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A Phase 3 Study to Assess Efficacy Safety and Tolerability of Remibrutinib in Adult Patients With Moderate to Severe Hidradenitis Suppurativa

Phase 3
Recruiting
Conditions
Hidradenitis Suppurativa
Interventions
Drug: Remibrutinib Dose A
Drug: Remibrutinib Dose B
Drug: Placebo 1
Drug: Placebo 2
Registration Number
NCT06799000
Lead Sponsor
Novartis Pharmaceuticals
Brief Summary

The purpose of this study is to establish the efficacy, safety, and tolerability of remibrutinib (LOU064) Dose A and Dose B compared to placebo in participants with moderate to severe hidradenitis suppurativa (HS).

Detailed Description

The total duration of the study is 76 weeks and consists of: Screening (up to 4 weeks), Treatment Period 1 (16 weeks, double-blind treatment with remibrutinib (Dose A or Dose B) or placebo, Treatment Period 2 (52 weeks, treatment with remibrutinib (Dose A or Dose B) and Safety Follow-Up (treatment-free follow-up for 4 weeks).

Participants who prematurely discontinue study treatment (either during Treatment Period 1 or Treatment Period 2) are encouraged to remain in the study. Participants who do not wish to remain in the study will enter a 4-week Safety Follow-Up period.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
555
Inclusion Criteria
  1. Male and female participants ≥ 18 years of age at the time of signing of the informed consent.

  2. Diagnosis of HS based on clinical history and physical examination for at least 6 months prior to the Baseline visit.

  3. Participants with moderate to severe HS defined as:

    • A total of at least 5 AN count (abscesses and/or inflammatory nodules) AND
    • Inflammatory lesions should affect at least 2 distinct anatomic areas (e.g., left and right axillae)

Key

Exclusion Criteria
  1. Presence of more than 20 fistulae/tunnels (both draining and non-draining) in total at baseline.
  2. Any active skin disease or conditions that may interfere with the assessment of HS.
  3. Previous exposure to remibrutinib or other BTK inhibitors.
  4. Use of other investigational drugs within 5 half-lives of enrollment, or within 30 days (for small molecules) prior to randomization, or until the pharmacodynamic effect has returned to baseline (for biologics), whichever is longer.
  5. Significant bleeding risk or coagulation disorders.
  6. History of gastrointestinal bleeding.
  7. Requirement for anti-platelet (except for acetylsalicylic acid up to 100 mg/d or clopidogrel up to 75 mg/d) or anti-coagulant medication.
  8. History or current hepatic disease.
  9. Evidence of clinically significant cardiovascular, neurological, psychiatric, pulmonary, renal, hepatic, endocrine, metabolic, hematological disorders, gastrointestinal disease or immunodeficiency that, in the Investigator's opinion, would compromise the safety of the participant, interfere with the interpretation of the study results or otherwise preclude participation or protocol adherence of the participant.
  10. History of hypersensitivity to any of the study drug constituents.
  11. Known or suspected infectious disease that is active, chronic or recurrent which precludes the participant from participating in the trial as per investigator's assessment. These infectious diseases include and are not limited to opportunistic infections (e.g., tuberculosis, atypical mycobacterioses, listeriosis or aspergillosis) and/or known or suspected Human Immunodeficiency Virus (HIV) infection. Should it be required by local regulations and/or considered appropriate by the investigator, an HIV test can be performed to confirm eligibility.
  12. History of live attenuated vaccine administration within 6 weeks prior to randomization or requirement to receive these vaccinations at any time while on study treatment.
  13. Major surgery within 8 weeks prior to screening or planned surgery for the duration of the study.

Other protocol-defined inclusion/exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Remibrutinib Dose A (Treatment Period 1 and 2)Remibrutinib Dose AParticipants randomized to receive remibrutinib Dose A during Treatment Period 1 and 2
Remibrutinib Dose B (Treatment Period 1 and 2)Remibrutinib Dose BParticipants randomized to receive remibrutinib Dose B during Treatment Period 1 and 2
Placebo (Treatment Period 1) + remibrutinib Dose B (Treatment Period 2)Remibrutinib Dose BParticipants randomized to receive placebo during Treatment Period 1 followed by remibrutinib dose B during Treatment Period 2
Placebo (Treatment Period 1) + remibrutinib Dose B (Treatment Period 2)Placebo 1Participants randomized to receive placebo during Treatment Period 1 followed by remibrutinib dose B during Treatment Period 2
Placebo (Treatment Period 1) + remibrutinib Dose B (Treatment Period 2)Placebo 2Participants randomized to receive placebo during Treatment Period 1 followed by remibrutinib dose B during Treatment Period 2
Primary Outcome Measures
NameTimeMethod
Proportion of participants with Hidradenitis Suppurativa clinical response 50 (HiSCR50) at Week 16Week 16

HiSCR50 is defined as at least a 50% decrease in Abscess and Inflammatory Nodule (AN) count with no increase in the number of abscesses and in the number of draining tunnels/fistulae compared to baseline.

