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KPL-301 for Subjects With Giant Cell Arteritis

Primary Purpose

Giant Cell Arteritis

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
mavrilimumab
placebo
prednisone
Sponsored by
Kiniksa Pharmaceuticals, Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Giant Cell Arteritis focused on measuring GCA, temporal arteritis, Horton's disease

Eligibility Criteria

50 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Selected Inclusion Criteria:

  1. Subjects with new-onset or relapsing/refractory GCA.
  2. Westergren erythrocyte sedimentation rate > 30 mm/hour or c-reactive protein ≥ 1 mg/ dL.
  3. Remission of GCA at or before Day 0.
  4. Female subjects must be postmenopausal or permanently sterile following documented hysterectomy, bilateral salpingectomy, bilateral oophorectomy, or tubal ligation or having a male partner with vasectomy as affirmed by the subject, or nonpregnant, nonlactating, and if sexually active having agreed to use a highly effective method of contraception.
  5. Male subjects must have documented vasectomy or if sexually active must agree to use a highly effective method of contraception with their partners of childbearing potential.

Selected Exclusion Criteria:

  1. Transplanted organs (except corneal transplant performed more than 3 months prior to randomization).
  2. Concurrent enrollment in another interventional clinical study.
  3. Treatment with non-biologic investigational drug therapy within 4 weeks or 5 half-lives of the study agent, whichever was longer, prior to screening.
  4. Cell-depleting biological therapies within 12 months prior to Day 0, or noncell-depleting biological therapies within 8 weeks (or 5 half-lives, whichever is longer) prior to screening.
  5. Treatment with alkylating agents within 12 weeks prior to screening.
  6. Intramuscular, Intra-articular or IV corticosteroids within 4 weeks prior to screening.
  7. Receipt of live (attenuated) vaccine within the 4 weeks before Day 0.
  8. Treatment with hydroxychloroquine, cyclosporine A, azathioprine, cyclophosphamide, or mycophenolate mofetil (MMF) within 4 weeks of screening.
  9. Female subjects who are pregnant, intending to become pregnant, or are breastfeeding.
  10. Known history of allergy or reaction to any component of the mavrilimumab or placebo formulation or to any other biologic therapy or prednisone or any of its excipients.
  11. Positive (or 2 indeterminate) QuantiFERON test results.
  12. Clinically significant active infection or infection requiring hospitalization or IV antibiotics within 12 weeks before screening or opportunistic infection within 6 months before screening.
  13. Chronic active hepatitis B infection.
  14. Subjects at a high risk of infection, a history of an infected joint prosthesis still in situ, leg ulcers, indwelling urinary catheter, or persistent or recurrent chest infections.
  15. History of cancer within the last 10 years, except for basal and squamous cell carcinoma of the skin or in situ carcinoma of the cervix treated and considered cured.
  16. Evidence of clinically-uncontrolled respiratory disease.
  17. History of chronic respiratory tract infections.

Sites / Locations

  • Site 1703
  • Site 1708
  • Site 1706
  • Site 1701
  • Site 1707
  • Site 1704
  • Site 1702
  • Site 1705
  • Site 2102
  • Site 2105
  • Site 2106
  • Site 2101
  • Site 2104
  • Site 2204
  • Site 2202
  • Site 2201
  • Site 2203
  • Site 2303
  • Site 2401
  • Site 2402
  • Site 2502
  • Site 2504
  • Site 2507
  • Site 2506
  • Site 2503
  • Site 2508
  • Site 2501
  • Site 2601
  • Site 2703
  • Site 2701
  • Site 2702
  • Site 2704
  • Site 2802
  • Site 2801
  • Site 2902
  • Site 2901
  • Site 1002
  • Site 1101
  • Site 1102
  • Site 1103
  • Site 1201
  • Site 1303
  • Site 1301
  • Site 1304
  • Site 1302
  • Site 1604
  • Site 1603
  • Site 1602
  • Site 1601

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

mavrilimumab

placebo

Arm Description

Subjects randomized to mavrilimumab will receive 150 mg every other week by subcutaneous injection co-administered with a 26-week corticosteroid taper.

Subjects randomized to placebo will receive placebo every other week by subcutaneous injection co-administered with a 26-week corticosteroid taper.

