A Study to Evaluate Efficacy, Safety, and Pharmacokinetics of XEMBIFY® Plus Standard Medical Treatment (SMT) Compared to Placebo Plus SMT to Prevent Infections in Participants With Hypogammaglobulinemia and Recurrent or Severe Infections Associated With B-cell Chronic Lymphocytic Leukemia

Bacterial Infections Clinical Trial

Official title:

A Multi-Center, Parallel, Double-Blinded, Placebo-Controlled Clinical Trial to Evaluate Efficacy, Safety, and Pharmacokinetics of XEMBIFY® Plus Standard Medical Treatment Compared to Placebo Plus Standard Medical Treatment to Prevent Infections in Patients With Hypogammaglobulinemia and Recurrent or Severe Infections Associated With B-cell Chronic Lymphocytic Leukemia

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05645107
• Other study ID #: GC2202
• Secondary ID: XEMBIFY® - CLL20
• Status: Recruiting
• Phase: Phase 3
• Start date: December 26, 2022
• Est. completion date: June 2026

Study information

• Verified date: March 2024
• Source: Grifols Therapeutics LLC
• Contact: Terra Stockwell
• Phone: 019195649275
• Email: Terra.Stockwell[@]grifols.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The primary purpose of the study is to evaluate whether weekly administered XEMBIFY® plus Standard Medical Treatment (SMT) over a one-year period will reduce the rate of major bacterial infections per participant per year in participants with hypogammaglobulinemia (HGG) associated with B-cell chronic lymphocytic leukemia (CLL) in comparison to the Placebo plus SMT group.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 386
• Est. completion date: June 2026
• Est. primary completion date: May 2026
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Participants =18 years of age at screening
• Participants with documented and confirmed diagnosis of B-cell CLL according to International Workshop on CLL (iwCLL) criteria.
• Participants with hypogammaglobulinemia with immunoglobulin G (IgG) levels <4 grams per liter (g/L)
• Participants with RAI staging of intermediate (1 and 2) or high (3 and 4) as documented in the participant's medical history.
• Participants with documented history of at least one severe bacterial infection or recurrent bacterial infections (that is., = 3 infections) within 12 months before the screening visit. Severe bacterial infections = Grade 3 (as defined by Common Terminology Criteria for Adverse Events [CTCAE] Grades).

Exclusion Criteria:

• Participants with documented history of hematopoietic stem cell transplant.
• Participants currently receiving immunoglobulin replacement therapy (IgRT) or have received IgG replacement treatment (i.e., prior immune globulin replacement therapy) within 6 months before the screening visit.
• Participants with active infections or receiving therapeutic or prophylactic antibiotic treatment at time of screening visit. Specific supportive anti-infective prophylactic defined in the CLL National Comprehensive Cancer Network (NCCN) or iwCLL guidelines or recommended in the updated labelling of specific antileukemic medicines used during the participation in the trial is allowed.
• Participants with active second malignancies.
• Participants with known primary immunodeficiency (PI).
• Participants with a life expectancy less than 1.5 years.
• Participants with clinical evidence of any significant acute or chronic disease that, in the opinion of the investigator, may interfere with successful completion of the trial or place the subject at undue medical risk.
• Participants have had a known serious adverse reaction (AR) to immunoglobulin or any anaphylactic reaction to blood or any blood-derived product.
• Participants have a history of blistering skin disease, bleeding disorder, diffuse rash, recurrent skin infections, or other disorders where SC therapy would be contraindicated during the study based upon the Investigator's discretion.
• Participants have known Selective Immunoglobulin A (IgA) Deficiency (with or without antibodies to IgA) (Note: exclusion is for the specific diagnostic entity. It does not exclude other forms of humoral primary immunodeficiency which have decreased IgA in addition to decreased IgG requiring IgG replacement).
• Participants with severe known kidney disease [as defined by estimated glomerular filtration rate [eGFR] less than (<) 30 milliliter (mL)/min/1.73 square meter (m2)] as determined by the Principal Investigator.
• Participants that have liver enzyme levels (alanine aminotransferase [ALT], aspartate aminotransferase [AST], gammaglutamyl transferase [GGT], or lactate dehydrogenase [LDH]) greater than 3 times the upper limit of normal (ULN) at the Screening Visit as defined by the testing laboratory.
• Participants have a history (either 1 episode within the year prior to the Screening Visit or 2 previous episodes over a lifetime) of or current diagnosis of thromboembolism (example, myocardial infarction, cerebrovascular accident, or transient ischemic attack) or deep venous thrombosis.
• Participants are currently receiving anti-coagulation therapy which would make SC administration inadvisable (vitamin K antagonists, nonvitamin K antagonist oral anticoagulants [example, dabigatran etexilate targeting Factor IIa, rivaroxaban, edoxaban, and apixaban targeting Factor Xa], and parenteral anticoagulants [example, fondaparinux]).
• Participants currently have a known hyperviscosity syndrome or hypercoagulable states.
• Participants have a known previous infection with or clinical signs and symptoms consistent with current hepatitis B virus or hepatitis C virus infection.
• Participants with non-controlled arterial hypertension (systolic blood pressure [SBP] more than (>)140 millimeters of mercury (mmHg) and/or diastolic blood pressure [DBP] >90 mmHg), and/or a heart rate (HR) >100 bpm.
• Participants with known substance or prescription drug abuse within 12 months before the Screening Visit.
• Participants have participated in another clinical trial within 30 days prior to screening (observational studies without investigative treatments [non-interventional] are permitted).

