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A Study of TAK-755 (rADAMTS13) With Little to No Plasma Exchange (PEX) Treatment in Adults With Immune-mediated Thrombotic Thrombocytopenic Purpura (iTTP)

Phase 2
Active, not recruiting
Conditions
Thrombotic Thrombocytopenic Purpura (TTP)
Interventions
Registration Number
NCT05714969
Lead Sponsor
Takeda
Brief Summary

This is a study of TAK-755 in adults with immune-mediated thrombotic thrombocytopenic purpura (iTTP). The main aim of this study is to determine the percentage of participants with a clinical (Part 1) or platelet (Part 2) response without plasma exchange during the study. Participants who have an acute attack of iTTP will receive TAK-755 and immunosuppressive therapy during their stay at the hospital until they achieve a clinical response in Part 1 or platelet response in Part 2. Participants will also be treated with TAK-755 for an additional time of up to 6 weeks after the acute phase. In total, participants will stay in the study for approximately 3 months.

Detailed Description

This study consists of 2-parts. Part 1 is a double-blind, randomized study in which participants were randomized 1:1, in a blinded fashion, into 2 TAK-755 dose groups. Part 1, randomization was stratified based on whether the participant had received pre-study PEX and on the participant's Glasgow Coma Scale. Part 2 is an open-label study in which participants with iTTP experiencing an acute iTTP episode will be enrolled and assigned to a single-arm treatment.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
33
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part 1: TAK-755 Dose 1 in Acute Phase and Dose 2 in Post-acute PhaseTAK-755TAK-755 Dose 1, IV infusion, in the acute phase until clinical response is achieved. All participants achieving clinical response will receive TAK-755 at Dose 2, for up to 6 weeks during the post-acute phase.
Part 1: TAK-755 Dose 2 in Both Acute and Post-Acute PhaseTAK-755TAK-755 Dose 2, IV infusion, in the acute phase until clinical response is achieved. All participants achieving clinical response will receive TAK-755 at Dose 2, for up to 6 weeks during the post-acute phase.
Part 2: TAK-755 Dose 3 in Acute Phase and Dose 2 in Post-acute PhaseTAK-755TAK-755 Dose 3, IV infusion, in the acute phase until 48-hour platelet response is achieved. All participants achieving platelet response will receive TAK-755 at Dose 2, 4 times per week for Week 1 and 3 times per week for Week 2 and 3 during the post-acute phase based on investigator judgement as high-risk for developing iTTP recurrence.
Primary Outcome Measures
NameTimeMethod
Incidence of Adverse Events (AEs), Serious Adverse Events (SAEs), and Adverse Event of Special Interest (AESIs) After Receiving any Dose of Investigational Product (IP)Through study completion, approximately 12 weeks

An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (e.g., a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. SAE: Signs, symptoms or outcomes which results in death, requires inpatient hospitalization or prolongation of hospitalization, results in persistent or significant disability/incapacity, results in a congenital abnormality/birth defect, or is an important medical event. Adverse events of special interest include major thrombotic events and treatment-related bleeding events.

Secondary Outcome Measures
NameTimeMethod
Part 1: Achievement of Clinical Response Without On-Study Plasma Exchange (PEX)Through study completion, approximately 12 weeks

Clinical response is defined as normalization of platelets and no clinical evidence of new or progressive ischemic organ injury. Normalization of platelets: First occurrence of normal platelet count (greater than or equal to \[\>=\]150,000/microliter \[mcL\]) that is followed by a confirmatory platelet count of \>=150,000/mcL and a lactate dehydrogenase (LDH) \<1.5×upper limit of normal (ULN) at 48±12 hours after the first occurrence.

Part 2: Achievement of Platelet Response Without On-Study Plasma Exchange (PEX)Through study completion, approximately 12 weeks

Platelet response is defined as first occurrence of normal platelet count (\>=150,000/mcL) that is followed by a confirmatory platelet count of \>=150,000/mcL at 48±12 hours after the first occurrence.

Part 1: Achievement of Clinical Response With Zero or Minimal on-Study PEXThrough study completion, approximately 12 weeks

The number of PEX administered considered Zero when no PEX is administered and considered Minimal when 1 to 3 PEX are administered.

Part 2: Achievement of Platelet Response With Zero or Minimal on-Study PEXThrough study completion, approximately 12 weeks

The number of PEX administered considered Zero when no PEX is administered and considered Minimal when 1 to 3 PEX are administered.

Part 1: Achievement of Clinical Response OverallThrough study completion, approximately 12 weeks

Overall indicates clinical response regardless of whether on-study PEX is administered, or the number of PEX administered.

Part 2: Achievement of Platelet Response OverallThrough study completion, approximately 12 weeks

Overall indicates platelet response regardless of whether on-study PEX is administered, or the number of PEX administered.

Part 1: Time to Clinical Response (Acute Phase)Through study completion, approximately 12 weeks
Part 2: Time to Platelet Response (Acute Phase)Through study completion, approximately 12 weeks
Part 1: Time to First On-Study PEX in Participants who Achieved Clinical ResponseThrough study completion, approximately 12 weeks
Part 2: Time to First On-Study PEX in Participants who Achieved Platelet ResponseThrough study completion, approximately 12 weeks
Part 1: Number of Days of On-study PEX in Participants to Achieve Clinical Response (Acute Phase)Through study completion, approximately 12 weeks
Part 2: Number of Days of On-study PEX in Participants to Achieve Platelet Response (Acute Phase)Through study completion, approximately 12 weeks
Part 1: Total Volume of Plasma Administered (Acute Phase) to Achieve Clinical ResponseThrough study completion, approximately 12 weeks
Part 2: Total Volume of Plasma Administered (Acute Phase) to Achieve Platelet ResponseThrough study completion, approximately 12 weeks
Part 1: Occurrence of Treatment FailureThrough study completion, approximately 12 weeks

Treatment failure is defined as failure to achieve clinical response, or experience iTTP recurrence.

