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A Study of Ianalumab (VAY736) in Patients With Primary Immune Thrombocytopenia (ITP) Previously Treated With at Least Two Lines of Therapies

Primary Purpose

Primary Immune Thrombocytopenia (ITP)

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Ianalumab
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Immune Thrombocytopenia (ITP) focused on measuring Primary immune thrombocytopenia (ITP), ianalumab, VAY736, B-cell depletion, B-cell Activating Factor Receptor (BAFF-R) blockade

Eligibility Criteria

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

Inclusion Criteria: Signed informed consent obtained prior to participation in the study. Male or female participants aged 18 years and older on the day of signing informed consent. Confirmed diagnosis of primary ITP. Prior treatment with at least a corticosteroid (±IVIG) and a TPO-RA: Prior additional therapies are allowed; the corticosteroid or the TPO-RA do not need to be the last treatment. Documented response to IVIG/anti-D or a corticosteroid that was not maintained. At last ITP treatment, loss of response, insufficient response, no response or intolerance. Platelet count <30 G/L and assessed as needing treatment (per physician's discretion) at screening. If concomitant ITP medication is clinically indicated, the platelet assessment showing a value <30 G/L must be performed after at least 14 days on a stable dose of a corticosteroid or/and a TPO-RA (less than 10% variation from current dose) and continue stable thereafter. Key exclusion criteria: Diagnosis of secondary thrombocytopenia. Platelet or whole blood transfusion, plasmapheresis, or use of any other rescue medications within 14 days before first ianalumab infusion. Neutrophils <1000/mm3 at screening. Treatment with a B-cell depleting therapy (e.g., rituximab) or anti-B-cell Activating Factor of the TNF Family (BAFF) (e.g., belimumab) within 12 weeks prior to the first administration of ianalumab. Immunosuppressant drugs other than corticosteroids within 5 times the elimination half-life of the drug or 14 days before first ianalumab infusion, whichever is longer. Prior splenectomy. Other protocol-defined inclusion/exclusion criteria may apply.

Sites / Locations

  • New York Oncology Hematology Saratoga NYOHRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting
  • Novartis Investigative SiteRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single-arm

Arm Description

All eligible participants will receive ianalumab at the same dose.

Outcomes

Primary Outcome Measures

Confirmed response
Confirmed response is defined as a platelet count of equal or above 50 G/L at two (or more) consecutive assessments at least 7 days apart, in the absence of: Rescue treatment for ≥4 weeks prior to the assessment of the platelet count, and New ITP treatment before reaching a confirmed response.

Secondary Outcome Measures

Time to confirmed response
Time from the first administration of ianalumab to the first assessment in the first sequence of two (or more) platelet assessments meeting the criteria of a confirmed response as defined by the primary endpoint.
Duration of confirmed response
Time from the first assessment in the first sequence of two (or more) platelet assessments meeting the criteria of a confirmed response to loss of response; with loss of response defined as the first of the following events: platelet count <30 G/L, start of any rescue or new ITP treatment, death (whatever the cause).
Complete Response rate at each timepoint
Percentage of participants with a platelet count of at least 100 G/L in the absence of rescue treatment/new ITP treatment.
Response rate at each timepoint
Percentage of participants with a platelet count of at least 50 G/L in the absence of rescue treatment/new ITP treatment.
Stable response at 6 months
Percentage of participants with at least 75% of platelet counts collected at month 6 (between study days 121 and 183) equal to or above 50 G/L in the absence of rescue treatment/new ITP treatment.
Stable response at 1 year
Percentage of participants with at least 66% of platelet counts collected at year 1 (between study days 296 and 379) equal to or above 50 G/L in the absence of rescue treatment/new ITP treatment.
Number of participants with bleeding events according to the Modified World Health Organization (WHO) bleeding scale
Number of participants reporting bleeding events for each grade of the World Health Organization (WHO) bleeding scale at each time point. Severity is graded from 0 to 4, with 0 = no bleeding and 4 = severe hemodynamic instability/central nervous system (CNS) bleeding/fatal.
Percentage of participants with bleeding events according to the Modified World Health Organization (WHO) bleeding scale
Percentage of participants reporting bleeding events for each grade of the WHO bleeding scale at each time point. Severity is graded from 0 to 4, with 0 = no bleeding and 4 = severe hemodynamic instability/central nervous system (CNS) bleeding/fatal.
Number of participants who received rescue treatment
Number of participants who required rescue treatment
Percentage of participants who received rescue treatment
Percentage of participants who required rescue treatment
Change from baseline in the frequency of CD19+ B-cell counts
Post-baseline frequency of CD19+ B-cell counts compared to baseline
Change from baseline in the absolute number of CD19+ B-cell counts
Post-baseline absolute number of CD19+ B-cell counts compared to baseline
Time to first occurrence of B-cell recovery defined as ≥80% of baseline ≥50 cells/µL
Time to B-cell recovery defined as ≥80% of baseline or ≥50 cells/µL
Change from baseline in immunoglobulins
Post-baseline immunoglobulin levels (change in titers of Total Ig, IgG, IgM, IgA) compared to baseline
Incidence of anti-ianalumab antibodies in serum (ADA assay) over time
Anti-drug antibodies (ADA) will be evaluated in samples collected from all participants to assess the immunogenicity of ianalumab
Titer of anti-ianalumab antibodies in serum (ADA assay) over time
Anti-drug antibodies (ADA) will be evaluated in samples collected from all participants to assess the immunogenicity of ianalumab
Ianalumab serum concentrations over time
Ianalumab concentration in serum over time, including end of infusion and concentration at trough.

