MedPath

Efficacy, Safety and Pharmacokinetics of Rilzabrutinib in Patients With Warm Autoimmune Hemolytic Anemia (wAIHA)

Phase 2
Active, not recruiting
Conditions
Warm Autoimmune Hemolytic Anemia (wAIHA)
Interventions
Registration Number
NCT05002777
Lead Sponsor
Sanofi
Brief Summary

All participants will receive rilzabrutinib orally. The screening period is up to 28 days, followed by a treatment period of 24 weeks for Part A. Participants who complete Part A and are deemed eligible for Part B can continue in the Core Part B period followed by an Extended Part B period for up to 253 weeks.

There will be a 7-day safety follow-up period after receiving the last dose of study medication either in Part A (for those not eligible for Part B or early terminated) or Part B. In addition, each participant will be asked to attend an EOT-Core Part B visit when the last participant completes 52 weeks in Core Part B. The Extended Part B period will last for up to 253 weeks.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
22
Inclusion Criteria
  • Male and female patients with a confirmed diagnosis of primary wAIHA or systemic lupus erythematosus (SLE)-associated wAIHA (without other SLE-related manifestations apart from cutaneous and musculoskeletal manifestations)
  • Participants who have previously failed to maintain a sustained response after treatment with corticosteroids.
  • Eastern Cooperative Oncology Group (ECOG) performance status grade 2 or lower.
  • Up-to-date vaccination status as per local guidelines.
  • Body mass index (BMI) >17.5 and <40 kg/m2
  • All contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.

Core Part B

  • Evidence of treatment efficacy to rilzabrutinib as defined by achieving overall response during Part A.
  • Completion of Part A treatment period (24 weeks). Extended Part B
  • Completion of Core Part B period.
Exclusion Criteria
  • Clinically significant medical history or ongoing chronic illness that would jeopardize the safety of the participant or compromise the quality of the data derived from his or her participation in the study as determined by the Investigator.
  • Participants with medical history of lymphoma, leukemia, or any malignancy within the past 5 years except for basal cell or squamous epithelial carcinomas of the skin that have been resected with no evidence of metastatic disease for the past 3 years.
  • Secondary wAIHA from any cause including drugs, lymphoproliferative disorders (low-count monoclonal B-cell lymphocytosis is allowed), infectious or autoimmune disease, or active hematologic malignancies. Participants with positive antinuclear antibodies but without a definitive diagnosis of an autoimmune disease are allowed.
  • Myelodysplastic syndrome.
  • Uncontrolled or active HBV infection: Patients with positive HBsAg and/or HBV DNA.
  • HIV infection.
  • Concurrent treatment with other experimental drugs or participation in another clinical trial with any investigational drug within 30 days or 5 half-lives, whichever is greater, prior to treatment start.
  • Known allergy to any of the study medications, their analogues, or excipients in the various formulations of any agent.

Part B only

  • Participants who receive any therapy during Part A known to be active in wAIHA.
  • Presence of unacceptable side effect(s) or toxicity associated with rilzabrutinib such that there is an unfavorable risk-benefit assessment for continued treatment with rilzabrutinib in the opinion of the Investigator and/or Sponsor.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
RilzabrutinibrilzabrutinibOral rilzabrutinib 400 mg BID
Primary Outcome Measures
NameTimeMethod
Part A: Proportion of participants with overall hemoglobin responseBy Week 24 in Part A

Response is defined as an increase in hemoglobin (Hb) by ≥2 g/dL from baseline and an absence of transfusion in the last 7 days, without biochemical resolution of hemolysis at the time response is achieved and an absence of rescue medications during the last 4 weeks.

Complete Response is defined as hemoglobin ≥11 g/dL (women) or ≥12 g/dL (men), no evidence of hemolysis (normal bilirubin, lactate dehydrogenase (LDH) , haptoglobin, and reticulocytes), and absence of transfusion in the last 7 days and an absence of rescue medications during the last 4 weeks.

Part B: Proportion of participants who maintain durable response achieved during Part A or achieve a durable response during Part B and have a hemoglobin responseBy Week 50 in Part B

Durable response (Part B) is defined as Hb level ≥10 g/dL with an increase from baseline (Part A) of ≥2 g/dL on three consecutive scheduled visits during Week 24 to Week 50; with absence of transfusion and no rescue medication during the period of 3 consecutive visits and for at least 7 days (transfusions) and 4 weeks (rescue medication) prior to the first consecutive visit.

