A Study Evaluating the Efficacy and Safety of Mitapivat in Participants With Non-Transfusion-Dependent Alpha- or Beta-Thalassemia (α- or β-NTDT) (ENERGIZE)
Non-Transfusion-dependent Alpha-Thalassemia, Non-Transfusion-dependent Beta-Thalassemia
About this trial
This is an interventional treatment trial for Non-Transfusion-dependent Alpha-Thalassemia
Eligibility Criteria
Inclusion Criteria:
- Documented diagnosis of thalassemia (β-thalassemia with or without α-globin gene mutations, hemoglobin E (HbE)/β-thalassemia, or α-thalassemia/hemoglobin H [HbH] disease) based on Hb electrophoresis, Hb high-performance liquid chromatography (HPLC)), and/or deoxyribonucleic acid (DNA) analysis;
- Hb concentration ≤10.0 grams per deciliter (g/dL) (100.0 grams per liter [g/L]), based on an average of at least 2 Hb concentration measurements (separated by ≥7 days) collected during the Screening Period;
- Non-transfusion-dependent, defined as ≤5 red blood cell (RBC) units during the 24-week period before randomization; and no RBC transfusions ≤8 weeks before providing informed consent and no RBC transfusions during the Screening Period;
- If taking hydroxyurea, the hydroxyurea dose must be stable for ≥16 weeks before randomization;
- Women of child-bearing potential (WOCBP) must be abstinent of sexual activities that may result in pregnancy as part of their usual lifestyle or agree to use 2 forms of contraception, one of which must be considered highly effective, from the time of providing informed consent, throughout the study, and for 28 days after the last dose of study drug. The second form of contraception can be an acceptable barrier method;
- Written informed consent before any study-related procedures are conducted and willing to comply with all study procedures for the duration of the study.
Exclusion Criteria:
- Pregnant, breastfeeding, or parturient
- Documented history of homozygous or heterozygous sickle hemoglobin (HbS) or hemoglobin C (HbC);
- Prior exposure to gene therapy or prior bone marrow or stem cell transplantation;
- Currently receiving treatment with luspatercept; the last dose must have been administered ≥18 weeks before randomization;
- Currently receiving treatment with hematopoietic stimulating agents; the last dose must have been administered ≥18 weeks before randomization;
- History of malignancy, (active or treated) ≤5 years before providing informed consent;
- History of active and/or uncontrolled cardiac or pulmonary disease ≤6 months before providing informed consent, except for nonmelanomatous skin cancer in situ, cervical carcinoma in situ, or breast carcinoma in situ;
- Hepatobiliary disorders;
- Estimated glomerular filtration rate <45 milliliters per minute (mL/min)/1.73 m^2 by Chronic Kidney Disease Epidemiology Collaboration creatinine equation;
- Nonfasting triglycerides >440 milligrams per deciliter (mg/dL) (5 millimoles per liter [mmol/L]);
- Active infection requiring systemic antimicrobial therapy at the time of providing informed consent;
- Positive test for hepatitis C virus antibody (HCVAb) with evidence of active HCV infection, or positive test for hepatitis B surface antigen (HBsAg);
- Positive test for human immunodeficiency virus (HIV)-1 antibody (Ab) or HIV-2 Ab;
- History of major surgery (including splenectomy) ≤16 weeks before providing informed consent and/or a major surgical procedure planned during the study;
- Current enrollment or past participation (≤12 weeks before administration of the first dose of study drug or a timeframe equivalent to 5 half-lives of the investigational study drug, whichever is longer) in any other clinical study involving an investigational treatment or device;
- Receiving strong CYP3A4/5 inhibitors that have not been stopped for ≥5 days or a timeframe equivalent to 5 half-lives (whichever is longer); or strong CYP3A4 inducers that have not been stopped for ≥4 weeks or a timeframe equivalent to 5 half-lives (whichever is longer), before randomization;
- Receiving anabolic steroids that have not been stopped for at least 4 weeks before randomization. Testosterone replacement therapy to treat hypogonadism is allowed. The testosterone dose and preparation must be stable for ≥10 weeks before randomization;
