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A Study to Evaluate the Pharmacokinetics (PK), Efficacy and Safety and Tolerability of Pegcetacoplan in Patients With TA-TMA After Hematopoietic Stem Cell Transplantation (HSCT)

Primary Purpose

Transplant-Associated Thrombotic Microangiopathy

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Pegcetacoplan
Sponsored by
Swedish Orphan Biovitrum
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Transplant-Associated Thrombotic Microangiopathy focused on measuring TA-TMA

Eligibility Criteria

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

Inclusion Criteria:

  1. Male and female patients aged ≥ 18 years at the time of informed consent form (ICF) signature.
  2. Received allogeneic HSCT.
  3. Diagnosis of TA-TMA established, as per laboratory markers indicating TMA.
  4. Have a diagnosis of TA-TMA that persists despite initial management of any triggering condition.
  5. Have rUPCR ≥ 1 mg/mg.
  6. Women of childbearing potential, defined as any women who have experienced menarche and who are NOT permanently sterile or postmenopausal, must have a negative serum pregnancy test at screening and agree to use protocol-defined methods of contraception for the duration of the study and 8 weeks after their last IMP dose.

    Note: Postmenopausal is defined as having had 12 consecutive months with no menses without an alternative medical cause.

  7. Men must agree to the following for the duration of the study and 8 weeks after their last dose of IMP:

    1. Avoid fathering a child.
    2. Use protocol-defined methods of contraception.
    3. Refrain from donating sperm.
  8. Patient and/or legally authorized representative must be capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the ICF.

Exclusion Criteria:

  1. Positive direct Coombs test.
  2. Known familial or acquired ADAMTS13 deficiency.
  3. Known Shiga toxin-related hemolytic uremic syndrome.
  4. Known bone marrow or graft failure.
  5. Diagnosis of disseminated intravascular coagulation.
  6. Diagnosis of veno-occlusive disease (VOD).
  7. Active GI bleeding (hematemesis or hematochezia) at baseline.
  8. Body weight < 30 kg and > 100 kg.
  9. Uncontrolled systemic bacterial or fungal infection, presence or suspicion of sepsis.
  10. Previously or currently treated with a complement inhibitor (approved or investigational).
  11. Pregnancy or breastfeeding.
  12. Positive human immunodeficiency virus antibody at screening or documented in pre-HSCT medical record.
  13. Hepatitis C virus detectable by polymerase chain reaction at screening or documented in pre-HSCT medical record.
  14. Chronic inactive hepatitis B virus with viral loads > 1000 IU/mL (> 5000 copies/mL) at screening or documented in pre-HSCT medical record. Eligible patients who are chronic active carriers (≤ 1000 IU/mL) must receive prophylactic antiviral treatment (e.g., entecavir, tenofovir, lamivudine) according to local country guidelines.
  15. Known or suspected hereditary fructose intolerance.
  16. Hypersensitivity to pegcetacoplan or any of its excipients.
  17. Inability to cooperate with study procedures or any condition that, in the opinion of the investigator, could increase the patient's risk by participating in the study or confound the outcome of the study.

Sites / Locations

  • Ryotaro Nakamura, MDRecruiting
  • Hassan AlKhateeb, MDRecruiting
  • Michael Loschi, MDRecruiting
  • Flore Sicre de Fontbrune, MDRecruiting
  • Jerome Cornillon, MDRecruiting
  • Panagiotis Tsirigotis, MDRecruiting
  • Ioannis Baltadakis, MDRecruiting
  • Ioanna Sakellari, MDRecruiting
  • Antonio Risitano, MDRecruiting
  • Giovanni Grillo, MDRecruiting
  • Elisabetta Terruzi, MDRecruiting
  • Luca Castagna, MDRecruiting
  • Simona Sica, MDRecruiting
  • Rafael Francisco Duarte Palomino, MDRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pegcetacoplan

Arm Description

Outcomes

Primary Outcome Measures

Pegcetacoplan PK parameter AUC0-tau
Area under the concentration-time curve over the dosing interval
Pegcetacoplan PK parameter Cmax
Maximum observed serum concentration
Pegcetacoplan PK parameter Tmax
Time of maximum measured serum concentration
Pegcetacoplan PK parameter Ctrough
Observed serum concentration predose

Secondary Outcome Measures

Absolute levels, change from baseline, and percent change in sC5b-9
Absolute levels, change from baseline, and percent change from baseline to Week 24 in biomarker of complement activation sC5b-9
Number of participants reaching clinical response at week 24
A participant will be declared as reaching a clinical response upon improvement in laboratory markers of TMA and resolution of TMA clinical symptoms
Number of participants reaching TMA response at week 24
A participant will be declared as reaching TMA response upon improvement in laboratory markers of TMA
Overall survival
Survival
Overall survival
Survival
Time to clinical response.
Both clinical response sustained at week 24 and clinical response at any time during the study will be assessed.
Time to TMA response.
Both TMA response sustained at week 24 and TMA response at any time during the study will be assessed.
Duration of clinical response.
Duration of TMA response.
TA-TMA relapse at Week 24.
A participant will be declared as relapsing upon appearance of laboratory markers of TMA
Number of participants reaching clinical response at week 12
Number of participants reaching TMA response at week 12

