A Multicenter, Open-label, Non-randomized, Phase 1b/2 Study to Evaluate the Safety, Pharmacokinetics, and Efficacy of Subcutaneous Isatuximab in Adults With Warm Autoimmune Hemolytic Anemia
Overview
- Phase
- Phase 2
- Intervention
- Isatuximab SAR650984
- Conditions
- Warm Autoimmune Hemolytic Anemia (wAIHA)
- Sponsor
- Sanofi
- Enrollment
- 8
- Locations
- 6
- Primary Endpoint
- Part A: Number of Participants With Treatment Emergent Adverse Events (TEAEs) And Treatment Emergent Serious Adverse Events (TESAEs)
- Status
- Terminated
- Last Updated
- last year
Overview
Brief Summary
Primary Objectives:
- Part A: To evaluate the safety and tolerability of subcutaneous injections of isatuximab in adults with wAIHA
- Part B: To evaluate the efficacy of the selected dose in adults with wAIHA
Secondary Objectives:
- Part A (Cohorts 2 and 3 only)
- To evaluate the efficacy of isatuximab in adults with wAIHA
- To evaluate the durability of response to isatuximab and time to response
- To evaluate the impact of isatuximab treatment on fatigue
Part B
- To evaluate the safety and tolerability of isatuximab in adults with wAIHA
- To evaluate the durability of response to isatuximab and time to response
- To evaluate the impact of isatuximab treatment on fatigue
Parts A (all Cohorts) and B
- To evaluate the effect of isatuximab on markers of hemolysis
- To characterize the pharmacokinetic profile of isatuximab in adults with wAIHA
- To evaluate the immunogenicity of isatuximab
Detailed Description
28 weeks (including screening)
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Arms & Interventions
Part A: Cohort 1: Isatuximab 140 mg SC Q2W x2
Participants received 2 doses of Isatuximab 140 milligrams (mg) (1 milliliter \[mL\]) via subcutaneous (SC) injection every 2 weeks (Q2W) on Day 1 and Day 15.
Intervention: Isatuximab SAR650984
Part A: Cohort 2: Isatuximab 280 mg SC Q2W x6
Participants received 6 doses of Isatuximab 280 mg (2 mL) via SC injection Q2W through Day 71.
Intervention: Isatuximab SAR650984
Part A: Cohort 3: Isatuximab 560 mg SC Q2W x6
Participants received 6 doses of Isatuximab 560 mg (4 mL) via SC injection Q2W through Day 71.
Intervention: Isatuximab SAR650984
Part B: Isatuximab up to 560 mg SC Q2W x6
Participants were planned to receive 6 doses of Isatuximab up to 560 mg (4 mL) via SC injection Q2W through Day 71
Intervention: Isatuximab SAR650984
Outcomes
Primary Outcomes
Part A: Number of Participants With Treatment Emergent Adverse Events (TEAEs) And Treatment Emergent Serious Adverse Events (TESAEs)
Time Frame: From first dose of study drug (Day 1) up to 30 days after last study intervention administration, approximately 101 days
An adverse event (AE) is any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. TEAE is defined as an AE that occurred from the time of the first IMP administration up to 30 days (included) after the last IMP administration. A serious adverse event (SAE) is defined as any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent disability/incapacity, was a congenital anomaly/birth defect, was a medically important event.
Part A: Number of Participants With Potentially Clinically Significant Abnormality (PCSA): Hematology
Time Frame: From first dose of study drug (Day 1) up to end of study, approximately 169 days
Blood samples were collected to determine the hematology laboratory significant abnormalities. PCSA values: abnormal values considered medically important by the Sponsor, according to predefined criteria/thresholds based on literature reviews and defined by the Sponsor. Criteria for PCSA: Hemoglobin (Hb): ≤ 115 grams per Liter (g/L) (Male\[M\]); ≤ 95 g/L (Female\[F\]), ≥ 185 g/L (M); ≥ 165 g/L (F), Decrease from baseline ≥ 20 g/L; Hematocrit: ≤ 0.37 volume per volume (v/v) (M); ≤ 0.32 v/v (F), ≥ 0.55 v/v (M); ≥ 0.5 v/v (F); Erythrocyte Count: ≥ 6 x 10\^12 per Liter (/L); Platelet count: \< 100 x 10\^9/L, ≥ 700 x 10\^9/L; Leukocytes: \< 3 x 10\^9/L (Non-Black \[NB\]); \< 2 x 10\^9/L (Black \[B\]), ≥ 16 x 10\^9/L; Neutrophils: \< 1.5 x 10\^9/L (B); \< 1 x 10\^9/L (B); Lymphocytes: \> 4 x 10\^9/L; Monocytes: \> 0.7 x 10\^9/L; Basophils: \> 0.1 x 10\^9/L; Eosinophils: \> 0.5 x 10\^9/L or \> Upper limit of Normal (ULN) (if ULN ≥ 0.5 x 10\^9/L).
