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Therapeutic Use of Tadekinig Alfa in NLRC4 Mutation and XIAP Deficiency As Open Label Extension

Phase 3
Completed
Conditions
XIAP Deficiency
NLRC4-MAS
Interventions
Registration Number
NCT03512314
Lead Sponsor
AB2 Bio Ltd.
Brief Summary

This is an open-label extension study for patients previously enrolled in the AB2 Bio Ltd. ongoing Phase III clinical trial NLRC4/XIAP.2016.001 (IND N° 127953). This OLE study will evaluate the long-term safety and tolerability of Tadekinig alfa in patients suffering from pediatric monogenic autoinflammatory diseases harboring deleterious mutations of NLRC4 and XIAP.

Detailed Description

Pediatric auto-inflammatory conditions related to spontaneous activating mutations of the NLRC4 and with recurrent MAS-like flares with constitutive IL-18 hypersecretion, may require long-term blockade of the IL-18 pathway.

Patients with X-linked inhibitor of apoptosis (XIAP) deficiency and suffering from Hemophagocytic-Lymphohistiocytosis (HLH), a MAS-like syndrome, also show high levels of serum IL-18 and may benefit from IL-18 blockade treatment until a curative hematopoietic stem cell transplantation can be performed The safety of IL-18 blockade during long-term periods is of major interest for the treatment of these patients

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
11
Inclusion Criteria

(both criteria must be met)

  1. Patients have participated in AB2 Bio ltd. Phase III clinical trial NLRC4/XIAP.2016.001 (IND N° 127953) by one of the following mechanisms : a) Patients that have completed the first 18-week RCT phase of the preceding clinical trial but were not eligible for the RW phase due to flare symptoms. Or b) Patients that completed the first 18-week RCT phase and completed the RW phase of the preceding clinical trial. Or c) Patients who have exited either the RCT or RW phase of the preceding clinical trial due to treatment failure requiring rescue immunosuppression. Such patients must wait a minimum of 4 weeks after treatment discontinuation from the preceding clinical trial before enrolling in this OLE. If patients do not consent to enroll in the OLE after their early termination in the main study, they will be asked to continue with the planned visits of the main study
  2. Women of childbearing potential with negative urine pregnancy test (UPT) at all visits
Exclusion Criteria
  1. Patients may not enter the OLE if they voluntarily withdrew from RCT or RW study or if the time period between participation exceeds 3 months
  2. Evidence or history of malignancy
  3. Evidence of invasive or life-threatening infection
  4. History of tuberculosis
  5. Life-threatening bleeding within 2 weeks of screening
  6. Vaccination with a live vaccine within the previous 3 months
  7. Evidence of severe organ compromise including but not limited to: (see details in the protocol)
  8. Pregnant or breastfeeding females
  9. Inability to follow highly effective birth control recommendations during the study and until 1 month after the end of the treatment.
  10. Inability to provide informed consent, and also assent if applicable
  11. Life expectancy less than 4 weeks
  12. Concomitant use of other immunosuppression except NSAIDs, glucocorticoids, cyclosporine, tacrolimus, IL-1 inhibitors (Anakinra, Canakinumab, or Rilonacept)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Tadekinig alfaTadekinig alfaActive drug treatment during 26 weeks
Primary Outcome Measures
NameTimeMethod
Reports of abnormal laboratory results26 weeks

Report of clinically significant abnormal laboratory results (i.eSerum CRP (ug/mL), Serum Ferritin (ng/mL). and any other abnormal lab results

Immunogenicity evaluation26 weeks

Generation of anti-recombinant human Interleukin-18 Binding Protein (anti-rhIL-18BP) antibodies

Evaluation of the local tolerability at the injection site26 weeks

Evaluation will be done based on the Local Tolerability Index where the patients will be asked to assess the degree of pain, redness, swelling, bruising, tenderness and itching, they are experiencing from each injection.

Reports of adverse events26 weeks

The incidence, nature and severity of AEs will be reported

Reports of abnormal physical examination26 weeks

Measurements will be done using the modified Auto-inflammatory Disease Activity Index (mAIDAI) including multiple measurements aggregated as 1 / 0.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (11)

UCSD _ Department of Pediatrics / Rady Children's Hospital

🇺🇸

La Jolla, California, United States

Shands Children's Hospital

🇺🇸

Gainsville, Florida, United States

Children's Healthcare of Atlanta at Egleston

🇺🇸

Atlanta, Georgia, United States

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

Children Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Children's Hospital of Pittsburgh of UPMC

🇺🇸

Pittsburgh, Pennsylvania, United States

Texas Children's Hospital _ Baylor College of Medicine

🇺🇸

Houston, Texas, United States

The Hospital for Sick Children

🇨🇦

Toronto, Ontario, Canada

CHU Sainte-Justine

🇨🇦

Montréal, Canada

Universitätsklinikum Freiburg, Centrum für Chronische Immundefizienz (CCI) - Paediatric Unit

🇩🇪

Freiburg, Baden-Württemberg, Germany

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