higher score = poor QOL. The total ABQoL score was calculated by summing the score of each question and it ranged from 0 to 51, where higher score = more QOL impairment. Percentage of participants with ABQOL score of '0' were reported in this outcome measure.
Change From Baseline in the European Quality of Life Working Group Health Status Measure 5 Dimensions, 5 Levels (EQ-5D-5L) Score: Visual Analogue Scale (VAS) Scores at Weeks 5, 13, 25, 37, 61, and 109
EQ-5D-5L: standardized measure of health status that provides general assessment of health and wellbeing. EQ-5D VAS was used to record a participant's rating for his/her current health-related quality of life state and captured on a vertical VAS scale ranging from 0 to 100, where 0=worst imaginable health state and 100=best imaginable health state, where higher states indicated better outcomes.
Change From Baseline in the European Quality of Life Working Group Health Status Measure 5 Dimensions, 5 Levels Score: Individual Dimension at Weeks 5, 13, 25, 37, 61, and 109
EQ-5D-5L: standardized measure of health status that provides general assessment of health and wellbeing. The EQ-5D descriptive system comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has a 5-level response: no problems, slight problems, moderate problems, severe problems, and extreme problems. Response options are measured with a 5-point Likert scale (for the 5L version). The 5D-5L systems are converted into a single index utility score between 0 to 1, where higher score indicates a better health state and lower score indicate worse health state.
Time to First Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Weeks 61 and 109
Time to first CR was the time (in days) to achieve CR while on a CS dose of <=10 mg/day from Baseline to Week 61 and from Baseline to Week 109. Complete remission was defined as absence of new and established lesions to the "no disease activity".
Total Number of Disease Relapses/Flares From Initial Control of Disease Activity (CDA) to Week 37: PV mITT Population
Total Number of Disease Relapses/Flares which occurred from initial CDA to Week 37 were reported. CDA was defined as disappearance of new lesions cease to form and established lesions begin to heal. Relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA.
Total Number of Disease Relapses/Flares From Initial Control of Disease Activity to Week 37: mITT Population
Total Number of Disease Relapses/Flares which occurred from initial CDA to Week 37 were reported. CDA was defined as disappearance of new lesions cease to form and established lesions begin to heal. Relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA.
Time to Initial Relapse/Flare From Initial Control of Disease Activity to Week 37: PV mITT Population
Time duration (in days) from the time of initial relapse/flare which occurred from initial CDA up to Week 37 were reported in this OM. CDA was defined as the visit at which new lesions cease to form and established lesions begin to heal. Relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA. Kaplan-Meier method was used for the analysis.
Time to Initial Relapse/Flare From Initial Control of Disease Activity to Week 37: mITT Population
Time duration (in days) from the time of initial relapse/flare which occurred from initial CDA up to Week 37 were reported in this OM. CDA was defined as the visit at which new lesions cease to form and established lesions begin to heal. Relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA. Kaplan-Meier method was used for the analysis.
Percentage of Participants With 3 or More New Lesions Within 1 Month That do Not Heal Spontaneously Within 1 Week, or With Extension of Established Lesions at Week 37: PV mITT Population
Percentage of Participants With 3 or More New Lesions Within past 1 month that do not heal spontaneously within past 1 week, or with extension of established lesions, were assessed at Week 37 and reported in this OM.
Percentage of Participants With 3 or More New Lesions Within 1 Month That do Not Heal Spontaneously Within 1 Week, or With Extension of Established Lesions at Week 37: mITT Population
Percentage of participants with 3 or more new lesions within past 1 month that do not heal spontaneously within past 1 week, or with extension of established lesions, were assessed at Week 37 and reported in this OM.
Percentage of Participants With at Least One Disease Relapse/Flare From Initial Control of Disease Activity to Week 37: PV mITT Population
CDA was defined as the visit at which new lesions cease to form and established lesions begin to heal. Disease relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA. Percentages were calculated based on number of participants assessed (i.e. participants achieved CDA) in each treatment group. Percentage of participants with at least one disease relapse/flare from Initial CDA to Week 37 were reported in this OM.
Percentage of Participants With at Least One Disease Relapse/Flare From Initial Control of Disease Activity to Week 37: mITT Population
CDA was defined as the visit at which new lesions cease to form and established lesions begin to heal. Disease relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA. Percentages were calculated based on number of participants assessed (i.e. participants achieved CDA) in each treatment group. Percentage of participants with at least one disease relapse/flare from Initial CDA to Week 37 were reported in this OM.
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Week 37 to Week 61: PV mITT Population
Cumulative duration (in days) of CR post first dose of CS <=10 mg/day from Week 37 to Week 61 were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Week 37 to Week 61: mITT Population
Cumulative duration (in days) of CR post first dose of CS <=10 mg/day from Week 37 to Week 61 were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Cumulative Duration of Complete Remission With a Corticosteroids Dose = 0 mg/Day From Week 37 to Week 61: PV mITT Population
Cumulative duration (in days) of CR post first dose of CS = 0 mg/day from Week 37 to Week 61 were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Cumulative Duration of Complete Remission With a Corticosteroids Dose = 0 mg/Day From Week 37 to Week 61: mITT Population
Cumulative duration (in days) of CR post first dose of CS = 0 mg/day from Week 37 to Week 61 were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)
An adverse event (AE) was defined as any untoward medical occurrence in a participant who received study drug and does not necessarily had to have a causal relationship with the treatment. Serious AEs (SAEs) were any untoward medical occurrence that resulted in any of the following outcomes: death, life-threatening, required initial or prolonged in-patient hospitalization, persistent or significant disability/incapacity, congenital anomaly/birth defect, or considered as medically important event. TEAEs were the AEs that developed or worsened or became serious after the administration of first dose of study drug in each period.
