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Efficacy and Safety of GNR-038 vs Berinert® in Patients With Hereditary Angioedema

Primary Purpose

Hereditary Angioedema

Status
Withdrawn
Phase
Phase 2
Locations
Russian Federation
Study Type
Interventional
Intervention
GNR-038, 50 МЕ/ kg
GNR-038, 100 МЕ/ kg
Berinert®, 20 МЕ/ kg
Placebo
GNR-038. The dose will be selected according to results of stage 1 clinical trial.
Berinert®, 20 МЕ/ kg
Sponsored by
AO GENERIUM
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hereditary Angioedema focused on measuring Hereditary angioedema, Swelling, GNR-038, C1-inhibitor, Mutation, SERPING1 gene, HAE, Genetic disease, C1-INH deficiency, Hypersensitivity, Immune System Diseases, Genetic Diseases, Inborn, Immunologic Factors, Physiological Effects of Drugs, Complement Inactivating Agents, Immunosuppressive Agents, Angioedema, Angioedemas, Hereditary, Complement C1 Inhibitor Protein, Complement C1 Inactivator Proteins

Eligibility Criteria

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

Inclusion Criteria

  1. Men and women 18 years and older at the time of signing the Informed Consent Form.
  2. Availability of written informed consent signed by the patient prior to the start of any procedures related to the study.
  3. Confirmed diagnosis of HAE:

    • C4 level <50% of the lower limit of the range of normal laboratory values and one of the points below:
    • the C1INH level <50% of the lower limit of the range of normal laboratory values, OR
    • the level of C1INH within normal values, while the level of functional activity of C1INH is below 50% of the lower limit of the range of normal values.
  4. Localization of the edema in the abdominal cavity, in the face area (lips, eyelids, subcutaneous tissue), limbs, trunk or in the area of the external genitals in the anamnesis.
  5. ≥4 HAE attacks requiring treatment or causing significant functional impairment for 2 consecutive months in the 3-month period prior to Screening, properly documented in the medical records.
  6. Patient's consent to adhere to reliable methods of contraception.

Exclusion Criteria

  1. Deviation of the C1q level below the normal limit.
  2. B-cell lymphoproliferative diseases in the anamnesis or at the time of inclusion in clinical trial.
  3. The presence of anti-C1INH autoantibodies.
  4. Allergic reactions to the components of C1INH drugs or other blood components.
  5. Glomerular filtration rate ≤59 ml/min/1.73 m2, calculated by the formula CKD-EPI Creatinine Equation (2009) (see Appendix).
  6. The concentration of peripheral blood leukocytes >20*109/L.
  7. Drug addiction, solvent abuse, alcoholism in the anamnesis or at the time of inclusion.
  8. Participation in clinical trials of C1-esterase inhibitor drugs, blood transfusion and its components during the last 90 days prior to screening.
  9. Participation in clinical trials of any other investigational drugs within the last 30 (thirty) days prior to screening.
  10. Positive laboratory results for HIV and hepatitis B and C.
  11. Pregnancy and lactation.
  12. Diseases and conditions associated with thrombosis (myocardial infarction, transient ischemic attacks, deep and superficial vein thrombosis, and pulmonary embolism) less than 6 months before the start of the screening period, as well as an increased risk of arterial or venous thrombosis according to the study doctor's opinion.
  13. Concomitant diseases and conditions that according to the study doctor's opinion put the patient's safety at risk when participating in the study, or that will affect the analysis of safety data if this disease/condition worsens during the study, including:

    • Mental illness;
    • Diseases of the immune and endocrine system that are not controlled by drug therapy (including decompensated diabetes mellitus and thyroid diseases);
    • Hematological diseases requiring chemotherapy;
    • Cancer or cancer in the past medical history, with the exception of cured basal cell carcinoma;
    • Decompensated liver diseases.

Sites / Locations

  • National Research Center - Institute of Immunology Federal Medical-Biological Agency of Russia
  • Moscow City Clinical Hospital 52
  • Federal State Budgetary Scientific Institution Research Institute of Fundamental and Clinical Immunology
  • Rostov State Medical University
  • LLC "Scientific Medical Center of General Therapy and Pharmacology"

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Study stage 1: GNR-038, 50 МЕ/ kg

