Study of Ianalumab Versus Placebo in Addition to First-line Corticosteroids in Primary Immune Thrombocytopenia (ITP)
- Conditions
- Primary Immune Thrombocytopenia (ITP)
- Interventions
- Registration Number
- NCT05653349
- Lead Sponsor
- Novartis Pharmaceuticals
- Brief Summary
The purpose of this study is to evaluate the effect of two different doses of ianalumab versus placebo in addition to first-line corticosteroids in maintaining platelet count ≥30 G/L in adult participants with primary ITP.
- Detailed Description
This is a multi-center, randomized, double-blind Phase 3 study to assess the efficacy and safety of two different doses of ianalumab compared to placebo in adults with primary ITP (platelets count \<30 G/L) who require first-line standard-of-care corticosteroids.
After completion of the screening period, the participants will enter the randomized treatment period (ianalumab/placebo with standard of care corticosteroids).
After the treatment period, all participants will enter the follow-up period to be monitored for efficacy and safety or safety only depending on how they respond to the study treatment.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 225
- Signed informed consent prior to participation in the study.
- Male or female participants aged 18 years and older on the day of signing informed consent
- Primary ITP diagnosed within 3 months before initiating first-line ITP therapy (corticosteroids, IVIG)
- Platelet count below 30 G/L before starting any first-line ITP therapy (corticosteroids, IVIG)
- Response (platelet count >=50 G/L) to corticosteroids (+/- IVIG) at any time prior to randomization. Note: Platelet count measured within 7 days of platelet transfusion will not be considered as response.
Key
- Evans syndrome or any other cytopenia (patients with low grade anemia related to bleeding or iron deficiency are eligible)
- Current life-threatening bleeding
- Previous ITP treatment, including splenectomy, except for corticosteroids and/or IVIG initiated as first-line therapy for up to 28 days before randomization and rescue corticosteroids and/or IVIG given prior to confirmed diagnosis of primary ITP .
- Prior use of B-cell depleting therapy (e.g., rituximab).
- Absolute neutrophil count below 1.0 G/L at randomization
- Participants with concurrent coagulation disorders and/or receiving anti-platelet or anticoagulant medication with an exemption of low dose of acetylsalicylic acid
Other protocol-defined Inclusion/Exclusion may apply.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Ianalumab Lower dose Ianalumab Lower dose of ianalumab administered intravenously with corticosteroids oral or parental (if clinically justified) Ianalumab Lower dose Corticosteroids Lower dose of ianalumab administered intravenously with corticosteroids oral or parental (if clinically justified) Ianalumab Higher dose Ianalumab Higher dose of ianalumab administered intravenously with corticosteroids oral or parental (if clinically justified) Ianalumab Higher dose Corticosteroids Higher dose of ianalumab administered intravenously with corticosteroids oral or parental (if clinically justified) Placebo Placebo Placebo administered intravenously with corticosteroids oral or parental (if clinically justified) Placebo Corticosteroids Placebo administered intravenously with corticosteroids oral or parental (if clinically justified)
- Primary Outcome Measures
Name Time Method Time from randomization to treatment failure (TTF) Randomization to end of study (up to 39 months after randomization of last patient) Time from randomization until platelet count below 30 G/L, need for a rescue treatment or start of a second-line therapy or death.
- Secondary Outcome Measures
Name Time Method Complete Response (CR) rate in each treatment group Randomization to end of study (up to 39 months after randomization of last patient) Complete Response (CR) rate at each timepoint defined as the proportion of participants with any platelet count of at least 100 G/L in the absence of rescue treatment or new ITP treatment.
Response (R) rate in each treatment group Randomization to end of study (up to 39 months after randomization of last patient) Response (R) rate at each timepoint defined as the proportion of participants with any platelet count of at least 50 G/L in the absence of rescue treatment or new ITP treatment.
Time to complete response in each treatment group Randomization to end of study (up to 39 months after randomization of last patient) Time from randomization to date of first complete response.
Duration of response in each treatment group Randomization to end of study (up to 39 months after randomization of last patient) Time from achievement of complete response to loss of complete response
Stable response at 6 months At 6 months Percentage of participants with at least 2 platelet count collected at month 6 (between study dates 107 and 183) and at least 66% of platelet counts qualified as a response
Stable response at 1 year At 1 year Percentage of participants with at least 2 platelet counts collected at year 1 (between study days 296 and 379) and at least 66% of platelet counts qualified as a response
Percentage of participants with bleeding events overall and by World Health Organization (WHO) bleeding scale severity Randomization to end of study (up to 39 months after randomization of last patient) This is to assess the incidence and severity of bleeding in each treatment arm
Number of participants with bleeding events overall and by World Health Organization (WHO) bleeding scale severity Randomization to end of study (up to 39 months after randomization of last patient) This is to assess the number and severity of bleeding in each treatment arm
Number of participants receiving rescue treatment (cummulative dose/duration of steroids exposure) Randomization to end of study (up to 39 months after randomization of last patient) This is to assess the number of participants receiving rescue treatment.
Percentage of participants receiving rescue treatment (cummulative dose/duration of steroids exposure) Randomization to end of study (up to 39 months after randomization of last patient) This is to assess the need of rescue treatment in each treatment group by percentage.