Pharmacokinetics (PK): Plasma Concentration of Rilzabrutinib
Data for this OM was not planned to be collected and analyzed for placebo arm of the study.
Pharmacodynamics (PD): Change From Baseline in Antibody Levels - Anti-desmoglein 1 (Anti-dsg 1) and Anti-desmoglein 3 (Anti-dsg 3) at Weeks 13, 25, 37, 49, 61, 73, 85, 97, and 109: PV mITT Population
Anti-dsg1 and anti-dsg3 autoantibody levels was assessed by enzyme-linked immunosorbent assay (ELISA) method.
Pharmacodynamics: Change From Baseline in Antibody Levels - Anti-desmoglein 1 (Anti-dsg 1) and Anti-desmoglein 3 (Anti-dsg 3) at Weeks 13, 25, 37, 49, 61, 73, 85, 97 and 109: mITT Population
Anti-dsg1 and anti-dsg3 autoantibody levels was assessed by ELISA method.

Full Information

First Posted
November 29, 2018
Last Updated
July 21, 2023
Sponsor
Principia Biopharma, a Sanofi Company
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1. Study Identification

Unique Protocol Identification Number
NCT03762265
Brief Title
A Study of PRN1008 in Patients With Pemphigus
Official Title
A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial to Evaluate the Efficacy and Safety of Oral BTK Inhibitor Rilzabrutinib (PRN1008) in Moderate to Severe Pemphigus
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Terminated
Why Stopped
Sponsor decision based on lack of efficacy
Study Start Date
January 8, 2019 (Actual)
Primary Completion Date
July 30, 2021 (Actual)
Study Completion Date
December 17, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Principia Biopharma, a Sanofi Company

4. Oversight

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

5. Study Description

Brief Summary
This was a Phase 3 randomized, parallel-group, double-blind, placebo-controlled trial (blinded treatment [BT] period) followed by an open-label extension [OLE] period intended to evaluate the efficacy and safety of oral PRN1008 in moderate to severe pemphigus. After completing the open-label extension period, eligible participants might continue in a long term extension (LTE) Period of 48 weeks.
Detailed Description
A total of 131 male or female participants with newly diagnosed or relapsing moderate to severe pemphigus (pemphigus vulgaris [PV] or pemphigus foliaceus [PF]) were enrolled in the trial worldwide. The trial would last 68 weeks (approximately 17 months) for each participant. For participants eligible to enroll in the LTE, the trial might last up to 116 weeks. Participants were randomized at Day 1, using a 1:1 ratio to receive PRN1008 or placebo twice per day, by relapsing/newly diagnosed disease history (newly diagnosed defined as within 6 months of screening).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pemphigus
Keywords
Pemphigus Vulgaris (PV), Pemphigus Foliaceus (PF)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
131 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo Then Rilzabrutinib
Arm Type
Placebo Comparator
Arm Description
In BT period, participants received placebo orally twice daily (BID) up to 37 weeks along with sponsor-provided corticosteroids (CS). After at least two weeks of control of disease activity (CDA; no new lesions and established lesions begin to heal), based on protocol-specified clinical criteria, investigators could decrease the CS dose to a minimum of 5 milligrams (mg) prednisone/prednisolone per day from Week 29 to Week 37. Post completion of BT period, eligible participants received rilzabrutinib 400 mg BID up to Week 61 in OLE period and those who were eligible after OLE period completion, continued the same treatment until Week 109 in LTE period according to protocol-specified criteria.
Arm Title
Rilzabrutinib Then Rilzabrutinib
Arm Type
Experimental
Arm Description
In BT period, participants received rilzabrutinib 400 mg orally BID up to 37 weeks along with sponsor-provided CS. After at least two weeks of CDA (no new lesions and established lesions begin to heal), based on protocol-specified clinical criteria, investigators could decrease the CS dose to a minimum of 5 mg prednisone/prednisolone per day from Week 29 to Week 37. Post completion of BT period, eligible participants received rilzabrutinib 400 mg BID up to Week 61 in OLE period and those who were eligible after OLE period completion, continued the same treatment until Week 109 in LTE period according to protocol-specified criteria.
Intervention Type
Drug
Intervention Name(s)
Rilzabrutinib
Intervention Description
Pharmaceutical form: Tablet Route of administration: Oral
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Pharmaceutical form: Tablet Route of administration: Oral
Primary Outcome Measure Information:
Title
Percentage of Participants Who Achieved Complete Remission (CR) With a Corticosteroids Dose of Less Than or Equal to (<=) 10 mg/Day From Week 29 to Week 37: Pemphigus Vulgaris Participants in Modified Intent-to-Treat (PV mITT) Population
Description
Complete remission was defined as absence of new and established lesions and was intended to mean "no disease activity" for 2 consecutive weeks, with Pemphigus Disease Area Index (PDAI) activity score =0 and CS dose <=10 mg. PDAI score weighted for number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). PDAI total score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. In this outcome measure (OM), percentage of participants who achieved CR while on a daily corticosteroids dose of <=10 mg/day were reported.
Time Frame
From Week 29 to Week 37
Title
Percentage of Participants Who Achieved Complete Remission With a Corticosteroids Dose of <=10 mg/Day From Week 29 to Week 37: Modified Intent-to-Treat (mITT) Population
Description
Complete remission was defined as absence of new and established lesions and was intended to mean "no disease activity" for 2 consecutive weeks, with PDAI activity score =0 and CS dose <=10 mg. PDAI score weighted for number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). PDAI total score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. In this OM, percentage of participants who achieved CR while on a daily corticosteroids dose of <=10 mg/day were reported.
Time Frame
From Week 29 to Week 37
Secondary Outcome Measure Information:
Title
Cumulative Oral Corticosteroid Dose From Baseline to Week 37: PV mITT Population
Description
The cumulative dose (in milligrams) of sponsor-provided oral CS (prednisone or prednisolone) received by the participants during the BT period was calculated from Baseline to Week 37 and is reported in this OM.
Time Frame
Baseline to Week 37
Title
Cumulative Oral Corticosteroid Dose From Baseline to Week 37: mITT Population
Description
The cumulative dose (in milligrams) of sponsor-provided oral CS (prednisone or prednisolone) received by the participants during the BT period was calculated from Baseline to Week 37 and is reported in this OM.
Time Frame
Baseline to Week 37
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Week 37: PV mITT Population
Description
Cumulative duration (in days) of CR post first CS dose of <= 10 mg/day from Baseline to Week 37 was analyzed with a zero-inflated negative binomial model with terms of treatment group and disease history, and an offset based on the number of days on blinded treatment period and were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Time Frame
Baseline to Week 37
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Week 37: mITT Population
Description
Cumulative duration (in days) of CR post first CS dose of <= 10 mg/day from Baseline to Week 37 was analyzed with a zero-inflated negative binomial model with terms of treatment group and disease history, and an offset based on the number of days on blinded treatment period and were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Time Frame
Baseline to Week 37
Title
Time to First Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Week 37: PV mITT Population
Description
Time to first CR was the time (in days) to achieve CR while on CS dose of <=10 mg/day. Complete remission was defined as the absence of new and established lesions to the "no disease activity". Kaplan-Meier method was used for the analysis.
Time Frame
Baseline to Week 37
Title
Time to First Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Week 37: mITT Population
Description
Time to first CR was the time (in days) to achieve CR while on CS dose of <=10 mg/day. Complete remission was defined as the absence of new and established lesions to the "no disease activity". Kaplan-Meier method was used for the analysis.
Time Frame
Baseline to Week 37
Title
Percentage of Participants Who Achieved Complete Remission With a Corticosteroids Dose of <=5 mg/Day From Week 29 to Week 37: PV mITT Population
Description
Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity". In this OM, percentage of participants who achieved CR while on a daily corticosteroids dose of <=5 mg/day were reported.
Time Frame
From Week 29 to Week 37
Title
Percentage of Participants Who Achieved Complete Remission With a Corticosteroids Dose of <=5 mg/Day From Week 29 to Week 37: mITT Population
Description
Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity". In this OM, percentage of participants who achieved CR while on a daily corticosteroids dose of <=5 mg/day were reported.
Time Frame
From Week 29 to Week 37
Title
Percentage of Participants Who Had Pemphigus Disease Area Index (PDAI) Score <3 With a Corticosteroids Dose <=10 mg/Day From Week 29 to Week 37: PV mITT Population
Description
PDAI is specific cutaneous and mucosal disease activity assessment performed by investigator based on evaluation of lesions in well-defined anatomical locations. The score weighted for the number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). Thus, PDAI total activity score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. In this OM, participants with PDAI score <3 while on a CS dose of <=10 mg/day were reported.
Time Frame
From Week 29 to Week 37
Title
Percentage of Participants Who Had Pemphigus Disease Area Index Score <3 With a Corticosteroids Dose <=10 mg/Day From Week 29 to Week 37: mITT Population
Description
PDAI is specific cutaneous and mucosal disease activity assessment performed by investigator based on evaluation of lesions in well-defined anatomical locations. The score weighted for the number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). Thus, PDAI total activity score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. In this OM, participants with PDAI score <3 while on a CS dose of <=10 mg/day were reported.
Time Frame
From Week 29 to Week 37
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Weeks 61 and 109: PV mITT Population
Description
Cumulative duration (in days) of CR post all doses of CS <=10 mg/day during Baseline to Week 61 and Baseline to Week 109 were reported in this OM. Complete remission was defined as the absence of new and established lesions to the "no disease activity".
Time Frame
Baseline to Week 61 and Baseline to Week 109
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Weeks 61 and 109: mITT Population
Description
Cumulative duration (in days) of CR post all doses of CS <=10 mg/day during Baseline to Week 61 and Baseline to Week 109 were reported in this OM. Complete remission was defined as the absence of new and established lesions to the "no disease activity".
Time Frame
Baseline to Weeks 61 and Baseline to Week 109
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose = 0 mg/Day From Baseline to Weeks 61 and 109: PV mITT Population
Description
Cumulative duration (in days) of CR post all doses of CS =0 mg/day during Baseline to Week 61 and Baseline to Week 109 were reported in this OM. Complete remission was defined as the absence of new and established lesions to the "no disease activity".