Study stage 1: GNR-038, 100 МЕ/ kg

Study stage 1: Berinert®, 20 МЕ/ kg

Study stage 1: Placebo

Study stage 2: GNR-038 in selected dose

Study stage 2: Berinert®, 20 МЕ/ kg

Arm Description

Recombinant C1 esterase inhibitor

Recombinant C1 esterase inhibitor

Human C1 esterase inhibitor

Placebo

Recombinant C1 esterase inhibitor

Human C1 esterase inhibitor

Outcomes

Primary Outcome Measures

Time to symptoms relief onset of acute HAE attack within 24 hours after the end of the drug administration.
A persistent decrease in the intensity of symptoms by 20 mm from the initial level on the visual analogue scale (VAS) will be regarded as a relief of symptoms of HAE. 0 mm is the absence of symptoms, 100 mm is the maximum possible intensity of symptoms

Secondary Outcome Measures

Time to complete resolution of the symptoms of an acute HAE attack within 24 hours after the end of the study drug administration.
Persistent absence of symptoms - 0 (zero) mm on the visual analogue scale (VAS). 0 mm is the absence of symptoms, 100 mm is the maximum possible intensity of symptoms
Time to minimum manifestation onset of acute HAE attack symptoms after the completion of study drug administration.
Persistent reduction in the intensity of symptoms below 20 (twenty) mm on the visual analogue scale(VAS). 0 mm is the absence of symptoms, 100 mm is the maximum possible intensity of symptoms
The proportion of HAE exacerbation episodes that achieved symptom relief after 1 hour and 4 (four) hours after the end of study drug administration.
The rate of attacks with HAE current localization relapse or with the occurrence of a new acute attack of a different localization within 24 (twenty-four) hours after the study drug administration.
The rate of attacks that required additional administration of emergency drugs (human C1-esterase inhibitor or icatibant).
The rate of attacks that did not respond therapeutically to the study drug administration
the lack of relief of HAE symptoms within 4 (four) hours after administration of the drug, the occurrence of a relapse of HAE of the current localization or the occurrence of a new acute attack of another localization within 24 (twenty-four) hours after drug administration, the need to use drugs that can weaken the symptoms of HAE (see drugs that are not recommended to treatment), within 24 (twenty-four) hours after drug administration.
The intensity of acute HAE attack symptoms within 24 (twenty-four) hours after study drug administration.
HAE intensity wiil be measured by visual analogue scale (VAS). 0 mm is the absence of symptoms, 100 mm is the maximum possible intensity of symptoms
Frequency of adverse events.
Frequency of anti-drug antibody formation.
The level of anti-drug antibodies neutralizing activity.
Laboratory measurement of antidrug antibody with neutralixing activity.

Full Information

First Posted
May 18, 2021
Last Updated
January 21, 2022
Sponsor
AO GENERIUM
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1. Study Identification

Unique Protocol Identification Number
NCT04898309
Brief Title
Efficacy and Safety of GNR-038 vs Berinert® in Patients With Hereditary Angioedema
Official Title
A Placebo-controlled Randomized Trial to Evaluate the Efficacy and Safety of GNR-038 in Comparison With Berinert® for Acute Attacks Relief in Patients With Hereditary Angioedema
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Withdrawn
Why Stopped
Company pipeline revision
Study Start Date
December 1, 2021 (Anticipated)
Primary Completion Date
May 31, 2023 (Anticipated)
Study Completion Date
May 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AO GENERIUM

4. Oversight

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

5. Study Description

Brief Summary
It is a placebo-controlled randomized trial to evaluate the efficacy and safety of GNR-038 in comparison with Berinert® in patients with hereditary angioedema
Detailed Description
Hereditary angioedema is a rare, potentially life-threatening genetically determined disease associated with a deficiency or impairment of the functional activity of the C1-esterase inhibitor (C1-inhibitor). The main clinical manifestation of hereditary angioedema is recurrent subcutaneous or submucosal swelling of various localization. Most often, the development of the disease is based on a mutation in the SERPING1 gene. The prevalence of the disease in the world ranges from 1:10 000 to 1:150 000. GNR-038 is a recombinant C1 inhibitor (rhC1INH), which is a complete structural and functional analog of the plasma C1 inhibitor. Phase I study results showed convincing safety and tolerability evidence of GNR-038.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hereditary Angioedema
Keywords
Hereditary angioedema, Swelling, GNR-038, C1-inhibitor, Mutation, SERPING1 gene, HAE, Genetic disease, C1-INH deficiency, Hypersensitivity, Immune System Diseases, Genetic Diseases, Inborn, Immunologic Factors, Physiological Effects of Drugs, Complement Inactivating Agents, Immunosuppressive Agents, Angioedema, Angioedemas, Hereditary, Complement C1 Inhibitor Protein, Complement C1 Inactivator Proteins

