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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03500549
Other study ID # APL2-302
Secondary ID
Status Completed
Phase Phase 3
First received
Last updated
Start date June 14, 2018
Est. completion date August 13, 2020

Study information

Verified date March 2022
Source Apellis Pharmaceuticals, Inc.
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Evaluation of the Efficacy and Safety of APL-2 in Patients with Paroxysmal Nocturnal Hemoglobinuria


Recruitment information / eligibility

Status Completed
Enrollment 80
Est. completion date August 13, 2020
Est. primary completion date November 14, 2019
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - At least 18 years of age - Primary diagnosis of PNH confirmed by high-sensitivity flow cytometry - On treatment with eculizumab. Dose of eculizumab must have been stable for at least 3 months prior to the Screening Visit - Hb <10.5 g/dL at the Screening Visit - Absolute reticulocyte count > 1.0x ULN at the Screening Visit - Platelet count of >50,000/mm3 at the Screening Visit - Absolute neutrophil count >500/mm3 at the Screening Visit - Vaccination against Neisseria meningitides types A, C, W, Y and B, Streptococcus pneumoniae and Haemophilus influenzae Type B (Hib) either within 2 years prior to Day 1 dosing, or within 14 days after starting treatment with APL-2. Unless documented evidence exists that subjects are non-responders to vaccination as evidenced by titers or display titer levels within acceptable local limits - Women of child-bearing potential (WOCBP) must have a negative pregnancy test at the Screening and Day -28 Visit (Run-in Period) and must agree to use protocol defined methods of contraception for the duration of the study and 90 days after their last dose of study drug - Males must agree to use protocol defined methods of contraception and agree to refrain from donating sperm for the duration of the study and 90 days after their last dose of study drug - Willing and able to give informed consent - Willing and able to self-administer APL-2 (administration by caregiver will be allowed) - Have a body mass index (BMI) =35.0 kg/m2 Exclusion Criteria: - Active bacterial infection that has not resolved within 14 week of Day -28 (first dose of APL-2) - Receiving iron, folic acid, vitamin B12 and EPO, unless the dose is stable, in the 4 weeks prior to Screening - Hereditary complement deficiency - History of bone marrow transplantation - History or presence of hypersensitivity or idiosyncratic reaction to compounds related to the investigational product or SC administration - Participation in any other investigational drug trial or exposure to other investigational agent within 30 days or 5 half-lives (whichever is longer) - Currently breast-feeding women - Inability to cooperate or any condition that, in the opinion of the investigator, could increase the subject's risk of participating in the study or confound the outcome of the study This study includes cardiac safety evaluations. The following cardiac eligibility criteria are necessary to avoid confounding the cardiac safety outcomes: - History or family history of Long QT Syndrome or torsade de pointes, unexplained syncope, syncope from an uncorrected cardiac etiology, or family history of sudden death - Myocardial infarction, CABG, coronary or cerebral artery stenting and /or angioplasty, stroke, cardiac surgery, or hospitalization for congestive heart failure within 3 months or greater than Class 2 Angina Pectoris or NYHA Heart Failure Class >2 - QTcF > 470 ms, PR > 280 ms - Mobitz II 2nd degree AV Block, 2:1 AV Block, High Grade AV Block, or Complete Heart Block unless the patient has an implanted pacemaker or implantable cardiac defibrillator (ICD) with backup pacing capabilities - Receiving Class 1 or Class 3 antiarrhythmic agents, or arsenic, methadone, ondansetron or pentamidine at screening - Receiving any other QTc-prolonging drugs (see Appendix 4 in Section 19.4), at a stable dose for less than 3 weeks prior to dosing - Receiving prophylactic ciprofloxacin, erythromycin or azithromycin for less than one week prior to the first dose of study medication (must have a repeat screening ECG after one week of prophylactic antibiotics with QTcF < 470 ms)

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Pegcetacoplan
Complement (C3) Inhibitor
Soliris
Complement (C5) Inhibitor

