Efficacy and safety of iptacopan (LNP023) in adult patients with atypical hemolytic uremic syndrome naïve to complement inhibitor therapy

Phase 1

• Conditions: atypical hemolytic uremic syndrome; MedDRA version: 20.1Level: LLTClassification code 10079841Term: Atypical hemolytic uremic syndromeSystem Organ Class: 10005329 - Blood and lymphatic system disorders; Therapeutic area: Diseases [C] - Blood and lymphatic diseases [C15]

• Registration Number: EUCTR2020-005186-13-SK
• Lead Sponsor: ovartis Pharma AG

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2022-10-20
• Last Update Posted: 8 July 2024

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

- Male and female patients = 18 years of age with evidence of active thrombotic microangiopathy (TMA), including thrombocytopenia, evidence of hemolysis, and acute kidney injury, based on the following laboratory findings:
-Platelet count <150x109/L during the Screening Period, and
- LDH =1.5 x upper limit of normal (ULN) during the Screening Period
and hemoglobin = lower limit of normal (LLN) for age and gender during
the Screening Period, and
• Serum creatinine =ULN during the Screening Period with acute
worsening of kidney function. (Patients requiring dialysis for acute
kidney injury are eligible) • Vaccination against Neisseria meningitidis and Streptococcus pneumoniae infections is required prior to the start of study treatment. If the patient has not been previously vaccinated, or if a booster is required, vaccine should be given according to local regulations, at least 2 weeks prior to first study drug administration. If study treatment has to start earlier than 2 weeks post vaccination or before vaccination is given, prophylactic antibiotic treatment must be administered at the start of study treatment and for at least 2 weeks after vaccination
- If not received previously, vaccination against Haemophilus influenzae infection should be given if available and according to local regulations. The vaccine should be given at least 2 weeks prior to first study drug administration.
- Among patients with a kidney transplant, (a) known history of aHUS prior to current kidney transplantation, or (b) If no history of aHUS prior
to the current transplantation is available, patients may be eligible
without changes of immunosuppressive regimen if investigator excludes
other causes of TMA not attributable to aHUS, especially transplant
rejection. If immunosuppressive regimens (e.g., calcineurin inhibitor
[CNI] or mammalian target of rapamycin inhibitor [mTORi] need to be
modified after transplantation, evidence that TMA has persisted for at
least 4 days after modification needs to be available.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 45
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 5

Exclusion Criteria

• Previous or ongoing Treatment with complement inhibitors, including anti-C5 antibody
• A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) deficiency, and/or Shiga toxin-related hemolytic uremic syndrome (STX-HUS), and/or Positive direct Coombs test
• Identified drug exposure-related HUS or HUS related to known genetic defects of cobalamin C metabolism or known diacylglycerol kinase e (DGKE) mediated aHUS
• Started receiving PE/PI 14 days or longer before the start of screening visit for the current TMA
• Bone marrow transplantation (BMT)/hematopoietic stem cell transplantation (HSCT), heart, lung, small bowel, pancreas, or liver transplantation
• In patients with a kidney transplant, acute kidney dysfunction consistent with the diagnosis of transplantation failure due to
acute/chronic active T-Cell mediated rejection (TCMR) and/or
active/chronic active antibody-mediated rejection (ABMR) according to Banff 2017 criteria
• Among patients with native kidney, history or presence of any kidney disease other than aHUS, such as:
- Known kidney biopsy finding suggestive of underlying disease other than aHUS
- Kidney ultrasound finding demonstrating small kidneys suggestive of chronic kidney failure
- Known family history and/or genetic diagnosis of non-complement mediated genetic kidney disease (eg, focal segmental glomerulosclerosis)
- Laboratory tests indicative of a kidney disease other than aHUS (eg, Anti-glomerular Basement Membrane (anti-GBM) antibodies, Anti-Neutrophil Cytoplasmic Antibodies (ANCA), Anti-Phospholipase A2 Receptor (anti-PLA2R) antibodies, anti-double stranded DNA (anti-dsDNA) antibodies)
- Liver disease or liver injury at screening
- Patients with sepsis or active severe systemic bacterial, viral (including COVID-19) or fungal infection
- Presence of systemic infections (bacterial, viral, fungal or parasitic) that, in the opinion of the Investigator, confounds an accurate diagnosis of aHUS or impedes the ability to manage the aHUS disease
• Active infection, or history of recurrent invasive infections, caused by encapsulated bacteria (i.e. meningococcus, pneumococcus), or H. influenzae
• Systemic sclerosis (scleroderma), systemic lupus erythematosus
(SLE), or antiphospholipid antibody positivity or syndrome
• Chronic hemo- or peritoneal dialysis
• Any adenoviral COVID-19 vaccine within 28 days prior to screening visit

Study & Design

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