Time Frame
Baseline to Week 61 and Baseline to Week 109
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose = 0 mg/Day From Baseline to Weeks 61 and 109: mITT Population
Description
Cumulative duration (in days) of CR post all doses of CS dose = 0 mg/day during Baseline to Week 61 and Baseline to Week 109 were reported in this OM. Complete remission was defined as the absence of new and established lesions to the "no disease activity".
Time Frame
Baseline to Week 61 and Baseline to Week 109
Title
Glucocorticoid Toxicity Index (GTI) - Cumulative Worsening Score (CWS) and Aggregate Improvement Score (AIS) at Week 37: PV mITT Population
Description
GTI assessed glucocorticoid (GC) related morbidity and GC-sparing ability of other therapies; composed of 2 components: Composite GTI and specific list. Composite GTI had 9 domains and specific list had 23 items (11 domains), used as complementary tool to C-GTI. Composite GTI score:sum of 9 domain-specific scores at each visit and cumulative GTI score:sum of composite GTI scores across each visit. 2 cumulative GTI scores: CWS and AIS at Week 37 reported in this OM. CWS assessed cumulative GC toxicity regardless of whether toxicity had lasting effects/was transient. AIS assessed new therapy effectiveness in decreasing any Baseline GC toxicity over time. CWS composite score range: 0 to 439 and AIS composite score range: -346 to 439. In CWS and AIS, minimum score=least toxicity and maximum score=most toxicity. Least square (LS) mean and standard error (SE) from analysis of covariance model using treatment, disease history as fixed effects and Baseline GTI score and CS dose as covariates.
Time Frame
At Week 37
Title
Glucocorticoid Toxicity Index - Cumulative Worsening Score and Aggregate Improvement Score at Week 37: mITT Population
Description
GTI assessed GC related morbidity and GC-sparing ability of other therapies; composed of 2 components: Composite GTI and specific list. Composite GTI contained 9 domains and specific list contained of 23 items (11 domains), used as complementary tool to C-GTI. Composite GTI score: sum of 9 domain-specific scores at each visit and cumulative GTI score: sum of composite GTI scores across each visit. Two cumulative GTI scores: CWS and AIS at Week 37 were reported in this OM. CWS assessed cumulative GC toxicity regardless of whether toxicity had lasting effects/was transient. AIS assessed new therapy effectiveness in decreasing any Baseline GC toxicity over time. CWS composite score ranged from 0 to 439 and AIS composite score ranged from -346 to 439. For CWS and AIS, minimum score = least toxicity and maximum score = most toxicity. LS mean and SE from analysis of covariance model using treatment, disease history as fixed effects and Baseline GTI score and CS dose as covariates.
Time Frame
At Week 37
Title
Change From Baseline in Pemphigus Disease Area Index Score at Weeks 5, 13, 25, 37, 61, and 109: PV mITT Population
Description
PDAI is specific cutaneous and mucosal disease activity assessment performed by investigator based on evaluation of lesions in well-defined anatomical locations. The score weighted for the number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). Thus, PDAI total activity score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. PDAI activity score was measured independently of the CS dose administered in the participants.
Time Frame
Baseline, Weeks 5, 13, 25, 37, 61, and 109
Title
Change From Baseline in Pemphigus Disease Area Index Score at Weeks 5, 13, 25, 37, 61, and 109: mITT Population
Description
PDAI is specific cutaneous and mucosal disease activity assessment performed by investigator based on evaluation of lesions in well-defined anatomical locations. The score weighted for the number and size of lesions with score of 0 (absent) to 10 given for skin (12 body locations), scalp and mucous membrane showing disease activity (erosions/blisters or new erythema). Thus, PDAI total activity score ranged from 0 to 250 points representing disease activity (120 points for skin activity; 10 points for scalp activity; 120 points for mucosal activity). Higher score indicated more disease activity. PDAI activity score was measured independently of the CS dose administered in the participants.
Time Frame
Baseline, Weeks 5, 13, 25, 37, 61, and 109
Title
Change From Baseline in Autoimmune Bullous Disease Quality of Life (ABQOL) Score at Weeks 5, 13, 25, 37, 61, and 109: PV mITT Population
Description
ABQOL, a 17-item questionnaire is a valid and reliable tool to assess quality of life in participants with autoimmune blistering diseases. Each question score ranged from 0 to 3 points, 0 = never, 1 = occasionally, 2 = sometimes and 3 = all the time, where higher score = poor QOL. The total ABQoL score was calculated by summing the score of each question and it ranged from 0 to 51, where higher score = more QOL impairment.
Time Frame
Baseline, Weeks 5, 13, 25, 37, 61, and 109
Title
Change From Baseline in Autoimmune Bullous Disease Quality of Life Score at Weeks 5, 13, 25, 37, 61, and 109: mITT Population
Description
ABQOL, a 17-item questionnaire is a valid and reliable tool to assess quality of life in participants with autoimmune blistering diseases. Each question score ranged from 0 to 3 points, 0 = never, 1 = occasionally, 2 = sometimes and 3 = all the time, where higher score = poor QOL. The total ABQoL score was calculated by summing the score of each question and it ranged from 0 to 51, where higher score = more QOL impairment.
