A Proof-of-Mechanism Study to Determine the Effect of Danicopan on C3 Levels in Participants With C3G or IC-MPGN

C3 Glomerulopathy Clinical Trial

Official title:

A Phase 2a Proof-of-Mechanism, Open-Label Study to Determine the Effect of ACH-0144471 on C3 Levels in Participants With Low C3 Levels Due to Either C3 Glomerulopathy (C3G) or Immune-Complex Membranoproliferative Glomerulonephritis (IC-MPGN)

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03124368
• Other study ID #: ACH471-201
• Secondary ID: 2016-003525-42
• Status: Completed
• Phase: Phase 2
• Start date: August 9, 2017
• Est. completion date: January 9, 2019

Study information

• Verified date: October 2021
• Source: Alexion Pharmaceuticals
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The primary objective of this study was to determine whether ACH-0144471 (also known as danicopan and ALXN2040) increases blood C3 complement protein (C3) levels in participants with low C3 levels due to either C3G or IC-MPGN.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 6
• Est. completion date: January 9, 2019
• Est. primary completion date: December 21, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 16 Years to 65 Years

Eligibility

Key Inclusion Criteria:

• Must have had clinical diagnosis of C3G (C3 glomerulonephritis or dense deposit disease, the 2 types of C3G) or idiopathic IC-MPGN by renal biopsy for at least 3 months prior to dosing, with the pathologic diagnosis verified by a review of the renal biopsy by the study central pathologist
• C3 must have been <50% of the lower limit of normal
• C4 complement protein (C4) must have been >90% of the lower limit of normal
• Must have been willing to comply with study-specific vaccination requirements for Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis strains A, C, W, and Y
• Negative pregnancy test for females prior to dosing and throughout the study

Key Exclusion Criteria:

• History of a major organ transplant (for example, heart, lung, kidney, liver) or hematopoietic stem cell/marrow transplant. Individuals receiving renal replacement therapy were also excluded
• Evidence of monoclonal gammopathy of unclear significance, infections, malignancy, autoimmune diseases, or other conditions to which C3G or IC-MPGN may have been secondary
• Estimated glomerular filtration rate (using Modification of Diet in Renal Disease equation) <45 milliliters/minute/1.73 square meters at the time of Screening or at any time over the preceding 4 weeks
• Receipt of eculizumab at any dose or interval within the past 75 days prior to dosing
• Use of tacrolimus or cyclosporine within 2 weeks of the first dose of danicopan
• History of febrile illness, a body temperature >38°Celsius, or other evidence of a clinically significant active infection, within 14 days prior to study drug administration
• History of meningococcal infection, or a first-degree relative or household contact with a history of meningococcal infection
• Females who were pregnant, nursing, or planning to become pregnant during the study or within 90 days of study drug administration or participants with a female partner who was pregnant, nursing, or planning to become pregnant during the study or within 90 days of study drug administration

Related Conditions & MeSH terms

• C3 Glomerulonephritis
• C3 Glomerulopathy
• Dense Deposit Disease
• Glomerulonephritis
• Glomerulonephritis, Membranoproliferative
• Immune Complex Mediated Membranoproliferative Glomerulonephritis

Intervention

Drug:
• Danicopan
Participants received study drug for 14 days (Treatment Period), followed by a taper over the next 7 days (Taper Period).

Locations

Country	Name	City	State
Australia	Clinical Trial Site	Melbourne
Belgium	Clinical Trial Site	Antwerpen
Netherlands	Clinical Trial Site	Leiden

Sponsors (2)

Lead Sponsor	Collaborator
Alexion Pharmaceuticals	Achillion, a wholly owned subsidiary of Alexion

Countries where clinical trial is conducted

Australia,  Belgium,  Netherlands, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change From Baseline In Serum C3 Complement Protein (C3) Levels On Day 15	Serum C3 levels were measured by conventional Roche immunoturbidimetric assay method.; Change from Baseline = Serum C3 levels on Day 15 - Baseline Serum C3 levels	Baseline, Day 15
Primary	Change From Baseline In Plasma Intact C3 Level On Day 15	Plasma Intact C3 level were measured by a novel multiplex assay method. Change from Baseline = Plasma Intact C3 levels on Day 15 - Baseline Plasma Intact C3 levels	Baseline, Day 15
Secondary	Change From Baseline In Total Complement Classical Pathway (CP) Activity On Day 14	CP activity was measured in serum by the DiaSorin Complement Activation Enzyme (CAE) functional immunoassay method, which measures terminal complement complex formation following activation. Results are expressed in CAE units which are calculated relative to previously established CAE activity of a positive control serum.; Change from Baseline = Total Complement CP Activity on Day 14 - Baseline Total Complement CP Activity	Baseline, Day 14
Secondary	Change From Baseline In Total Complement Alternative Pathway (AP) Functional Activity (AP Wieslab) On Day 15	AP functional activity was measured in serum by the Wieslab functional immunoassay method, which measures terminal complement complex (TCC) formation following AP-specific activation. Results are expressed as percent TCC production relative to a positive control serum.; Change from Baseline = Total Complement AP Functional Activity on Day 15 - Baseline Total Complement AP Functional Activity	Baseline, Day 15
Secondary	Time To Achieving Peak Serum C3 Levels	Serial serum samples were collected on Days 1, 7, and 14.	From The First Day Of Dosing through Day 14
Secondary	Number Of Participants With Serious Adverse Events (SAEs), Grade 3 And Grade 4 Treatment-emergent Adverse Events (TEAEs), And Adverse Events (AEs) Leading To Discontinuation	An AE was as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An SAE was an AE that met at least 1 of the following criteria: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization for the AE, persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), important medical event or reaction. The intensity of an AE was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) Adverse Event Severity Grading Table. A summary of SAEs and other non-serious AEs regardless of causality is located in the Reported Adverse Events module.	Up to Day 49
Secondary	Pharmacokinetics (PK): Area Under The Plasma Concentration-time Curve From Time Of Administration To 8 Hours Postdose (AUC0-8)	Serial blood samples were collected at 0, 1, 1.5, 2, 2.5, 3, 4, 6, and 8 hours post-dose on Days 1 and 7.	Days 1 and 7
Secondary	PK: Maximum Plasma Concentration (Cmax)	Serial blood samples were collected at 0, 1, 1.5, 2, 2.5, 3, 4, 6, and 8 hours post-dose on Days 1 and 7.	Days 1 and 7
Secondary	PK: Time To Maximum Concentration (Tmax)	Serial blood samples were collected at 0, 1, 1.5, 2, 2.5, 3, 4, 6, and 8 hours post-dose on Days 1 and 7.	Days 1 and 7
Secondary	Change From Baseline In Bb Fragment Of Complement Factor B (Bb) At Day 15	Plasma Bb was measured by enzyme-linked immunosorbent assay (ELISA).; Change from Baseline = Complement Bb on Day 15 - Baseline	Baseline, Day 15
Secondary	Change From Baseline In Soluble Terminal Complement Complex (sC5b-9) At Day 15	Plasma sC5b-9 was measured by ELISA.; Change from Baseline = sC5b-9 on Day 15 - Baseline sC5b-9	Baseline, Day 15