Full Information

First Posted
May 15, 2023
Last Updated
October 17, 2023
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT05885555
Brief Title
A Study of Ianalumab (VAY736) in Patients With Primary Immune Thrombocytopenia (ITP) Previously Treated With at Least Two Lines of Therapies
Official Title
A Phase 2 Study to Evaluate the Efficacy and Safety of Ianalumab (VAY736) in Patients With Primary Immune Thrombocytopenia (ITP) Previously Treated With at Least a Corticosteroid and a Thrombopoietin Receptor Agonist (TPO-RA)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 16, 2023 (Actual)
Primary Completion Date
November 25, 2024 (Anticipated)
Study Completion Date
November 23, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate the therapeutic efficacy, safety and tolerability of ianalumab in adult patients with primary ITP previously treated with at least one corticosteroid and one TPO-RA.
Detailed Description
This is a phase 2, open-label, single-arm study to evaluate the efficacy, safety and tolerability of ianalumab in participants with primary ITP (platelet count <30 G/L at screening) previously treated with at least a corticosteroid and a TPO-RA. The study consists of the screening period, the primary endpoint assessment period, the follow-up period. The screening period will last for up to 14 days prior to the first dose of ianalumab. All eligible participants will be treated with the same dose of ianalumab and will complete the primary endpoint assessment period. After completion of the primary endpoint assessment period, all participants will continue in safety monitoring and those with a platelet count ≥30 G/L in absence of a new line of ITP therapy and rescue therapy will also continue in efficacy monitoring. The study will end once all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Immune Thrombocytopenia (ITP)
Keywords
Primary immune thrombocytopenia (ITP), ianalumab, VAY736, B-cell depletion, B-cell Activating Factor Receptor (BAFF-R) blockade

