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Efficacy and Safety Study of Canakinumab Administered for 6 Months (24 Weeks) in Japanese Patients With Cryopyrin-associated Periodic Syndromes Followed by an Extension Phase

Primary Purpose

Cryopyrin-associated Periodic Syndromes, Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome

Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
canakinumab
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cryopyrin-associated Periodic Syndromes focused on measuring CAPS, FCAS, MWS, NOMID, cryopyrin-associated periodic syndromes, Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, Neonatal Onset Multisystem Inflammatory Disease, canakinumab, ACZ885, children, systemic autoinflammatory disease, NALP-3, human monoclonal anti-human interleukin-1beta (IL-1beta)antibody, autosomal dominant, familial autoinflammatory syndrome

Eligibility Criteria

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

Inclusion Criteria:

  1. At study entry, patients should have a clinical diagnosis of FCAS, MWS or NOMID and require medication. At the time of screening, patients can be either untreated or treated with other medication.
  2. Presence, or history of at least 2 of the following symptoms:

    • For NOMID patients:

      • Typical NOMID urticarial rash
      • Signs of central nervous system (CNS) involvement such as increased intracranial pressure and/or papilledema and/or cerebral spinal fluid pleiocytosis and/or stroke and/or seizures, and/or sensorineural hearing loss
      • Typical arthropatic changes on X-rays: epiphysal and/or patellar overgrowth With start of NOMID symptoms before or at 6 months of age
    • For MWS patients:

      • periodic fever
      • headache/migraine
      • arthralgia
      • urticarial skin rash
      • conjunctivitis
      • myalgia
      • sensorineural hearing impairment
    • For FCAS patients:

      • urticarial skin rash
      • fever/chills
      • conjunctivitis
      • joint pain
  3. Patients requiring oral steroids, NSAIDs and/or disease-modifying antirheumatic drugs (DMARDs) can be enrolled if they are on a stable dose (oral steroids: < 20 mg/day or < or = 0.4 mg/kg prednisone or prednisone equivalent, whichever applies) for at least 4 weeks prior to the screening visit.
  4. Able to communicate with the investigator and comply with the requirements of the study (for children the parent can assist when necessary).

Exclusion Criteria:

  1. Pregnant or nursing (lactating) women.
  2. All women capable of becoming pregnant unless they are postmenopausal or are using one or more methods of contraception.
  3. Participation in any other study within 30 days
  4. Infection with HIV, Hepatitis B or C.
  5. Live vaccinations within 3 months prior to the start of the trial, during the trial, and up to 3 months following the last dose.
  6. History of drug or alcohol abuse within the 12 months prior to dosing.
  7. Donation or loss of 400 mL or more of blood within 8 weeks prior to dosing for adults.
  8. History of significant medical conditions, which in the doctor's opinion would exclude the patient from participating in this trial.
  9. History of renal transplantation.
  10. Presence of any additional rheumatic diseases or significant systemic diseases. For example, major chronic infectious/ inflammatory/ immunologic disease (such as inflammatory bowel disease, psoriatic arthritis, spondyloarthropathy, systemic lupus erythematosus in addition to the autoinflammatory disease).
  11. Presence of any of the following laboratory abnormalities: ALT or AST greater than 2 times the upper limit of normal (ULN), platelet count less than 100x109/L.
  12. History of recurrent and/or evidence of clinically significant active bacterial, fungal, or viral infections.
  13. History of contact with patients with suspected tuberculosis symptoms; or history or complication of tuberculosis infection.
  14. Use of the following therapies:

    • Etanercept in the 4 weeks prior to the baseline visit (Day 1) and thereafter
    • Adalimumab in the 8 weeks prior to the baseline visit (Day 1) and thereafter
    • Infliximab in the 12 weeks prior to the baseline visit (Day 1) and thereafter
    • Rituximab in the 26 weeks prior to the baseline visit (Day 1) and thereafter
    • Tocilizumab in the 3 weeks prior to the baseline visit (Day 1) and thereafter
    • Any other investigational biologics in the 8 weeks prior to the baseline visit (Day 1) and thereafter (with the exception of anakinra therapy-see below)
    • Anakinra therapy after the baseline visit (Day 1). Last anakinra injection should occur not less than 6 hours prior to the canakinumab injection at Day 1
    • Leflunomide in the 4 weeks prior to the baseline visit (Day 1) and thereafter. After the completion of leflunomide treatment a cholestiramine in dose 8 g 3 times per day for 14 days is recommended.
    • Thalidomide in the 4 weeks prior to the baseline visit (Day 1) and thereafter
    • Cyclosporine in the 4 weeks prior to the baseline visit (Day 1) and thereafter
    • i.v. immunoglobulin (i.v. Ig) in the 8 weeks prior to the baseline visit (Day 1) and thereafter
    • 6-Mercaptopurine, azathioprine, cyclophosphamide, or chlorambucil in the 12 weeks prior to the baseline visit (Day 1) and thereafter
    • Dapsone, mycophenolate mofetil in the 3 weeks prior to the baseline visit (Day 1) and thereafter
    • > or = 20 mg/day or >0.4 mg/kg, whichever applies, of prednisone or prednisone equivalent in the 4 week prior to the baseline visit (Day 1) and thereafter
    • Methyl prednisone pulse therapy in the 4 weeks prior to baseline visit and thereafter
  15. History of allergic reaction to similar drugs. No additional exclusions may be applied by the doctor, in order to ensure that the study population will be representative of all eligible patients.

