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A Study of Maribavir in Chinese Adults With Cytomegalovirus (CMV) Infections

Phase 3
Recruiting
Conditions
Cytomegalovirus (CMV)
Interventions
Registration Number
NCT06439342
Lead Sponsor
Takeda
Brief Summary

The main aim of this study is to learn how safe maribavir is in Chinese adults who have undergone hematopoietic stem cell or organ transplantation and have a cytomegalovirus (CMV) infection and how well they tolerate treatment with maribavir. Other aims are to see how effective maribavir is in treating CMV infection and getting rid of the symptoms, the recurrence rate of CMV infection after treatment with maribavir and if the treatment is required again. Researchers will also check for changes (mutations) occurring in the virus which may cause treatment with maribavir to no longer work well or to not work at all (resistance to maribavir).

The participants will be treated with maribavir for 8 weeks.

During the study, participants will visit their study clinic 18 times.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria

Not provided

Exclusion Criteria
  • The participant has CMV disease with central nervous system (CNS involvement) (eg, CMV encephalitis) or ophthalmic involvement (eg, CMV retinitis) as assessed by the investigator at the time of screening.
  • That participant has uncontrolled other type of infection as assessed by the investigator on the date of treatment assignment.
  • The participant has a history of clinically relevant alcohol or drug abuse that may interfere with treatment compliance or assessments with the protocol as determined by the investigator.
  • The participant has a known hypersensitivity to maribavir or to any excipients.
  • The participant has severe vomiting, diarrhea, or other severe gastrointestinal (GI) illness within 24 hours prior to the first dose of investigational product or a GI absorption abnormality that would preclude administration of oral medication.
  • The participant has any clinically significant medical or surgical condition that, in the investigator's opinion, could interfere with interpretation of study results, contraindicate the administration of the investigational product, or compromise the safety or well-being of the participant.
  • The participant is receiving valganciclovir, ganciclovir, cidofovir, foscarnet, letermovir, leflunomide, or artesunate when investigational product is initiated, or anticipated to require one of these agents during the 8-week treatment period.
  • The participant requires mechanical ventilation or vasopressors for hemodynamic support at the time of baseline.
  • The participant has previously received maribavir.
  • The participant has previously completed, discontinued, or have been withdrawn from this study.
  • The participant has received any investigational agent with known anti-CMV activity within 30 days before initiation of investigational product or CMV vaccine at any time.
  • The participant has received any investigational agent or device within 30 days before initiation of investigational product.
  • The participant has serum aspartate aminotransferase (AST) >5 times upper limit of normal (ULN) at screening, or serum alanine aminotransferase (ALT) >5 times ULN at screening, or total bilirubin >=3.0 × ULN at screening (except for documented Gilbert's syndrome), by a local laboratory. Note: Participants with biopsy confirmed CMV hepatitis will not be excluded from study participation despite AST or ALT >5 times ULN at screening.
  • The participant has known (previously documented) positive results for human immunodeficiency virus (HIV). Participant must have a confirmed negative HIV test result within 3 months of study entry or, if unavailable, be tested by a local laboratory during the screening period.
  • The participant has active malignancy with the exception of nonmelanoma skin cancer, as determined by the investigator. Participants who experience relapse or progression of their underlying malignancy (for which hematopoietic stem-cell transplantation (HSCT) or solid organ transplant (SOT) was performed), as determined by the investigator, are not to be enrolled.
  • The participant is undergoing treatment for acute or chronic hepatitis C and hepatitis B.
  • The participant is pregnant or expecting to conceive or nursing/breastfeeding.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
MaribavirMaribavirParticipants will receive maribavir 400 milligrams (mg), tablets, orally twice a day (BID) for up to 8 weeks.
Primary Outcome Measures
NameTimeMethod
Number of Participants with Treatment-Emergent Adverse Events (TEAEs), Serious Adverse Events (SAE), and Adverse Events of Special interest (AESIs)From first dose of study drug up to Week 20

TEAEs will be defined as those with a start date on or after the first dose of study treatment, or with a start date before the date of first dose of study treatment but increasing in severity after the first dose of study treatment. An SAE is any untoward medical occurrence or effect that at any dose 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 or is medically important due to other reasons than the above-mentioned criteria. AESIs is defined as any adverse event of special interest.

Number of Participants With Clinically Significant Abnormalities in Laboratory ParametersFrom first dose of study drug up to Week 20

Clinical laboratory parameters will include chemistry, hematology, and urinalysis. Any clinical laboratory abnormalities which will be deemed clinically significant by the investigator will be recorded.