Full Information

First Posted
October 21, 2021
Last Updated
June 8, 2023
Sponsor
Swedish Orphan Biovitrum
Collaborators
Apellis Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05148299
Brief Title
A Study to Evaluate the Pharmacokinetics (PK), Efficacy and Safety and Tolerability of Pegcetacoplan in Patients With TA-TMA After Hematopoietic Stem Cell Transplantation (HSCT)
Official Title
An Open-label, Single-arm, Multicenter Pilot Study to Evaluate the Pharmacokinetics, Pharmacodynamics, Efficacy and Safety of Pegcetacoplan in Patients With Transplant-associated Thrombotic Microangiopathy (TA-TMA) After Hematopoietic Stem Cell Transplantation (HSCT)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 1, 2022 (Actual)
Primary Completion Date
March 31, 2024 (Anticipated)
Study Completion Date
March 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Swedish Orphan Biovitrum
Collaborators
Apellis Pharmaceuticals, Inc.

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 the study is to assess PK, Pharmacodynamics (PD), Efficacy and safety of pegcetacoplan in patients with TA-TMA after HSCT.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Transplant-Associated Thrombotic Microangiopathy
Keywords
TA-TMA

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
open label, single arm, multicenter
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Pegcetacoplan
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Pegcetacoplan
Intervention Description
20-cc glass vials-1080 mg
Primary Outcome Measure Information:
Title
Pegcetacoplan PK parameter AUC0-tau
Description
Area under the concentration-time curve over the dosing interval
Time Frame
Week 24
Title
Pegcetacoplan PK parameter Cmax
Description
Maximum observed serum concentration
Time Frame
Week 24
Title
Pegcetacoplan PK parameter Tmax
Description
Time of maximum measured serum concentration
Time Frame
Week 24
Title
Pegcetacoplan PK parameter Ctrough
Description
Observed serum concentration predose
Time Frame
Week 24
Secondary Outcome Measure Information:
Title
Absolute levels, change from baseline, and percent change in sC5b-9
Description
Absolute levels, change from baseline, and percent change from baseline to Week 24 in biomarker of complement activation sC5b-9
Time Frame
Week 24
Title
Number of participants reaching clinical response at week 24
Description
A participant will be declared as reaching a clinical response upon improvement in laboratory markers of TMA and resolution of TMA clinical symptoms
Time Frame
Week 24
Title
Number of participants reaching TMA response at week 24
Description
A participant will be declared as reaching TMA response upon improvement in laboratory markers of TMA
Time Frame
Week 24
Title
Overall survival
Description
Survival
Time Frame
Day 100 from diagnosis
Title
Overall survival
Description
Survival
Time Frame
Week 24 from treatment start
Title
Time to clinical response.
Description
Both clinical response sustained at week 24 and clinical response at any time during the study will be assessed.
Time Frame
From treatment start to first documentation of attainment of a clinical response
Title
Time to TMA response.
Description
Both TMA response sustained at week 24 and TMA response at any time during the study will be assessed.
Time Frame
From treatment start to first documentation of attainment of a TMA response
Title
Duration of clinical response.
Time Frame
From the first observed clinical response until the response criteria is no longer fulfilled or until end of study
Title
Duration of TMA response.
Time Frame
From the first observed TMA response until the response criteria is no longer fulfilled or until end of study
Title
TA-TMA relapse at Week 24.
Description
A participant will be declared as relapsing upon appearance of laboratory markers of TMA
Time Frame
Week 24
Title
Number of participants reaching clinical response at week 12
Time Frame
Week 12
Title
Number of participants reaching TMA response at week 12
Time Frame
Week 12
Other Pre-specified Outcome Measures:
Title
Number of participants with treatment-related adverse events.
Description
Occurrence and severity of treatment-emergent adverse events.
Time Frame
From treatment start to end of study, an average of 6 months
Title
Number of participants with clinically significant changes in vital signs.
Description
Occurrence of clinically significant changes in vital signs.
Time Frame
Week 24
Title
Number of participants with clinically significant changes in abnormal electrocardiogram findings.
Description
Occurrence of clinically significant abnormal electrocardiogram findings.
Time Frame
Week 24
Title
Number of participants with antibodies to polyethylene glycol (PEG) and pegcetacoplan throughout treatment and follow-up periods.
Description
