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A Study of Mavorixafor in Participants With Congenital and Acquired Primary Autoimmune and Idiopathic Chronic Neutropenic Disorders Who Are Experiencing Recurrent and/or Serious Infections

Primary Purpose

Neutropenia

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Mavorixafor
Placebo
Sponsored by
X4 Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neutropenia focused on measuring Mavorixafor, Chronic neutropenia, Chronic idiopathic neutropenia, SCN, CXCR4, Congenital and acquired neutropenia, autoimmune disease

Eligibility Criteria

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

Key Inclusion Criteria: Diagnosis of congenital or acquired primary autoimmune and idiopathic chronic neutropenic disorder ≥6 months prior to the screening visit that is not attributable to medications, active or recent infections or malignancy. Have a confirmed trough ANC <1500 cells/µL during the screening visit (single ANC measurement) and at baseline visit (mean ANC over 6 hours) held at least 2 weeks prior to Day 1 dosing, with no clinical evidence of infection. Participants who are on G-CSF or other active SoC must have been receiving these therapies for ≥12 months, be on a stable dose and dosing schedule for ≥4 weeks prior to screening visit and remain on this dose and dosing schedule throughout the study (unless ANC >10,000 cells/µL for ≥4 weeks). Participants must be willing to keep their G-CSF doses/regimens stable (other than for safety reasons) for the duration of the trial. Key Exclusion Criteria: A diagnosis of secondary neutropenia including those due to: Hypersplenism Infection Malignancy Autoimmune disease, for example, systemic lupus erythematosus, rheumatoid arthritis, irritable bowel disease, graft-versus-host disease, thyroid disease Nutritional deficiency, for example, vitamin B12, folic acid, copper, caloric malnutrition Drug-induced cause, for example, chemotherapy, clozapine, antiretrovirals, antibiotics, monoclonal antibodies. A diagnosis of any of the following: Aplastic anemia Warts, hypogammaglobulinemia, infections, and myelokathexis (WHIM) syndrome Certain Congenital Neutropenias, including but not limited to these classifications are excluded: Isolated with a cyclic presentation, for example, elastase, neutrophil expressed (ELANE) Associated with immune dysregulation, for example, autoimmune lymphoproliferative syndrome, Familial hemophagocytic lymphohistiocytosis, Chédiak-Higashi syndrome Associated with bone marrow failure, for example, Fanconi Anemia, Diamond-Blackfan anemia, Telomere diseases c. Neutropenia associated with a Duffy-null phenotype (formerly known as benign ethnic neutropenia). Known active COVID-19 infection or a positive test within the local accepted clinical and governmental guidelines for a communicable window. A medical or personal condition that may potentially compromise the safety of the participant, may preclude the participant's successful completion of the clinical study, or could, in the opinion of the Investigator or the Sponsor, interfere with the objectives of the study. Received more than 1 dose of mavorixafor in the past. Received C-X-C chemokine receptor 4 (CXCR4) antagonist (other than mavorixafor) in the past 6 months. Participants taking pegylated-G-CSF unless they have a diagnosis of congenital neutropenia confirmed at screening. Participant is currently taking or have taken other investigational drug at least <30 days prior to the screening visit. Note: Other protocol-defined inclusion and exclusion criteria may apply.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Mavorixafor

    Placebo

    Arm Description

    Participants will receive mavorixafor orally once daily starting from Day 1 through Week 52.

    Participants will receive placebo matching to mavorixafor orally once daily starting from Day 1 through Week 52.

    Outcomes

    Primary Outcome Measures

    Number of Participants Meeting the Definition of a Positive Absolute Neutrophil Count (ANC) Response During the First 3 Months
    Positive ANC response: ANC ≥1500 cells/microliter (µL), with the exception of participants with severe congenital neutropenia (SCN); Baseline ANC <500 cells/µL; positive response is defined as a ≥ 2-fold increase in ANC from baseline.
    Number of Participants With Decreased Infection Based on Infections Adjudicated by Blinded, Independent Adjudication Committee (AC) During the 12-Month Treatment Period

