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A Study of Nipocalimab in Reducing the Risk of Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT)

Phase 3
Recruiting
Conditions
Thrombocytopenia, Neonatal Alloimmune
Interventions
Drug: Placebo
Registration Number
NCT06449651
Lead Sponsor
Janssen Research & Development, LLC
Brief Summary

The purpose of this study is to evaluate the effectiveness of nipocalimab compared with placebo in reducing the risk of severe fetal and neonatal alloimmune thrombocytopenia (FNAIT).

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
39
Inclusion Criteria
  • Pregnant and an estimated gestational age (GA; based on ultrasound dating) from Week 13 to 18 at randomization
  • Has a history of greater than or equal to (>=) 1 prior pregnancy with fetal and neonatal alloimmune thrombocytopenia (FNAIT) (including neonatal platelet count less than (<) 150×10^9/Liter) with none of them affected by fetal/neonatal intracranial hemorrhage (ICH) or severe hemorrhage based on medical records
  • Current pregnancy with presence of maternal anti- human platelet antigen (HPA)-1a alloantibody and positive fetal HPA-1a genotype as confirmed by cell-free fetal deoxyribonucleic acid (DNA) in maternal blood
  • Health status considered stable by the investigator based on physical examination, medical history, vital signs, 12-lead Electrocardiogram (ECG), and clinical laboratory tests performed at screening
  • For maternal participant and neonate/infant, willing to forego participation in another clinical study of an investigational therapy until the last follow-up visit
Exclusion Criteria
  • Currently pregnant with multiple gestations (twins or more)
  • History of severe preeclampsia in a previous pregnancy
  • History of myocardial infarction, unstable ischemic heart disease, or stroke
  • Known allergies, hypersensitivity, or intolerance to nipocalimab or its excipients (refer to the Investigator Brochure (IB))
  • Has any confirmed or suspected clinical immunodeficiency syndrome or has a family history of congenital or hereditary immunodeficiency unless confirmed absent in the participant

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
NipocalimabNipocalimabMaternal participants will receive nipocalimab Intravenously (IV).
PlaceboPlaceboMaternal participants will receive placebo IV.
Primary Outcome Measures
NameTimeMethod
Fetus/Neonate with Outcome of Death or Adjudicated Severe Bleeding or Platelet Count Less Than (<) 30*10^9/LUp to 1 week post birth

Outcome of fetus/neonate death or adjudicated severe bleeding up to the first week post birth or platelet count \<30\*10\^9/L will be reported.

Secondary Outcome Measures
NameTimeMethod
Neonate/Fetus With Adjudicated BleedingUp to 1 Week post birth

Neonate/fetus With adjudicated bleeding will be reported.

Platelet Count at Birth in a NeonateAt birth

Platelet count at birth in a neonate will be reported.

Neonate/Fetus with Outcome of DeathUp to 1 Week post birth

Fetus/neonate with outcome of death will be reported.

Platelet Count at Birth <10×10^9/L in a NeonateAt birth

Platelet count at birth \<10×10\^9/L in a neonate will be reported.

Number of Platelet Transfusion(s) in Neonate/FetusUp to 1 Week post birth

Number of Platelet transfusion(s) per neonate will be reported.

Platelet Count at Birth <30×10^9/ L In a NeonateAt birth

Platelet count at birth \<30×10\^9/L in a neonate will be reported.

Platelet Count at Birth <50×10^9/L In a NeonateAt birth

Platelet count at birth \<50×10\^9/L in a neonate will be reported.

Platelet Count at Birth <150×10^9/L In a NeonateAt birth

Platelet count at birth \<150×10\^9/L in a neonate will be reported.

Nadir Platelet Count of a Neonate Over the First Week Post BirthUpto 1 Week post birth

Nadir platelet count in a neonate will be reported.

Neonate/Fetus Requiring Platelet Transfusion(s)Up to 1 Week post birth

Neonate(s) who require at least one platelet transfusion(s) will be reported.

Number of Donor Exposures for Platelet Transfusion(s) in Neonate/FetusUp to 1 Week post birth

Number of donor exposures for neonates who received platelet transfusion(s) will be reported.

Neonate/Fetus With Adjudicated Severe BleedingUp to 1 week post birth

Neonate/Fetus With adjudicated severe bleeding will be reported.

Neonates With Postnatal Intravenous Immunoglobulin (IVIG) for The Treatment of ThrombocytopeniaUp to 1 Week post birth

Neonates with IVIG for the treatment of thrombocytopenia will be reported.