Time Frame
Baseline, Weeks 5, 13, 25, 37, 61, and 109
Title
Percentage of Participants With Autoimmune Bullous Disease Quality of Life Score of Zero at Weeks 5, 13, 25, 37, 61, and 109: PV mITT Population
Description
ABQOL, a 17-item questionnaire is a valid and reliable tool to assess quality of life in participants with autoimmune blistering diseases. Each question score ranged from 0 to 3 points, 0 = never, 1 = occasionally, 2 = sometimes and 3 = all the time, where higher score = poor QOL. The total ABQoL score was calculated by summing the score of each question and it ranged from 0 to 51, where higher score = more QOL impairment. Percentage of participants with ABQOL score of '0' were reported in this outcome measure.
Time Frame
At Weeks 5, 13, 25, 37, 61, and 109
Title
Percentage of Participants With Autoimmune Bullous Disease Quality of Life Score of Zero at Weeks 5, 13, 25, 37, 61, and 109: mITT Population
Description
ABQOL, a 17-item questionnaire is a valid and reliable tool to assess quality of life in participants with autoimmune blistering diseases. Each question score ranged from 0 to 3 points, 0 = never, 1 = occasionally, 2 = sometimes and 3 = all the time, where higher score = poor QOL. The total ABQoL score was calculated by summing the score of each question and it ranged from 0 to 51, where higher score = more QOL impairment. Percentage of participants with ABQOL score of '0' were reported in this outcome measure.
Time Frame
At Weeks 5, 13, 25, 37, 61, and 109
Title
Change From Baseline in the European Quality of Life Working Group Health Status Measure 5 Dimensions, 5 Levels (EQ-5D-5L) Score: Visual Analogue Scale (VAS) Scores at Weeks 5, 13, 25, 37, 61, and 109
Description
EQ-5D-5L: standardized measure of health status that provides general assessment of health and wellbeing. EQ-5D VAS was used to record a participant's rating for his/her current health-related quality of life state and captured on a vertical VAS scale ranging from 0 to 100, where 0=worst imaginable health state and 100=best imaginable health state, where higher states indicated better outcomes.
Time Frame
Baseline, Weeks 5, 13, 25, 37, 61, and 109
Title
Change From Baseline in the European Quality of Life Working Group Health Status Measure 5 Dimensions, 5 Levels Score: Individual Dimension at Weeks 5, 13, 25, 37, 61, and 109
Description
EQ-5D-5L: standardized measure of health status that provides general assessment of health and wellbeing. The EQ-5D descriptive system comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has a 5-level response: no problems, slight problems, moderate problems, severe problems, and extreme problems. Response options are measured with a 5-point Likert scale (for the 5L version). The 5D-5L systems are converted into a single index utility score between 0 to 1, where higher score indicates a better health state and lower score indicate worse health state.
Time Frame
Baseline, Weeks 5, 13, 25, 37, 61, and 109
Title
Time to First Complete Remission With a Corticosteroids Dose <=10 mg/Day From Baseline to Weeks 61 and 109
Description
Time to first CR was the time (in days) to achieve CR while on a CS dose of <=10 mg/day from Baseline to Week 61 and from Baseline to Week 109. Complete remission was defined as absence of new and established lesions to the "no disease activity".
Time Frame
Baseline to Week 61 and Baseline to Week 109
Title
Total Number of Disease Relapses/Flares From Initial Control of Disease Activity (CDA) to Week 37: PV mITT Population
Description
Total Number of Disease Relapses/Flares which occurred from initial CDA to Week 37 were reported. CDA was defined as disappearance of new lesions cease to form and established lesions begin to heal. Relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA.
Time Frame
From initial CDA up to Week 37 (i.e., during any time from Baseline up to Week 37)
Title
Total Number of Disease Relapses/Flares From Initial Control of Disease Activity to Week 37: mITT Population
Description
Total Number of Disease Relapses/Flares which occurred from initial CDA to Week 37 were reported. CDA was defined as disappearance of new lesions cease to form and established lesions begin to heal. Relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA.
Time Frame
From initial CDA up to Week 37 (i.e., during any time from Baseline up to Week 37)
Title
Time to Initial Relapse/Flare From Initial Control of Disease Activity to Week 37: PV mITT Population
Description
Time duration (in days) from the time of initial relapse/flare which occurred from initial CDA up to Week 37 were reported in this OM. CDA was defined as the visit at which new lesions cease to form and established lesions begin to heal. Relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA. Kaplan-Meier method was used for the analysis.
Time Frame
From initial CDA up to Week 37 (i.e., during any time from Baseline up to Week 37)
Title
Time to Initial Relapse/Flare From Initial Control of Disease Activity to Week 37: mITT Population
Description
Time duration (in days) from the time of initial relapse/flare which occurred from initial CDA up to Week 37 were reported in this OM. CDA was defined as the visit at which new lesions cease to form and established lesions begin to heal. Relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA. Kaplan-Meier method was used for the analysis.
Time Frame
From initial CDA up to Week 37 (i.e., during any time from Baseline up to Week 37)
Title
Percentage of Participants With 3 or More New Lesions Within 1 Month That do Not Heal Spontaneously Within 1 Week, or With Extension of Established Lesions at Week 37: PV mITT Population
Description
Percentage of Participants With 3 or More New Lesions Within past 1 month that do not heal spontaneously within past 1 week, or with extension of established lesions, were assessed at Week 37 and reported in this OM.