    Secondary Outcome Measures

    Number of Participants not on Chronic Granulocyte-colony Stimulating Factor (G-CSF) Treatment Meeting the definition of a Positive ANC Response During the First 3 Months
    Positive ANC response: ANC ≥1500 cells/ µL, with the exception of participants with SCN; Baseline ANC <500 cells/µL; positive response is defined as a ≥ 2-fold increase in ANC from baseline.
    Number of Participants not on Chronic G-CSF Treatment, With Decreased Infection Based on Infections Adjudicated by Blinded, Independent AC During the 12-Month Treatment Period
    Change From Baseline in Patient Reported Outcomes Measurement Information System Short Form (PROMIS SF) Fatigue Questionnaire Total Score at Week 52
    Number of Participants With Oral Ulcers
    Number of Participants who Use Antibiotics Due to Infection
    Duration of Positive ANC Response
    Duration of Positive ANC Response in Participants not Receiving Chronic G-CSF
    Number of Participants with an Overall Positive ANC Response During the 12-Month Treatment Period
    Infection Duration Based on Duration of Infections Adjudicated by Blinded, Independent AC During the 12-Month Treatment Period in Those Participants who Developed Infections
    Total Absolute Lymphocyte Count
    Absolute Monocyte Count (AMC)
    ANC
    White Blood Cell Count
    Number of Participants With Decreased Severity of Infections Adjudicated by Blinded, Independent AC During the 12-Month Treatment Period

    Full Information

    First Posted
    September 20, 2023
    Last Updated
    September 20, 2023
    Sponsor
    X4 Pharmaceuticals
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06056297
    Brief Title
    A Study of Mavorixafor in Participants With Congenital and Acquired Primary Autoimmune and Idiopathic Chronic Neutropenic Disorders Who Are Experiencing Recurrent and/or Serious Infections
    Official Title
    A Phase 3, Randomized, Double-blind, Placebo-controlled, Multicenter Study of Mavorixafor in Participants With Congenital and Acquired Primary Autoimmune and Idiopathic Chronic Neutropenic Disorders Who Are Experiencing Recurrent and/or Serious Infections
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    January 2024 (Anticipated)
    Primary Completion Date
    January 2025 (Anticipated)
    Study Completion Date
    April 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    X4 Pharmaceuticals

    4. Oversight

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

    5. Study Description

    Brief Summary
    The purpose of this study is to demonstrate the efficacy and evaluate the safety, and tolerability of mavorixafor in participants with congenital or acquired primary autoimmune and idiopathic chronic neutropenic disorders who are experiencing recurrent and/or serious infections as assessed by increasing levels of circulating neutrophils as well as demonstrating its clinical benefit.
    Detailed Description
    All participants will continue their pre-study background therapy, defined as the participant's current treatment regimen. Options include, but are not limited to, G CSF, immunoglobulin replacement therapy, prophylactic antibiotics, or "watchful waiting".

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Neutropenia
    Keywords
    Mavorixafor, Chronic neutropenia, Chronic idiopathic neutropenia, SCN, CXCR4, Congenital and acquired neutropenia, autoimmune disease

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    128 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Mavorixafor
    Arm Type
    Experimental
    Arm Description
    Participants will receive mavorixafor orally once daily starting from Day 1 through Week 52.
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Participants will receive placebo matching to mavorixafor orally once daily starting from Day 1 through Week 52.
    Intervention Type
    Drug
    Intervention Name(s)
    Mavorixafor
    Other Intervention Name(s)
    X4P-001
    Intervention Description
    Mavorixafor will be administered per schedule specified in the arm description.
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Placebo will be administered per schedule specified in the arm description.
    Primary Outcome Measure Information:
    Title
    Number of Participants Meeting the Definition of a Positive Absolute Neutrophil Count (ANC) Response During the First 3 Months
    Description
    Positive ANC response: ANC ≥1500 cells/microliter (µL), with the exception of participants with severe congenital neutropenia (SCN); Baseline ANC <500 cells/µL; positive response is defined as a ≥ 2-fold increase in ANC from baseline.
    Time Frame
    Baseline up to Month 3
    Title
    Number of Participants With Decreased Infection Based on Infections Adjudicated by Blinded, Independent Adjudication Committee (AC) During the 12-Month Treatment Period
    Time Frame
    Baseline up to Month 12
    Secondary Outcome Measure Information:
    Title
    Number of Participants not on Chronic Granulocyte-colony Stimulating Factor (G-CSF) Treatment Meeting the definition of a Positive ANC Response During the First 3 Months
    Description
    Positive ANC response: ANC ≥1500 cells/ µL, with the exception of participants with SCN; Baseline ANC <500 cells/µL; positive response is defined as a ≥ 2-fold increase in ANC from baseline.
    Time Frame
    Baseline up to Month 3
    Title
    Number of Participants not on Chronic G-CSF Treatment, With Decreased Infection Based on Infections Adjudicated by Blinded, Independent AC During the 12-Month Treatment Period
    Time Frame
    Baseline up to Month 12
    Title
    Change From Baseline in Patient Reported Outcomes Measurement Information System Short Form (PROMIS SF) Fatigue Questionnaire Total Score at Week 52
    Time Frame
    Baseline, Week 52
    Title
    Number of Participants With Oral Ulcers
    Time Frame
    Baseline up to Month 12
    Title
    Number of Participants who Use Antibiotics Due to Infection
    Time Frame
    Baseline up to Month 12
    Title
    Duration of Positive ANC Response
    Time Frame
    Baseline up to Month 12
    Title
    Duration of Positive ANC Response in Participants not Receiving Chronic G-CSF
    Time Frame
    Baseline up to Month 12
    Title
    Number of Participants with an Overall Positive ANC Response During the 12-Month Treatment Period
    Time Frame
    Baseline up to Month 12
    Title
    Infection Duration Based on Duration of Infections Adjudicated by Blinded, Independent AC During the 12-Month Treatment Period in Those Participants who Developed Infections
    Time Frame
    Baseline up to Month 12
    Title
    Total Absolute Lymphocyte Count
    Time Frame
    Baseline up to Month 12
    Title
    Absolute Monocyte Count (AMC)
    Time Frame
    Baseline up to Month 12
    Title
    ANC
    Time Frame
    Baseline up to Month 12
    Title
    White Blood Cell Count
    Time Frame
    Baseline up to Month 12
    Title
    Number of Participants With Decreased Severity of Infections Adjudicated by Blinded, Independent AC During the 12-Month Treatment Period
    Time Frame
    Baseline up to Month 12