Secondary Outcome Measures
NameTimeMethod
Proportion of participants with durable hemoglobin responseBy Week 24 in Part A

Durable response (Part A) is defined as Hb level ≥10 g/dL with an increase from baseline of ≥2 g/dL on three consecutive evaluable visits during the 24-week treatment period; with absence of transfusion and no rescue medication during the period of 3 consecutive visits and for at least 7 days (transfusions) and 4 weeks (rescue medication) prior to the first consecutive visit.

Median time from baseline to first hemoglobin responseFrom Day 1 to Week 24 in Part A
Frequency of rescue therapy (any wAIHA-directed therapy other than predniso[lo]ne or transfusion) receivedAfter Week 1 of treatment to Week 24 in Part A and Week 305 in Part B
Change from baseline in FACIT-Fatigue scale scoreUntil Week 24 in Part A and Week 305 in Part B

The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale is a 13-item questionnaire used to assesses self-reported fatigue and its impact on daily activities and function.

Incidence of treatment emergent adverse events (TEAEs), serious TEAEs, adverse events of special interest (AESIs)Until Week 24 in Part A and Week 305 in Part B

Safety assessment including clinical laboratory evaluations, vital sign measurements and ECG

Trial Locations

Locations (27)

University of Southern California_Investigational Site Number: 8400009

🇺🇸

Los Angeles, California, United States

TOI Clinical Research LLC_Santa Ana_Investigational Site Number: 8400006

🇺🇸

Santa Ana, California, United States

The Lundquist Institute_Investigational Site Number: 8400005

🇺🇸

Torrance, California, United States

Klinik für Hämatologie und Stammzellentransplantation_Investigational Site Number: 2760001

🇩🇪

Essen, Germany

Fejer Varmegyei Szent Gyorgy Egyetemi Oktato Korhaz_Investigational Site Number: 3480001

🇭🇺

Szekesfehervar, Hungary

Ospedale Maggiore Policlinico_Investigational Site Number: 3800001

🇮🇹

Milan, Italy

The Oncology Institute of Hope & Innovation Site Number : 8400006

🇺🇸

Cerritos, California, United States

Oncology & Hematology Associates of West Broward_Investigational Site Number: 8400002

🇺🇸

Tamarac, Florida, United States

Ospedale Giuseppe Moscati_Investigational Site Number: 3800002

🇮🇹

Avellino, Italy

Hanush-Krankenhaus_Investigational Site Number: 0400001

🇦🇹

Vienna, Austria

Massachusetts General Hospital_Investigational Site Number: 8400001

🇺🇸

Boston, Massachusetts, United States

Georgetown University Hospital_Investigational Site Number: 8400003

🇺🇸

Washington, District of Columbia, United States

TOI Clinical Research LLC_ Cerritos_Investigational Site Number: 8400006

🇺🇸

Cerritos, California, United States

TOI Clinical Research LLC_Long Beach_Investigational Site Number: 8400006

🇺🇸

Long Beach, California, United States

TOI Clinical Research LLC_Glendale_Investigational Site Number: 8400006

🇺🇸

Glendale, California, United States

TOI Clinical Research LLC_ Whittier_Investigational Site Number: 8400006

🇺🇸

Whittier, California, United States

Peking Union Medical College Hospital_Investigational Site Number: 1560002

🇨🇳

Beijing, China

Institute of hematology&blood diseases hospital_Investigational Site Number: 1560003

🇨🇳

Tianjin, China

Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori"_Investigational Site Number: 3800003

🇮🇹

Meldola, Italy

Odense Universitetshospital Hæmatologisk Forskningsenhed_Investigational Site Number: 2080001

🇩🇰

Odense, Denmark

Hospital Universitario de Cruces_Investigational Site Number: 7240004

🇪🇸

Barakaldo, Spain

Hospital Clinic de Barcelona_Investigational Site Number: 7240001

🇪🇸

Barcelona, Spain

Hospital Universitario La Paz_Investigational Site Number: 7240003

🇪🇸

Madrid, Spain

Hospital Universitario Virgen del Rocío_Investigational Site Number: 7240002

🇪🇸

Sevilla, Spain

Barts Health NHS Trust_Investigational Site Number: 8260005

🇬🇧

London, United Kingdom

Imperial College Healthcare NHS Trust_Investigational Site Number: 8260002

🇬🇧

London, United Kingdom

Leeds Teaching Hospitals NHS Trust_Investigational Site Number: 8260001

🇬🇧

Leeds, United Kingdom

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