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NCT Number: NCT04654468

A Study Evaluating the Efficacy, Safety, Pharmacokinetics and Pharmacodynamics of Crovalimab in Participants With Paroxysmal Nocturnal Hemoglobinuria (PNH) Not Previously Treated With Complement Inhibition

This study will enroll participants aged 12 years or older with a body weight ≥ 40 kilograms (kg) diagnosed with PNH who have not been previously treated with complement inhibitor therapy. Approximately 50 participants will be treated with Crovalimab for at least 24 weeks.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

12 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

West China Hospital, Sichuan University, Chengdu, China

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Body weight ≥ 40 kg at screening
  • Willingness and ability to comply with all study visits and procedures
  • Documented diagnosis of PNH, confirmed by high sensitivity flow cytometry
  • LDH Levels ≥ 2x the ULN at screening
  • Participants who have at least four transfusions during 12 months prior to screening (documented in the medical record)
  • Presence of one or more of the PNH-related signs or symptoms within 3 months of screening
  • Vaccination against Neisseria meningitidis serotypes A, C, W, and Y < 3 years prior to initiation of study treatment (Day 1)
  • Vaccination against Haemophilius influenzae type B and Streptococcus pneumonia according to national vaccination recommendations
  • For participants receiving other therapies (e.g., immunosuppressants, corticosteroids): stable dose for ≥ 28 days prior to screening and up to the first drug administration
  • Adequate hepatic and renal function
  • Women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception during the treatment period and for 46 weeks (approximately 10.5 months) after the final dose of crovalimab
  • Platelet count ≥30,000 per cubic millimeter (mm^3) at screening
  • ANC > 500/microlitres (μl) at screening

Exclusion criteria

  • Current or previous treatment with a complement inhibitor
  • History of allogeneic bone marrow transplantation
  • History of Neisseria meningitidis infection within 6 months prior to screening and up to first drug administration
  • Known or suspected immune or hereditary complement deficiency
  • Known HIV infection with cluster of differentiation 4 (CD4) count < 200 cells/µl within 24 weeks prior to screening
  • Infection requiring hospitalization or treatment with IV antibiotics within 28 days prior to screening and up to the first drug administration, or oral antibiotics within 14 days prior to screening and up to the first drug administration
  • Active systemic bacterial, viral, or fungal infection within 14 days before first drug administration
  • Presence of fever (≥ 38˚C) within 7 days before the first drug administration
  • Splenectomy < 6 months before screening
  • History of malignancy within 5 years prior to screening and up to the first drug administration
  • Pregnant or intending to become pregnant during the study or within 46 weeks (10.5 months) after the final dose of study treatment
  • Participation in another interventional treatment study with an investigational agent or use of any experimental therapy within 28 days of screening or within 5 half-lives of that investigational product, whichever is greater

Treatment and study plan

Crovalimab

Drug

Crovalimab will be administered at a dose of 1000 milligrams (mg) IV (for participants with body weight between 40 and 100 kg) or 1500 mg IV (for participants with body weight ≥ 100 kg) on Week 1 Day 1. On Week 1 Day 2 and on Weeks 2, 3 and 4, it will be administered at a dose of 340 mg SC. For Week 5 and Q4W thereafter, it will be administered at a dose of 680 mg SC (for participants with body weight between 40 and 100 kg) or 1020 mg SC (for participants with body weight ≥ 100 kg). Dosing schedule will be as described above.

Primary outcomes

  1. Mean Percentage of Participants With Hemolysis Control

    Time frame: From Week 5 up to Week 25

    A Generalized Estimating Equation (GEE) was used to estimate the population-average percentage of the participants with hemolysis control (measured by lactate dehydrogenase (LDH) ≤1.5 x upper limit of normal (ULN)) from Week 5 to Week 25 taking account of the intra-patient and inter-patient correlation between LDH control statuses across visits. The dependent variable was the binary indicator for hemolysis control. Independent variables are categorical effects of visits, continuous baseline LDH.

  2. Difference in Percentage of Participants With Transfusion Avoidance (TA) From Baseline Through Week 25 and Within 24 Weeks Prior to Screening

    Time frame: 24 Weeks Prior to Screening, Baseline to Week 25

    TA was defined as participants who were packed red blood cell (pRBC) transfusion-free and did not require transfusion per protocol-specified guidelines. TA within 24 weeks prior to screening was based on the pRBC transfusion history in the medical records. Reported in this outcome measure is the difference in the percentage of participants between "baseline through Week 25" and "within 24 weeks prior to screening". 95% Confidence Interval (CI) for the difference between the percentage of participants with transfusion avoidance between Pre-screening and Post-baseline is calculated using the Newcombe method.