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Single-arm
Arm Type
Experimental
Arm Description
All eligible participants will receive ianalumab at the same dose.
Intervention Type
Biological
Intervention Name(s)
Ianalumab
Other Intervention Name(s)
VAY736
Intervention Description
Intravenous infusion, prepared from concentrate solution
Primary Outcome Measure Information:
Title
Confirmed response
Description
Confirmed response is defined as a platelet count of equal or above 50 G/L at two (or more) consecutive assessments at least 7 days apart, in the absence of: Rescue treatment for ≥4 weeks prior to the assessment of the platelet count, and New ITP treatment before reaching a confirmed response.
Time Frame
Between Week 1 Day 1 and Week 25 Day 1
Secondary Outcome Measure Information:
Title
Time to confirmed response
Description
Time from the first administration of ianalumab to the first assessment in the first sequence of two (or more) platelet assessments meeting the criteria of a confirmed response as defined by the primary endpoint.
Time Frame
From Week 1 Day 1 to Week 25 Day 1
Title
Duration of confirmed response
Description
Time from the first assessment in the first sequence of two (or more) platelet assessments meeting the criteria of a confirmed response to loss of response; with loss of response defined as the first of the following events: platelet count <30 G/L, start of any rescue or new ITP treatment, death (whatever the cause).
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Complete Response rate at each timepoint
Description
Percentage of participants with a platelet count of at least 100 G/L in the absence of rescue treatment/new ITP treatment.
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Response rate at each timepoint
Description
Percentage of participants with a platelet count of at least 50 G/L in the absence of rescue treatment/new ITP treatment.
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Stable response at 6 months
Description
Percentage of participants with at least 75% of platelet counts collected at month 6 (between study days 121 and 183) equal to or above 50 G/L in the absence of rescue treatment/new ITP treatment.
Time Frame
At 6 months
Title
Stable response at 1 year
Description
Percentage of participants with at least 66% of platelet counts collected at year 1 (between study days 296 and 379) equal to or above 50 G/L in the absence of rescue treatment/new ITP treatment.
Time Frame
At 1 year
Title
Number of participants with bleeding events according to the Modified World Health Organization (WHO) bleeding scale
Description
Number of participants reporting bleeding events for each grade of the World Health Organization (WHO) bleeding scale at each time point. Severity is graded from 0 to 4, with 0 = no bleeding and 4 = severe hemodynamic instability/central nervous system (CNS) bleeding/fatal.
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Percentage of participants with bleeding events according to the Modified World Health Organization (WHO) bleeding scale
Description
Percentage of participants reporting bleeding events for each grade of the WHO bleeding scale at each time point. Severity is graded from 0 to 4, with 0 = no bleeding and 4 = severe hemodynamic instability/central nervous system (CNS) bleeding/fatal.
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Number of participants who received rescue treatment
Description
Number of participants who required rescue treatment
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Percentage of participants who received rescue treatment
Description
Percentage of participants who required rescue treatment
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Change from baseline in the frequency of CD19+ B-cell counts
Description
Post-baseline frequency of CD19+ B-cell counts compared to baseline
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Change from baseline in the absolute number of CD19+ B-cell counts
Description
Post-baseline absolute number of CD19+ B-cell counts compared to baseline
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Time to first occurrence of B-cell recovery defined as ≥80% of baseline ≥50 cells/µL
Description
Time to B-cell recovery defined as ≥80% of baseline or ≥50 cells/µL
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Change from baseline in immunoglobulins
Description
Post-baseline immunoglobulin levels (change in titers of Total Ig, IgG, IgM, IgA) compared to baseline
Time Frame
From Week 1 Day 1 to end of study (until all participants have completed 24 months of safety follow-up since their last dose of ianalumab or discontinued the study earlier)
Title
Incidence of anti-ianalumab antibodies in serum (ADA assay) over time
Description
Anti-drug antibodies (ADA) will be evaluated in samples collected from all participants to assess the immunogenicity of ianalumab
Time Frame
Up to 20 weeks after last dose of ianalumab
Title
Titer of anti-ianalumab antibodies in serum (ADA assay) over time
Description
Anti-drug antibodies (ADA) will be evaluated in samples collected from all participants to assess the immunogenicity of ianalumab
Time Frame
Up to 20 weeks after last dose of ianalumab
Title
Ianalumab serum concentrations over time
Description
Ianalumab concentration in serum over time, including end of infusion and concentration at trough.
Time Frame
First dose (pre-dose, 2, 168, 336, 504, 672 hours post-dose); Subsequent doses (pre-dose and 2 hours post-dose); Last dose (pre-dose, 2 336, 672, 1344, 2016, 3360 hours post-dose)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent obtained prior to participation in the study. Male or female participants aged 18 years and older on the day of signing informed consent. Confirmed diagnosis of primary ITP. Prior treatment with at least a corticosteroid (±IVIG) and a TPO-RA: Prior additional therapies are allowed; the corticosteroid or the TPO-RA do not need to be the last treatment. Documented response to IVIG/anti-D or a corticosteroid that was not maintained. At last ITP treatment, loss of response, insufficient response, no response or intolerance. Platelet count <30 G/L and assessed as needing treatment (per physician's discretion) at screening. If concomitant ITP medication is clinically indicated, the platelet assessment showing a value <30 G/L must be performed after at least 14 days on a stable dose of a corticosteroid or/and a TPO-RA (less than 10% variation from current dose) and continue stable thereafter. Key exclusion criteria: Diagnosis of secondary thrombocytopenia. Platelet or whole blood transfusion, plasmapheresis, or use of any other rescue medications within 14 days before first ianalumab infusion. Neutrophils <1000/mm3 at screening. Treatment with a B-cell depleting therapy (e.g., rituximab) or anti-B-cell Activating Factor of the TNF Family (BAFF) (e.g., belimumab) within 12 weeks prior to the first administration of ianalumab. Immunosuppressant drugs other than corticosteroids within 5 times the elimination half-life of the drug or 14 days before first ianalumab infusion, whichever is longer. Prior splenectomy. Other protocol-defined inclusion/exclusion criteria may apply.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Novartis Pharmaceuticals
Phone
1-888-669-6682
Email
novartis.email@novartis.com
First Name & Middle Initial & Last Name or Official Title & Degree
Novartis Pharmaceuticals
Phone
+41613241111
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
New York Oncology Hematology Saratoga NYOH
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Edward Hagopian
Email
edward.hagopian@usoncology.com
First Name & Middle Initial & Last Name & Degree
Mihir Pradipkumar Raval
Facility Name
Novartis Investigative Site
City
Prahran
State/Province
Victoria
ZIP/Postal Code
3181
Country
Australia
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Dijon
ZIP/Postal Code
21034
Country
France
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Seoul
State/Province
Seocho Gu
ZIP/Postal Code
06591
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Seoul
ZIP/Postal Code
06351
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Edirne
ZIP/Postal Code
22030
Country
Turkey
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Kocaeli
ZIP/Postal Code
41380
Country
Turkey
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
IPD Sharing URL
https://www.clinicalstudydatarequest.com

Learn more about this trial

A Study of Ianalumab (VAY736) in Patients With Primary Immune Thrombocytopenia (ITP) Previously Treated With at Least Two Lines of Therapies

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