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Clinical Trial of BCD-148 and Soliris® for the Treatment of Patients With Paroxysmal Nocturnal Hemoglobinuria

Primary Purpose

Paroxysmal Nocturnal Hemoglobinuria

Status
Completed
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
BCD-148
Soliris
Sponsored by
Biocad
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Paroxysmal Nocturnal Hemoglobinuria

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. He/she gave written informed consent.
  2. Male or female ≥18 and ≤65 years of age.
  3. PNH diagnosis documented by flow cytometry data at screening .
  4. PNH granulocyte clone size ≥10% (according to flow cytometry performed at screening).
  5. Lactate dehydrogenase (LDH) level ≥1.5 times the upper limit of normal (ULN) at screening and at least one of the following symptoms/syndromes: hemoglobinuria, thrombotic complications, transfusion-dependent chronic hemolysis, anemic syndrome, acute kidney injury episodes or chronic kidney disease, pulmonary hypertension, and signs of smooth muscle dystonia (e.g., abdominal pain, dysphagia, erectile dysfunction, and etc.) within three months before informed consent.
  6. Platelet count ≥30х109/L at screening.
  7. Absolute count of neutrophil granulocytes ≥0.75х109/L at screening.
  8. Willingness to undergo vaccination against Neisseria meningitidis during the screening period and at least 14 days before the first administration of an investigational product .
  9. If immunosuppressive drug products are used, the duration of this therapy should be at least three months by informed consent date.
  10. The willingness of patients and their sexual partners of childbearing potential to use reliable contraception methods starting from the informed consent, throughout the study, and for four weeks after the last dose of an investigational product. This requirement does not apply to patients who underwent surgical sterilization and women with menopause established more than two years ago. Reliable contraception methods include one barrier method in combination with one of the following: spermicides or an intrauterine device.
  11. The patient is able, in the Investigator's opinion, to follow study procedures.

Exclusion Criteria:

  1. History of meningococcal infection (either well-documented or according to oral information provided by a patient).
  2. Other well-documented complement deficiencies (except for those concerning complement component 5).
  3. History of bone marrow transplantation (either well-documented or according to oral information provided by a patient).
  4. HIV, hepatitis B, active hepatitis C, and syphilis .
  5. A patient with newly diagnosed or relapsing aplastic anemia and/or progressive bone marrow failure with indications for allogeneic bone marrow transplantation or combined immunosuppressive therapy within 6 months after informed consent.
  6. Acute infection (either well-documented and/or according to oral information provided by a patient) within 4 weeks before informed consent and/or during the screening period and/or relapse of chronic disease at the moment of informed consent and/or during the screening period .
  7. Any other chronic diseases present at the time of the informed consent which can negatively affect the patient's safety during the study, in the Investigator' opinion.
  8. Use of eculizumab and/other anti-C5 monoclonal antibodies within three months before informed consent .
  9. Hypersensitivity to any of BCD-148/Soliris® ingredients, murine proteins and other ingredients of these drug products, and to any of meningococcal vaccine ingredients.
  10. Documented malignancy, except for cured basal cell carcinoma or cervical carcinoma in situ .
  11. A known alcoholic or drug abuse or signs of present alcoholic/drug abuse that, in the Investigator's opinion, can be a contraindication to treatment with an investigational product or limit treatment compliance.
  12. Participation in other clinical studies within 30 days before informed consent and during this study.
  13. Pregnancy or lactation or planning for pregnancy/paternity during the clinical study.

Sites / Locations

  • Federal State Budgetary Educational Institution of Higher Education "Academician I.P. Pavlov First St. Petersburg State Medical University" of the Ministry of Healthcare of Russian Federation

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

BCD-148

Soliris

Arm Description

14 participants in BCD-148 group. During the main period (first 27 weeks), test product BCD-148 will be administered as 25- to 45-minute intravenous infusions. After Week 27 BCD-148 900 mg will be administered biweekly as maintenance therapy.

14 participants in Soliris group. During the main period (first 27 weeks), Soliris® will be administered as 25- to 45-minute intravenous infusions. After Week 27, patients be switched to BCD-148 900 mg biweekly as maintenance therapy.

