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Completed

NCT Number: NCT04320602

Ravulizumab in Adult Participants With Paroxysmal Nocturnal Hemoglobinuria Currently Treated With High-Dose Eculizumab

The primary purpose of this study is to assess the safety, efficacy, pharmacokinetics, and pharmacodynamics of ravulizumab in participants who are prescribed and are receiving a higher than approved dose of eculizumab to treat paroxysmal nocturnal hemoglobinuria (PNH).

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Key information

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

Clinical Study Site, Leeds, United Kingdom

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

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

Key Inclusion Criteria:

  • Documented diagnosis of PNH, confirmed by high-sensitivity flow cytometry evaluation of red blood cells and white blood cells, with granulocyte or monocyte clone size of ≥ 5%.
  • Received 1200 mg eculizumab every 12 to 16 days (every 2 weeks) for at least 3 months prior to Screening.
  • LDH ≤ 2 x upper limit of normal (ULN) according to central laboratory, at Screening.
  • To reduce the risk of meningococcal infection (Neisseria meningitidis), all participants must be vaccinated against meningococcal infections within 3 years prior to initiating study drug.
  • Body weight ≥ 40 kilograms.

Key Exclusion Criteria:

  • History of major adverse vascular events within 6 months of Day 1.
  • History of bone marrow transplantation.
  • Lymphoma, leukemia, myelodysplastic syndrome, or any malignancy within the past 5 years except for basal cell or squamous epithelial carcinomas of the skin that have been resected with no evidence of metastatic disease for 3 years.
  • Concomitant use of anticoagulants is prohibited if not on a stable regimen for at least 2 weeks prior to Day 1.
  • Concomitant use of any of the following medications and not on a stable regimen (as judged by the Investigator) for the time period indicated prior to Screening:
  • Erythropoietin or immunosuppressants for at least 8 weeks
  • Systemic corticosteroids for at least 4 weeks
  • Vitamin K antagonists (for example, warfarin) with a stable international normalized ratio level for at least 4 weeks
  • Iron supplements or folic acid for 4 weeks
  • Live vaccine(s) within 1 month prior to Screening or plans to receive such vaccines during the study.
  • More than 1 LDH value > 2 × ULN within the 6 months prior to Day 1.
  • Platelet count < 30,000/cubic millimeter (30 × 10^9/Liter [L]) at Screening.
  • Absolute neutrophil count < 500/microliter (0.5 × 10^9/L) at Screening.

Treatment and study plan

Eculizumab

Biological

Participants must have been prescribed and be receiving a stable dose of eculizumab 1200 milligrams (mg) every 2 weeks (q2w) for at least 3 months prior to the Screening Period. During the Screening Period, participants will continue to receive eculizumab 1200 mg q2w.

Other names: Soliris

Ravulizumab

Biological

During the Treatment Period, participants will receive a loading dose of ravulizumab on Day 1, followed by maintenance doses on Day 15 and every 8 weeks, administered by intravenous infusion. Ravulizumab loading and maintenance doses will be based on participants' body weight per approved dose regimen.

Other names: ALXN1210, Ultomiris

Primary outcomes

  1. Percentage of Participants Who Experienced Free C5-associated BTH

    Time frame: Baseline through Day 351

    Free C5-associated BTH was defined as BTH concurrent with free C5 concentrations ≥0.5 micrograms (μg)/milliliter (mL). 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 {g}/deciliter {dL}], major adverse vascular event [MAVE], including thrombosis, dysphagia, or erectile dysfunction) in the presence of elevated lactate dehydrogenase (LDH) ≥2 * upper limit of normal (ULN).

Secondary outcomes

  1. Percentage of Participants Who Experienced BTH

    Time frame: Baseline through Day 351

    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 g/dL], MAVE, including thrombosis, dysphagia, or erectile dysfunction) in the presence of elevated LDH ≥2 * ULN.

  2. Percent Change From Baseline in LDH at Day 351

    Time frame: Baseline, Day 351

  3. Percentage of Participants Who Received a Red Blood Cell (RBC) Transfusion

    Time frame: Baseline through Day 351

  4. Percentage of Participants With Stabilized Hemoglobin

    Time frame: Baseline through Day 351

    Stabilized hemoglobin was defined as avoidance of a ≥2 g/dL decrease in hemoglobin level from baseline in the absence of transfusion from Baseline to Day 351.

Sponsors and collaborators

Lead sponsor

Alexion Pharmaceuticals, Inc.

Industry

Registry information

Official study title

Phase 4, Single-Arm Study of Ravulizumab in Adult Participants With Paroxysmal Nocturnal Hemoglobinuria Currently Treated With High-Dose Eculizumab

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Mar 25, 2020
Registry last updated
Sep 5, 2024

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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