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A Rollover Extension Program (REP) to Evaluate the Long-term Safety and Tolerability of Open Label Iptacopan/LNP023 in Participants With Primary IgA Nephropathy

Primary Purpose

Primary IgA Nephropathy

Status
Recruiting
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
LNP023
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary IgA Nephropathy focused on measuring Immunoglobulin A nephropathy, Primary IgA nephropathy, IgAN, chronic kidney disease, glomerulonephritis, complement alternative pathway, eGFR, UPCR, UACR, LNP023

Eligibility Criteria

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

Inclusion Criteria:

  • For LNP023X2203, participants must have completed part 1 or part 2 of the trial. For LNP023A2301, participants must have completed the entire core trial defined as the full 24 month treatment period.
  • eGFR* ≥ 20 ml/min/1.73m2

    *eGFR calculated using the CKD-EPI formula (or modified MDRD formula according to specific ethnic groups and local practice guidelines)

  • Per investigator's clinical judgement, the participant may benefit from receiving the open-label treatment of iptacopan 200 mg b.i.d.
  • Prior Vaccination against Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae infections should be up to date (i.e. any boosters required administered according to local regulations.
  • All participants must be on supportive care regimen of ACEi or ARB* as per KDIGO guidelines.

    • participants who are not taking KDIGO guideline doses because they have documented allergies or intolerance to ACEi and ARB are eligible for the study

Exclusion Criteria:

  • participants who screen or baseline failed in the CLNP023X2203 Part 1 or Part 2, or CLNP023A2301 studies or who prematurely withdrew from either study for any reason.
  • Evidence of severe urinary obstruction or difficulty in voiding; any urinary tract disorder other than IgAN at screening and before dosing with LNP023.
  • Current (within 4 weeks of study drug administration in the REP) acute kidney injury (AKI)
  • Presence of Rapidly Progressive Glomerulonephritis (RPGN) as defined by 50% decline in eGFR within the last 3 months.
  • Participants treated with immunosuppressive or other immunmodulatory agents such as but not limited to cyclophosphamide, rituximab, infliximab, eculizumab, canakinumab, mycophenolate mofetil (MMF) or mycophenolate sodium (MPS), cyclosporine, tacrolimus, sirolimus, everolimus and/or systemic corticosteroids exposure (>7.5 mg/d prednisone/prednisolone equivalent) within 5 half-lives of respective medication or 90 days prior to first study drug administration, whichever is shorter. Rituximab requires 180 days wash out.
  • Use of other investigational drugs at the time of enrolment, or within 5 half-lives of enrolment or within 30 days whichever is longer.
  • History of recurrent invasive infections caused by encapsulated organisms, such as meningococcus and pneumococcus.

Sites / Locations

  • Novartis Investigative SiteRecruiting
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Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

LNP023

Arm Description

All participants are receiving 200 mg b.i.d

Outcomes

Primary Outcome Measures

Number and percentage of participants with serious adverse event
Summary statistics on serious adverse events
Number and percentage of participants with adverse event
Summary statistics on adverse events
Number and percentage of participants with adverse events of special interest
Summary statistics on adverse events of special interest
Number and percentage of participants with abnormalities in vital signs
Summary statistics on abnormalities in vital sign parameters
Number and percentage of participants with abnormalities in ECG
Summary statistics in abnormalities in ECG parameters
Number and percentage of participants with abnormalities in clinical laboratory evaluations
Summary statistics on abnormalities in clinical laboratory evaluations

Secondary Outcome Measures

Annualized total eGFR slope
Annualized rate of renal disease progression as measured by mean eGFR slope at post baseline visits
Change from baseline in eGFR
Average change from baseline in eGFR at post-baseline visits
Log transformed ratio to baseline in UPCR, UACR
Log transformed ratio to baseline in UPCR, UACR at post-baseline visits. The log transformation refers to the natural log (base on e)

Full Information

First Posted
September 15, 2020
Last Updated
July 26, 2023
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04557462
Brief Title
A Rollover Extension Program (REP) to Evaluate the Long-term Safety and Tolerability of Open Label Iptacopan/LNP023 in Participants With Primary IgA Nephropathy
Official Title
A Multicenter Rollover Extension Program (REP) to Evaluate the Long-term Safety and Tolerability of Open Label Iptacopan in Adult Participants With Primary IgA Nephropathy Who Have Completed Study CLNP023X2203 or CLNP023A2301
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 20, 2021 (Actual)
Primary Completion Date
May 31, 2032 (Anticipated)
Study Completion Date
May 31, 2032 (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 long-term safety and tolerability, of open label iptacopan in primary IgA nephropathy participants who have completed either the CLNP023X2203 or CLNP023A2301 clinical trials. The open-label design of the current study is appropriate to provide study participants the opportunity to receive treatment with iptacopan until marketing authorizations are received and the drug product becomes commercially available while enabling collection of long-term safety and tolerability data for the investigational drug. Furthermore efficacy assessments conducted every 6 months will afford the opportunity to evaluate the clinical effects of iptacopan on long-term disease progression.
Detailed Description
This is an open-label, non-randomized, multicenter roll-over extension program (REP) to: CLNP023X2203, a Phase II trial investigating the dose ranging effects of LNP023 on efficacy, pharmacokinetics (PK), pharmacodynamics (PD), safety and tolerability in primary IgAN patients, and CLNP023A2301, a Phase III trial, investigating the efficacy, pharmacokinetics (PK), pharmacodynamics (PD), safety and tolerability of LNP023 in patients with primary IgAN. Subjects completing the CLNP023X2203 and CLNP023A2301 trials on study drug, who want to continue treatment and who meet the inclusion/exclusion requirements of the roll over extension program, will have the opportunity to receive iptacopan until: 3 years from LPFV of this study CLNP023A2002B, or the participant no longer derives benefit from iptacopan according to the Investigator, or the benefit-risk profile of the product in IgAN is no longer positive, or initiation of maintenance hemodialysis, kidney transplantation or eGFR < 15 mL/min/1.73m2 , or the product becomes commercially available in a specific country following product launch and subsequent reimbursement for IgAN, where applicable, or if a marketing application or reimbursement of an investigational product is rejected/not pursued in a region/country for the indication under study or which ever is sooner