Outcomes

Primary Outcome Measures

Time to Flare by Week 26
Time to flare by Week 26 was defined as time from randomization to the date of first flare occurring within the 26-week period, as assessed by independent adjudication. Kaplan-Meier method used to estimate the survival functions for each treatment arm. Flare/relapse was defined as a C-reactive protein (CRP) of 1 mg/dL or greater and/or erythrocyte sedimentation rate (ESR) of 30 mm/h or greater AND at least one of the following signs or symptoms attributed to GCA: Cranial symptoms (new-onset localized headache; scalp or temporal artery tenderness; ischemic-related vision loss; unexplained mouth or jaw pain upon mastication; transient ischemic attack or stroke related to GCA); Extracranial symptoms (claudication of the extremities; symptoms of polymyalgia rheumatica); New or worsening angiographic abnormalities detected via MRI, CT/CTA, or PET-CT of the aorta or other great vessels or via ultrasound of the temporal arteries.

Secondary Outcome Measures

Sustained Remission Rate at Week 26
The sustained remission rate at Week 26 is defined as the percentage of participants with sustained remission, as assessed by independent adjudication, at Week 26, derived from the time to flare curve. Kaplan-Meier Survival Estimates with standard error and 95% CI for each arm. Participants who completed the treatment period without a flare by Week 26 were considered to have sustained remission.
Time to Elevated Erythrocyte Sedimentation Rate (ESR) by Week 26
Elevated ESR is defined as first occurrence of ESR value ≥ 30 mm/hr. Participants with elevated ESR within 3 days of first dose are excluded from the analysis. Kaplan-Meier method used to estimate the survival functions for each treatment arm.
Time to Elevated C-Reactive Protein (CRP) by Week 26
Elevated CRP is defined as first occurrence of CRP value ≥ 1.0 mg/dL. Participants with elevated CRP within 3 days of first dose are excluded from the analysis. Kaplan-Meier method used to estimate the survival functions for each treatment arm.
Time to Signs/Symptoms of Giant Cell Arteritis (GCA) or New or Worsening Vasculitis on Imaging by Week 26
Kaplan-Meier method used to estimate the survival functions for each treatment arm.
Cumulative Corticosteroid Dose at Week 26
Percentage of Participants Who Completed the 26-Week Corticosteroid Taper and Who Had a Normal ESR
Participants were considered to have completed the corticosteroid taper if by week 26 receiving 1 mg/day for those who start with 60 mg/day, or 0 mg/day for those who start with doses < 60 mg/day. 95% CI calculated using Clopper-Pearson confidence intervals.
Percentage of Participants Who Completed the 26-Week Corticosteroid Taper and Who Had a Normal CRP Level
Participants were considered to have completed the corticosteroid taper if by week 26 receiving 1 mg/day for those who start with 60 mg/day, or 0 mg/day for those who start with doses < 60 mg/day. 95% CI calculated using Clopper-Pearson confidence intervals.
Percentage of Participants Who Completed the 26-week Corticosteroid Taper and Who Had No Signs or Symptoms of GCA Nor New or Worsening Vasculitis by Imaging by Week 26
Participants were considered to have completed the corticosteroid taper if by week 26 receiving 1 mg/day for those who start with 60 mg/day, or 0 mg/day for those who start with doses < 60 mg/day. 95% CI calculated using Clopper-Pearson confidence intervals.
Cumulative Corticosteroid Dose at the End of the Washout Safety Follow-up Period

Full Information

First Posted
January 25, 2019
Last Updated
October 17, 2023
Sponsor
Kiniksa Pharmaceuticals, Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03827018
Brief Title
KPL-301 for Subjects With Giant Cell Arteritis
Official Title
A Phase 2, Randomized, Double-blind Placebo-controlled Study to Test the Efficacy and Safety of KPL-301 in Giant Cell Arteritis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Completed
Study Start Date
September 20, 2018 (Actual)
Primary Completion Date
August 13, 2020 (Actual)
Study Completion Date
November 25, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kiniksa Pharmaceuticals, Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of the study is to evaluate the efficacy of mavrilimumab (KPL-301) versus placebo, co-administered with a 26-week corticosteroid taper, for maintaining sustained remission for 26 weeks in subjects with new onset or relapsing/refractory giant cell arteritis (GCA).
Detailed Description
This Phase 2 randomized, double-blind, placebo-controlled proof of concept study will evaluate the efficacy and safety of mavrilimumab co-administered with a 26-week corticosteroid taper in subjects with GCA. The study will consist of a screening period (up to 6 weeks), a 26-week double-blind placebo-controlled period during which subjects will receive blinded mavrilimumab or placebo co-administered with a 26-week corticosteroid taper, and a 12-week washout safety follow-up period during which subjects will discontinue and wash off blinded mavrilimumab or placebo.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Giant Cell Arteritis
Keywords
GCA, temporal arteritis, Horton's disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Upon successful completion of the screening procedures, diagnosis criteria will be entered into an interactive web response system, and eligible subjects will be stratified for randomized study treatment into two cohorts according to whether subjects have new-onset or relapsing/refractory disease.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
70 (Actual)

