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Efficacy and Safety of Switching From Anti-C5 Antibody Treatment to Iptacopan Treatment in Study Participants With Atypical Hemolytic Uremic Syndrome (aHUS)

Primary Purpose

Atypical Hemolytic Uremic Syndrome

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Iptacopan
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atypical Hemolytic Uremic Syndrome focused on measuring Atypical Hemolytic Uremic Syndrome, aHUS, thrombotic microangiopathy, TMA

Eligibility Criteria

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

Inclusion Criteria: Male and female adult participants ≥ 18 years of age with diagnosis of aHUS for whom etiologies of other types of TMA and non-aHUS kidney disease have been excluded. Currently on the recommended weight-based dosage regimen of anti-C5 antibody treatment for at least 3 months prior to the screening visit. Clinical evidence of response to anti-C5 antibody treatment (in absence of PE/PI) for at least 3 months prior to entering the screening period as defined by: Hematological normalization in platelet count ≥150 x 109/L and LDH below upper limit of normal [ULN], and Stable or improving kidney function as defined by ≤15% increase in serum creatinine. Vaccination against Neisseria meningitidis and Streptococcus pneumoniae infections is required prior to the start of treatment with iptacopan. If not received previously or if a booster is required, vaccination against Haemophilus influenzae infection, should be given, if available and according to local regulations. Exclusion Criteria: History of aHUS disease relapse while on anti-C5 antibody treatment. eGFR < 30 ml/min/1.73m^2 Active infection or history of recurrent invasive infections caused by encapsulated bacteria, i.e., meningococcus, pneumococcus (eg., N. meningitidis, S. pneumoniae) or H. influenzae. Participants with sepsis or active systemic bacterial, viral (including COVID-19) or fungal infection within 14 days prior to study treatment administration. Kidney, bone marrow transplant (BMT)/hematopoietic stem cell transplant (HSCT), heart, lung, small bowel, pancreas, liver transplantation or any other cell or solid organ transplantation Female patients who are pregnant or breastfeeding, or intending to conceive during the course of the study Any medical condition deemed likely to interfere with the patient's participation in the study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    iptacopan 200 mg b.i.d.

    Arm Description

    open label arm of iptacopan 200 mg b.i.d.

    Outcomes

    Primary Outcome Measures

    Percentage of participants free of TMA manifestation
    Absence of thrombotic microangiopathy (TMA) manifestation, without use of anti-C5 antibody, during the 12 months of iptacopan treatment following the switch of treatment from an anti-C5 antibody to iptacopan treatment.

    Secondary Outcome Measures

    Percentage of participants free of TMA manifestation in study participants with functionally significant mutations in complement genes or positive anti FH antibodies
    Absence of thrombotic microangiopathy (TMA) manifestation in study participants with functionally significant mutations in complement genes or positive anti FH antibodies, without the use of anti-C5 antibody during iptacopan treatment following the switch of treatment from an anti-C5 antibody to iptacopan treatment.
    Percentage of participants free of TMA manifestation
    Absence of thrombotic microangiopathy (TMA) manifestation, without use of anti-C5 antibody, during the 24 months of iptacopan treatment following the switch of treatment from an anti-C5 antibody to iptacopan treatment.
    Time to TMA manifestation
    Time to thrombotic microangiopathy (TMA) manifestation
    Change from baseline in platelets
    Change from baseline in platelets at month 12 and month 24.
    Change from baseline in LDH
    Change from baseline in lactate dehydrogenase (LDH) at month 12 and month 24.
    Change from baseline in hemoglobin
    Change from baseline in hemoglobin at month 12 and month 24.
    Change from baseline in serum creatinine
    Change from baseline in serum creatinine at month 12 and month 24.
    Change from baseline in UPCR
    Change from baseline in urine protein to creatinine ratio (UPCR) at month 12 and month 24.
    Change from baseline in eGFR
    Change from baseline in estimated glomerular filtration rate (eGFR) at month 12 and month 24.
    Change from baseline in CKD stage
    Change from baseline in chronic kidney disease (CKD) stage at month 12 and month 24.
    Number of participants who require dialysis
    Dialysis requirement status (Yes/ No)
    Percentage of participants with TMA related events.
    Percentage of participants with thrombotic microangiopathy (TMA) related events.

    Full Information

    First Posted
    June 29, 2023
    Last Updated
    June 29, 2023
    Sponsor
    Novartis Pharmaceuticals
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05935215
    Brief Title
    Efficacy and Safety of Switching From Anti-C5 Antibody Treatment to Iptacopan Treatment in Study Participants With Atypical Hemolytic Uremic Syndrome (aHUS)
    Official Title
    A Multicenter, Single Arm, Open-label Study to Evaluate Efficacy and Safety of Switching From Anti-C5 Antibody Treatment to Iptacopan Treatment in Study Participants With aHUS
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 4, 2023 (Anticipated)
    Primary Completion Date
    October 2, 2028 (Anticipated)
    Study Completion Date
    October 2, 2028 (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 Phase 3 study is to evaluate the efficacy and safety of iptacopan upon switching from anti-C5 antibody to iptacopan treatment in study participants with aHUS.
    Detailed Description
    The study is designed as a multicenter, single-arm, open label study to evaluate the efficacy and safety of iptacopan upon switching from anti-C5 antibody to iptacopan treatment in participants with aHUS. It consists of a screening period of up to 8 weeks followed by a 12-Month Core Treatment period and 12-Month Extension Treatment period. The study will assess the effects of iptacopan on a range of efficacy assessments relevant to aHUS.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Atypical Hemolytic Uremic Syndrome
    Keywords
    Atypical Hemolytic Uremic Syndrome, aHUS, thrombotic microangiopathy, TMA

