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A Phase 2 Study of KZR-616 to Evaluate Safety and Efficacy in Patients With Active Polymyositis or Dermatomyositis (PRESIDIO)

Primary Purpose

Polymyositis, Dermatomyositis

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
KZR-616
Placebo
Sponsored by
Kezar Life Sciences, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Polymyositis focused on measuring Myositis, Idiopathic inflammatory myopathies, Polymyositis, Dermatomyositis, Musculoskeletal Diseases, Muscular Diseases

Eligibility Criteria

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

Inclusion Criteria:

  1. Adult patients at least 18 years of age
  2. Body Mass Index (BMI) of 18 to 40 kg/m2
  3. Diagnosis of probable or definite DM or PM
  4. Must confirm eligibility unless at least 1 of the following is present:

    1. Muscle biopsy with evidence of active myositis within the last 6 months prior to or at Screening
    2. Electromyography or magnetic resonance imaging with evidence of active myositis within the last 6 months prior to Screening
    3. A creatine kinase (CK) ≥4 × upper limit of normal (ULN).
  5. Must have demonstrable muscle weakness as measured by the Manual Muscle Testing-8 muscle Groups (MMT-8) with a score ≥80/150 but ≤136/150 units and any 2 of the following:

    1. Physician Global Assessment (MDGA) visual analog scale (VAS) ≥2 cm
    2. Patient Global Assessment of Disease Activity (PtGADA) VAS ≥2 cm
    3. At least one muscle enzyme laboratory measurement ≥1.3 × ULN
    4. Myositis Disease Activity Assessment Tool (MDAAT) Extramuscular Global Activity VAS ≥1 cm.
  6. Documented inadequate response OR have demonstrated documented toxicity or intolerance to prior standard of care therapies
  7. Has had age-appropriate cancer screening that is up to date and negative for evidence of malignancy as per local standard of care

Exclusion Criteria:

  1. Has significant muscle damage or has a muscle damage VAS score ≥5 cm on the MDI
  2. Any other form of myositis or myopathy other than PM or DM
  3. Any condition that precludes the ability to quantitate muscle strength
  4. Has severe interstitial lung disease or has a pulmonary damage VAS score ≥5 cm on the Myositis Damage Index (MDI)
  5. Presence of autoinflammatory disease
  6. Use of nonpermitted medications or treatments within the specified washout periods prior to screening
  7. Patient has had recent serious or ongoing infection, or risk for serious infection
  8. Any of the following laboratory values at Screening:

    1. Estimated glomerular filtration rate <45 mL/min
    2. Hemoglobin <10 g/dL
    3. White blood cell (WBC) count <3.0 × 109/L
    4. Absolute neutrophil count (ANC) <1.5 × 109/L (1500/mm3)
    5. Platelet count <100 × 109/L
    6. Serum AST or serum ALT >2.5 × ULN (unless considered consistent with muscle origin)
    7. Serum alkaline phosphatase >2.5 × ULN
    8. Total bilirubin >1.5 × ULN (3 × ULN for patients with documented Gilbert's syndrome)
    9. Thyroid stimulating hormone outside of the central laboratory normal range
    10. Immunoglobulin G (IgG) <500 mg/dL.
  9. Presence of New York Heart Association Class III or IV heart failure, or uncontrolled blood pressure, or prolonged QT interval
  10. Major surgery within 12 weeks before Screening or planned during the study period
  11. Clinical evidence of significant unstable or uncontrolled diseases
  12. Any active or suspected malignancy, including myeloproliferative or lymphoproliferative disorder, or history of documented malignancy within the last 5 years before Screening or within 3 years of diagnosis of myositis, except appropriately excised and cured cervical carcinoma in situ or basal or squamous cell carcinoma of the skin

Sites / Locations

  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site
  • KZR Research Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Other

Other

Arm Label

Arm A

Arm B

Arm Description

Treatment Period 1: KZR-616 30 mg SC weekly for 2 weeks, then 45 mg SC weekly for 14 weeks Treatment Period 2: Placebo SC weekly for 16 weeks

Treatment Period 1: Placebo SC weekly for 16 weeks Treatment Period 2: KZR-616 30 mg SC weekly for 2 weeks, then 45 mg SC weekly for 14 weeks

Outcomes

Primary Outcome Measures

Primary Outcome Measure
Mean change from start to end of KZR-616 treatment in the Total Improvement Score (TIS), which ranges from 0 to 100.