8. Arms, Groups, and Interventions

Arm Title
mavrilimumab
Arm Type
Active Comparator
Arm Description
Subjects randomized to mavrilimumab will receive 150 mg every other week by subcutaneous injection co-administered with a 26-week corticosteroid taper.
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
Subjects randomized to placebo will receive placebo every other week by subcutaneous injection co-administered with a 26-week corticosteroid taper.
Intervention Type
Combination Product
Intervention Name(s)
mavrilimumab
Other Intervention Name(s)
KPL-301
Intervention Description
1 mL of 150 mg in a pre-filled syringe
Intervention Type
Combination Product
Intervention Name(s)
placebo
Intervention Description
1 mL of placebo in a pre-filled syringe
Intervention Type
Drug
Intervention Name(s)
prednisone
Intervention Description
Prednisone tablets for oral administration containing either 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg or 50 mg of prednisone United States Pharmacopeia (USP)
Primary Outcome Measure Information:
Title
Time to Flare by Week 26
Description
Time to flare by Week 26 was defined as time from randomization to the date of first flare occurring within the 26-week period, as assessed by independent adjudication. Kaplan-Meier method used to estimate the survival functions for each treatment arm. Flare/relapse was defined as a C-reactive protein (CRP) of 1 mg/dL or greater and/or erythrocyte sedimentation rate (ESR) of 30 mm/h or greater AND at least one of the following signs or symptoms attributed to GCA: Cranial symptoms (new-onset localized headache; scalp or temporal artery tenderness; ischemic-related vision loss; unexplained mouth or jaw pain upon mastication; transient ischemic attack or stroke related to GCA); Extracranial symptoms (claudication of the extremities; symptoms of polymyalgia rheumatica); New or worsening angiographic abnormalities detected via MRI, CT/CTA, or PET-CT of the aorta or other great vessels or via ultrasound of the temporal arteries.
Time Frame
Week 26
Secondary Outcome Measure Information:
Title
Sustained Remission Rate at Week 26
Description
The sustained remission rate at Week 26 is defined as the percentage of participants with sustained remission, as assessed by independent adjudication, at Week 26, derived from the time to flare curve. Kaplan-Meier Survival Estimates with standard error and 95% CI for each arm. Participants who completed the treatment period without a flare by Week 26 were considered to have sustained remission.
Time Frame
Week 26
Title
Time to Elevated Erythrocyte Sedimentation Rate (ESR) by Week 26
Description
Elevated ESR is defined as first occurrence of ESR value ≥ 30 mm/hr. Participants with elevated ESR within 3 days of first dose are excluded from the analysis. Kaplan-Meier method used to estimate the survival functions for each treatment arm.
Time Frame
Week 26
Title
Time to Elevated C-Reactive Protein (CRP) by Week 26
Description
Elevated CRP is defined as first occurrence of CRP value ≥ 1.0 mg/dL. Participants with elevated CRP within 3 days of first dose are excluded from the analysis. Kaplan-Meier method used to estimate the survival functions for each treatment arm.
Time Frame
Week 26
Title
Time to Signs/Symptoms of Giant Cell Arteritis (GCA) or New or Worsening Vasculitis on Imaging by Week 26
Description
Kaplan-Meier method used to estimate the survival functions for each treatment arm.
Time Frame
Week 26
Title
Cumulative Corticosteroid Dose at Week 26
Time Frame
Week 26
Title
Percentage of Participants Who Completed the 26-Week Corticosteroid Taper and Who Had a Normal ESR
Description
Participants were considered to have completed the corticosteroid taper if by week 26 receiving 1 mg/day for those who start with 60 mg/day, or 0 mg/day for those who start with doses < 60 mg/day. 95% CI calculated using Clopper-Pearson confidence intervals.
Time Frame
Week 26
Title
Percentage of Participants Who Completed the 26-Week Corticosteroid Taper and Who Had a Normal CRP Level
Description