Related Conditions & MeSH terms

• Agammaglobulinemia
• B-cell Chronic Lymphocytic Leukemia
• Bacterial Infections
• Communicable Diseases
• Hypogammaglobulinemia
• Infections
• Leukemia
• Leukemia, Lymphocytic, Chronic, B-Cell
• Leukemia, Lymphoid

Intervention

Drug:
• Xembify
SC infusion pump
• Placebo
SC infusion pump

Locations

Country	Name	City	State
Bulgaria	"University multiprofile hospital for active treatment - Burgas" AD, Internal diseases II level, clinical hematology I level	Burgas
Bulgaria	"Medical Center Leo Clinic" EOOD, consulting room 15	Plovdiv
Bulgaria	"Complex oncology center - Ruse" EOOD, Department - medical oncology II level	Ruse
Bulgaria	"""Specialized Hospital for active treatment of hematological diseases"" EAD, First department clinical hematology to clinic on clinical hematology - clinical hematology III level"	Sofia
Bulgaria	"Medical Center "Sirtuin"" Ltd, consulting room 7	Sofia
Bulgaria	"Specialized Hospital for active treatment of hematological diseases" EAD, Second department clinical hematology to clinic on clinical hematology - clinical hematology III level	Sofia
Bulgaria	"University First multiprofile hospital for active treatment - Sofia "St. Joan Krastitel"" EAD, Third Department of Internal Diseases	Sofia
Bulgaria	"University multiprofile hospital for active treatment "Sv. Ivan Rilski"" EAD, Department of clinical hematology at Clinical Hematology Clinic - clinical hematology III level	Sofia
Bulgaria	"University multiprofile hospital for active treatment and emergency medicine "N.I. Pirogov"" EAD, Internal diseases - internal diseases III level	Sofia
Poland	Wojewodzki Szpital Specjalistyczny w Legnicy, Oddzial Hematologii	Legnica	Dolnoslaskie
Poland	Wojewodzki Szpital Specjalistyczny imienia Janusza Korczaka w Slupsku Sp. z o.o., Oddzial Hematologii	Slupsk	Pomorskie
Poland	Centrum Medyczne MICS Torun	Torun	Kujawsko-pomorskie
Romania	Onco Card Srl	Brasov	RO
Romania	Spitalul Clinic Coltea	Bucuresti	RO
Romania	IOCN	Cluj-Napoca	RO
Romania	Spitalul Clinic Municipal de Urgenta Timisoara	Timisoara	RO
Serbia	"University Clinical Center of Serbia, Clinic of Hematology"	Belgrade
Serbia	"University Clinical Center Kragujevac, Clinic of Hematology"	Kragujevac
Serbia	"University Clinical Center Nis, Clinic for Hematology, Alergology and Clinical Immunology "	Nis
Serbia	"Oncology Institute of Vojvodina, Clinic for Internal Oncology "	Sremska Kamenica
United States	Gabrail Cancer and Research Center	Canton	Ohio
United States	Optimed Research, LLC	Columbus	Ohio
United States	Valley Cancer Associates	Harlingen	Texas
United States	JD Medical Group LLC	Miami	Florida
United States	Allergy and Clinical Immunology Associates	Pittsburgh	Pennsylvania
United States	Carolina Blood and Cancer Care	Rockville	South Carolina

Sponsors (1)

Lead Sponsor	Collaborator
Grifols Therapeutics LLC

Countries where clinical trial is conducted

United States,  Bulgaria,  Poland,  Romania,  Serbia, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Annual Rate of Major Bacterial Infections per Year		Up to Week 53
Secondary	Time to First Onset of Major Bacterial Infection		Up to Week 53
Secondary	Percentage of Participants who Experience Major Bacterial Infections		Up to Week 53
Secondary	Rate of all Bacterial Infections Determined by the Investigator		Up to Week 53
Secondary	Time to First Onset of Non-Major Bacterial Infections		Up to Week 53
Secondary	Percentage of Participants who Experience Bacterial Infections		Up to Week 53
Secondary	Number of Days on Which Participants Were on Antibiotics		Up to Week 53
Secondary	Number of Hospitalizations due to any Infections		Up to Week 53
Secondary	Duration of Hospitalizations due to any Infections		Up to Week 53
Secondary	Number of Hospitalizations due to Major Bacterial Infections		Up to Week 53
Secondary	Duration of Hospitalizations due to Major Bacterial Infections		Up to Week 53
Secondary	Rate of all Infections as Determined by the Investigator		Up to Week 53
Secondary	Number of Participants with Validated Infections		Up to Week 53
Secondary	Time to First Onset of any Infection		Up to Week 53