Other protocol-defined inclusion/exclusion criteria may apply

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

canakinumab

Arm Description

Outcomes

Primary Outcome Measures

Number of participants without a relapse

Secondary Outcome Measures

Number of complete responder patients
Clinical improvement (or resolution) with regards to: central nervous system (CNS) involvement, eye disease, hearing impairment, skin disease, joint disease, fever, and kidney function
Number of patients experiencing a relapse during the entire study
How much canakinumab is contained in the patients' blood (pharmacokinetics) and what are the effect of canakinumab on the patients' body (pharmacodynamic)
Presence of antibody against canakinumab

Full Information

First Posted
October 6, 2009
Last Updated
September 23, 2020
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00991146
Brief Title
Efficacy and Safety Study of Canakinumab Administered for 6 Months (24 Weeks) in Japanese Patients With Cryopyrin-associated Periodic Syndromes Followed by an Extension Phase
Official Title
An Open-label, Efficacy and Safety Study of Canakinumab (Anti-interleukin-1β Monoclonal Antibody) Administered for 6 Months (24 Weeks) in Japanese Patients With the Following Cryopyrin-associated Periodic Syndromes: Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, or Neonatal Onset Multisystem Inflammatory Disease, Followed by an Extension Phase to Provide Canakinumab to Study Patients Until it is Approved and Marketed in Japan
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
October 2009 (undefined)
Primary Completion Date
February 2012 (Actual)
Study Completion Date
February 2012 (Actual)

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
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
To date there are no approved effective therapies for the treatment of cryopyrin-associated periodic syndromes (CAPS) including Familial Cold Autoinflammatory Syndrome (FCAS), Muckle-Wells Syndrome (MWS), or Neonatal Onset Multisystem Inflammatory Disease (NOMID) in Japan. The study will assess the efficacy and safety of canakinumab in Japanese patients with cryopyrin-associated periodic syndromes (CAPS). In previous and currently ongoing CAPS studies (CACZ885A2102, CACZ885D2201, CACZ885D2304, CACZ885D2306), it has been observed that treatment with canakinumab in patients with CAPS contributed to ensure absence of relapse, to improve signs and symptoms and to prevent secondary disease complications. However, no Japanese patients have been included in those studies. This study will allow access for Japanese patients to a new potentially efficacious treatment for CAPS patients with a convenient dosing regimen.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cryopyrin-associated Periodic Syndromes, Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, Neonatal Onset Multisystem Inflammatory Disease
Keywords
CAPS, FCAS, MWS, NOMID, cryopyrin-associated periodic syndromes, Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, Neonatal Onset Multisystem Inflammatory Disease, canakinumab, ACZ885, children, systemic autoinflammatory disease, NALP-3, human monoclonal anti-human interleukin-1beta (IL-1beta)antibody, autosomal dominant, familial autoinflammatory syndrome

