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A Study in Adult Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH) to Evaluate How Safe Long-term Treatment with Pozelimab + Cemdisiran Combination Therapy is and How Well it Works.

Phase 3
Recruiting
Conditions
Paroxysmal nocturnal hemoglobinuria (PNH)
Registration Number
2023-510336-36-00
Lead Sponsor
Regeneron Pharmaceuticals Inc.
Brief Summary

The primary objective of the study is to describe the long-term safety, tolerability, and efficacy of pozelimab + cemdisiran combination therapy in patients with PNH.

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised, recruiting
Sex
Not specified
Target Recruitment
17
Inclusion Criteria

Patients Entering from the Parent Study: Patients with PNH who have completed, without permanent discontinuation, study treatment in the parent study (R3918-PNH-2021[NCT05133531]), including the post-Open-label treatment period (OLTP) transition period, if applicable.

Patients Entering from the Parent Study: Willing and able to comply with clinic visits and study-related procedures, including meningococcal vaccinations required per protocol

Patients Entering with C5 polymorphism: Patients with PNH who have a documented C5 polymorphism rendering them refractory to eculizumab or ravulizumab (eg, p.Arg885His, p.Arg885Cys), as described in the protocol

Patients Entering with C5 polymorphism: Diagnosis of PNH confirmed by high-sensitivity flow cytometry testing with PNH granulocytes or monocytes

Patients Entering with C5 polymorphism: Active disease, as defined by the presence of 1 or more PNH-related sign or symptom as described in the protocol

Patients Entering with C5 polymorphism: LDH level ≥2 × upper limit of normal (ULN) at the screening visit

Patients Entering with C5 polymorphism: Willing and able to comply with clinic visits and study-related procedures, including meningococcal vaccinations required per protocol

Exclusion Criteria

Patients Entering from the Parent Study: Significant protocol deviation(s) in the parent study based on the investigator’s judgment and to the extent that these would (if continued) impact the study objectives and/or safety of the patient

Patients Entering with C5 polymorphism: Documented history of liver cirrhosis or patients with liver disease with evidence of current impaired liver function or patients with elevations in Alanine aminotransferase (ALT) or Aspartate aminotransferase (AST) (unrelated to PNH or its complications) as described in the protocol Note: Other protocol-defined Inclusion/ Exclusion Criteria apply

Patients Entering from the Parent Study: Any new condition or worsening of an existing condition which, in the opinion of the investigator, would make the patient unsuitable for enrollment or could interfere with the patient participating in or completing the study

Patients Entering with C5 polymorphism: Prior treatment with complement inhibitors within 5 half-lives of the respective agent prior to screening, except for prior eculizumab or ravulizumab which are not exclusionary

Patients Entering with C5 polymorphism: Receipt of an organ transplant, history of bone marrow transplantation or other hematologic transplant

Patients Entering with C5 polymorphism: Not meeting meningococcal vaccination requirements and, at a minimum, documentation of quadrivalent meningococcal vaccination within 5 years prior to enrollment and serotype B vaccine within 3 years prior to enrollment as described in the protocol

Patients Entering with C5 polymorphism: Positive hepatitis B surface antigen or hepatitis C virus Ribonucleic acid (RNA) during screening

Patients Entering with C5 polymorphism: Patients with known HIV with history of opportunistic infections in the last 1 year as described in the protocol

Patients Entering with C5 polymorphism: Known hereditary complement deficiency

Patients Entering with C5 polymorphism: Documented history of active, uncontrolled, ongoing systemic autoimmune diseases

Study & Design

Study Type
Not specified
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Incidence of treatment-emergent serious adverse events (SAEs)

Incidence of treatment-emergent serious adverse events (SAEs)

Severity of treatment-emergent SAEs

Severity of treatment-emergent SAEs

Incidence of treatment emergent adverse events of special interest (AESIs)

Incidence of treatment emergent adverse events of special interest (AESIs)

