MedPath

Evaluate Efficacy, Safety and Tolerability, PK and PD of Emapalumab in Children and Adults With MAS in Still's or SLE

Phase 3
Active, not recruiting
Conditions
Macrophage Activation Syndrome
SJIA
MAS
Secondary Hemophagocytic Lymphohistiocytosis
Still Disease
Systemic Lupus Erythematosus
AOSD
Interventions
Registration Number
NCT05001737
Lead Sponsor
Swedish Orphan Biovitrum
Brief Summary

The purpose of this study is to assess the safety, tolerability and efficacy of emapalumab in children and adults with macrophage activation syndrome (sHLH/MAS) in Still's disease (including systemic juvenile idiopathic arthritis and adult onset Still's disease) or with sHLH/MAS in systemic lupus erythematous, resenting an inadequate response to high dose glucocorticoid treatment.

Detailed Description

Study NI-0501-14 is a two-cohort trial that enrolls subjects who are diagnosed with sHLH/MAS (MAS being a form of secondary HLH) and who are presenting an inadequate response to high doses of GCs. These subjects will be enrolled in 2 cohorts as per their background disease. The cohorts are defined as follows:

* Cohort 1: MAS in the context of sJIA and AOSD.

* Cohort 2: MAS in the context of pediatric and adult SLE.

The study has the objectives to investigate the efficacy, safety and tolerability, for 8 weeks, and PK and PD, QoL and immunogenicity in these 2 cohorts for up to 1 year after last dose of of emapalumab.

Macrophage Activation Syndrome (MAS) Secondary Hemophagocytic Lymphohistiocytosis (sHLH) systemic Juvenile Idiopathic Arthritis (sJIA) Adult-onset Still's Disease (AOSD) Systemic Lupus Erythematosus (SLE)

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
41
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Cohort 1 (sJIA and AOSD) and Cohort 2 (SLE)EmapalumabMAS in the context of systemic juvenile idiopathic arthritis and adult onset Still's disease (sJIA and AOSD) or SLE
Primary Outcome Measures
NameTimeMethod
Proportion of subjects with complete response (CR) at Week 8 after first administration of emapalumab8 weeks

Resolution of clinical signs and symptoms present at baseline: The MAS clinical activity will be measured on a visual analog scale (VAS) 10 cm.

Resolution of clinical signs and symptoms present at baseline: The MAS clinical activity will be measured on a visual analog scale (VAS) 10 cm. Clinical signs will be considered as resolved if VAS is below or equal to 1/10.

And

Normalization of laboratory parameters relevant to MAS, as follows:

WBC above LLN platelet count above LLN LDH below 1.5 ULN ALT below 1.5 ULN AST below 1.5 ULN fibrinogen higher than 100 mg/dL ferritin levels decreased by at least 80 % from values at screening or baseline (whichever is higher) or below 2000 ng/ml, whichever is low

Secondary Outcome Measures
NameTimeMethod
Time to achieve GCs tapering as defined above.At any time in the study, up to 1 year

GC tapering as per investigator discretion

Time to first Complete RemissionAt any time in the study, up to 1 year

Time to CR

GCs tapering to a dose below 50% of prednisolone (PDN) equivalent at the time of emapalumab start or to the same (or lower) dose being administered before the occurrence of MAS whichever occurs firstAt any time in the study, up to 1 year

GC tapering as per investigator discretion

Proportion of subjects with overall response as defined by CR or PRAt any time in the study, up to 1 year

Resolution of clinical signs and symptoms present at baseline: The MAS clinical activity will be measured on a visual analog scale (VAS) 10 cm.

Survival timeAt any time in the study, up to 1 year

Time to Survival

GCs tapering to ≤1mg/kg/day of PDN equivalent at any time during the study.At any time in the study, up to 1 year

GC tapering as per investigator discretion

MAS recurrence at anytime after achievement of CRAt any time after CR, up to 1 year

Time to MAS recurrence after CR

Time to first overall response as defined by CR or PRAt any time in the study, up to 1 year

CR defined as below:

Resolution of clinical signs and symptoms present at baseline: The MAS clinical activity will be measured on a visual analog scale (VAS) 10 cm.