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Two-stage study. In the first stage - 4 groups are presented. At the second stage - 2 study groups 200 HAE attacks to be randomized in 50 patients
Masking
ParticipantInvestigator
Masking Description
At the first stage - the study will be blinded, at the second stage - open-label
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Study stage 1: GNR-038, 50 МЕ/ kg
Arm Type
Experimental
Arm Description
Recombinant C1 esterase inhibitor
Arm Title
Study stage 1: GNR-038, 100 МЕ/ kg
Arm Type
Experimental
Arm Description
Recombinant C1 esterase inhibitor
Arm Title
Study stage 1: Berinert®, 20 МЕ/ kg
Arm Type
Experimental
Arm Description
Human C1 esterase inhibitor
Arm Title
Study stage 1: Placebo
Arm Type
Experimental
Arm Description
Placebo
Arm Title
Study stage 2: GNR-038 in selected dose
Arm Type
Experimental
Arm Description
Recombinant C1 esterase inhibitor
Arm Title
Study stage 2: Berinert®, 20 МЕ/ kg
Arm Type
Experimental
Arm Description
Human C1 esterase inhibitor
Intervention Type
Drug
Intervention Name(s)
GNR-038, 50 МЕ/ kg
Other Intervention Name(s)
Recombinant C1 esterase inhibitor, 50 МЕ/ kg
Intervention Description
A single intravenous infusion of GNR-038, 50 МЕ/ kg less than 5 hours after the onset of edema.
Intervention Type
Drug
Intervention Name(s)
GNR-038, 100 МЕ/ kg
Other Intervention Name(s)
Recombinant C1 esterase inhibitor, 100 МЕ/ kg
Intervention Description
A single intravenous infusion of GNR-038, 100 МЕ/ kg less than 5 hours after the onset of edema.
Intervention Type
Drug
Intervention Name(s)
Berinert®, 20 МЕ/ kg
Other Intervention Name(s)
Human C1 esterase inhibitor
Intervention Description
A single intravenous infusion of Berinert®, 20 МЕ/ kg less than 5 hours after the onset of edema.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
A single intravenous infusion of Placebo less than 5 hours after the onset of edema.
Intervention Type
Drug
Intervention Name(s)
GNR-038. The dose will be selected according to results of stage 1 clinical trial.
Other Intervention Name(s)
Recombinant C1 esterase inhibitor.
Intervention Description
A single intravenous infusion of GNR-038 less than 5 hours after the onset of edema.
Intervention Type
Drug
Intervention Name(s)
Berinert®, 20 МЕ/ kg
Other Intervention Name(s)
Human C1 esterase inhibitor
Intervention Description
A single intravenous infusion of Berinert®, 20 МЕ/ kg less than 5 hours after the onset of edema.
Primary Outcome Measure Information:
Title
Time to symptoms relief onset of acute HAE attack within 24 hours after the end of the drug administration.
Description
A persistent decrease in the intensity of symptoms by 20 mm from the initial level on the visual analogue scale (VAS) will be regarded as a relief of symptoms of HAE. 0 mm is the absence of symptoms, 100 mm is the maximum possible intensity of symptoms
Time Frame
24 hours
Secondary Outcome Measure Information:
Title
Time to complete resolution of the symptoms of an acute HAE attack within 24 hours after the end of the study drug administration.
Description
Persistent absence of symptoms - 0 (zero) mm on the visual analogue scale (VAS). 0 mm is the absence of symptoms, 100 mm is the maximum possible intensity of symptoms
Time Frame
24 hours
Title
Time to minimum manifestation onset of acute HAE attack symptoms after the completion of study drug administration.
Description
Persistent reduction in the intensity of symptoms below 20 (twenty) mm on the visual analogue scale(VAS). 0 mm is the absence of symptoms, 100 mm is the maximum possible intensity of symptoms
Time Frame
24 hours
Title
The proportion of HAE exacerbation episodes that achieved symptom relief after 1 hour and 4 (four) hours after the end of study drug administration.
Time Frame
1 hour; 4 hours.
Title
The rate of attacks with HAE current localization relapse or with the occurrence of a new acute attack of a different localization within 24 (twenty-four) hours after the study drug administration.
Time Frame
24 hours
Title
The rate of attacks that required additional administration of emergency drugs (human C1-esterase inhibitor or icatibant).
Time Frame
24 hours
Title
The rate of attacks that did not respond therapeutically to the study drug administration
Description
the lack of relief of HAE symptoms within 4 (four) hours after administration of the drug, the occurrence of a relapse of HAE of the current localization or the occurrence of a new acute attack of another localization within 24 (twenty-four) hours after drug administration, the need to use drugs that can weaken the symptoms of HAE (see drugs that are not recommended to treatment), within 24 (twenty-four) hours after drug administration.
Time Frame
4 hours; 24 hours
Title
The intensity of acute HAE attack symptoms within 24 (twenty-four) hours after study drug administration.