Number of Participants With Clinically Significant Electrocardiogram (ECG) FindingsFrom first dose of study drug up to Week 20

12-lead ECG will be evaluated. Any ECG assessments which will be deemed clinically significant by the investigator will be reported.

Number of Participants With Clinically Significant Changes in Vital SignsFrom first dose of study drug up to Week 20

Vital signs will include temperature, arterial blood pressure (systolic and diastolic) and pulse. Any change in vital signs assessments which will be deemed clinically significant by the investigator will be reported.

Number of Participants Who will Discontinue From the Study Drug and StudyFrom first dose of study drug up to Week 20

Participants discontinuing the study drug treatment and the study will be reported.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Achievement of CMV Viremia Clearance and CMV Infection Symptom Control After Completion of 8 weeks Therapy Followed by Maintenance of This Treatment Effect Through Weeks 12, 16 and 20At Weeks 12, 16 and 20

Confirmed CMV viremia clearance will be defined as plasma CMV DNA concentration \<LLOQ, when assessed by CMV Test (Roche COBAS CMV 6800/8800) at a central specialty laboratory, in 2 consecutive postbaseline samples, separated by at least 5 days (after completion of 8 weeks therapy). Symptom control is defined as resolution or improvement of tissue invasive CMV disease or CMV syndrome for participants symptomatic at baseline or no new symptoms of tissue invasive CMV disease or CMV syndrome for participants asymptomatic at baseline. The maintenance of treatment effect will be based on the achievement of CMV viremia clearance and symptom control at Week 8 after completion of 8 weeks therapy, followed by maintenance of this treatment effect through Weeks 12, 16 and 20.

Percentage of Participants With Recurrence of CMV Viremia During the First 8 Weeks and Through Week 12 to Week 20From first dose of study drug up to Week 8, and through Week 12 to Week 20

Recurrence of CMV viremia is defined as plasma CMV DNA concentrations greater than or equal to (\>=) LLOQ, when assessed by central specialty laboratory, in 2 consecutive plasma samples separated by at least 5 days after achieving confirmed viremia clearance.

Percentage of Participants With Recurrence of CMV Viremia Requiring Alternative Treatment After Achieving CMV Viremia Clearance at Study Week 8At Week 8

Recurrence of CMV viremia is defined as plasma CMV DNA concentrations \>=LLOQ, when assessed by central specialty laboratory, in 2 consecutive plasma samples separated by at least 5 days after achieving confirmed viremia clearance.

Percentage of Participants With Recurrence of CMV Viremia During on Treatment and off TreatmentFrom first dose of study drug up to Week 8 (on treatment) and Week 20 (off treatment)

Recurrence of CMV viremia is defined as plasma CMV DNA concentrations \>= LLOQ, when assessed by central specialty laboratory, in 2 consecutive plasma samples separated by at least 5 days after achieving confirmed viremia clearance. On treatment is the period over which participant received actual dosing (that can be before the stipulated 8 weeks of study-assigned treatment). Off treatment is the period after study treatment.

Number of Participants With All-cause Mortality During the StudyUp to Week 20

All-cause mortality during the study will be reported.

Percentage of Participants With Confirmed Clearance of Plasma CMV Deoxyribose Nucleic Acid (DNA) (CMV Viremia Clearance) at Week 8At Week 8

Confirmed CMV viremia clearance is defined as plasma CMV DNA concentration below the lower limit of quantification (\<LLOQ), when assessed by CMV Test (Roche COBAS CMV 6800/8800) at a central specialty laboratory, in 2 consecutive postbaseline samples, separated by at least 5 days, regardless of whether either study-assigned treatment was discontinued before the end of the stipulated 8 weeks of therapy.

Percentage of Participants With Achievement of CMV Viremia Clearance and CMV Infection Symptom Control at Weeks 8, 12, 16, and 20At Weeks 8, 12, 16 and 20

Confirmed CMV viremia clearance is defined as plasma CMV DNA concentration below the lower limit of quantification (\<LLOQ), when assessed by CMV Test (Roche COBAS CMV 6800/8800) at a central specialty laboratory, in 2 consecutive postbaseline samples, separated by at least 5 days, regardless of whether either study-assigned treatment was discontinued before the end of the stipulated 8 weeks of therapy. Symptom control is defined as resolution or improvement of tissue invasive CMV disease or CMV syndrome for participants symptomatic at baseline or no new symptoms of tissue invasive CMV disease or CMV syndrome for participants asymptomatic at baseline. This outcome measure will be assessed regardless of whether participants complete the stipulated 8 weeks of study-assigned treatment.

