AN OPEN-LABEL, MULTI-CENTER CONTROLLED CLINICAL TRIAL OF ECULIZUMAB IN ADULT PATIENTS WITH PLASMA THERAPY-RESISTANT ATYPICAL HEMOLYTIC-UREMIC SYNDROME (AHUS)

• Conditions: Adult patients with plasma therapy-resistant Atypical Hemolytic-UremicSyndrome (aHUS); MedDRA version: 9.1Level: LLTClassification code 10018932Term: Haemolytic uraemic syndrome

• Registration Number: EUCTR2008-006952-23-NL
• Lead Sponsor: ALEXION PHARMACEUTICALS, INC.

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2009-02-26
• Last Update Posted: 22 April 2013

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 8

Inclusion Criteria

1. Male or female patients =18 years of age who have been diagnosed with Atypical
Hemolytic-Uremic Syndrome (aHUS). Patients may be newly diagnosed, experiencing a relapse of the disease, or having a post-transplant recurrence of the disease.
2. Patients must exhibit a decrease in platelet count despite at least 4 Plasma Therapy (PT) treatments in the 1 week immediately prior to screening. At screening, platelet count must be < 150 x 10^9/L and at least 25% lower than the average of 3 platelet counts obtained during remission and at least 1 month apart over the 12 months prior to screening (designated the average remission platelet count”).
3. If historical counts are not available, platelet count at screening must be < 75 x 10^9/L despite PT treatment administration of at least 4 PT treatments in the 1 week
immediately prior to screening.
4. Known complement regulatory protein genetic abnormality, i.e., a mutation in
Complement Protein 3, factor H or associated factor, factor I, or membrane cofactor
protein 1 (MCP-1) or known Factor B gain-of-function mutation, or known Anti-
CFH antibody (aHUS lesions”).
• Patients diagnosed with aHUS with any of these aHUS lesions are eligible and
will be assigned to one of the following parallel categories during the treatment
period of the trial:
- (Category 1) Complement Protein 3 or factor H or factor I functional
deficiency or abnormal factor interaction (C3/CFH/CFI FFP Group);
- (Category 2) Factor B Gain of Function;
- (Category 3) Anti-CFH Antibody (anti-CFH Group);
- (Category 4) MCP-1 deficiency (MCP-1 Group);
5. Patients diagnosed with HUS of the atypical type without documented complement
regulatory protein genetic abnormality or known anti-CFH antibody are eligible if
other etiologies of HUS have been ruled out as confirmed in the Exclusion Criteria
(i.e., including Shiga-toxin negative, non-infectious, non-drug-exposure-related [e.g.,
cyclosporine]), no known HIV positivity, and anti-phospholipid antibody negative).
Thrombotic thrombocytopenic purpura also must be ruled out (i.e., ADAMTS-13
activity must be > 5%; see Exclusion Criteria). Patients meeting these conditions
will be assigned to Category 5. In addition, these patients will undergo genetic
testing to determine if a mutation can be identified. If a mutation is identified, the
patient will be reassigned to the appropriate category.
6. Lactate dehydrogenase (LDH) level = ULN;
7. Creatinine level = ULN for age (patients requiring acute dialysis for acute renal
failure also eligible).
8. Sexually active women of childbearing potential must be practicing an effective,
reliable and medically acceptable contraceptive regimen during the entire duration of
the study, including the follow-up period.
9. Able to give informed consent or consent from a legal guardian.
10. Able and willing to comply with study procedures.
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
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

1. ADAMTS-13 inhibitor or deficiency (i.e., ADAMTS-13 activity <5%) as measured
at the screening visit.
2. Malignancy.
3. Typical HUS (Shiga toxin +).
4. Known HIV infection.
5. Identified drug exposure-related HUS.
6. Infection-related HUS.
7. Renal function status requiring chronic dialysis (defined as dialysis on a regular basis as renal replacement therapy).
8. Patients with a confirmed diagnosis of sepsis defined as positive blood cultures
within 7 days of the screening visit and not treated with antibiotics to which the
organism is sensitive.
9. Presence or suspicion of active and untreated systemic bacterial infection that, in the opinion of the Investigator confounds an accurate diagnosis of aHUS or impedes the ability to manage the aHUS disease.
10. Pregnancy or lactation.
11. Unresolved meningococcal disease.
12. Known Systemic Lupus Erythematosus (SLE) or antiphospholipid antibody
positivity or syndrome.
13. Any medical or psychological condition that, in the opinion of the investigator, could increase the patient’s risk by participating in the study or confound the outcome of the study.
14. Patients receiving IVIg or Rituximab therapy.
15. Patients receiving other immunosuppressive therapies such as steroids, mTOR
inhibitors or FK506 inhibitors are excluded unless: [1] part of a post-transplant anti rejection regime, [2] patient has confirmed anti-CFH antibody requiring immunosuppressive therapy and [3] dose of such medications have been unchanged
for at least 4 weeks prior to the screening period.
16. Patients receiving Erythrocyte stimulating agents (ESAs) unless already on a stable dose for at least 4 weeks prior to the screening period.
17. Participation in any other investigational drug trial or exposure to other
investigational agent, device, or procedures beginning 4 weeks prior to screening and throughout the entire trial.

Study & Design

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