Locations

Country Name City State
Australia Royal Melbourne Hospital Melbourne Victoria
Belgium AZ Delta Campus Wilgenstraat Roeselare West-Vlaanderen
Belgium Cliniques Universitaires Saint-Luc Woluwe-Saint-Lambert Vlaams-Brabant
Canada University of Alberta Edmonton Alberta
Canada Toronto General Hospital Toronto Ontario
France Centre Hospitalier Annecy Genevois Annecy
France Centre Hospitalier William Morey Chalon-sur-Saône
France Centre Hospitalier Universitaire de Lille Lille
France Institut Paoli-Calmettes Marseille Marseille
France Hôpital Saint-Louis Paris
France Centre Hospitalier Lyon Sud Pierre-Bénite
France Centre Hospitalier de Saint-Quentin Saint-Quentin
France Institut Universitaire du Cancer Toulouse - Oncopole Toulouse
Germany Uniklinik RWTH Aachen Aachen North Rhine-Westphalia
Germany Universitätsklinikum Essen Essen North Rhine-Westphalia
Germany Universitätsklinikum Hamburg Eppendorf Hamburg
Germany Universitätsklinikum Ulm Ulm Baden-Württemberg
Japan Juntendo University Hospital Bunkyo-ku Tokyo
Japan Shinshu University Hospital Matsumoto Nagano
Japan Japanese Red Cross Nagoya Daiichi Hospital Nagoya Aichi
Japan Okayama University Hospital Okayama-shi Okayama
Japan NTT Medical Center Tokyo Shinagawa-ku Tokyo
Japan Japanese Red Cross Nagoya Daini Hospital Showa-ku Aichi
Japan Kinan Hospital Tanabe Wakayama
Japan University of Tsukuba Hospital Tsukuba Ibaraki
Korea, Republic of Soonchunhyang University Bucheon Hospital Bucheon
Korea, Republic of Chungnam National University Hospital Daejeon
Korea, Republic of Samsung Medical Center Seoul
Russian Federation Pavlov First Saint Petersburg State Medical University Saint Petersburg
Russian Federation Pavlov First Saint Petersburg State Medical University of Russian Ministry of Health Saint Petersburg
Russian Federation Institution of Health Care of Tyumen Region Tyumen
Spain Hospital Universitario de Gran Canaria Dr. Negrín Las Palmas De Gran Canaria
Spain Hospital Universitario Politécnico La Fe Valencia
United Kingdom St. James' Institute of Oncology, Leeds Teaching Hospitals Leeds
United States Winship Cancer Institute of Emory University Atlanta Georgia
United States New York Cancer & Blood Specialists Bronx New York
United States Roswell Park Cancer Institute Buffalo New York
United States Northwestern University Chicago Illinois
United States Good Samaritan Hospital Corvallis Oregon
United States Denver Health Denver Colorado
United States Duke University Medical Center Durham North Carolina
United States New York Cancer & Blood Specialists East Setauket New York
United States Cancer & Hematology Centers of Western Michigan Grand Rapids Michigan
United States Investigative Clinical Research of Indiana Indianapolis Indiana
United States Cancer Specialists of North Florida Jacksonville Florida
United States University of Tennessee Medical Center Knoxville Tennessee
United States University of Southern California Los Angeles California
United States Baptist Cancer Center Memphis Tennessee
United States Lakes Research Miami Lakes Florida
United States Mid Florida Hematology and Oncology Orange City Florida
United States Sarcoma Oncology Research Center Santa Monica California
United States HOPE Cancer Center of East Texas Tyler Texas
United States Georgetown University Hospital Washington District of Columbia

Sponsors (1)

Lead Sponsor Collaborator
Apellis Pharmaceuticals, Inc.