Part A: Number of Participants With PCSA: Clinical Chemistry And Electrolyte Parameters
Time Frame: From first dose of study drug (Day 1) up to end of study, approximately 169 days
Blood samples were collected to determine the clinical chemistry laboratory and electrolyte parameters significant abnormalities. PCSA values were defined as abnormal values considered medically important by the Sponsor, according to predefined criteria/thresholds based on literature reviews and defined by the Sponsor. Criteria for PCSA: Glucose: ≤ 3.9 millimoles per Liter (mmol/L) and \< Lower limit of normal (LLN), ≥ 11.1 mmol/L (unfasted); ≥ 7 mmol/L (fasted); Creatinine: ≥ 150 micromoles (µmol)/L, ≥ 30% change from baseline, ≥ 100% change from baseline, Alanine Aminotransferase (ALT): \> 3 ULN, \> 5 ULN, \> 10 ULN; Aspartate Aminotransferase (AST): \> 3 ULN; Alkaline Phosphatase (ALP): \> 1.5 ULN; Total Bilirubin: \> 1.5 ULN, \> 2 ULN; Sodium: ≤ 129 mmol/L, ≥ 160 mmol/L and Potassium: \< 3 mmol/L, ≥ 5.5 mmol/L.
Part B: Overall Response Rate (Response [R] Or Complete Response [CR]) At Day 85
Time Frame: Day 85
Overall response rate was defined as the percentage of participants with a response (R) or complete response (CR) over the evaluable participants. R was defined as an increase in Hb by ≥2 g/dL from baseline and an absence of transfusion in the last 7 days and absence of rescue medications in the past 4 weeks. Biochemical evidence of hemolysis might still be present. CR was defined as Hb ≥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 absence of rescue medication in the past 4 weeks.
Part A: Number of Participants With Potentially Clinically Significant Abnormality: Vital Signs
Time Frame: From first dose of study drug (Day 1) up to end of study, approximately 169 days
Vital signs were examined to determine the abnormalities. Vital signs included Sitting systolic blood pressure (SSBP), Sitting diastolic blood pressure (SDBP), Sitting heart rate (SHR) and weight. PCSA values were defined as abnormal values considered medically important by the Sponsor, according to predefined criteria/thresholds based on literature reviews and defined by the Sponsor. Criteria for PCSA: SSBP: ≤95 millimeters of mercury (mmHg) and decrease from baseline ≥20 mmHg; ≥160 mmHg and increase from baseline ≥20 mmHg; SDBP: ≤45 mmHg and decrease from baseline ≥10 mmHg, ≥ 110 mmHg and increase from baseline ≥ 10 mmHg; SHR: ≤ 50 beats per minute (bpm) and decrease from baseline ≥ 20 bpm, ≥120 bpm and increase from baseline ≥ 20 bpm; Weight: ≥ 5% decrease from baseline, ≥5% increase from baseline.
Part A: Number of Participants With Potentially Clinically Significant Abnormality: Urinalysis
Time Frame: From first dose of study drug (Day 1) up to end of study, approximately 169 days
Urine samples were collected to determine the urinalysis parameter significant abnormalities. PCSA values were defined as abnormal values considered medically important by the Sponsor, according to predefined criteria/thresholds based on literature reviews and defined by the Sponsor. Criteria for PCSA: pH: ≤ 4.6 or ≥ 8.
