A Phase 2 Study on Narsoplimab in Paediatric Patients with High Risk Haematopoietic Stem Cell Transplant Thrombotic Microangiopathy

Phase 1

Recruiting

• Conditions: Haematopoietic Stem Cell Transplant Thrombotic Microangiopathy; MedDRA version: 20.0Level: HLGTClassification code: 10064477Term: Coagulopathies and bleeding diatheses (excl thrombocytopenic) Class: 10005329; MedDRA version: 20.0Level: HLTClassification code: 10053567Term: Coagulopathies Class: 10005329; MedDRA version: 20.0Level: PTClassification code: 10043645Term: Thrombotic microangiopathy Class: 100000004851; Therapeutic area: Diseases [C] - Immune System Diseases [C20]

• Registration Number: CTIS2023-509710-11-00
• Lead Sponsor: Omeros Corp.

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2024-05-23
• Last Update Posted: 22 July 2024

Recruitment & Eligibility

• Status: Recruiting
• Sex: All
• Target Recruitment: 18

Inclusion Criteria

Age at least 28 days and less than 18 years prior to informed consent (Visit 0)., Have informed consent from at least one parent or legal guardian as required by local law and regulation. Patient informed consent will be required if the patient has reached the local legal age of majority., Assent from patients as required by local law and regulation., Have received an allogeneic haematopoietic stem cell transplant for the treatment of non-malignant or malignant disease. All donor cell sources are allowed (i.e., matched, mismatched, and haploidentical; related and unrelated; bone marrow, peripheral blood stem cells, and umbilical cord blood)., Have a diagnosis of high-risk HSCT-TMA, defined as having both of the following: • Platelet count < 50,000/µL or a decrease in platelet count > 50% from the highest value obtained following transplant • Evidence of microangiopathic hemolysis (presence of schistocytes, serum LDH > ULN, or haptoglobin < lower limit of normal [LLN]), Have at least one of the following HSCT-TMA high-risk criteria: • HSCT-TMA persistence = 2 weeks following modification of calcineurin inhibitors or sirolimus OR • Have evidence of high-risk HSCT-TMA defined as at least one of the following: - Spot protein/creatinine ratio = 2 mg/mg - Serum creatinine > 1.5 x the creatinine level prior to TMA development - Biopsy-proven gastrointestinal TMA - TMA-related neurological abnormality (e.g., confusion, stroke, transient ischemic attack [TIA], or seizures) - Pericardial or pleural effusion without alternative explanation - Pulmonary hypertension without alternative explanation - Have Grade III or Grade IV GVHD or, in the opinion of the Investigator, risk for development of Grade III or Grade IV GVHD if immunosuppression were to be modified - Have elevated serum C5b-9 (> 244 ng/mL), If sexually active and of childbearing potential (for female paediatric patients, defined as starting at onset of menses), must agree to practice a highly effective method of birth control throughout the study drug treatment and for at least 12 weeks after the last dose of study drug, such method of birth control defined as one that results in a low failure rate (i.e., less than 1% per year) when used consistently and correctly, such as implants, injectables, combined oral contraceptives, some intrauterine devices, sexual abstinence (abstinence is acceptable when it is in line with the patient’s preferred and usual lifestyle and is defined as complete abstinence of sexual intercourse, not periodic abstinence or withdrawal), or vasectomized partner., Male patients must be willing to avoid fathering children for at least 12 weeks following the last dose of study medication.

Exclusion Criteria

All treatments for HSCT-TMA are allowed except eculizumab, ravulizumab, and defibrotide within 3 months prior to informed consent, unless failure of therapy can be documented. a. Patients may not be on eculizumab, ravulizumab, or defibrotide for any indication at screening., Have a positive test by antigen, antibody, or polymerase chain reaction (PRC) for human immunodeficiency virus (HIV); if negative within 28 days prior to informed consent, the test does not need to be repeated., Patients or their parent or legal guardian who are an employee of Omeros, Clinical Research Organization (CRO), an Investigator, a study staff member, or an immediate family member., Have a known hypersensitivity to any constituent of the product., Presence of any condition that the Investigator believes would put the patient at risk., Have Shiga toxin-producing Escherichia coli haemolytic uraemic syndrome (STEC-HUS). Test results obtained within 28 days prior to informed consent may be used., Have ADAMTS13 activity < 10%. Test results obtained within 28 days prior to informed consent may be used., Have a severe, uncontrolled systemic bacterial or fungal infection requiring antimicrobial therapy, or a severe uncontrolled viral infection (as determined by the investigator); prophylactic antimicrobial therapy administered as standard of care is allowed., Have malignant hypertension (blood pressure [BP] > 99th percentile plus 5 mmHg with bilateral hemorrhages or cotton-wool” exudates on fundoscopic examination)., Due to conditions other than HSCT-TMA, have a poor prognosis with a life expectancy of less than 3 months in the opinion of the Investigator., If pregnant, or lactating., Have received treatment with an investigational drug or device within 4 weeks entering study., Have abnormal liver function tests defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 5 times ULN within 28 days prior to informed consent through prior to the first dose.

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified