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NCT Number: NCT05133531

A Study to Evaluate How Safe Pozelimab + Cemdisiran Combination Therapy is and How Well it Works in Adult Patients With Paroxysmal Nocturnal Hemoglobinuria (PNH) Who Have Not Recently Received or Have Not Received Complement Inhibitor Treatment

This study is researching a clinical treatment combination with two experimental drugs called pozelimab and cemdisiran. The study is focused on people with paroxysmal nocturnal hemoglobinuria (PNH). The aim of the study is to see how safe and effective the pozelimab + cemdisiran combination is for people with PNH and how the combination compares with 2 existing treatments: ravulizumab and eculizumab.

The pozelimab + cemdisiran combination may be referred to as "study drugs". Ravulizumab and eculizumab may also be called the "comparator drug".

The study is looking at several research questions, including:

* How effective is the pozelimab + cemdisiran combination compared to ravulizumab? * How effective is pozelimab + cemdisiran combination compared to eculizumab? * What side effects may happen from taking the study drugs? * How much study drugs are in the blood at different times? * Whether the body makes antibodies against the study drugs (which could make the study drugs less effective or could lead to side effects)

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Centro de Estudos e Pesquisas em Hematologia e Oncologia, Santo André, São Paulo, Brazil

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

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

Key Inclusion Criteria:

  • Diagnosis of PNH confirmed by high-sensitivity flow cytometry testing with PNH granulocytes or monocytes as described in the protocol
  • Active disease, as defined by the presence of 1 or more PNH-related signs or symptoms as described in the protocol
  • LDH level ≥2 × ULN at the screening visit
  • Willing and able to comply with clinic/remote visits and study-related procedures, including completion of the full series of meningococcal vaccinations required per protocol

Key Exclusion Criteria:

  • Prior treatment with eculizumab within 3 months prior to screening, ravulizumab within 6 months prior to screening, or other complement inhibitors within 5 half-lives of the respective agent prior to screening
  • Receipt of an organ transplant, history of bone marrow transplantation or other hematologic transplant
  • Body weight <40 kilograms at screening visit
  • Planned use of any complement inhibitor therapy other than study drugs during the treatment period
  • Not meeting meningococcal vaccination requirements and, at a minimum documentation of quadrivalent meningococcal vaccination within 5 years prior to the screening visit and serotype B vaccine within 3 years prior to the screening visit as described in the protocol.
  • Any contraindication for receiving Neisseria meningitidis vaccinations (serotypes ACWY and B).
  • Unable to take antibiotics for meningococcal prophylaxis (if required by local ravulizumab [Cohort A] or eculizumab [Cohort B] prescribing information, where available, or national guidelines/local practice, or if necessary when administration of the first dose of the quadrivalent meningococcal vaccine [serotype ACWY] or the second dose of the serotype B meningococcal vaccine [when available] is less than 2 weeks prior to study treatment initiation) as described in the protocol
  • Any active, ongoing infection or a recent infection requiring ongoing systemic treatment with antibiotics, antivirals, or antifungals within 2 weeks of screening or during the screening period
  • Documented history of active, uncontrolled, ongoing systemic autoimmune diseases

Note: Other protocol-defined Inclusion/ Exclusion Criteria apply

Treatment and study plan

Ravulizumab

Drug

Administered Intravenous (IV) per the protocol

Other names: ALXN1210, Ultomiris

Pozelimab

Drug

Administered IV and subcutaneous (SC) per the protocol

Other names: REGN3918

Cemdisiran

Drug

Administered SC per the protocol

Other names: ALN-CC5

Eculizumab

Drug

Administered IV per the protocol

Other names: Soliris

Primary outcomes

  1. Percent change in lactate dehydrogenase (LDH)

    Time frame: From baseline to week 26

    Cohort A

  2. Transfusion avoidance

    Time frame: From post-baseline day 1 through week 26

    Cohort B Not requiring a red blood cell (RBC) transfusion per the protocol

  3. Adequate control of hemolysis

    Time frame: From week 8 through week 26, inclusive

    Cohort B LDH ≤1.5 × ULN at each visit

Secondary outcomes

  1. Maintenance of adequate control of hemolysis

    Time frame: From week 8 through week 26, inclusive

    Cohort A and B LDH ≤1.5 × ULN

  2. Breakthrough hemolysis

    Time frame: From post-baseline day 1 through week 26

    Cohort A and B LDH ≥2 × ULN per the protocol

  3. Adequate control of hemolysis

    Time frame: From week 8 through week 26, inclusive

    Cohort A LDH ≤1.5 × ULN

  4. Hemoglobin stabilization

    Time frame: From day 1 (post-baseline) through week 26

    Cohort A and B Patients who do not receive an RBC transfusion and have no decrease in hemoglobin level per the protocol

  5. Normalization of LDH

    Time frame: Between week 8 through week 26, inclusive

    Cohort A and B LDH ≤1.0 × ULN per the protocol

  6. Transfusion avoidance

    Time frame: Day 1 through week 26

    Cohort A Not requiring an RBC transfusion as per protocol algorithm based on post-baseline hemoglobin values.

  7. Change in fatigue as measured by the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale

    Time frame: From baseline to week 26

    Cohort A and B FACIT-Fatigue Scale is a 13-item, self-reported PRO measure assessing an individual's level of fatigue during their usual daily activities over the past week. This questionnaire is part of the FACIT measurement system, a compilation of questions measuring health-related quality of life (QoL) in patients with cancer and other chronic illnesses. The FACIT-fatigue assesses the level of fatigue using a Likert scale ranging from 0 (not at all) to 4 (very much). Scores range from 0 to 52, with higher scores indicating greater fatigue.

  8. Change in physical function (PF) scores on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30)

    Time frame: From baseline to week 26

    Cohort A and B EORTC-QLQ-C30 is a 30-item subject self-report questionnaire composed of both multi-item and single scales, including global health status/quality of life, functional Scales (physical, role, emotional, cognitive, and social), symptom scales (fatigue, nausea and vomiting, and pain), and 7 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, sleep and financial difficulties). Participants rate items on a 4-point scale, with 1 as "not at all" and 4 as "very much."

  9. Change in global health status (GHS)/QoL scale score on the EORTC-QLC-C30

    Time frame: From baseline to week 26

    Cohort A and B EORTC-QLQ-C30 is a 30-item subject self-report questionnaire composed of both multi-item and single scales, including global health status/quality of life, functional Scales (physical, role, emotional, cognitive, and social), symptom scales (fatigue, nausea and vomiting, and pain), and 7 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, sleep and financial difficulties). Participants rate items on a 4-point scale, with 1 as "not at all" and 4 as "very much."

  10. Percent change in LDH

    Time frame: From baseline to week 26

    Cohort B

  11. Rate of RBC transfused

    Time frame: Post-baseline Day 1 through week 26

    Cohort A and B Per protocol algorithm

  12. Number of units of RBC transfused

    Time frame: Post-baseline Day 1 through week 26

    Cohort A and B Per protocol algorithm

  13. Time to first LDH ≤1.5 × ULN

    Time frame: Up to Week 26

    Cohort A and B

  14. Time to first LDH ≤1.0 × ULN

    Time frame: Up to Week 26

    Cohort A and B

  15. Percentage of days with LDH ≤1.5 × ULN

    Time frame: Between week 8 and week 26, inclusive

    Cohort A and B

  16. Change in hemoglobin levels

    Time frame: From baseline to week 26

    Cohort A and B

  17. Incidence and severity of treatment emergent serious adverse events (SAEs)

    Time frame: Up to 26 weeks

    Cohort A and B

  18. Incidence and severity of treatment-emergent adverse events (TEAEs) of special interest

    Time frame: Up to 26 weeks

    Cohort A and B

  19. Incidence and severity of TEAEs leading to treatment discontinuation

    Time frame: Up to 26 weeks

    Cohort A and B

  20. Change in total CH50

    Time frame: From baseline to week 26

    Cohort A and B

  21. Percent change in total CH50

    Time frame: From baseline to week 26

    Cohort A and B

  22. Concentration of total C5 in plasma

    Time frame: Up to 60 weeks

    Cohort A and B

  23. Concentrations of total pozelimab in serum

    Time frame: Up to 60 weeks

    Cohort A and B

  24. Concentrations of cemdisiran in plasma

    Time frame: Up to 60 weeks

    Cohort A and B

  25. Concentrations of total ravulizumab in serum

    Time frame: Up to 34 weeks

    Cohort A

  26. Concentrations of total eculizumab in serum

    Time frame: Up to 30 weeks

    Cohort B

  27. Incidence of treatment emergent anti-drug antibodies (ADAs) to pozelimab

    Time frame: Up to 60 weeks

    Cohort A and B

  28. Incidence of treatment emergent ADAs to cemdisiran

    Time frame: Up to 60 weeks

    Cohort A and B

Sponsors and collaborators

Lead sponsor

Regeneron Pharmaceuticals

Industry

Registry information

Official study title

A Randomized, Open-Label, C5 Inhibitor-Controlled Study to Evaluate the Efficacy and Safety of Pozelimab and Cemdisiran Combination Therapy in Patients With Paroxysmal Nocturnal Hemoglobinuria Who Are Complement Inhibitor Treatment-Naive or Have Not Recently Received Complement Inhibitor Therapy

Acronym: ACCESS-1

Important dates

Study start
2022
Primary completion
2026
Study completion
2026
First posted
Nov 24, 2021
Registry last updated
Apr 30, 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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