- Known allergy to mitapivat or its excipients (microcrystalline cellulose, croscarmellose sodium, sodium stearyl fumarate, mannitol, and magnesium stearate, Opadry® II Blue [hypromellose, titanium dioxide, lactose monohydrate, triacetin, and FD&C Blue #2]);
Any medical, hematological, psychological, or behavioral condition(s) or prior or current therapy that, in the opinion of the Investigator, may confer an unacceptable risk to participating in the study and/or could confound the interpretation of the study data Also excluded are:
- Participants who are institutionalized by regulatory or court order
- Participants with any condition(s) that could create undue influence (including but not limited to incarceration, involuntary psychiatric confinement, and financial or familial affiliation with the Investigator or Sponsor)
Sites / Locations
- San Diego Hospital, UC San Diego Health
- Children's Hospital Oakland
- Stanford Medicine
- Massachusetts General Hospital
- Weill Cornell Medical Center
- Duke University Medical Center
- Penn Medicine - University of Pennsylvania Health System
- Universidade de Caxias do Sul
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP
- HEMORIO Instituto Nacional de Hematologia
- Praxis Pesquisa Medica
- Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidad de São Paulo
- GSH Banco de Sangue de São Paulo
- MHAT "Dr. Nikola Vasiliev" AD
- UMHAT "Sveti Georgi" EAD
- SHATHD Sofia
- Toronto General Hospital, University Health Network
- Rigshospitalet
- CHU Hôpital Henri Mondor
- Hopital Edouard Herriot, CHU de Lyon
- University General Hospital of Patras
- Children's Hospital Agia Sophia, National and Kapodistrian University of Athens Medical School
- Laiko General Hospital
- University Hospital of Ioannina
- Ippokrateio General Hospital
- Ospedale "A. Perrino" - Brindisi
- Ospedale Pediatrico Microcitemico
- Ospedale Sant'Anna
- Ente Ospedaliero Ospedali Galliera
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
- A.O.U Di Modena
- A.O.R.N. "A. Cardarelli"
- AOU L. Vanvitelli Universita degli Studi della Campania Luigi Vanvitelli
- A.O.U. San Luigi Gonzaga
- Chronic Care Center
- Hospital Sultanah Bahiyah
- Hospital Ampang
- Hospital Sultanah Aminah Johor Bahru
- Hospital Queen Elizabeth, Kota Kinabalu
- Hospital Tunku Azizah
- Hospital Tengku Ampuan Afzan
- Hospital Umum Sarawak
- Hospital Pulau Pinang
- Universitair Medisch Centrum Utrecht
- Erasmus MC
- King Abdulaziz Hospital - Al Ahsa
- King Abdullah International Medical Research Center
- King Khalid University Hospital
- Hospital Universitario Vall d'Hebron
- Hospital Universitario La Paz
- Hospital Universitario Virgen Arrixaca
- Hospital Universitario Virgen del Rocío
- China Medical University, Taiwan
- National Taiwan University Hospital
- Phramongkutklao Hospital
- Ramathibodi Hospital
- Faculty of Medicine Siriraj Hospital
- Maharaj Nakorn Chiang Mai Hospital
- Srinagarind Hospital, Khon Kaen University
- Naresuan University Hospital
- King Chulalongkorn Memorial Hospital
- Acibadem Adana Hospital
- Akdeniz University Faculty of Medicine
- Çukurova University
- Ege University Faculty of Medicine
- Istanbul University Faculty of Medicine
- Hacettepe University
- Burjeel Medical City
- Thalassemia Centre Dubai
- Cambridge University Hospitals NHS Foundation Trust - Addenbrookes Hospital
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust
- Imperial College Healthcare NHS Trust - Hammersmith Hospital
- University College London
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Mitapivat
Placebo
Double-blind Period: Participants will receive mitapivat 100 milligrams (mg), orally, twice daily (BID) for 24 weeks. Open-label Extension Period: Participants who do not discontinue study drug may choose to continue to receive mitapivat for up to an additional 5 years after the Double-blind Period.
Double-blind Period: Participants will receive placebo matching mitapivat, orally, BID for 24 weeks. Open-label Extension Period: Participants who do not discontinue study drug may choose to receive mitapivat for up to an additional 5 years after the Double-blind Period.