Withdrawal from the study due to lack of response as per Investigator decisionAt any time in the study, up to 1 year

Time to withdrawal

Trial Locations

Locations (46)

Universitair Ziekenhuis Leuven

🇧🇪

Leuven, Belgium

Children's Hospital of Fudan University

🇨🇳

Shanghai, China

UMC Utrecht

🇳🇱

Utrecht, Netherlands

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

Nationwide Children's Hospital, Abigail Wexner Research Institute

🇺🇸

Columbus, Ohio, United States

UPMC Children's Hospital of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

UAB Hospital

🇺🇸

Birmingham, Alabama, United States

UCLA Health

🇺🇸

Los Angeles, California, United States

Akron Children's Hospital

🇺🇸

Akron, Ohio, United States

Children's Healthcare of Atlanta

🇺🇸

Atlanta, Georgia, United States

University of Minnesota Masonic Children's Hospital

🇺🇸

Minneapolis, Minnesota, United States

University of Calgary

🇨🇦

Calgary, Canada

Alberta Children's Hospital

🇨🇦

Calgary, Canada

Hospital for sick children

🇨🇦

Toronto, Canada

Centre Hospitalier de l'Université de Montréal

🇨🇦

Montréal, Canada

Centre Hospitalier Universitaire Sainte-Justine

🇨🇦

Montréal, Canada

Beijing Children's Hospital

🇨🇳

Beijing, China

Beijing Friendship Hospital

🇨🇳

Beijing, China

Hôpital De La Conception

🇫🇷

Marseille, France

Vseobecna Fakultni Nemocnice v Praze

🇨🇿

Praha, Czechia

Hôpital Claude Huriez

🇫🇷

Lille, France

Fakultní nemocnice Olomouc

🇨🇿

Olomouc, Czechia

Hôpital Necker-Enfants Malades

🇫🇷

Paris, France

Charité Universitätsmedizin

🇩🇪

Berlin, Germany

Hôpital Universitaire Pitié Salpêtrière

🇫🇷

Paris, France

Universitätsklinikum Heidelberg

🇩🇪

Heidelberg, Germany

IRCCS G. Gaslini

🇮🇹

Genova, Italy

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

🇮🇹

Milano, Italy

St. Marianna University School of Medicine Hospital

🇯🇵

Kawasaki, Japan

IRCCS - Materno-Infantile Burlo Garofolo

🇮🇹

Trieste, Italy

Ospedale Pediatrico Bambino Gesù

🇮🇹

Roma, Italy

Osaka Medical and Pharmaceutical University Hospital

🇯🇵

Takatsuki, Japan

Tokyo Medical and Dental University Hospital

🇯🇵

Tokyo, Japan

Yokohama City University Hospital

🇯🇵

Yokohama, Japan

Szpital Specjalistyczny im. J. Dietla w Krakowie

🇵🇱

Kraków, Poland

Wojewódzki Specjalistyczny Szpital Dziecięcy im. św. Ludwika w Krakowie

🇵🇱

Kraków, Poland

Ortopedyczno - Rehabilitacyjny Szpital Kliniczny im. Wiktora Degi Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu

🇵🇱

Poznań, Poland

Hospital Sant Joan de Déu

🇪🇸

Barcelona, Spain

Hospital Universitario La Paz

🇪🇸

La Paz, Spain

Hospital Universitario

🇪🇸

La Paz, Spain

Hospital Universitari i Politècnic La Fe

🇪🇸

Valencia, Spain

Karolinska Universitetssjukhuset Solna

🇸🇪

Stockholm, Sweden

Karolinska Universitetssjukhuset Solna (Ped. Rheum.)

🇸🇪

Stockholm, Sweden

Great Ormond Street Hospital

🇬🇧

London, United Kingdom

Imperial College Healthcare NHS Trust

🇬🇧

London, United Kingdom

University of Florida

🇺🇸

Gainesville, Florida, United States

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