Time Frame
At Week 37
Title
Percentage of Participants With 3 or More New Lesions Within 1 Month That do Not Heal Spontaneously Within 1 Week, or With Extension of Established Lesions at Week 37: mITT Population
Description
Percentage of participants with 3 or more new lesions within past 1 month that do not heal spontaneously within past 1 week, or with extension of established lesions, were assessed at Week 37 and reported in this OM.
Time Frame
At Week 37
Title
Percentage of Participants With at Least One Disease Relapse/Flare From Initial Control of Disease Activity to Week 37: PV mITT Population
Description
CDA was defined as the visit at which new lesions cease to form and established lesions begin to heal. Disease relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA. Percentages were calculated based on number of participants assessed (i.e. participants achieved CDA) in each treatment group. Percentage of participants with at least one disease relapse/flare from Initial CDA to Week 37 were reported in this OM.
Time Frame
From initial CDA up to Week 37 (i.e., during any time from Baseline up to Week 37)
Title
Percentage of Participants With at Least One Disease Relapse/Flare From Initial Control of Disease Activity to Week 37: mITT Population
Description
CDA was defined as the visit at which new lesions cease to form and established lesions begin to heal. Disease relapse/flare was defined by the appearance of 3 or more new lesions after CDA and within a month that do not heal spontaneously within 1 week, or by the extension of established lesions, in a participant who had achieved CDA. Percentages were calculated based on number of participants assessed (i.e. participants achieved CDA) in each treatment group. Percentage of participants with at least one disease relapse/flare from Initial CDA to Week 37 were reported in this OM.
Time Frame
From initial CDA up to Week 37 (i.e., during any time from Baseline up to Week 37)
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Week 37 to Week 61: PV mITT Population
Description
Cumulative duration (in days) of CR post first dose of CS <=10 mg/day from Week 37 to Week 61 were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Time Frame
From Week 37 to Week 61
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose <=10 mg/Day From Week 37 to Week 61: mITT Population
Description
Cumulative duration (in days) of CR post first dose of CS <=10 mg/day from Week 37 to Week 61 were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Time Frame
From Week 37 to Week 61
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose = 0 mg/Day From Week 37 to Week 61: PV mITT Population
Description
Cumulative duration (in days) of CR post first dose of CS = 0 mg/day from Week 37 to Week 61 were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Time Frame
From Week 37 to Week 61
Title
Cumulative Duration of Complete Remission With a Corticosteroids Dose = 0 mg/Day From Week 37 to Week 61: mITT Population
Description
Cumulative duration (in days) of CR post first dose of CS = 0 mg/day from Week 37 to Week 61 were reported in this OM. Complete remission was defined as the absence of new and established lesions and was intended to mean "no disease activity".
Time Frame
From Week 37 to Week 61
Title
Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)
Description
An adverse event (AE) was defined as any untoward medical occurrence in a participant who received study drug and does not necessarily had to have a causal relationship with the treatment. Serious AEs (SAEs) were any untoward medical occurrence that resulted in any of the following outcomes: death, life-threatening, required initial or prolonged in-patient hospitalization, persistent or significant disability/incapacity, congenital anomaly/birth defect, or considered as medically important event. TEAEs were the AEs that developed or worsened or became serious after the administration of first dose of study drug in each period.
Time Frame
BT Period: From Day 1 of Week 1 to Week 37, OLE Period: from Week 37 to Week 61 and LTE Period: from Week 61 up to 4 weeks after the last dose at Week 109 (i.e., up to Week 113)
Title
Pharmacokinetics (PK): Plasma Concentration of Rilzabrutinib
Description
Data for this OM was not planned to be collected and analyzed for placebo arm of the study.
Time Frame
Pre-dose and 2 hours post-dose on Day 1
Title
Pharmacodynamics (PD): Change From Baseline in Antibody Levels - Anti-desmoglein 1 (Anti-dsg 1) and Anti-desmoglein 3 (Anti-dsg 3) at Weeks 13, 25, 37, 49, 61, 73, 85, 97, and 109: PV mITT Population
Description
Anti-dsg1 and anti-dsg3 autoantibody levels was assessed by enzyme-linked immunosorbent assay (ELISA) method.
Time Frame
Baseline, Weeks 13, 25, 37, 49, 61, 73, 85, 97, and 109
Title
Pharmacodynamics: Change From Baseline in Antibody Levels - Anti-desmoglein 1 (Anti-dsg 1) and Anti-desmoglein 3 (Anti-dsg 3) at Weeks 13, 25, 37, 49, 61, 73, 85, 97 and 109: mITT Population
Description
Anti-dsg1 and anti-dsg3 autoantibody levels was assessed by ELISA method.