Percentage of Participants With Achievement of CMV Viremia Clearance and CMV Infection Symptom Control at Week 8 (After Completion of 8 Weeks Therapy)At Week 8

Confirmed CMV viremia clearance will be defined as plasma CMV DNA concentration \<LLOQ, when assessed by CMV Test (Roche COBAS CMV 6800/8800) at a central specialty laboratory, in 2 consecutive postbaseline samples, separated by at least 5 days (after completion of 8 weeks therapy). Symptom control is defined as resolution or improvement of tissue invasive CMV disease or CMV syndrome for participants symptomatic at baseline or no new symptoms of tissue invasive CMV disease or CMV syndrome for participants asymptomatic at baseline.

Percentage of Participants With Mutations in the CMV Genes Conferring Resistance to MaribavirUp to Week 20

Percentage of participants with mutations in the CMV genes conferring resistance to maribavir will be reported.

Area Under the Plasma Concentration-Time Curve From Time 0 to Time of the Last Quantifiable Concentration Area (AUC0-t) at Steady State for MaribavirWeek 1, Day 7: Pre-dose, 0.5, 1.5, 3, 4, 6, 8 and 12 hours post-dose

AUC0-t at steady state for maribavir will be assessed.

Area Under the Plasma Concentration-Time Curve Over 1 Dosing Interval of 12 Hours (AUC0-tau) at Steady State for MaribavirWeek 1, Day 7: Pre-dose, 0.5, 1.5, 3, 4, 6, 8 and 12 hours post-dose

AUC0-tau at steady state for maribavir will be assessed.

Half -life (t1/2) at Steady State for MaribavirWeek 1, Day 7: Pre-dose, 0.5, 1.5, 3, 4, 6, 8 and 12 hours post-dose

t1/2 at steady state for maribavir will be assessed.

Maximum Observed Plasma Concentration (Cmax) at Steady State for MaribavirWeek 1, Day 7: Pre-dose, 0.5, 1.5, 3, 4, 6, 8, and 12 hours post-dose

Cmax at steady state for maribavir will be assessed.

Time to Reach Cmax (Tmax) at Steady State for MaribavirWeek 1, Day 7: Pre-dose, 0.5, 1.5, 3, 4, 6, 8 and 12 hours post-dose

Tmax at steady state of maribavir will be assessed.

Minimum Observed Plasma Concentration (Cmin) for MaribavirPre-dose and at Weeks 1, 4, and 8

Cmin of maribavir will be assessed.

Apparent Oral Clearance (CL/F) at Steady State for MaribavirWeek 1, Day 7: Pre-dose, 0.5, 1.5, 3, 4, 6, 8 and 12 hours post-dose

CL/F at steady state for maribavir will be assessed.

Apparent Volume of Distribution (Vz/F) at Steady State for MaribavirWeek 1, Day 7: Pre-dose, 0.5, 1.5, 3, 4, 6, 8 and 12 hours post-dose

Vz/F at steady state for maribavir will be assessed.

Terminal Elimination Rate Constant (Lambda z) at Steady State for MaribavirWeek 1, Day 7: Pre-dose, 0.5, 1.5, 3, 4, 6, 8 and 12 hours post-dose

Lambda z at steady state for maribavir will be assessed.

Trial Locations

Locations (11)

Anhui Provincial Hospital(The First Affiliated Hospital of USTC)

🇨🇳

Hefei, Anhui, China

Xinqiao Hospital Army Medical University

🇨🇳

Chongqing, Chongqing, China

Guangzhou First People's Hospital

🇨🇳

Guangzhou, Guangdong, China

Nanfang Hospital Southern Medical University

🇨🇳

Guangzhou, Guangdong, China

Henan Cancer Hospital

🇨🇳

Zhengzhou, Henan, China

Union Hospital Tongji Medical College Huazhong University of Science and Technology

🇨🇳

Wuhan, Hubei, China

The First Affiliated Hospital of Soochow University

🇨🇳

Suzhou, Jiangsu, China

Peking University People's Hospital

🇨🇳

Beijing, North China, China

Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences

🇨🇳

Tianjin, Tianjin, China

The First Affiliated Hospital, Zhejiang University School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

The Second Affiliated Hospital, Zhejiang University School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

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