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary IgA Nephropathy
Keywords
Immunoglobulin A nephropathy, Primary IgA nephropathy, IgAN, chronic kidney disease, glomerulonephritis, complement alternative pathway, eGFR, UPCR, UACR, LNP023

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
LNP023
Arm Type
Experimental
Arm Description
All participants are receiving 200 mg b.i.d
Intervention Type
Drug
Intervention Name(s)
LNP023
Other Intervention Name(s)
iptacopan
Intervention Description
Capsule 200 mg (b.i.d.) taken orally twice a day
Primary Outcome Measure Information:
Title
Number and percentage of participants with serious adverse event
Description
Summary statistics on serious adverse events
Time Frame
Date of first administration of (Day 1) to 7 days after the date of the last actual administration of study treatment
Title
Number and percentage of participants with adverse event
Description
Summary statistics on adverse events
Time Frame
Date of first administration of study treatment (Day 1) to 7 days after the date of the last actual administration of study treatment
Title
Number and percentage of participants with adverse events of special interest
Description
Summary statistics on adverse events of special interest
Time Frame
Date of first administration of study treatment (Day 1) to 7 days after the date of the last actual adminstration of study treatment
Title
Number and percentage of participants with abnormalities in vital signs
Description
Summary statistics on abnormalities in vital sign parameters
Time Frame
Date of first administration of study treatment (Day 1) to 7 days after the date of the last actual administration of study treatment
Title
Number and percentage of participants with abnormalities in ECG
Description
Summary statistics in abnormalities in ECG parameters
Time Frame
Date of first administration of study treatment (Day 1) to 7 days after the date of the last actual administration of study treatment
Title
Number and percentage of participants with abnormalities in clinical laboratory evaluations
Description
Summary statistics on abnormalities in clinical laboratory evaluations
Time Frame
Date of first administration of study treatment (Day 1) to 7 days after the date of the last actual administration of study treatment
Secondary Outcome Measure Information:
Title
Annualized total eGFR slope
Description
Annualized rate of renal disease progression as measured by mean eGFR slope at post baseline visits
Time Frame
Screening visit, Months 1, 3, 6, 9, 12 and every 6 months thereafter
Title
Change from baseline in eGFR
Description
Average change from baseline in eGFR at post-baseline visits
Time Frame
Screening visit, Months 1, 3, 6, 9, 12 and every 6 months thereafter
Title
Log transformed ratio to baseline in UPCR, UACR
Description
Log transformed ratio to baseline in UPCR, UACR at post-baseline visits. The log transformation refers to the natural log (base on e)
Time Frame
Screening visit, Months 1, 3, 6, 9, 12 and every 6 months thereafter