Time Frame
Baseline, Weeks 13, 25, 37, 49, 61, 73, 85, 97, and 109

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female participants, aged 18 to 80 years old with moderate to severe, newly diagnosed or relapsing PV or PF, with a clinical presentation and histopathology consistent with PV or PF. Positive circulating anti-desmoglein 1 (anti-dsg1) or 3 autoantibody titer. At screening, pemphigus disease area index score of at least 9 points for relapsing participants or at least 15 points for newly diagnosed participants. Adequate hematologic, hepatic, and renal function. Effective means of contraception. Exclusion Criteria: Suspected paraneoplastic pemphigus and other forms of pemphigus that were not PV or PF. Previous use of a Bruton tyrosine kinase inhibitor. Pregnant or lactating women. Electrocardiogram clinically significant abnormalities. A history of malignancy of any type within 5 years before Day 1, other than surgically excised non-melanoma skin cancers or in situ cervical cancer. Use of immunologic response modifiers as concomitant medication and with the washout period. Use of proton pump inhibitor drugs such as omeprazole and esomeprazole within 3 days of Day 1. Concomitant use of known strong-to-moderate inducers or inhibitors of cytochrome P450 3A (CYP3A) within 3 days or 5 half-lives (whichever is longer) of Day 1 Use of CYP3A-sensitive substrate drugs. Had received any investigational drug within the 30 days before Day 1. History of drug abuse within the previous 12 months. Alcoholism or excessive alcohol use. Any other clinically significant disease, condition or medical history that, in the opinion of the Investigator, would interfere with participant safety, trial evaluations, and/or trial procedures.
Facility Information:
Facility Name
Central Recruiting (Principia Biopharma)
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33433
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Coral Gables
State/Province
Florida
ZIP/Postal Code
33134
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48103
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87131
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
New York
State/Province
New York
ZIP/Postal Code
10028
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Austin
State/Province
Texas
ZIP/Postal Code
78705
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Murray
State/Province
Utah
ZIP/Postal Code
84107
Country
United States
Facility Name
Central Recruiting (Principia Biopharma)
City
Buenos Aires
ZIP/Postal Code
B1663GJR
Country
Argentina
Facility Name
Central Recruiting (Principia Biopharma)
City
Buenos Aires
ZIP/Postal Code
C1199ABD
Country
Argentina
Facility Name
Central Recruiting (Principia Biopharma)
City
San Nicolás
ZIP/Postal Code
B2900DPA
Country
Argentina
Facility Name
Central Recruiting (Principia Biopharma)
City
Fremantle
State/Province
Western Australia
ZIP/Postal Code
6160
Country
Australia
Facility Name
Central Recruiting (Principia Biopharma)
City
Melbourne
ZIP/Postal Code
3050
Country
Australia
Facility Name
Central Recruiting (Principia Biopharma)
City
Sydney
ZIP/Postal Code
2217
Country
Australia
Facility Name
Central Recruiting (Principia Biopharma)
City
Campinas
ZIP/Postal Code
87131-001
Country
Brazil
Facility Name
Central Recruiting (Principia Biopharma)
City
Campo Grande
ZIP/Postal Code
79080-190
Country
Brazil
Facility Name
Central Recruiting (Principia Biopharma)
City
Ribeirão Preto
ZIP/Postal Code
14051-140
Country
Brazil
Facility Name
Central Recruiting (Principia Biopharma)
City
Pleven
ZIP/Postal Code
5800
Country
Bulgaria
Facility Name
Central Recruiting (Principia Biopharma)
City
Plovdiv
ZIP/Postal Code
4002
Country
Bulgaria
Facility Name
Central Recruiting (Principia Biopharma)
City
Sofia
ZIP/Postal Code
01431
Country
Bulgaria
Facility Name
Central Recruiting (Principia Biopharma)
City
Winnipeg
State/Province
Manitoba
ZIP/Postal Code
R3M 3Z4
Country
Canada
Facility Name
Central Recruiting (Principia Biopharma)
City
Osijek
ZIP/Postal Code
31000
Country
Croatia
Facility Name
Central Recruiting (Principia Biopharma)
City
Zagreb
ZIP/Postal Code
10000
Country
Croatia
Facility Name
Central Recruiting (Principia Biopharma)
City
Bobigny
ZIP/Postal Code
93009
Country
France
Facility Name
Central Recruiting (Principia Biopharma)
City
Bordeaux
ZIP/Postal Code
33000
Country
France
Facility Name
Central Recruiting (Principia Biopharma)
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
Central Recruiting (Principia Biopharma)
City
Pierre-Bénite
ZIP/Postal Code
69495
Country
France
Facility Name
Central Recruiting (Principia Biopharma)
City
Rouen
ZIP/Postal Code
76031
Country
France
Facility Name
Central Recruiting (Principia Biopharma)
City
Toulouse
ZIP/Postal Code
31059
Country
France
Facility Name
Central Recruiting (Principia Biopharma)
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Central Recruiting (Principia Biopharma)
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Central Recruiting (Principia Biopharma)
City
Düsseldorf
ZIP/Postal Code
40225
Country
Germany
Facility Name
Central Recruiting (Principia Biopharma)
City
Erlangen
ZIP/Postal Code
91054
Country
Germany
Facility Name
Central Recruiting (Principia Biopharma)