Secondary Outcome Measures

Proportion of patients with an increase ≥20 points on the TIS from start to end of KZR-616 treatment.
Proportion of patients from start to end of KZR-616 treatment meeting International Myositis Assessment and Clinical Studies Group (IMACS) Definition of Improvement (DOI).
Absolute change from start to end of KZR-616 treatment in the IMACS individual core set activity measures (CSAMs)
Percent change from start to end of KZR-616 treatment in the IMACS individual CSAMs
For patients with DM, the mean change from start to end of KZR-616 treatment in the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI)
For patients with DM, the mean change from start to end of KZR-616 treatment in the Peak Pruritus Numeric Rating Scale.
The Peak Pruritus Numeric Rating Scale ranges from a score of 0 to 10, with 0 representing no itch and 10 representing the worst itch imaginable during the worst moment within a 24-hour recall period.
Safety and tolerability of KZR-616 in patients with PM or DM as assessed by monitoring incidence and severity of adverse events (AEs)
Peak plasma concentration (Cmax) following KZR-616 injection
Time to peak plasma concentration (Tmax) following KZR-616 injection
Area under the plasma concentration versus time curve (AUC) following KZR-616 injection
Half life (T1/2) following KZR-616 injection

Full Information

First Posted
July 23, 2019
Last Updated
September 30, 2022
Sponsor
Kezar Life Sciences, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04033926
Brief Title
A Phase 2 Study of KZR-616 to Evaluate Safety and Efficacy in Patients With Active Polymyositis or Dermatomyositis
Acronym
PRESIDIO
Official Title
A Phase 2 Randomized, Double-blind, Placebo-controlled, Crossover Multicenter Study to Evaluate the Safety and Efficacy of KZR-616 in the Treatment of Patients With Active Polymyositis or Dermatomyositis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Completed
Study Start Date
January 14, 2020 (Actual)
Primary Completion Date
April 6, 2022 (Actual)
Study Completion Date
April 6, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kezar Life Sciences, Inc.

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 is a Phase 2 randomized, double-blind, placebo-controlled, crossover, multicenter study to evaluate the safety, tolerability, efficacy, Pharmacokinetics (PK) and Pharmacodynamics (PD) of treatment with KZR-616 in patients with active Polymyositis (PM) or Dermatomyositis (DM). Patients will be evaluated for eligibility during the Screening Period. Eligible patients will be randomized 1:1 to Arm A or Arm B of the study. During the 32-week treatment period, patients will receive study drug subcutaneously (SC) once weekly with 2 treatment periods of 16 weeks each. This study will be conducted on an outpatient basis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Polymyositis, Dermatomyositis
Keywords
Myositis, Idiopathic inflammatory myopathies, Polymyositis, Dermatomyositis, Musculoskeletal Diseases, Muscular Diseases