Participants were considered to have completed the corticosteroid taper if by week 26 receiving 1 mg/day for those who start with 60 mg/day, or 0 mg/day for those who start with doses < 60 mg/day. 95% CI calculated using Clopper-Pearson confidence intervals.
Time Frame
Week 26
Title
Percentage of Participants Who Completed the 26-week Corticosteroid Taper and Who Had No Signs or Symptoms of GCA Nor New or Worsening Vasculitis by Imaging by Week 26
Description
Participants were considered to have completed the corticosteroid taper if by week 26 receiving 1 mg/day for those who start with 60 mg/day, or 0 mg/day for those who start with doses < 60 mg/day. 95% CI calculated using Clopper-Pearson confidence intervals.
Time Frame
Week 26
Title
Cumulative Corticosteroid Dose at the End of the Washout Safety Follow-up Period
Time Frame
Final Safety Follow-up visit (Week 38)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Selected Inclusion Criteria: Subjects with new-onset or relapsing/refractory GCA. Westergren erythrocyte sedimentation rate > 30 mm/hour or c-reactive protein ≥ 1 mg/ dL. Remission of GCA at or before Day 0. Female subjects must be postmenopausal or permanently sterile following documented hysterectomy, bilateral salpingectomy, bilateral oophorectomy, or tubal ligation or having a male partner with vasectomy as affirmed by the subject, or nonpregnant, nonlactating, and if sexually active having agreed to use a highly effective method of contraception. Male subjects must have documented vasectomy or if sexually active must agree to use a highly effective method of contraception with their partners of childbearing potential. Selected Exclusion Criteria: Transplanted organs (except corneal transplant performed more than 3 months prior to randomization). Concurrent enrollment in another interventional clinical study. Treatment with non-biologic investigational drug therapy within 4 weeks or 5 half-lives of the study agent, whichever was longer, prior to screening. Cell-depleting biological therapies within 12 months prior to Day 0, or noncell-depleting biological therapies within 8 weeks (or 5 half-lives, whichever is longer) prior to screening. Treatment with alkylating agents within 12 weeks prior to screening. Intramuscular, Intra-articular or IV corticosteroids within 4 weeks prior to screening. Receipt of live (attenuated) vaccine within the 4 weeks before Day 0. Treatment with hydroxychloroquine, cyclosporine A, azathioprine, cyclophosphamide, or mycophenolate mofetil (MMF) within 4 weeks of screening. Female subjects who are pregnant, intending to become pregnant, or are breastfeeding. Known history of allergy or reaction to any component of the mavrilimumab or placebo formulation or to any other biologic therapy or prednisone or any of its excipients. Positive (or 2 indeterminate) QuantiFERON test results. Clinically significant active infection or infection requiring hospitalization or IV antibiotics within 12 weeks before screening or opportunistic infection within 6 months before screening. Chronic active hepatitis B infection. Subjects at a high risk of infection, a history of an infected joint prosthesis still in situ, leg ulcers, indwelling urinary catheter, or persistent or recurrent chest infections. History of cancer within the last 10 years, except for basal and squamous cell carcinoma of the skin or in situ carcinoma of the cervix treated and considered cured. Evidence of clinically-uncontrolled respiratory disease. History of chronic respiratory tract infections.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John Paolini, M.D.
Organizational Affiliation
Kiniksa Pharmaceuticals, Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Site 1703
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34239
Country
United States
Facility Name
Site 1708
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Site 1706
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Site 1701
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Site 1707
City
Lansing
State/Province
Michigan
ZIP/Postal Code
48910
Country
United States
Facility Name
Site 1704
City