Outcomes

Primary Outcome Measures

AUC LDH
AUC - Area Under Curve of Lactate dehydrogenase

Secondary Outcome Measures

The proportion of patients with thrombotic complications
The proportion of patients who required red blood cell transfusion
The proportion of patients with stable Hb level during the maintenance therapy period
Mean Hb level over the maintenance therapy period
Frequency of breakthrough hemolysis episodes
Changes in LDH level over time
Change in the count of circulating red blood cells with the PNH phenotype RBC
Red blood cells (RBC )
Change in mean FACIT-Fatigue score
FACIT Fatigue Scale is a short, 13-item, easy to administer tool that measures an individual's level of fatigue during their usual daily activities over the past week. The level of fatigue is measured on a four point Likert scale (4 = not at all fatigued to 0 = very much fatigued)
Change in mean EORTC QLQ-C30 score
EORTC QLQ-C30 is questionnaire developed to assess the quality of life. All of the scales and single-item measures range in score from 0 to 100. Higher score for the functioning scales and global health status denote a better level of functioning (i.e. a better state of the patient), while higher scores on the symptom and single-item scales indicate a higher level of symptoms (i.e. a worse state of the patient). QLQ - Quality of Life Questionnaire
The proportion of patients with AE/SAE related to an investigational product, in the Investigator's opinion
AE - adverse event, SAE - serious adverse event
The proportion of patients with СТСАЕ v.5.0 Grade 3-4 AE related to an investigational product, in the Investigator's opinion, by arm
The proportion of patients who discontinued early due to AE/SAE related to an investigational product, in the Investigator's opinion, by arm
The proportion of BAb- and NAb-positive patients.
BAb - Binding antibodies, NAb - neutralizing antibodies

Full Information

First Posted
August 13, 2019
Last Updated
February 11, 2021
Sponsor
Biocad
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1. Study Identification

Unique Protocol Identification Number
NCT04060264
Brief Title
Clinical Trial of BCD-148 and Soliris® for the Treatment of Patients With Paroxysmal Nocturnal Hemoglobinuria
Official Title
Randomized, Open-Label, International, Multi-center, Comparative Study of Efficacy and Safety of BCD-148 (JSC BIOCAD, Russia) and Soliris® in Patients With Paroxysmal Nocturnal Hemoglobinuria
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Completed
Study Start Date
April 4, 2019 (Actual)
Primary Completion Date
April 27, 2020 (Actual)
Study Completion Date
December 30, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Biocad

4. Oversight

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

5. Study Description

Brief Summary
This clinical study is a randomized, open-label, international, multi-center, comparative study of efficacy and safety of BCD-148 and Soliris® in PNH patients. It is planned to investigate the efficacy, safety, and immunogenicity of one-year eculizumab course in this study. PNH - Paroxysmal nocturnal hemoglobinuria

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Paroxysmal Nocturnal Hemoglobinuria