Severity of treatment emergent AESIs

Severity of treatment emergent AESIs

Incidence of adverse events (AEs) leading to permanent treatment discontinuation

Incidence of adverse events (AEs) leading to permanent treatment discontinuation

Severity of adverse events (AEs) leading to permanent treatment discontinuation

Severity of adverse events (AEs) leading to permanent treatment discontinuation

Percent change from baseline in lactate dehydrogenase (LDH)

Percent change from baseline in lactate dehydrogenase (LDH)

Secondary Outcome Measures
NameTimeMethod
Maintenance of adequate control of hemolysis (LDH ≤1.5 × ULN)

Maintenance of adequate control of hemolysis (LDH ≤1.5 × ULN)

Breakthrough hemolysis (defined as LDH ≥2 × ULN [subsequent to initial achievement of LDH ≤1.5 × ULN] concomitant with signs or symptoms associated with hemolysis)

Breakthrough hemolysis (defined as LDH ≥2 × ULN [subsequent to initial achievement of LDH ≤1.5 × ULN] concomitant with signs or symptoms associated with hemolysis)

Change in fatigue

Change in fatigue

Change in physical function (PF) scores on the EORTC QLQ-C30

Change in physical function (PF) scores on the EORTC QLQ-C30

Change in GHS/quality of life (QOL) scale on the EORTC QLQ-C30

Change in GHS/quality of life (QOL) scale on the EORTC QLQ-C30

Normalization of LDH

Normalization of LDH

Rate of red blood cell (RBC) transfusion

Rate of red blood cell (RBC) transfusion

Number of units of RBC transfusion

Number of units of RBC transfusion

Percentage of days with LDH ≤1.5x upper limit of normal (ULN)

Percentage of days with LDH ≤1.5x upper limit of normal (ULN)

Change in hemoglobin levels

Change in hemoglobin levels

Change in total complement hemolytic activity assay (CH50)

Change in total complement hemolytic activity assay (CH50)

Percent change in CH50

Percent change in CH50

Concentrations of total pozelimab in serum

Concentrations of total pozelimab in serum

Concentrations of cemdisiran in plasma

Concentrations of cemdisiran in plasma

Incidence of treatment-emergent anti-drug antibodies to pozelimab

Incidence of treatment-emergent anti-drug antibodies to pozelimab

Incidence of treatment-emergent anti-drug antibodies to cemdisiran

Incidence of treatment-emergent anti-drug antibodies to cemdisiran

Concentration of total complement component 5 (C5) in plasma

Concentration of total complement component 5 (C5) in plasma

Percent change of concentration of total C5 in plasma

Percent change of concentration of total C5 in plasma

Adequate control of hemolysis (LDH ≤1.5 × ULN)

Adequate control of hemolysis (LDH ≤1.5 × ULN)

Transfusion avoidance

Transfusion avoidance

Hemoglobin stabilization

Hemoglobin stabilization

Percent change in LDH

Percent change in LDH

Trial Locations

Locations (12)

Geniko Nosokomeio Thessalonikis George Papanikolaou

🇬🇷

Thessaloniki, Greece

Semmelweis University

🇭🇺

Budapest VIII, Hungary

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

🇮🇹

Rome, Italy

Azienda Ospedaliero Universitaria Careggi

🇮🇹

Florence, Italy

Azienda Ospedaliera Universitaria Citta Della Salute E Della Scienza Di Torino

🇮🇹

Turin, Italy

Spitalul Clinic Municipal Filantropia Craiova

🇷🇴

Craiova, Romania

Institute Of Oncology Prof. Dr. Ion Chiricuta Cluj-Napoca

🇷🇴

Cluj-Napoca, Romania

Spitalul Clinic Judetean De Urgenta Targu Mures

🇷🇴

Targu Mures, Romania

Hospital Universitario Basurto

🇪🇸

Bilbao, Spain

Hospital Clinic De Barcelona

🇪🇸

Barcelona, Spain

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Geniko Nosokomeio Thessalonikis George Papanikolaou
🇬🇷Thessaloniki, Greece
Chrysavgi Lalayanni
Site contact
+302313307522
luizana6@gmail.com

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