Description
HAE intensity wiil be measured by visual analogue scale (VAS). 0 mm is the absence of symptoms, 100 mm is the maximum possible intensity of symptoms
Time Frame
24 hours
Title
Frequency of adverse events.
Time Frame
14 days
Title
Frequency of anti-drug antibody formation.
Time Frame
7 and 14 days
Title
The level of anti-drug antibodies neutralizing activity.
Description
Laboratory measurement of antidrug antibody with neutralixing activity.
Time Frame
7 and 14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Men and women 18 years and older at the time of signing the Informed Consent Form. Availability of written informed consent signed by the patient prior to the start of any procedures related to the study. Confirmed diagnosis of HAE: C4 level <50% of the lower limit of the range of normal laboratory values and one of the points below: the C1INH level <50% of the lower limit of the range of normal laboratory values, OR the level of C1INH within normal values, while the level of functional activity of C1INH is below 50% of the lower limit of the range of normal values. Localization of the edema in the abdominal cavity, in the face area (lips, eyelids, subcutaneous tissue), limbs, trunk or in the area of the external genitals in the anamnesis. ≥4 HAE attacks requiring treatment or causing significant functional impairment for 2 consecutive months in the 3-month period prior to Screening, properly documented in the medical records. Patient's consent to adhere to reliable methods of contraception. Exclusion Criteria Deviation of the C1q level below the normal limit. B-cell lymphoproliferative diseases in the anamnesis or at the time of inclusion in clinical trial. The presence of anti-C1INH autoantibodies. Allergic reactions to the components of C1INH drugs or other blood components. Glomerular filtration rate ≤59 ml/min/1.73 m2, calculated by the formula CKD-EPI Creatinine Equation (2009) (see Appendix). The concentration of peripheral blood leukocytes >20*109/L. Drug addiction, solvent abuse, alcoholism in the anamnesis or at the time of inclusion. Participation in clinical trials of C1-esterase inhibitor drugs, blood transfusion and its components during the last 90 days prior to screening. Participation in clinical trials of any other investigational drugs within the last 30 (thirty) days prior to screening. Positive laboratory results for HIV and hepatitis B and C. Pregnancy and lactation. Diseases and conditions associated with thrombosis (myocardial infarction, transient ischemic attacks, deep and superficial vein thrombosis, and pulmonary embolism) less than 6 months before the start of the screening period, as well as an increased risk of arterial or venous thrombosis according to the study doctor's opinion. Concomitant diseases and conditions that according to the study doctor's opinion put the patient's safety at risk when participating in the study, or that will affect the analysis of safety data if this disease/condition worsens during the study, including: Mental illness; Diseases of the immune and endocrine system that are not controlled by drug therapy (including decompensated diabetes mellitus and thyroid diseases); Hematological diseases requiring chemotherapy; Cancer or cancer in the past medical history, with the exception of cured basal cell carcinoma; Decompensated liver diseases.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Oksana A. Markova, MD
Organizational Affiliation
AO GENERIUM
Official's Role
Study Chair
Facility Information:
Facility Name
National Research Center - Institute of Immunology Federal Medical-Biological Agency of Russia
City
Moscow
ZIP/Postal Code
115522
Country
Russian Federation
Facility Name
Moscow City Clinical Hospital 52
City
Moscow
ZIP/Postal Code
123182
Country
Russian Federation
Facility Name
Federal State Budgetary Scientific Institution Research Institute of Fundamental and Clinical Immunology
City
Moscow
ZIP/Postal Code
630099
Country
Russian Federation
Facility Name
Rostov State Medical University
City
Rostov-on-Don
ZIP/Postal Code
344022
Country
Russian Federation
Facility Name
LLC "Scientific Medical Center of General Therapy and Pharmacology"
City
Stavropol'
ZIP/Postal Code
355000
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://grls.rosminzdrav.ru/CIPermissionMini.aspx?CIStatementGUID=fdafdfaf-8475-4d3e-810a-e18d4fc64236&CIPermGUID=AEE75E93-3F3E-4A76-8EB1-B57F8C5A48C0
Description
Clinical trial registry, Ministry of Health of Russian Federation
URL
https://clinline.ru/reestr-klinicheskih-issledovanij/210-16.04.2021.html
Description
Clinical trial registry

Learn more about this trial

Efficacy and Safety of GNR-038 vs Berinert® in Patients With Hereditary Angioedema

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