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    12 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Key Inclusion Criteria: Diagnosis of congenital or acquired primary autoimmune and idiopathic chronic neutropenic disorder ≥6 months prior to the screening visit that is not attributable to medications, active or recent infections or malignancy. Have a confirmed trough ANC <1500 cells/µL during the screening visit (single ANC measurement) and at baseline visit (mean ANC over 6 hours) held at least 2 weeks prior to Day 1 dosing, with no clinical evidence of infection. Participants who are on G-CSF or other active SoC must have been receiving these therapies for ≥12 months, be on a stable dose and dosing schedule for ≥4 weeks prior to screening visit and remain on this dose and dosing schedule throughout the study (unless ANC >10,000 cells/µL for ≥4 weeks). Participants must be willing to keep their G-CSF doses/regimens stable (other than for safety reasons) for the duration of the trial. Key Exclusion Criteria: A diagnosis of secondary neutropenia including those due to: Hypersplenism Infection Malignancy Autoimmune disease, for example, systemic lupus erythematosus, rheumatoid arthritis, irritable bowel disease, graft-versus-host disease, thyroid disease Nutritional deficiency, for example, vitamin B12, folic acid, copper, caloric malnutrition Drug-induced cause, for example, chemotherapy, clozapine, antiretrovirals, antibiotics, monoclonal antibodies. A diagnosis of any of the following: Aplastic anemia Warts, hypogammaglobulinemia, infections, and myelokathexis (WHIM) syndrome Certain Congenital Neutropenias, including but not limited to these classifications are excluded: Isolated with a cyclic presentation, for example, elastase, neutrophil expressed (ELANE) Associated with immune dysregulation, for example, autoimmune lymphoproliferative syndrome, Familial hemophagocytic lymphohistiocytosis, Chédiak-Higashi syndrome Associated with bone marrow failure, for example, Fanconi Anemia, Diamond-Blackfan anemia, Telomere diseases c. Neutropenia associated with a Duffy-null phenotype (formerly known as benign ethnic neutropenia). Known active COVID-19 infection or a positive test within the local accepted clinical and governmental guidelines for a communicable window. A medical or personal condition that may potentially compromise the safety of the participant, may preclude the participant's successful completion of the clinical study, or could, in the opinion of the Investigator or the Sponsor, interfere with the objectives of the study. Received more than 1 dose of mavorixafor in the past. Received C-X-C chemokine receptor 4 (CXCR4) antagonist (other than mavorixafor) in the past 6 months. Participants taking pegylated-G-CSF unless they have a diagnosis of congenital neutropenia confirmed at screening. Participant is currently taking or have taken other investigational drug at least <30 days prior to the screening visit. Note: Other protocol-defined inclusion and exclusion criteria may apply.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Patient Affairs and Advocacy
    Phone
    857-529-5779
    Email
    clinicaltrialinfo@x4pharma.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Chief Medical Officer
    Organizational Affiliation
    X4 Pharmaceuticals
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    A Study of Mavorixafor in Participants With Congenital and Acquired Primary Autoimmune and Idiopathic Chronic Neutropenic Disorders Who Are Experiencing Recurrent and/or Serious Infections

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