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: For LNP023X2203, participants must have completed part 1 or part 2 of the trial. For LNP023A2301, participants must have completed the entire core trial defined as the full 24 month treatment period. eGFR* ≥ 20 ml/min/1.73m2 *eGFR calculated using the CKD-EPI formula (or modified MDRD formula according to specific ethnic groups and local practice guidelines) Per investigator's clinical judgement, the participant may benefit from receiving the open-label treatment of iptacopan 200 mg b.i.d. Prior Vaccination against Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae infections should be up to date (i.e. any boosters required administered according to local regulations. All participants must be on supportive care regimen of ACEi or ARB* as per KDIGO guidelines. participants who are not taking KDIGO guideline doses because they have documented allergies or intolerance to ACEi and ARB are eligible for the study Exclusion Criteria: participants who screen or baseline failed in the CLNP023X2203 Part 1 or Part 2, or CLNP023A2301 studies or who prematurely withdrew from either study for any reason. Evidence of severe urinary obstruction or difficulty in voiding; any urinary tract disorder other than IgAN at screening and before dosing with LNP023. Current (within 4 weeks of study drug administration in the REP) acute kidney injury (AKI) Presence of Rapidly Progressive Glomerulonephritis (RPGN) as defined by 50% decline in eGFR within the last 3 months. Participants treated with immunosuppressive or other immunmodulatory agents such as but not limited to cyclophosphamide, rituximab, infliximab, eculizumab, canakinumab, mycophenolate mofetil (MMF) or mycophenolate sodium (MPS), cyclosporine, tacrolimus, sirolimus, everolimus and/or systemic corticosteroids exposure (>7.5 mg/d prednisone/prednisolone equivalent) within 5 half-lives of respective medication or 90 days prior to first study drug administration, whichever is shorter. Rituximab requires 180 days wash out. Use of other investigational drugs at the time of enrolment, or within 5 half-lives of enrolment or within 30 days whichever is longer. History of recurrent invasive infections caused by encapsulated organisms, such as meningococcus and pneumococcus.
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
Facility Information:
Facility Name
Novartis Investigative Site
City
Glendale
State/Province
Arizona
ZIP/Postal Code
85308
Country
United States
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Houston
State/Province
Texas
ZIP/Postal Code
77054
Country
United States
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Parkville
State/Province
Victoria
ZIP/Postal Code
3065
Country
Australia
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Edegem
State/Province
Antwerpen
ZIP/Postal Code
2650
Country
Belgium
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Roeselare
ZIP/Postal Code
8800
Country
Belgium
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Curitiba
State/Province
PR
ZIP/Postal Code
80440-020
Country
Brazil
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Porto Alegre
State/Province
RS
ZIP/Postal Code
90020-090
Country
Brazil
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510080
Country
China
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Beijing
ZIP/Postal Code
100034
Country
China
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Shanghai
ZIP/Postal Code
200040
Country
China
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Praha
ZIP/Postal Code
12808
Country
Czechia
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Aalborg
ZIP/Postal Code
9000
Country
Denmark
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Arhus N
ZIP/Postal Code
DK-8200
Country
Denmark
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Paris
ZIP/Postal Code
75015
Country
France
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Magdeburg
ZIP/Postal Code
39120
Country
Germany
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Mainz
ZIP/Postal Code
55131
Country
Germany
Individual Site Status
Recruiting
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Novartis Investigative Site
City
Hong Kong SAR
Country
Hong Kong
Individual Site Status
Recruiting
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Novartis Investigative Site
City
Ashkelon
ZIP/Postal Code
78278
Country
Israel
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Jerusalem
ZIP/Postal Code
9112001
Country
Israel
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Petach Tikva
ZIP/Postal Code
4941492
Country
Israel
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Toyoake city
State/Province
Aichi
ZIP/Postal Code
470 1192
Country
Japan
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Toyota
State/Province
Aichi
ZIP/Postal Code
471-8513
Country
Japan
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Sapporo-city
State/Province
Hokkaido
ZIP/Postal Code
006-8555
Country
Japan
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Sapporo
State/Province
Hokkaido
ZIP/Postal Code
060-8604
Country
Japan
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Yokohama-city
State/Province
Kanagawa
ZIP/Postal Code
236-0004
Country
Japan
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Sendai
State/Province
Miyagi
ZIP/Postal Code
981-3205
Country
Japan
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Okayama-city
State/Province
Okayama
ZIP/Postal Code
700-8558
Country
Japan
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Osaka-city
State/Province
Osaka
ZIP/Postal Code
530-8480
Country
Japan
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Recruiting
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Novartis Investigative Site
City
Kuala Lumpur
ZIP/Postal Code
50589
Country
Malaysia
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Recruiting
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Novartis Investigative Site
City
Groningen
ZIP/Postal Code
9713 GZ
Country
Netherlands
Individual Site Status
Recruiting
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Novartis Investigative Site
City
Nordbyhagen
State/Province
Oslo
ZIP/Postal Code
1478
Country
Norway
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Bergen
ZIP/Postal Code
5021
Country
Norway
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
St. Petersburg
ZIP/Postal Code
197110
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Singapore
ZIP/Postal Code
169608
Country
Singapore
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Taichung
ZIP/Postal Code
40705
Country
Taiwan
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Taipei
ZIP/Postal Code
10048
Country
Taiwan
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Bangkok
ZIP/Postal Code
10330
Country
Thailand
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Bangkok
ZIP/Postal Code
10400
Country
Thailand
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Kocaeli
ZIP/Postal Code
41380
Country
Turkey
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Talas / Kayseri
ZIP/Postal Code
38039
Country
Turkey
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Cambridge
State/Province
Cambrigdeshire
ZIP/Postal Code
CB2 0QQ
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Salford
State/Province
Manchester
ZIP/Postal Code
M6 8HD
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Leicester
ZIP/Postal Code
LE5 4PW
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
London
ZIP/Postal Code
SE5 9RS
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Novartis Investigative Site
City
Newcastle Upon Tyne
ZIP/Postal Code
NE7 7DN
Country
United Kingdom
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.

Learn more about this trial

A Rollover Extension Program (REP) to Evaluate the Long-term Safety and Tolerability of Open Label Iptacopan/LNP023 in Participants With Primary IgA Nephropathy

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