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Central Recruiting (Principia Biopharma)
City
Kiel
ZIP/Postal Code
24105
Country
Germany
Facility Name
Central Recruiting (Principia Biopharma)
City
Lübeck
ZIP/Postal Code
23538
Country
Germany
Facility Name
Central Recruiting (Principia Biopharma)
City
Münster
ZIP/Postal Code
48151
Country
Germany
Facility Name
Central Recruiting (Principia Biopharma)
City
Athens
ZIP/Postal Code
16121
Country
Greece
Facility Name
Central Recruiting (Principia Biopharma)
City
Ioánnina
ZIP/Postal Code
54643
Country
Greece
Facility Name
Central Recruiting (Principia Biopharma)
City
Larisa
ZIP/Postal Code
41110
Country
Greece
Facility Name
Central Recruiting (Principia Biopharma)
City
Thessaloníki
ZIP/Postal Code
54643
Country
Greece
Facility Name
Central Recruiting (Principia Biopharma)
City
Thessaloníki
ZIP/Postal Code
56403
Country
Greece
Facility Name
Central Recruiting (Principia Biopharma)
City
Be'er Sheva
ZIP/Postal Code
8457108
Country
Israel
Facility Name
Central Recruiting (Principia Biopharma)
City
Haifa
ZIP/Postal Code
3109601
Country
Israel
Facility Name
Central Recruiting (Principia Biopharma)
City
Ramat Gan
ZIP/Postal Code
5262100
Country
Israel
Facility Name
Central Recruiting (Principia Biopharma)
City
Tel Aviv
ZIP/Postal Code
64239
Country
Israel
Facility Name
Central Recruiting (Principia Biopharma)
City
Brescia
ZIP/Postal Code
25123
Country
Italy
Facility Name
Central Recruiting (Principia Biopharma)
City
Catania
ZIP/Postal Code
95123
Country
Italy
Facility Name
Central Recruiting (Principia Biopharma)
City
Florence
ZIP/Postal Code
50121
Country
Italy
Facility Name
Central Recruiting (Principia Biopharma)
City
Milan
ZIP/Postal Code
20122
Country
Italy
Facility Name
Central Recruiting (Principia Biopharma)
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
Central Recruiting (Principia Biopharma)
City
Parma
ZIP/Postal Code
43100
Country
Italy
Facility Name
Central Recruiting (Principia Biopharma)
City
Rome
ZIP/Postal Code
00167
Country
Italy
Facility Name
Central Recruiting (Principia Biopharma)
City
Torino
ZIP/Postal Code
43100
Country
Italy
Facility Name
Central Recruiting (Principia Biopharma)
City
Gdańsk
ZIP/Postal Code
80-214
Country
Poland
Facility Name
Central Recruiting (Principia Biopharma)
City
Kraków
ZIP/Postal Code
31-066
Country
Poland
Facility Name
Central Recruiting (Principia Biopharma)
City
Lublin
ZIP/Postal Code
20-081
Country
Poland
Facility Name
Central Recruiting (Principia Biopharma)
City
Warsaw
ZIP/Postal Code
02-005
Country
Poland
Facility Name
Central Recruiting (Principia Biopharma)
City
Wroclaw
ZIP/Postal Code
51-124
Country
Poland
Facility Name
Central Recruiting (Principia Biopharma)
City
Wrocław
ZIP/Postal Code
50-367
Country
Poland
Facility Name
Central Recruiting (Principia Biopharma)
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Central Recruiting (Principia Biopharma)
City
Novi Sad
ZIP/Postal Code
21000
Country
Serbia
Facility Name
Central Recruiting (Principia Biopharma)
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
Facility Name
Central Recruiting (Principia Biopharma)
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Central Recruiting (Principia Biopharma)
City
Barcelona
ZIP/Postal Code
08916
Country
Spain
Facility Name
Central Recruiting (Principia Biopharma)
City
Córdoba
ZIP/Postal Code
14004
Country
Spain
Facility Name
Central Recruiting (Principia Biopharma)
City
Madrid
ZIP/Postal Code
28007
Country
Spain
Facility Name
Central Recruiting (Principia Biopharma)
City
Pamplona
ZIP/Postal Code
31008
Country
Spain
Facility Name
Central Recruiting (Principia Biopharma)
City
Dalin
ZIP/Postal Code
62247
Country
Taiwan
Facility Name
Central Recruiting (Principia Biopharma)
City
Kaohsiung
ZIP/Postal Code
83301
Country
Taiwan
Facility Name
Central Recruiting (Principia Biopharma)
City
Taipei
ZIP/Postal Code
100
Country
Taiwan
Facility Name
Central Recruiting (Principia Biopharma)
City
Fatih
ZIP/Postal Code
34093
Country
Turkey
Facility Name
Central Recruiting (Principia Biopharma)
City
Istanbul
ZIP/Postal Code
34662
Country
Turkey
Facility Name
Central Recruiting (Principia Biopharma)
City
Istanbul
ZIP/Postal Code
34722
Country
Turkey
Facility Name
Central Recruiting (Principia Biopharma)
City
Konyaaltı
ZIP/Postal Code
07070
Country
Turkey
Facility Name
Central Recruiting (Principia Biopharma)
City
Merkez
ZIP/Postal Code
61080
Country
Turkey
Facility Name
Central Recruiting (Principia Biopharma)
City
Dnipro
ZIP/Postal Code
49000
Country
Ukraine
Facility Name
Central Recruiting (Principia Biopharma)
City
Dnipro
ZIP/Postal Code
49074
Country
Ukraine
Facility Name
Central Recruiting (Principia Biopharma)
City
Kyiv
ZIP/Postal Code
04209
Country
Ukraine
Facility Name
Central Recruiting (Principia Biopharma)
City
Lviv
ZIP/Postal Code
79013
Country
Ukraine
Facility Name
Central Recruiting (Principia Biopharma)
City
Zaporizhzhya
ZIP/Postal Code
69063
Country
Ukraine
Facility Name
Central Recruiting (Principia Biopharma)
City
London
ZIP/Postal Code
E1 1BB
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

Learn more about this trial

A Study of PRN1008 in Patients With Pemphigus

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