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
During the main period (first 27 weeks), test product BCD-148 and reference product Soliris®. After Week 27, patients of both study arms will be switched to BCD-148 900 mg biweekly as maintenance therapy. Duration of this maintenance therapy will be 25 weeks.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
28 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BCD-148
Arm Type
Experimental
Arm Description
14 participants in BCD-148 group. During the main period (first 27 weeks), test product BCD-148 will be administered as 25- to 45-minute intravenous infusions. After Week 27 BCD-148 900 mg will be administered biweekly as maintenance therapy.
Arm Title
Soliris
Arm Type
Active Comparator
Arm Description
14 participants in Soliris group. During the main period (first 27 weeks), Soliris® will be administered as 25- to 45-minute intravenous infusions. After Week 27, patients be switched to BCD-148 900 mg biweekly as maintenance therapy.
Intervention Type
Biological
Intervention Name(s)
BCD-148
Intervention Description
Active substance of BCD-148 is eculizumab - a monoclonal antibody that targets complement protein C5. Cycle 1 (induction therapy): 600 mg of eculizumab QW for the first four weeks; Cycle 2 (maintenance therapy): 900 mg of eculizumab at Week 5 and 900 mg of eculizumab every 14±2 days until Week 27 (inclusive) afterwards (dosing regimen for the main study period). QW - once weekly
Intervention Type
Biological
Intervention Name(s)
Soliris
Intervention Description
Active substance of Soliris is eculizumab - a monoclonal antibody that targets complement protein C5. Cycle 1 (induction therapy): 600 mg of eculizumab QW for the first four weeks; Cycle 2 (maintenance therapy): 900 mg of eculizumab at Week 5 and 900 mg of eculizumab every 14±2 days until Week 27 (inclusive) afterwards (dosing regimen for the main study period).
Primary Outcome Measure Information:
Title
AUC LDH
Description
AUC - Area Under Curve of Lactate dehydrogenase
Time Frame
Weeks 5-27
Secondary Outcome Measure Information:
Title
The proportion of patients with thrombotic complications
Time Frame
week 27, week 52
Title
The proportion of patients who required red blood cell transfusion
Time Frame
week 27, week 52
Title
The proportion of patients with stable Hb level during the maintenance therapy period
Time Frame
Weeks 5-27
Title
Mean Hb level over the maintenance therapy period
Time Frame
Weeks 5-27
Title
Frequency of breakthrough hemolysis episodes
Time Frame
week 27, week 52
Title
Changes in LDH level over time
Time Frame
week 27, week 52
Title
Change in the count of circulating red blood cells with the PNH phenotype RBC
Description
Red blood cells (RBC )
Time Frame
week 27, week 52
Title
Change in mean FACIT-Fatigue score
Description
FACIT Fatigue Scale is a short, 13-item, easy to administer tool that measures an individual's level of fatigue during their usual daily activities over the past week. The level of fatigue is measured on a four point Likert scale (4 = not at all fatigued to 0 = very much fatigued)
Time Frame
week 27, week 52
Title
Change in mean EORTC QLQ-C30 score
Description
EORTC QLQ-C30 is questionnaire developed to assess the quality of life. All of the scales and single-item measures range in score from 0 to 100. Higher score for the functioning scales and global health status denote a better level of functioning (i.e. a better state of the patient), while higher scores on the symptom and single-item scales indicate a higher level of symptoms (i.e. a worse state of the patient). QLQ - Quality of Life Questionnaire
Time Frame
week 27, week 52
Title
The proportion of patients with AE/SAE related to an investigational product, in the Investigator's opinion
Description
AE - adverse event, SAE - serious adverse event
Time Frame
week 27, week 52
Title
The proportion of patients with СТСАЕ v.5.0 Grade 3-4 AE related to an investigational product, in the Investigator's opinion, by arm
Time Frame
week 27, week 52
Title
The proportion of patients who discontinued early due to AE/SAE related to an investigational product, in the Investigator's opinion, by arm
Time Frame
week 27, week 52
Title
The proportion of BAb- and NAb-positive patients.
Description
BAb - Binding antibodies, NAb - neutralizing antibodies
Time Frame
week 27, week 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: He/she gave written informed consent. Male or female ≥18 and ≤65 years of age. PNH diagnosis documented by flow cytometry data at screening . PNH granulocyte clone size ≥10% (according to flow cytometry performed at screening). Lactate dehydrogenase (LDH) level ≥1.5 times the upper limit of normal (ULN) at screening and at least one of the following symptoms/syndromes: hemoglobinuria, thrombotic complications, transfusion-dependent chronic hemolysis, anemic syndrome, acute kidney injury episodes or chronic kidney disease, pulmonary hypertension, and signs of smooth muscle dystonia (e.g., abdominal pain, dysphagia, erectile dysfunction, and etc.) within three months before informed consent. Platelet count ≥30х109/L at screening. Absolute count of neutrophil granulocytes ≥0.75х109/L at screening. Willingness to undergo vaccination against Neisseria meningitidis during the screening period and at least 14 days before the first administration of an investigational product . If immunosuppressive drug products are used, the duration of this therapy should be at least three months by informed consent date. The willingness of patients and their sexual partners of childbearing potential to use reliable contraception methods starting from the informed consent, throughout the study, and for four weeks after the last dose of an investigational product. This requirement does not apply to patients who underwent surgical sterilization and women with menopause established more than two years ago. Reliable contraception methods include one barrier method in combination with one of the following: spermicides or an intrauterine device. The patient is able, in the Investigator's opinion, to follow study procedures. Exclusion Criteria: History of meningococcal infection (either well-documented or according to oral information provided by a patient). Other well-documented complement deficiencies (except for those concerning complement component 5). History of bone marrow transplantation (either well-documented or according to oral information provided by a patient). HIV, hepatitis B, active hepatitis C, and syphilis . A patient with newly diagnosed or relapsing aplastic anemia and/or progressive bone marrow failure with indications for allogeneic bone marrow transplantation or combined immunosuppressive therapy within 6 months after informed consent. Acute infection (either well-documented and/or according to oral information provided by a patient) within 4 weeks before informed consent and/or during the screening period and/or relapse of chronic disease at the moment of informed consent and/or during the screening period . Any other chronic diseases present at the time of the informed consent which can negatively affect the patient's safety during the study, in the Investigator' opinion. Use of eculizumab and/other anti-C5 monoclonal antibodies within three months before informed consent . Hypersensitivity to any of BCD-148/Soliris® ingredients, murine proteins and other ingredients of these drug products, and to any of meningococcal vaccine ingredients. Documented malignancy, except for cured basal cell carcinoma or cervical carcinoma in situ . A known alcoholic or drug abuse or signs of present alcoholic/drug abuse that, in the Investigator's opinion, can be a contraindication to treatment with an investigational product or limit treatment compliance. Participation in other clinical studies within 30 days before informed consent and during this study. Pregnancy or lactation or planning for pregnancy/paternity during the clinical study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roman Ivanov, PhD
Organizational Affiliation
JSC BIOCAD
Official's Role
Study Chair
Facility Information:
Facility Name
Federal State Budgetary Educational Institution of Higher Education "Academician I.P. Pavlov First St. Petersburg State Medical University" of the Ministry of Healthcare of Russian Federation
City
Saint Petersburg
Country
Russian Federation

12. IPD Sharing Statement

Learn more about this trial

Clinical Trial of BCD-148 and Soliris® for the Treatment of Patients With Paroxysmal Nocturnal Hemoglobinuria

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