Part 2: Occurrence of Treatment FailureThrough study completion, approximately 12 weeks

Treatment failure is defined as failure to achieve platelet response, or experience iTTP recurrence.

Part 1: Occurrence of Immune-Mediated Thrombotic Thrombocytopenic Purpura (iTTP) Recurrence (Following Clinical Response), Exacerbation, or Relapse (Post-acute Phase)Through study completion, approximately 12 weeks

iTTP recurrence comprised of exacerbation or relapse. Clinical exacerbation: Occurs \<30 days after achieving initial clinical response (i.e., before clinical remission) and recurrent thrombocytopenia (platelet levels \<150,000/μL), with or without clinical evidence of new or progressive ischemic organ damage, requiring daily PEX or rescue therapy. Clinical relapses: Occurs \>=30 days after achieving initial clinical response (i.e., after clinical remission) and recurrent thrombocytopenia (platelet levels \<150,000/μL), with or without clinical evidence of new or progressive ischemic organ damage, requiring daily PEX or rescue therapy.

Part 2: Occurrence of iTTP Recurrence (Following Platelet Response), Exacerbation, or Relapse (Post-acute Phase)Through study completion, approximately 12 weeks

iTTP recurrence comprised of exacerbation or relapse. Clinical exacerbation: Occurs \<30 days after achieving initial platelet response (i.e., before clinical remission) and recurrent thrombocytopenia (platelet levels \<150,000/μL), with or without clinical evidence of new or progressive ischemic organ damage, requiring daily PEX or rescue therapy. Clinical relapses: Occurs \>=30 days after achieving initial platelet response (i.e., after clinical remission) and recurrent thrombocytopenia (platelet levels \<150,000/μL), with or without clinical evidence of new or progressive ischemic organ damage, requiring daily PEX or rescue therapy.

Part 1: Time to iTTP Recurrence (Following Clinical Response), Exacerbation, or RelapseThrough study completion, approximately 12 weeks
Part 2: Time to iTTP Recurrence (Following Platelet Response), Exacerbation, or RelapseThrough study completion, approximately 12 weeks
Part 1: Occurrence of Any One of the Following Events: Clinical Recurrence (Following Clinical Response), iTTP-Related Death, or Major Thrombotic Event From Time of First IP Administration Through Study CompletionThrough study completion, approximately 12 weeks
Part 2: Occurrence of Any One of the Following Events: Clinical Recurrence (Following Platelet Response), iTTP-Related Death, or Major Thrombotic Event From Time of First IP Administration Through Study CompletionThrough study completion, approximately 12 weeks
Part 1: Time to Occurrence of Any One of the Following Events: Clinical Recurrence (Following Clinical Response), iTTP-Related Death, or Major Thrombotic Event From Time of First IP Administration Through Study CompletionThrough study completion, approximately 12 weeks
Part 2: Time to Occurrence of Any One of the Following Events: Clinical Recurrence (Following Platelet Response), iTTP-Related Death, or Major Thrombotic Event From Time of First IP Administration Through Study CompletionThrough study completion, approximately 12 weeks
Part 1: Change From Baseline in Lactate Dehydrogenase [LDH] Levels at Clinical Response and Study CompletionThrough study completion, approximately 12 weeks
Part 2: Change From Baseline in LDH Levels at Platelet Response and Study CompletionThrough study completion, approximately 12 weeks
Part 1: Change From Baseline in Troponin Levels at Clinical Response and Study CompletionThrough study completion, approximately 12 weeks
Part 1 and 2: A Disintegrin and Metalloproteinase With Thrombospondin Motifs 13 (ADAMTS13) Antigen Level Resulting From TAK-755 Administration in Acute and Post-Acute PhasesThrough study completion, approximately 12 weeks
Part 1 and 2: ADAMTS13 Activity Level Resulting From TAK-755 Administration in Acute and Post-Acute PhasesThrough study completion, approximately 12 weeks
Part 1: Von Willebrand Factor (VWF) Antigen Level Resulting From TAK-755 Administration in Acute and Post-Acute PhasesThrough study completion, approximately 12 weeks
Part 1: VWF Activity Level Resulting From TAK-755 Administration in Acute and Post-Acute PhasesThrough study completion, approximately 12 weeks
Part 2: Change From Baseline in Troponin Levels at Platelet Response and Study CompletionThrough study completion, approximately 12 weeks
Part 1: Achievement of Clinical RemissionThrough study completion, approximately 12 weeks

Clinical remission is defined as achieving clinical response and no recurrence for \>=30 days.

Part 2: Achievement of Clinical RemissionThrough study completion, approximately 12 weeks

Clinical remission is defined as achieving platelet response and no recurrence for \>=30 days.

Part 1: Occurrence of Refractoriness (Acute Phase)Through study completion, approximately 12 weeks

Trial Locations

Locations (22)

University College London Hospital

🇬🇧

London, United Kingdom

University of Florida Shands

🇺🇸

Gainesville, Florida, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Brigham and Women's Hospital

🇺🇸

Boston, Massachusetts, United States

University of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

Rutgers University

🇺🇸

New Brunswick, New Jersey, United States

Weill Cornell Medical College New York Presbyterian Hospital

🇺🇸

New York, New York, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Leo Jenkins Cancer Center/ECU School of Medicine

🇺🇸

Greenville, North Carolina, United States

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University College London Hospital
🇬🇧London, United Kingdom
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