Secondary Outcome Measures
NameTimeMethod
Proportion of participants with Abscesses and inflammatory nodules 50 (AN50) response at Week 16Week 16

AN50 is defined as at least a 50% decrease in Abscess and Inflammatory Nodule (AN) count compared to baseline

Percentage change from baseline in International Hidradenitis Suppurativa Severity Score System (IHS4) at Week 16From baseline up to Week 16

The IHS4 is a disease severity scoring system developed by the European Hidradenitis Suppurativa Foundation. It is a weighted sum of different types of inflammatory lesion counts, calculated as 1 x number of nodules + 2 x number of abscesses + 4 x number of draining tunnels (=fistulae=sinuses).

Proportion of participants with HiSCR75 response at Week 16Week 16

HiSCR75 is defined as at least a 75% decrease in Abscess and Inflammatory Nodule (AN) count with no increase in the number of abscesses and in the number of draining tunnels/fistulae compared to baseline.

Proportion of participants experiencing Hidradenitis Suppurativa (HS) flares at Week 16Up to Week 16

Flare is defined as at least a 25% increase in AN count with a minimum increase of 2 AN relative to baseline.

Proportion of participants with HiSCR50 response at Week 8Week 8

HiSCR50 is defined as at least a 50% decrease in Abscess and Inflammatory Nodule (AN) count with no increase in the number of abscesses and in the number of draining tunnels/fistulae compared to baseline.

Proportion of participants with HiSCR90 response at Week 16Week 16

HiSCR90 is defined as at least a 90% decrease in Abscess and Inflammatory Nodule (AN) count with no increase in the number of abscesses and in the number of draining tunnels/fistulae compared to baseline.

Proportion of participants with clinical response in HS related skin pain (NRS 30), at worst at Week 16Week 16

Achievement of NRS30 at Week 16, among participants with baseline NRS ≥ 3 (pooled data from studies CLOU064J12301 and CLOU064J12302).

NRS30 is defined as at least a 30% reduction and at least 2-unit reduction from baseline in Patient's Global Assessment of Skin Pain - at worst over the past 7 days.

Incidence of treatment emergent adverse events and serious adverse events during the studyFrom randomization to end of study, assessed up to 72 weeks.

The distribution of adverse events will be done via the analysis of frequencies for treatment emergent Adverse Event (TEAEs), Serious Adverse Event (TESAEs) and Deaths due to AEs, through the monitoring of relevant clinical and laboratory safety parameters.

Trial Locations

Locations (20)

Cheryl Effron MD Inc

🇺🇸

Anaheim, California, United States

Olive View UCLA Medical Center

🇺🇸

Sylmar, California, United States

University of MiamiHealth System

🇺🇸

Miami, Florida, United States

Ziaderm Research LLC

🇺🇸

North Miami Beach, Florida, United States

Revival Research Institute

🇺🇸

Troy, Michigan, United States

Care Access Hoboken

🇺🇸

Hoboken, New Jersey, United States

Skinsearch of Rochester Inc

🇺🇸

Rochester, New York, United States

Essential Medical Research

🇺🇸

Tulsa, Oklahoma, United States

Johnson Dermatology

🇺🇸

Fort Smith, Arkansas, United States

Arkansas Research Trials

🇺🇸

North Little Rock, Arkansas, United States

Clinical Trials Research Institute

🇺🇸

Thousand Oaks, California, United States

Florida Academic Centers Research and Education LLC

🇺🇸

Coral Gables, Florida, United States

Gwinnett Clinical Research Center

🇺🇸

Snellville, Georgia, United States

Dawes Fretzin Clinical Rea Group

🇺🇸

Indianapolis, Indiana, United States

Michigan Center for Rsrch Company

🇺🇸

Clarkston, Michigan, United States

OnSite Clinical Solutions LLC

🇺🇸

Huntersville, North Carolina, United States

Medical University of South Carolina MUSC

🇺🇸

Charleston, South Carolina, United States

Advanced Research Experts

🇺🇸

Nashville, Tennessee, United States

RFSA Dermatology

🇺🇸

San Antonio, Texas, United States

Novartis Investigative Site

🇲🇾

Pulau Pinang, Malaysia

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