    Screening= Day -28 to Day -1 and Baseline= Day 1.

Secondary outcomes

  1. Percentage of Participants With Breakthrough Hemolysis (BTH)

    Time frame: Baseline, Week 25

    BTH was defined as at least one new or worsening symptom or sign of intravascular hemolysis (fatigue, hemoglobinuria, abdominal pain, shortness of breath [dyspnea], anemia [hemoglobin < 10 grams per deciliter (g/dL)], major adverse vascular event [MAVE, including thrombosis], dysphagia, or erectile dysfunction) in the presence of elevated LDH ≥2xULN after a prior LDH reduction to ≤1.5xULN from the start of study treatment. As pre-specified in the SAP participants withdrawing before Week 25 were deemed to have experienced a BTH event. Percentages have been rounded off to the first decimal point.

  2. Percentage of Participants With Stabilized Hemoglobin

    Time frame: Baseline, Week 25

    Stabilized hemoglobin was defined as avoidance of a ≥2 g/dL decrease in hemoglobin level from baseline, in the absence of transfusion. As pre-specified in the SAP participants withdrawing before Week 25 were deemed to not have hemoglobin stabilization.

  3. Change From Baseline in Fatigue in Adults Aged >=18 Years

    Time frame: Baseline, Week 2, Week 5, Week 9, Week 17, Week 25

    Fatigue was assessed using functional assessment of chronic illness therapy-fatigue (FACIT-F) scale. FACIT-F is a self-assessment questionnaire with a 7-day recall period and 13 items evaluating fatigue and its impact on daily life activities. Items are scored on a response scale that ranges from 0 ("not at all") to 4 ("very much so"). Relevant items are reverse scored, and all the items are summed to create a total score range from 0 to 52, with 0 being the worst possible score and 52 being the best possible score. A higher score indicates low fatigue severity. A positive mean change indicates improvement. FACIT-F was assessed in adult participants only. FACIT-F assessment was unintentionally missed in the Schedule of Activities (SoA) table, which site used to guide the assessments at each timepoint. Therefore, data were not collected at Week 25.

  4. Percentage of Participants With Adverse Events (AEs)

    Time frame: Up to 7 years

  5. Percentage of Participants With Injection-Site Reactions, Infusion-Related Reactions, Hypersensitivity, and Infections (Including Meningococcal Meningitis)

    Time frame: Up to 7 years

  6. Percentage of Participants With Adverse Events (AEs) Leading to Study Drug Discontinuation

    Time frame: Up to 7 years

  7. Trough Serum Concentration of Crovalimab Over Time

    Time frame: Up to 7 years

  8. Serum Concentrations of Crovalimab

    Time frame: Up to 7 years

  9. Percentage of Participants With Anti-Drug Antibodies (ADAs) to Crovalimab

    Time frame: Up to 7 years

  10. Terminal Complement Activity as Measured by Liposome Immunoassay (LIA)

    Time frame: Up to 7 years

  11. Change Over Time in Total and Free C5 Concentration

    Time frame: Up to 7 years

  12. Observed Value in Absolute Reticulocyte Count

    Time frame: Up to 7 years

  13. Observed Value in Free Hemoglobin

    Time frame: Up to 7 years

  14. Observed Value in Haptoglobin

    Time frame: Up to 7 years

  15. Percent Change From Baseline in Absolute Reticulocyte Count

    Time frame: Baseline, Week 25

  16. Percent Change From Baseline in Free Hemoglobin

    Time frame: Baseline, Week 25

  17. Percent Change From Baseline in Haptoglobin

    Time frame: Baseline, Week 25

Sponsors and collaborators

Lead sponsor

Hoffmann-La Roche

Industry

Registry information

Official study title

A Phase III, Multicenter, Single Arm Study Evaluating the Efficacy, Safety, Pharmacokinetics, and Pharmacodynamics of Crovalimab in Patients With Paroxysmal Nocturnal Hemoglobinuria (PNH) Not Previously Treated With Complement Inhibition

Acronym: COMMODORE 3

Important dates

Study start
2021
Primary completion
2022
Study completion
2026
First posted
Dec 4, 2020
Registry last updated
May 12, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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