Presence of antibodies to polyethylene glycol (PEG) and pegcetacoplan throughout treatment and follow-up periods.
Time Frame
from treatment start to the end of the study, an average of 6 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients aged ≥ 18 years at the time of informed consent form (ICF) signature. Received allogeneic HSCT. Diagnosis of TA-TMA established, as per laboratory markers indicating TMA. Have a diagnosis of TA-TMA that persists despite initial management of any triggering condition. Have rUPCR ≥ 1 mg/mg. Women of childbearing potential, defined as any women who have experienced menarche and who are NOT permanently sterile or postmenopausal, must have a negative serum pregnancy test at screening and agree to use protocol-defined methods of contraception for the duration of the study and 8 weeks after their last IMP dose. Note: Postmenopausal is defined as having had 12 consecutive months with no menses without an alternative medical cause. Men must agree to the following for the duration of the study and 8 weeks after their last dose of IMP: Avoid fathering a child. Use protocol-defined methods of contraception. Refrain from donating sperm. Patient and/or legally authorized representative must be capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the ICF. Exclusion Criteria: Positive direct Coombs test. Known familial or acquired ADAMTS13 deficiency. Known Shiga toxin-related hemolytic uremic syndrome. Known bone marrow or graft failure. Diagnosis of disseminated intravascular coagulation. Diagnosis of veno-occlusive disease (VOD). Active GI bleeding (hematemesis or hematochezia) at baseline. Body weight < 30 kg and > 100 kg. Uncontrolled systemic bacterial or fungal infection, presence or suspicion of sepsis. Previously or currently treated with a complement inhibitor (approved or investigational). Pregnancy or breastfeeding. Positive human immunodeficiency virus antibody at screening or documented in pre-HSCT medical record. Hepatitis C virus detectable by polymerase chain reaction at screening or documented in pre-HSCT medical record. Chronic inactive hepatitis B virus with viral loads > 1000 IU/mL (> 5000 copies/mL) at screening or documented in pre-HSCT medical record. Eligible patients who are chronic active carriers (≤ 1000 IU/mL) must receive prophylactic antiviral treatment (e.g., entecavir, tenofovir, lamivudine) according to local country guidelines. Known or suspected hereditary fructose intolerance. Hypersensitivity to pegcetacoplan or any of its excipients. Inability to cooperate with study procedures or any condition that, in the opinion of the investigator, could increase the patient's risk by participating in the study or confound the outcome of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Luis Lopez Lazaro, MD
Phone
0041 79 834 17 78
Email
Luis.LopezLazaro@sobi.com
Facility Information:
Facility Name
Ryotaro Nakamura, MD
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Individual Site Status
Recruiting
Facility Name
Hassan AlKhateeb, MD
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Individual Site Status
Recruiting
Facility Name
Michael Loschi, MD
City
Nice
ZIP/Postal Code
06202
Country
France
Individual Site Status
Recruiting
Facility Name
Flore Sicre de Fontbrune, MD
City
Paris
ZIP/Postal Code
75010
Country
France
Individual Site Status
Recruiting
Facility Name
Jerome Cornillon, MD
City
Saint-Priest-en-Jarez
ZIP/Postal Code
42270
Country
France
Individual Site Status
Recruiting
Facility Name
Panagiotis Tsirigotis, MD
City
Athens
State/Province
Chaidari
ZIP/Postal Code
12462
Country
Greece
Individual Site Status
Recruiting
Facility Name
Ioannis Baltadakis, MD
City
Athens
ZIP/Postal Code
10676
Country
Greece
Individual Site Status
Recruiting
Facility Name
Ioanna Sakellari, MD
City
Thessaloníki
ZIP/Postal Code
57010
Country
Greece
Individual Site Status
Recruiting
Facility Name
Antonio Risitano, MD
City
Avellino
ZIP/Postal Code
83100
Country
Italy
Individual Site Status
Recruiting
Facility Name
Giovanni Grillo, MD
City
Milan
ZIP/Postal Code
20162
Country
Italy
Individual Site Status
Recruiting
Facility Name
Elisabetta Terruzi, MD
City
Monza
ZIP/Postal Code
20900
Country
Italy
Individual Site Status
Recruiting
Facility Name
Luca Castagna, MD
City
Palermo
ZIP/Postal Code
900146
Country
Italy
Individual Site Status
Recruiting
Facility Name
Simona Sica, MD
City
Roma
ZIP/Postal Code
00168
Country
Italy
Individual Site Status
Recruiting
Facility Name
Rafael Francisco Duarte Palomino, MD
City
Madrid
ZIP/Postal Code
28222
Country
Spain
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study to Evaluate the Pharmacokinetics (PK), Efficacy and Safety and Tolerability of Pegcetacoplan in Patients With TA-TMA After Hematopoietic Stem Cell Transplantation (HSCT)

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