Countries where clinical trial is conducted

United States,  Australia,  Belgium,  Canada,  France,  Germany,  Japan,  Korea, Republic of,  Russian Federation,  Spain,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Least Squares (LS) Mean Change From Baseline to Week 16 in Hemoglobin (Hb) Level During the RCP Baseline was the average of measurements recorded before taking the first dose of pegcetacoplan, which included local and central laboratory values during the screening period. Analysis excluded data before the RCP and was censored for transfusions. Baseline and Week 16
Secondary Percentage of Subjects Who Did Not Require a Transfusion (Transfusion Avoidance) During the RCP Subjects who experienced more than 1 transfusion during the RCP are only counted once. Subjects who did not have a transfusion but withdrew before Week 16 were considered as having a transfusion in the analysis of transfusion avoidance. Day 1 to Week 16
Secondary LS Mean Change From Baseline to Week 16 in Absolute Reticulocyte Count (ARC) During the RCP Baseline was the average of available measurements recorded from central laboratory before taking the first dose of pegcetacoplan. Analysis excluded data before the RCP and was censored for transfusions. Baseline and Week 16
Secondary LS Mean Change From Baseline to Week 16 in Lactate Dehydrogenase (LDH) Level During the RCP Baseline was the average of available measurements recorded from central laboratory before taking the first dose of pegcetacoplan. Analysis excluded data before the RCP and was censored for transfusions. Baseline and Week 16
Secondary LS Mean Change From Baseline to Week 16 in Functional Assessment of Chronic Illness Therapy (FACIT) - Fatigue Scale Score During the RCP The FACIT-fatigue scale version 4 is a 13-item Likert scaled instrument where the subject was presented with 13 statements and asked to indicate their response as it applied to the past 7 days. The 5 possible responses were 'Not at all' (0), 'A little bit (1), 'Somewhat' (2), 'Quite a bit' (3) and 'Very much' (4). With 13 statements the total score had a range of 0 to 52. A higher score corresponds to a higher quality of life (QoL). Baseline was the last available, nonmissing observation before taking the first dose of pegcetacoplan. Data collected after transfusion is excluded from analysis. Baseline and Week 16
Secondary Percentage of Subjects Who Achieved a Hb Response in the Absence of Transfusions at Week 16 Hb response was defined as an increase of at least 1 g/dL in Hb from Baseline at Week 16. Baseline was the average of measurements recorded before taking the first dose of pegcetacoplan, which included local and central laboratory values during the screening period. Analysis excluded data before the RCP and was censored for transfusions. Baseline and Week 16
Secondary Percentage of Subjects Who Achieved Reticulocyte Normalization in the Absence of Transfusions at Week 16 Reticulocyte normalization was defined as the ARC being below the upper limit of the gender-specific normal range at Week 16, censored for transfusions. Subjects who received a transfusion between Day 1 and Week 16 or withdrew without providing efficacy data at Week 16 were classified as nonresponders. Week 16
Secondary Percentage of Subjects Who Achieved Hb Normalization in the Absence of Transfusions at Week 16 Hb normalization was defined as the Hb level being above the lower limit of the normal range at Week 16, censored for transfusions. Subjects who received a transfusion between Day 1 and Week 16 or withdrew without providing efficacy data at Week 16 are classified as nonnormalization. Week 16
Secondary LS Mean Change From Baseline to Week 16 in Indirect Bilirubin Level During the RCP Baseline was the average of available measurements recorded from central laboratory before taking the first dose of pegcetacoplan. Analysis excluded data before the RCP and was censored for transfusions. Baseline and Week 16
Secondary LS Mean Change From Baseline to Week 16 in Haptoglobin Level During the RCP Baseline was the average of available measurements recorded from central laboratory before taking the first dose of pegcetacoplan. Analysis excluded data before the RCP and was censored for transfusions. Baseline and Week 16
Secondary LS Mean Change From Baseline to Week 16 in Linear Analog Scale Assessment (LASA) Scores During the RCP The LASA consists of 3 items, where the respondents were asked to rate their perceived level of functioning. Specific domains included activity level, ability to carry out daily activities, and an item for overall QoL. Their level of functioning was reported on a 0 to 100 scale with 0 indicates "As low as could be" and 100 indicates "As high as could be". The combined score ranged from 0 to 300, with higher scores corresponding to a higher QoL. Baseline and Week 16
Secondary LS Mean Change From Baseline to Week 16 in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 Scale (QLQ-C30) Scores During the RCP The EORTC QLQ-C30 questionnaire (version 3.0) consists of 30 questions comprised of both multi-item scales and single-item measures to assess overall QoL in subjects. Questions are designated by functional scales, symptom scales, and global subject QoL/overall perceived health status. For the first 28 questions the 4 possible responses are "Not at all' (1), 'A little' (2), 'Quite a bit' (3) and 'Very much' (4). For the remaining 2 questions the response is requested on a 7-point scale from 1 ('Very poor') to 7 ('Excellent'). The raw scale scores were linear transformed, producing scale scores that ranged from 0% to 100%. A high scale score represents a higher response level. Hence for the functional scales and the global health status a higher score indicates a better QoL, whilst for the symptom scale scores this is implied by a lower score. Baseline and Week 16
Secondary Total Number of PRBC Units Transfused During the RCP Subjects who withdrew during the RCP before Week 16 will have their number of units of PRBC estimated from the duration they were in the study. Day 1 to Week 16