Saint Clair Shores
State/Province
Michigan
ZIP/Postal Code
48081
Country
United States
Facility Name
Site 1702
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905-0001
Country
United States
Facility Name
Site 1705
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Site 2102
City
Kogarah
ZIP/Postal Code
2217
Country
Australia
Facility Name
Site 2105
City
Nedlands
ZIP/Postal Code
6009
Country
Australia
Facility Name
Site 2106
City
Parkville
ZIP/Postal Code
3050
Country
Australia
Facility Name
Site 2101
City
Victoria Park
ZIP/Postal Code
6100
Country
Australia
Facility Name
Site 2104
City
Woodville South
ZIP/Postal Code
5011
Country
Australia
Facility Name
Site 2204
City
Brussels
ZIP/Postal Code
1070
Country
Belgium
Facility Name
Site 2202
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Facility Name
Site 2201
City
Liège
ZIP/Postal Code
4000
Country
Belgium
Facility Name
Site 2203
City
Yvoir
ZIP/Postal Code
5530
Country
Belgium
Facility Name
Site 2303
City
Zagreb
ZIP/Postal Code
10 000
Country
Croatia
Facility Name
Site 2401
City
Tallinn
ZIP/Postal Code
11312
Country
Estonia
Facility Name
Site 2402
City
Tartu
ZIP/Postal Code
50708
Country
Estonia
Facility Name
Site 2502
City
Tuebingen
State/Province
Baden-Württemberg
ZIP/Postal Code
72076
Country
Germany
Facility Name
Site 2504
City
Erlangen
State/Province
Bayern
ZIP/Postal Code
91054
Country
Germany
Facility Name
Site 2507
City
Freiburg im Breisgau
ZIP/Postal Code
79106
Country
Germany
Facility Name
Site 2506
City
Hamburg
ZIP/Postal Code
22763
Country
Germany
Facility Name
Site 2503
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Site 2508
City
Jena
ZIP/Postal Code
07747
Country
Germany
Facility Name
Site 2501
City
Kirchheim Unter Teck
ZIP/Postal Code
73230
Country
Germany
Facility Name
Site 2601
City
Dublin
ZIP/Postal Code
D04 T6F4
Country
Ireland
Facility Name
Site 2703
City
Milano
ZIP/Postal Code
20132
Country
Italy
Facility Name
Site 2701
City
Pieve Emanuele
ZIP/Postal Code
20090
Country
Italy
Facility Name
Site 2702
City
Reggio Emilia
ZIP/Postal Code
42100
Country
Italy
Facility Name
Site 2704
City
Udine
ZIP/Postal Code
33100
Country
Italy
Facility Name
Site 2802
City
Groningen
ZIP/Postal Code
9713 GZ
Country
Netherlands
Facility Name
Site 2801
City
Rotterdam
ZIP/Postal Code
3015 GD
Country
Netherlands
Facility Name
Site 2902
City
Christchurch
ZIP/Postal Code
8083
Country
New Zealand
Facility Name
Site 2901
City
Wellington
ZIP/Postal Code
6021
Country
New Zealand
Facility Name
Site 1002
City
Kraków
ZIP/Postal Code
31-121
Country
Poland
Facility Name
Site 1101
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Site 1102
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Site 1103
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Site 1201
City
Ljubljana
ZIP/Postal Code
1000
Country
Slovenia
Facility Name
Site 1303
City
A Coruña
ZIP/Postal Code
15006
Country
Spain
Facility Name
Site 1301
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Site 1304
City
Bilbao
ZIP/Postal Code
48013
Country
Spain
Facility Name
Site 1302
City
Santa Cruz De Tenerife
ZIP/Postal Code
38320
Country
Spain
Facility Name
Site 1604
City
Edinburgh
ZIP/Postal Code
EH4 2XU
Country
United Kingdom
Facility Name
Site 1603
City
Essex
ZIP/Postal Code
SS0 0RY
Country
United Kingdom
Facility Name
Site 1602
City
London
ZIP/Postal Code
E11 1NR
Country
United Kingdom
Facility Name
Site 1601
City
Newcastle Upon Tyne
ZIP/Postal Code
NE7 7DN
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35264321
Citation
Cid MC, Unizony SH, Blockmans D, Brouwer E, Dagna L, Dasgupta B, Hellmich B, Molloy E, Salvarani C, Trapnell BC, Warrington KJ, Wicks I, Samant M, Zhou T, Pupim L, Paolini JF; KPL-301-C001 Investigators. Efficacy and safety of mavrilimumab in giant cell arteritis: a phase 2, randomised, double-blind, placebo-controlled trial. Ann Rheum Dis. 2022 May;81(5):653-661. doi: 10.1136/annrheumdis-2021-221865. Epub 2022 Mar 9.
Results Reference
derived

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KPL-301 for Subjects With Giant Cell Arteritis

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