Maternal Participants With Treatment-Emergent Adverse Event (TEAE)From randomization up to 24 weeks postpartum

Maternal participants with a TEAE will be reported. An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. TEAEs are defined as AEs with onset or worsening on or after date of first dose of study treatment.

Maternal Participants With Serious Adverse Event (SAE)From randomization up to 24 weeks postpartum

Maternal participants with SAE will be reported. An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. SAE is any untoward medical occurrence that at any dose that results in death, is life-threatening, requires inpatient hospitalization/prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect and is medically important.

Maternal Participants With Adverse Event of Special Interest (AESI)From randomization up to 24 weeks postpartum

Maternal participants with an AESI will be reported. An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. AESIs are considered as infections that are severe, hypoalbuminemia, deep vein thrombosis and/or pulmonary embolism, and clinically significant bleeding.

Maternal Participants with TEAE Leading to Discontinuation of Study InterventionUp to Week 104

Maternal participants with TEAE leading to discontinuation of study intervention will be reported.

Neonate/Infant with TEAEUp to Week 104

Neonatal/infant participants with a TEAE will be reported. An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. TEAEs are defined as AEs with onset or worsening on or after date of first dose of study treatment.

Neonate/Infant with SAEUp to Week 104

Neonatal/infant participants with SAE will be reported. An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. An SAE is any untoward medical occurrence that at any dose that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect and is medically Important.

Neonate/Infant with AESIUp to Week 104

Neonatal/infant participants with AESI will be reported. An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. AESIs are considered as: In infants- clinically significant mortalities in fetus/neonates due to maternal infections, and hypogammaglobulinemia.

Fetus/Neonate With TEAE of BleedingUp to Week 104

Fetus/Neonate with TEAE of Bleeding will be reported. An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. Treatment-emergent AEs are defined as AEs with onset or worsening on or after date of first dose of study treatment.

Neonate With TEAE of InfectionUp to Week 104

Neonate with TEAE of Infection will be reported. An AE is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. Treatment-emergent AEs are defined as AEs with onset or worsening on or after date of first dose of study treatment.

Infant Development as Measured by Bayley Scales at Week 52 and Week 104At Week 52 and 104

The Bayley Scales of Infant and Toddler Development include a set of individually administered developmental scales designed to measure current developmental functioning in infants and toddlers up to 42 months of age in the areas of cognition, language, motor skills, social-emotional, and adaptive behavior, with age adjusted for prematurity. The cognition, language, motor skills scales are directly administered to the infant, while social-emotional, and adaptive behavior scales are caregiver questionnaires. The scores are standardized using norm reference samples with representative demographics and age adjusted for prematurity.

Maternal Participants With Antibodies to Nipocalimab Including Neutralizing Antibodies in Maternal Serum During Pregnancy and PostpartumUp to Week 24

Maternal participants with antibodies to nipocalimab including neutralizing antibodies in maternal serum during pregnancy and postpartum will be reported.

Trial Locations

Locations (20)

CHRU Lille

🇫🇷

Lille, France

Hopital trousseau- APHP

🇫🇷

Paris, France

Semmelweis Egyetem

🇭🇺

Budapest, Hungary

Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Fondazione Policlinico Universitario A Gemelli IRCCS

🇮🇹

Rome, Italy

Haukeland University Hospital

🇳🇴

Bergen, Norway

Oslo University Hospital HF Ulleval sykehus

🇳🇴

Oslo, Norway

Universitair Ziekenhuis Leuven

🇧🇪

Leuven, Belgium

Instituto de Medicina Integral Professor Fernando Figueira

🇧🇷

Recife, Brazil

Instituto D Or de Pesquisa e Ensino IDOR

🇧🇷

Rio de Janeiro, Brazil

Hospital Das Clinicas Da Faculdade De Medicina Da USP

🇧🇷

Sao Paulo, Brazil

Universitetssykehuset Nord-Norge HF

🇳🇴

Tromso, Norway

St. Olavs Hospital

🇳🇴

Trondheim, Norway

Univerzitna nemocnica L. Pasteura Kosice

🇸🇰

Kosice, Slovakia

Univerzitná nemocnica Martin

🇸🇰

Martin, Slovakia

Fakultna nemocnica s poliklinikou Nove Zamky

🇸🇰

Nove Zamky, Slovakia

Univerzitetni klinicni center Ljubljana

🇸🇮

Ljubljana, Slovenia

Hosp. Virgen Del Rocio

🇪🇸

Sevilla, Spain

Karolinska Universitetssjukhuset Huddinge

🇸🇪

Stockholm, Sweden

Centre Hospitalier Universitaire Vaudois CHUV

🇨🇭

Lausanne, Switzerland

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