Cumulative dose/duration of steroids exposure From screening to end of study (up to 39 months after randomization of last patient) Duration of exposure to corticosteroids calculated from randomization (first dose) to end of study or last last contact date (if the participant is lost to follow-up).
Change from baseline on T scores of the PROMIS SF v1.0 Fatigue 13a From screening (baseline) till end of study (up to 39 months after randomization of last patient) The Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form v1.0 Fatigue 13a includes 13 items that assess fatigue
Change from baseline in ITP-PAQ domain scores From screening (baseline) till end of study (up to 39 months after randomization of last patient) The ITP-PAQ is a 44 item scale for measuring HRQoL in adults with ITP across ten scales: Symptoms, Bother-Physical Health, Fatigue/Sleep, Activity, Fear, Psychological Health, Work, Social Activity, Women's Reproductive Health, and Overall QoL. Each item is rated on a Likert type scale
Change from baseline in frequency of CD19+ B cell counts Randomization to end of study (up to 39 months after randomization of last patient) Post baseline frequency (%within the CD45) of CD19+ B cell counts compare to baseline.
Change from baseline in absolute number of CD19+ B cell counts Randomization to end of study (up to 39 months after randomization of last patient) Post baseline absolute number of CD19+ B cell counts compare with baseline
Time to first occurrence of B-cell recovery Randomization to end of study (up to 39 months after randomized of last patient) B-cell recovery, defined as ≥80% of baseline or ≥50 cells/μL
Change from baseline in inmmunoglobulins Randomization to end of study (up to 39 months after last randomized patients) Change from baseline in immunoglobulin levels
PK parameters: AUClast After first dose (pre-dose, 2, 168, 336 and 504 hours post dose) and after last dose (pre-dose, 2, 336, 672, 1344, 2016, 3360 hours post dose) AUClast: area under the curve from time zero till the last measurable concentration sampling time (tlast)
PK parameter: AUCtau After first dose (pre-dose, 2, 168, 336 and 504 hours post dose) and after last dose (pre-dose, 2, 336, 672, 1344, 2016, 3360 hours post dose) Area under the curve calculated to the end of a dosing interval (tau)
PK parameters: Cmax After first dose (pre-dose, 2, 168, 336 and 504 hours post dose) and after last dose (pre-dose, 2, 336, 672, 1344, 2016, 3360 hours post dose) Maximum (peak) observed plasma, blood, serum, or other body fluid drug concentration after single dose administration
PK parameters: Tmax After first dose (pre-dose, 2, 168, 336 and 504 hours post dose) and after last dose (pre-dose, 2, 336, 672, 1344, 2016, 3360 hours post dose) Time to reach maximum (peak) plasma, blood, serum, or other body fluid drug concentration
PK parameters: Accumulation ratio Racc After last dose (pre-dose, 2, 336, 672, 1344, 2016, 3360 hours post dose) Accumulation ratio calculated using AUC values obtained between the last and first dose
Incidence of anti-ianalumab antibodies in serum (ADA assay) over time Up to Week 33 Anti-drug antibodies (ADA) will be evaluated in samples collected from all participants assess the immunogenicity of ianalumab
Titer of anti-ianalumab antibodies in serum (ADA assay) over time Up to Week 33 Anti-drug antibodies (ADA) will be evaluated in samples collected from all participants assess the immunogenicity of ianalumab
Trial Locations
- Locations (27)
Yuma Regional Medical Center
🇺🇸Yuma, Arizona, United States
Community Cancer Institute
🇺🇸Clovis, California, United States
Compassionate Care Res Group Inc
🇺🇸Fountain Valley, California, United States
University of Colorado Anschutz
🇺🇸Aurora, Colorado, United States
Napa Research
🇺🇸Margate, Florida, United States
New Tampa Health
🇺🇸Tampa, Florida, United States
Uni of Chi Medi Ctr Hema and Onco
🇺🇸Chicago, Illinois, United States
Parkview Research Center
🇺🇸Fort Wayne, Indiana, United States
Oncology Care Associates
🇺🇸Bethesda, Maryland, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Mayo Clinic Rochester
🇺🇸Rochester, Minnesota, United States
Metro Minnesota CCOP
🇺🇸Saint Louis Park, Minnesota, United States
St Vincent Frontier Cancer Center
🇺🇸Billings, Montana, United States
Summit Health
🇺🇸Florham Park, New Jersey, United States
Inspira Medical Cent Mullica Hill
🇺🇸Mullica Hill, New Jersey, United States
Clinical Research Alliance
🇺🇸Lake Success, New York, United States
Hematology Oncology Association of Rockland
🇺🇸Nyack, New York, United States
Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
STAT Research Inc
🇺🇸Dayton, Ohio, United States
INTEGRIS Cancer Institute of Oklahoma
🇺🇸Oklahoma City, Oklahoma, United States
University of Pennsylvania
🇺🇸Philadelphia, Pennsylvania, United States
Rhode Island Hospital
🇺🇸Providence, Rhode Island, United States
Texas Oncology-Baylor Res Ins
🇺🇸Dallas, Texas, United States
Texas Oncology
🇺🇸McAllen, Texas, United States
Mays Cancer Ctr Uthsa Mdacc
🇺🇸San Antonio, Texas, United States
Community Cancer Trials of Utah
🇺🇸Ogden, Utah, United States
Novartis Investigative Site
🇻🇳Ho Chi Minh, Vietnam