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
canakinumab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
canakinumab
Intervention Description
canakinumab
Primary Outcome Measure Information:
Title
Number of participants without a relapse
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Number of complete responder patients
Time Frame
29 days
Title
Clinical improvement (or resolution) with regards to: central nervous system (CNS) involvement, eye disease, hearing impairment, skin disease, joint disease, fever, and kidney function
Time Frame
24 months
Title
Number of patients experiencing a relapse during the entire study
Time Frame
24 months
Title
How much canakinumab is contained in the patients' blood (pharmacokinetics) and what are the effect of canakinumab on the patients' body (pharmacodynamic)
Time Frame
24 months
Title
Presence of antibody against canakinumab
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: At study entry, patients should have a clinical diagnosis of FCAS, MWS or NOMID and require medication. At the time of screening, patients can be either untreated or treated with other medication. Presence, or history of at least 2 of the following symptoms: For NOMID patients: Typical NOMID urticarial rash Signs of central nervous system (CNS) involvement such as increased intracranial pressure and/or papilledema and/or cerebral spinal fluid pleiocytosis and/or stroke and/or seizures, and/or sensorineural hearing loss Typical arthropatic changes on X-rays: epiphysal and/or patellar overgrowth With start of NOMID symptoms before or at 6 months of age For MWS patients: periodic fever headache/migraine arthralgia urticarial skin rash conjunctivitis myalgia sensorineural hearing impairment For FCAS patients: urticarial skin rash fever/chills conjunctivitis joint pain Patients requiring oral steroids, NSAIDs and/or disease-modifying antirheumatic drugs (DMARDs) can be enrolled if they are on a stable dose (oral steroids: < 20 mg/day or < or = 0.4 mg/kg prednisone or prednisone equivalent, whichever applies) for at least 4 weeks prior to the screening visit. Able to communicate with the investigator and comply with the requirements of the study (for children the parent can assist when necessary). Exclusion Criteria: Pregnant or nursing (lactating) women. All women capable of becoming pregnant unless they are postmenopausal or are using one or more methods of contraception. Participation in any other study within 30 days Infection with HIV, Hepatitis B or C. Live vaccinations within 3 months prior to the start of the trial, during the trial, and up to 3 months following the last dose. History of drug or alcohol abuse within the 12 months prior to dosing. Donation or loss of 400 mL or more of blood within 8 weeks prior to dosing for adults. History of significant medical conditions, which in the doctor's opinion would exclude the patient from participating in this trial. History of renal transplantation. Presence of any additional rheumatic diseases or significant systemic diseases. For example, major chronic infectious/ inflammatory/ immunologic disease (such as inflammatory bowel disease, psoriatic arthritis, spondyloarthropathy, systemic lupus erythematosus in addition to the autoinflammatory disease). Presence of any of the following laboratory abnormalities: ALT or AST greater than 2 times the upper limit of normal (ULN), platelet count less than 100x109/L. History of recurrent and/or evidence of clinically significant active bacterial, fungal, or viral infections. History of contact with patients with suspected tuberculosis symptoms; or history or complication of tuberculosis infection. Use of the following therapies: Etanercept in the 4 weeks prior to the baseline visit (Day 1) and thereafter Adalimumab in the 8 weeks prior to the baseline visit (Day 1) and thereafter Infliximab in the 12 weeks prior to the baseline visit (Day 1) and thereafter Rituximab in the 26 weeks prior to the baseline visit (Day 1) and thereafter Tocilizumab in the 3 weeks prior to the baseline visit (Day 1) and thereafter Any other investigational biologics in the 8 weeks prior to the baseline visit (Day 1) and thereafter (with the exception of anakinra therapy-see below) Anakinra therapy after the baseline visit (Day 1). Last anakinra injection should occur not less than 6 hours prior to the canakinumab injection at Day 1 Leflunomide in the 4 weeks prior to the baseline visit (Day 1) and thereafter. After the completion of leflunomide treatment a cholestiramine in dose 8 g 3 times per day for 14 days is recommended. Thalidomide in the 4 weeks prior to the baseline visit (Day 1) and thereafter Cyclosporine in the 4 weeks prior to the baseline visit (Day 1) and thereafter i.v. immunoglobulin (i.v. Ig) in the 8 weeks prior to the baseline visit (Day 1) and thereafter 6-Mercaptopurine, azathioprine, cyclophosphamide, or chlorambucil in the 12 weeks prior to the baseline visit (Day 1) and thereafter Dapsone, mycophenolate mofetil in the 3 weeks prior to the baseline visit (Day 1) and thereafter > or = 20 mg/day or >0.4 mg/kg, whichever applies, of prednisone or prednisone equivalent in the 4 week prior to the baseline visit (Day 1) and thereafter Methyl prednisone pulse therapy in the 4 weeks prior to baseline visit and thereafter History of allergic reaction to similar drugs. No additional exclusions may be applied by the doctor, in order to ensure that the study population will be representative of all eligible patients. Other protocol-defined inclusion/exclusion criteria may apply
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Novartis Investigative Site
City
Fukuoka-city
State/Province
Fukuoka
ZIP/Postal Code
812-8582
Country
Japan
Facility Name
Novartis Investigative Site
City
Yokohama-city
State/Province
Kanagawa
ZIP/Postal Code
236-0004
Country
Japan
Facility Name
Novartis Investigative Site
City
Kyoto-city
State/Province
Kyoto
ZIP/Postal Code
606-8507
Country
Japan

12. IPD Sharing Statement

Citations:
PubMed Identifier
23380020
Citation
Imagawa T, Nishikomori R, Takada H, Takeshita S, Patel N, Kim D, Lheritier K, Heike T, Hara T, Yokota S. Safety and efficacy of canakinumab in Japanese patients with phenotypes of cryopyrin-associated periodic syndrome as established in the first open-label, phase-3 pivotal study (24-week results). Clin Exp Rheumatol. 2013 Mar-Apr;31(2):302-9. Epub 2013 Feb 1.
Results Reference
result

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Efficacy and Safety Study of Canakinumab Administered for 6 Months (24 Weeks) in Japanese Patients With Cryopyrin-associated Periodic Syndromes Followed by an Extension Phase

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