Secondary Mean Change From Baseline to Week 48 in Hb Level During the Treatment Period Baseline was the average of measurements recorded before taking the first dose of pegcetacoplan, which included local and central laboratory values during the screening period. Analysis excluded data before the RCP and was censored for transfusions. Baseline and Week 48
Secondary Mean Change From Week 17 to Week 48 in Hb Level During the Open-label Period Baseline was the average of measurements recorded before taking the first dose of pegcetacoplan, which included local and central laboratory values during the screening period. Analysis excluded data before the RCP and was censored for transfusions. Week 17 and Week 48
Secondary Mean Change From Baseline to Week 48 in ARC During the Treatment Period Baseline was the average of available measurements recorded from central laboratory before taking the first dose of pegcetacoplan. Analysis excluded data before the RCP and was censored for transfusions. Baseline and Week 48
Secondary Mean Change From Week 17 to Week 48 in ARC During the Open-label Period Baseline was the average of available measurements recorded from central laboratory before taking the first dose of pegcetacoplan. Analysis excluded data before the RCP and was censored for transfusions. Week 17 and Week 48
Secondary Mean Change From Baseline to Week 48 in LDH Level During the Treatment Period Baseline was the average of available measurements recorded from central laboratory before taking the first dose of pegcetacoplan. Analysis excluded data before the RCP and was censored for transfusions. Baseline and Week 48
Secondary Mean Change From Week 17 to Week 48 in LDH Level During the Open-label Period Baseline was the average of available measurements recorded from central laboratory before taking the first dose of pegcetacoplan. Analysis excluded data before the RCP and was censored for transfusions. Week 17 and Week 48
Secondary Mean Change From Baseline to Week 48 in FACIT-Fatigue Scale Score During the Treatment Period The FACIT-fatigue scale version 4 is a 13-item Likert scaled instrument where the subject was presented with 13 statements and asked to indicate their response as it applied to the past 7 days. The 5 possible responses were 'Not at all' (0), 'A little bit (1), 'Somewhat' (2), 'Quite a bit' (3) and 'Very much' (4). With 13 statements the total score had a range of 0 to 52. A higher score corresponds to a higher QoL. Baseline was the last available, nonmissing observation before taking the first dose of pegcetacoplan. Data collected after transfusion is excluded from analysis. Baseline and Week 48
Secondary Mean Change From Week 17 to Week 48 in FACIT-Fatigue Scale Score During the Open-label Period The FACIT-fatigue scale is a 13 item Likert scaled instrument where the subject was presented with 13 statements and asked to indicate their response as it applied to the past 7 days. The 5 possible responses were 'Not at all' (0), 'A little bit (1), 'Somewhat' (2), 'Quite a bit' (3) and 'Very much' (4). With 13 statements the total score had a range of 0 to 52. Higher score corresponds to a higher QoL. Week 17 and Week 48
Secondary Mean Change From Baseline to Week 48 in LASA Scores During the Treatment Period The LASA consists of 3 items, where the respondents were asked to rate their perceived level of functioning. Specific domains included activity level, ability to carry out daily activities, and an item for overall QoL. Their level of functioning was reported on a 0 to 100 scale with 0 indicates "As low as could be" and 100 indicates "As high as could be". The combined score ranged from 0 to 300, with higher scores corresponding to a higher QoL. Baseline and Week 48
Secondary Mean Change From Week 17 to Week 48 in LASA Scores During the Open-label Period The FACIT-fatigue scale is a 13 item Likert scaled instrument where the subject was presented with 13 statements and asked to indicate their response as it applied to the past 7 days. The 5 possible responses were 'Not at all' (0), 'A little bit (1), 'Somewhat' (2), 'Quite a bit' (3) and 'Very much' (4). With 13 statements the total score had a range of 0 to 52. Higher score corresponds to a higher QoL. Week 17 and Week 48
Secondary Mean Change From Baseline to Week 48 in QLQ-C30 Scores During the Treatment Period The EORTC QLQ-C30 questionnaire (version 3.0) consists of 30 questions comprised of both multi-item scales and single-item measures to assess overall QoL in subjects. Questions are designated by functional scales, symptom scales, and global subject QoL/overall perceived health status. For the first 28 questions the 4 possible responses are 'Not at all' (1), 'A little' (2), 'Quite a bit' (3) and 'Very much' (4). For the remaining 2 questions the response is requested on a 7-point scale from 1 ('Very poor') to 7 ('Excellent'). The raw scale scores were linear transformed, producing scale scores that ranged from 0% to 100%. A high scale score represents a higher response level. Hence for the functional scales and the global health status a higher score indicates a better QoL, whilst for the symptom scale scores this is implied by a lower score. Baseline and Week 48
Secondary Mean Change From Week 17 to Week 48 in QLQ-C30 Scores During the Open-label Period The EORTC QLQ-C30 questionnaire (version 3.0) consists of 30 questions comprised of both multi-item scales and single-item measures to assess overall QoL in subjects. Questions are designated by functional scales, symptom scales, and global subject QoL/overall perceived health status. For the first 28 questions the 4 possible responses are 'Not at all' (1), 'A little' (2), 'Quite a bit' (3) and 'Very much' (4). For the remaining 2 questions the response is requested on a 7-point scale from 1 ('Very poor') to 7 ('Excellent'). The raw scale scores were linear transformed, producing scale scores that ranged from 0% to 100%. A high scale score represents a higher response level. Hence for the functional scales and the global health status a higher score indicates a better QoL, whilst for the symptom scale scores this is implied by a lower score. Week 17 and Week 48
Secondary Total Number of PRBC Units Transfused During the Open-Label Period Number of units of PRBC transfused to subjects in the open-label period are reported. Week 17 to Week 48
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