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A
Arm Type
Other
Arm Description
Treatment Period 1: KZR-616 30 mg SC weekly for 2 weeks, then 45 mg SC weekly for 14 weeks Treatment Period 2: Placebo SC weekly for 16 weeks
Arm Title
Arm B
Arm Type
Other
Arm Description
Treatment Period 1: Placebo SC weekly for 16 weeks Treatment Period 2: KZR-616 30 mg SC weekly for 2 weeks, then 45 mg SC weekly for 14 weeks
Intervention Type
Drug
Intervention Name(s)
KZR-616
Intervention Description
Subcutaneous 30 mg weekly for 2 weeks, then 45 mg weekly for 14 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Subcutaneous injection for 16 weeks
Primary Outcome Measure Information:
Title
Primary Outcome Measure
Description
Mean change from start to end of KZR-616 treatment in the Total Improvement Score (TIS), which ranges from 0 to 100.
Time Frame
From start to end of KZR-616 treatment for both sequence arms combined.
Secondary Outcome Measure Information:
Title
Proportion of patients with an increase ≥20 points on the TIS from start to end of KZR-616 treatment.
Time Frame
16 weeks
Title
Proportion of patients from start to end of KZR-616 treatment meeting International Myositis Assessment and Clinical Studies Group (IMACS) Definition of Improvement (DOI).
Time Frame
16 weeks
Title
Absolute change from start to end of KZR-616 treatment in the IMACS individual core set activity measures (CSAMs)
Time Frame
16 weeks
Title
Percent change from start to end of KZR-616 treatment in the IMACS individual CSAMs
Time Frame
16 weeks
Title
For patients with DM, the mean change from start to end of KZR-616 treatment in the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI)
Time Frame
16 weeks
Title
For patients with DM, the mean change from start to end of KZR-616 treatment in the Peak Pruritus Numeric Rating Scale.
Description
The Peak Pruritus Numeric Rating Scale ranges from a score of 0 to 10, with 0 representing no itch and 10 representing the worst itch imaginable during the worst moment within a 24-hour recall period.
Time Frame
16 weeks
Title
Safety and tolerability of KZR-616 in patients with PM or DM as assessed by monitoring incidence and severity of adverse events (AEs)
Time Frame
40 weeks
Title
Peak plasma concentration (Cmax) following KZR-616 injection
Time Frame
Day 1
Title
Time to peak plasma concentration (Tmax) following KZR-616 injection
Time Frame
Day 1
Title
Area under the plasma concentration versus time curve (AUC) following KZR-616 injection
Time Frame
Day 1
Title
Half life (T1/2) following KZR-616 injection
Time Frame
Day 1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult patients at least 18 years of age Body Mass Index (BMI) of 18 to 40 kg/m2 Diagnosis of probable or definite DM or PM Must confirm eligibility unless at least 1 of the following is present: Muscle biopsy with evidence of active myositis within the last 6 months prior to or at Screening Electromyography or magnetic resonance imaging with evidence of active myositis within the last 6 months prior to Screening A creatine kinase (CK) ≥4 × upper limit of normal (ULN). Must have demonstrable muscle weakness as measured by the Manual Muscle Testing-8 muscle Groups (MMT-8) with a score ≥80/150 but ≤136/150 units and any 2 of the following: Physician Global Assessment (MDGA) visual analog scale (VAS) ≥2 cm Patient Global Assessment of Disease Activity (PtGADA) VAS ≥2 cm At least one muscle enzyme laboratory measurement ≥1.3 × ULN Myositis Disease Activity Assessment Tool (MDAAT) Extramuscular Global Activity VAS ≥1 cm. Documented inadequate response OR have demonstrated documented toxicity or intolerance to prior standard of care therapies Has had age-appropriate cancer screening that is up to date and negative for evidence of malignancy as per local standard of care Exclusion Criteria: Has significant muscle damage or has a muscle damage VAS score ≥5 cm on the MDI Any other form of myositis or myopathy other than PM or DM Any condition that precludes the ability to quantitate muscle strength Has severe interstitial lung disease or has a pulmonary damage VAS score ≥5 cm on the Myositis Damage Index (MDI) Presence of autoinflammatory disease Use of nonpermitted medications or treatments within the specified washout periods prior to screening Patient has had recent serious or ongoing infection, or risk for serious infection Any of the following laboratory values at Screening: Estimated glomerular filtration rate <45 mL/min Hemoglobin <10 g/dL White blood cell (WBC) count <3.0 × 109/L Absolute neutrophil count (ANC) <1.5 × 109/L (1500/mm3) Platelet count <100 × 109/L Serum AST or serum ALT >2.5 × ULN (unless considered consistent with muscle origin) Serum alkaline phosphatase >2.5 × ULN Total bilirubin >1.5 × ULN (3 × ULN for patients with documented Gilbert's syndrome) Thyroid stimulating hormone outside of the central laboratory normal range Immunoglobulin G (IgG) <500 mg/dL. Presence of New York Heart Association Class III or IV heart failure, or uncontrolled blood pressure, or prolonged QT interval Major surgery within 12 weeks before Screening or planned during the study period Clinical evidence of significant unstable or uncontrolled diseases Any active or suspected malignancy, including myeloproliferative or lymphoproliferative disorder, or history of documented malignancy within the last 5 years before Screening or within 3 years of diagnosis of myositis, except appropriately excised and cured cervical carcinoma in situ or basal or squamous cell carcinoma of the skin
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kezar
Organizational Affiliation
Kezar Life Sciences, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
KZR Research Site
City
Beverly Hills
State/Province
California
ZIP/Postal Code
90211
Country
United States
Facility Name
KZR Research Site
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
KZR Research Site
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
KZR Research Site
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
KZR Research Site
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
KZR Research Site
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21224
Country
United States
Facility Name
KZR Research Site
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
KZR Research Site
City
Great Neck
State/Province
New York
ZIP/Postal Code
11021
Country
United States
Facility Name
KZR Research Site
City
Duncansville
State/Province
Pennsylvania
ZIP/Postal Code
16635
Country
United States
Facility Name
KZR Research Site
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
KZR Research Site
City
Austin
State/Province
Texas
ZIP/Postal Code
78756
Country
United States
Facility Name
KZR Research Site
City
Henrico
State/Province
Virginia
ZIP/Postal Code
23233
Country
United States
Facility Name
KZR Research Site
City
Prague
Country
Czechia
Facility Name
KZR Research Site
City
Göttingen
Country
Germany
Facility Name
KZR Research Site
City
Bydgoszcz
Country
Poland
Facility Name
KZR Research Site
City
Elbląg
Country
Poland
Facility Name
KZR Research Site
City
Kraków
Country
Poland
Facility Name
KZR Research Site
City
Szczecin
Country
Poland
Facility Name
KZR Research Site
City
Wrocław
Country
Poland

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase 2 Study of KZR-616 to Evaluate Safety and Efficacy in Patients With Active Polymyositis or Dermatomyositis

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