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    50 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    iptacopan 200 mg b.i.d.
    Arm Type
    Experimental
    Arm Description
    open label arm of iptacopan 200 mg b.i.d.
    Intervention Type
    Drug
    Intervention Name(s)
    Iptacopan
    Other Intervention Name(s)
    LNP023
    Intervention Description
    Open Label
    Primary Outcome Measure Information:
    Title
    Percentage of participants free of TMA manifestation
    Description
    Absence of thrombotic microangiopathy (TMA) manifestation, without use of anti-C5 antibody, during the 12 months of iptacopan treatment following the switch of treatment from an anti-C5 antibody to iptacopan treatment.
    Time Frame
    12 months
    Secondary Outcome Measure Information:
    Title
    Percentage of participants free of TMA manifestation in study participants with functionally significant mutations in complement genes or positive anti FH antibodies
    Description
    Absence of thrombotic microangiopathy (TMA) manifestation in study participants with functionally significant mutations in complement genes or positive anti FH antibodies, without the use of anti-C5 antibody during iptacopan treatment following the switch of treatment from an anti-C5 antibody to iptacopan treatment.
    Time Frame
    12 months, 24 months
    Title
    Percentage of participants free of TMA manifestation
    Description
    Absence of thrombotic microangiopathy (TMA) manifestation, without use of anti-C5 antibody, during the 24 months of iptacopan treatment following the switch of treatment from an anti-C5 antibody to iptacopan treatment.
    Time Frame
    24 months
    Title
    Time to TMA manifestation
    Description
    Time to thrombotic microangiopathy (TMA) manifestation
    Time Frame
    12 months, 24 months
    Title
    Change from baseline in platelets
    Description
    Change from baseline in platelets at month 12 and month 24.
    Time Frame
    Baseline, month 12, month 24
    Title
    Change from baseline in LDH
    Description
    Change from baseline in lactate dehydrogenase (LDH) at month 12 and month 24.
    Time Frame
    Baseline, month 12, month 24
    Title
    Change from baseline in hemoglobin
    Description
    Change from baseline in hemoglobin at month 12 and month 24.
    Time Frame
    Baseline, month 12, month 24
    Title
    Change from baseline in serum creatinine
    Description
    Change from baseline in serum creatinine at month 12 and month 24.
    Time Frame
    Baseline, month 12, month 24
    Title
    Change from baseline in UPCR
    Description
    Change from baseline in urine protein to creatinine ratio (UPCR) at month 12 and month 24.
    Time Frame
    Baseline, month 12, month 24
    Title
    Change from baseline in eGFR
    Description
    Change from baseline in estimated glomerular filtration rate (eGFR) at month 12 and month 24.
    Time Frame
    Baseline, month 12, month 24
    Title
    Change from baseline in CKD stage
    Description
    Change from baseline in chronic kidney disease (CKD) stage at month 12 and month 24.
    Time Frame
    Baseline, month 12, month 24
    Title
    Number of participants who require dialysis
    Description
    Dialysis requirement status (Yes/ No)
    Time Frame
    month 12 and month 24
    Title
    Percentage of participants with TMA related events.
    Description
    Percentage of participants with thrombotic microangiopathy (TMA) related events.
    Time Frame
    month 12 and month 24

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male and female adult participants ≥ 18 years of age with diagnosis of aHUS for whom etiologies of other types of TMA and non-aHUS kidney disease have been excluded. Currently on the recommended weight-based dosage regimen of anti-C5 antibody treatment for at least 3 months prior to the screening visit. Clinical evidence of response to anti-C5 antibody treatment (in absence of PE/PI) for at least 3 months prior to entering the screening period as defined by: Hematological normalization in platelet count ≥150 x 109/L and LDH below upper limit of normal [ULN], and Stable or improving kidney function as defined by ≤15% increase in serum creatinine. Vaccination against Neisseria meningitidis and Streptococcus pneumoniae infections is required prior to the start of treatment with iptacopan. If not received previously or if a booster is required, vaccination against Haemophilus influenzae infection, should be given, if available and according to local regulations. Exclusion Criteria: History of aHUS disease relapse while on anti-C5 antibody treatment. eGFR < 30 ml/min/1.73m^2 Active infection or history of recurrent invasive infections caused by encapsulated bacteria, i.e., meningococcus, pneumococcus (eg., N. meningitidis, S. pneumoniae) or H. influenzae. Participants with sepsis or active systemic bacterial, viral (including COVID-19) or fungal infection within 14 days prior to study treatment administration. Kidney, bone marrow transplant (BMT)/hematopoietic stem cell transplant (HSCT), heart, lung, small bowel, pancreas, liver transplantation or any other cell or solid organ transplantation Female patients who are pregnant or breastfeeding, or intending to conceive during the course of the study Any medical condition deemed likely to interfere with the patient's participation in the study
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Novartis Pharmaceuticals
    Phone
    +41613241111
    Email
    novartis.email@novartis.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Novartis Pharmaceuticals
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Novartis Pharmaceuticals
    Organizational Affiliation
    Novartis Pharmaceuticals
    Official's Role
    Study Director

    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

    Learn more about this trial

    Efficacy and Safety of Switching From Anti-C5 Antibody Treatment to Iptacopan Treatment in Study Participants With Atypical Hemolytic Uremic Syndrome (aHUS)

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