Secondary Outcomes
- Part A: Absolute Change From Baseline In Lactate Dehydrogenase (LDH) at 1, 2, 4, 8, 12, and 24 Weeks(Cohort 1 : Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, and 12; Cohorts 2 and 3: Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, 12, and 24)
- Part A: Absolute Change From Baseline In Haptoglobin at 1, 2, 4, 8, 12, and 24 Weeks(Cohort 1 : Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, and 12; Cohorts 2 and 3: Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, 12, and 24)
- Part A: Time to Reach Cmax (Tmax) of Isatuximab(Post-dose on Day 1)
- Part A: Area Under the Plasma Concentration Versus Time Curve Over the Dosing Interval (AUCtau) of Isatuximab(Post-dose on Day 1)
- Part B: Number of Participants With Potentially Clinically Significant Abnormality: Vital Signs(From first dose of study drug (Day 1) up to end of study, approximately 169 days)
- Part B: Percentage Of Participants With Durable Hemoglobin Response By Day 169(From first dose of study drug (Day 1) up to end of study (Day 169))
- Part B: Absolute Change From Baseline In FACIT-Fatigue Scale Score At Day 85 And Day 169(Baseline (Day 1) and Day 85 and Day 169)
- Part A: Cohorts 2 and 3: Overall Response Rate (Response [R] Or Complete Response [CR]) At Day 85 And Day 169(Day 85 and Day 169)
- Part A: Cohorts 2 and 3: Percentage Of Participants With Durable Hemoglobin (Hb) Response By Day 169(From first dose of study drug (Day 1) up to end of study (Day 169))
- Part A: Absolute Change From Baseline In Reticulocytes at 1, 2, 4, 8, 12, and 24 Weeks(Cohort 1 : Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, and 12; Cohorts 2 and 3: Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, 12, and 24)
- Part A: Absolute Change From Baseline In Total Bilirubin at 1, 2, 4, 8, 12, and 24 Weeks(Cohort 1 : Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, and 12; Cohorts 2 and 3: Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, 12, and 24)
- Part A: Maximum Observed Concentration (Cmax) Of Isatuximab(Post-dose on Day 1)
- Part B: Number of Participants With PCSA: Hematology(From first dose of study drug (Day 1) up to end of study, approximately 169 days)
- Part B: Absolute Change From Baseline In Reticulocytes at 1, 2, 4, 8, 12, and 24 Weeks(Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, 12, and 24)
- Part B: Cmax Of Isatuximab(Post-dose on Day 1)
- Part B: AUCtau of Isatuximab(Post-dose on Day 1)
- Part B: Mean Plasma Trough Concentration Of Isatuximab(Post-dose on Days 15, 29, 43 and 57)
- Part A: Cohorts 2 and 3: Absolute Change From Baseline in Functional Assessment Of Chronic Illness Therapy (FACIT)-Fatigue Scale Score At Day 85 and Day 169(Baseline (Day 1), Day 85 and Day 169)
- Part B: Number of Participants With Potentially Clinically Significant Abnormality: Urinalysis(From first dose of study drug (Day 1) up to end of study, approximately 169 days)
- Part B: Absolute Change From Baseline In Haptoglobin at 1, 2, 4, 8, 12, and 24 Weeks(Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, 12, and 24)
- Part B: Number Of Participants With Anti-Isatuximab Antibodies(Up to Days 169)
- Part A: Area Under the Plasma Concentration Versus Time Curve Calculated Using the Trapezoidal Method From Time Zero to Time of the Last Concentration Observed Above the Lower Limit of Quantification (Clast) (AUClast) of Isatuximab(Post-dose on Day 1)
- Part A: Number Of Participants With Anti-Isatuximab Antibodies(Up to Days 169)
- Part A: Mean Plasma Trough Concentration Of Isatuximab(Post-dose on Days 15, 29, 43 and 57)
- Part B: Number of Participants With PCSA: Clinical Chemistry And Electrolyte Parameters(From first dose of study drug (Day 1) up to end of study, approximately 169 days)
- Part B: Overall Response Rate (Response [R] Or Complete Response [CR]) At Day 169(Day 169)
- Part B: Absolute Change From Baseline In LDH at 1, 2, 4, 8, 12, and 24 Weeks(Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, 12, and 24)
- Part B: Number of Participants With TEAEs And TESAEs(From first dose of study drug (Day 1) up to end of study, approximately 169 days)
- Part B: Absolute Change From Baseline In Total Bilirubin at 1, 2, 4, 8, 12, and 24 Weeks(Baseline (Day 1) and pre-dose at Weeks 1, 2, 4, 8, 12, and 24)