Atypical Hemolytic Uremic Syndrome Clinical Trial
— APPELHUSOfficial title:
A Multicenter, Single-arm, Open Label Trial to Evaluate Efficacy and Safety of Oral, Twice Daily LNP023 in Adult aHUS Patients Who Are Naive to Complement Inhibitor Therapy
The purpose of this Phase 3 study is to determine whether iptacopan (LNP023) is efficacious and safe for the treatment of aHUS in adult patients who are treatment naive to complement inhibitor therapy.
Status | Recruiting |
Enrollment | 50 |
Est. completion date | January 6, 2026 |
Est. primary completion date | December 23, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Main Inclusion Criteria: - Adult patients with evidence of active thrombotic microangiopathy (TMA), including thrombocytopenia, evidence of hemolysis, and acute kidney injury - Vaccinations against Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae infections are required prior to the start of study treatment. If the patient has not been previously vaccinated, or if a booster is required, vaccine should be given according to local regulations, at least 2 weeks prior to first study drug administration. If study treatment has to start earlier than 2 weeks post vaccination or before vaccination is given, prophylactic antibiotic treatment must be administered at the start of study treatment and for at least 2 weeks after vaccination Main Exclusion Criteria: - Treatment with complement inhibitors, including anti-C5 antibody - ADAMTS13 deficiency (<10% activity or <0.1U/ml), and/or Shiga toxin-related hemolytic uremic syndrome (STx-HUS), and/or Positive direct Coombs test - Identified drug exposure-related HUS or HUS related to known genetic defects of cobalamin C metabolism or known diacylglycerol kinase e (DGKE) mediated aHUS - Receiving PE/PI, for 14 days or longer, prior to the start of screening for the current TMA - Bone marrow transplantation (BMT)/hematopoietic stem cell transplantation (HSCT), heart, lung, small bowel, pancreas, or liver transplantation - Patients with sepsis or active severe systemic bacterial, viral (including COVID-19) or fungal infection, systemic infection which confounds an accurate diagnosis of aHUS or impedes the ability to manage the aHUS disease, active infection (or history of recurrent invasive infections) caused by encapsulated bacteria - Kidney disease suggestive of other disease than aHUS or of chronic kidney failure or family history of non-complement mediated genetic kidney disease - Liver disease or liver injury at screening - Systemic sclerosis (scleroderma), systemic lupus erythematosus (SLE), or antiphospholipid antibody positivity or syndrome - Chronic hemo- or peritoneal dialysis Other protocol-defined inclusion/exclusion criteria may apply |
Country | Name | City | State |
---|---|---|---|
Austria | Novartis Investigative Site | Innsbruck | Tyrol |
Austria | Novartis Investigative Site | Wien | |
Brazil | Novartis Investigative Site | Belo Horizonte | MG |
Brazil | Novartis Investigative Site | Botucatu | SP |
Brazil | Novartis Investigative Site | Brasilia | DF |
Brazil | Novartis Investigative Site | Fortaleza | CE |
Brazil | Novartis Investigative Site | Pernambuco | Recife |
Brazil | Novartis Investigative Site | Porto Alegre | RS |
Brazil | Novartis Investigative Site | Rio de Janeiro | |
Brazil | Novartis Investigative Site | Salvador | |
Brazil | Novartis Investigative Site | Sao Paulo | SP |
Brazil | Novartis Investigative Site | Sao Paulo | SP |
Brazil | Novartis Investigative Site | São Paulo | SP |
China | Novartis Investigative Site | Beijing | |
China | Novartis Investigative Site | Beijing | |
China | Novartis Investigative Site | Beijing | |
China | Novartis Investigative Site | Guangzhou | Guangdong |
China | Novartis Investigative Site | Nanjing | Jiangsu |
China | Novartis Investigative Site | Shanghai | |
China | Novartis Investigative Site | Shanxi | |
China | Novartis Investigative Site | Yantai | Shandong |
Czechia | Novartis Investigative Site | Ostrava | Poruba |
Czechia | Novartis Investigative Site | Praha | |
Czechia | Novartis Investigative Site | Praha 4 | |
Greece | Novartis Investigative Site | Athens | |
Greece | Novartis Investigative Site | Heraklion Crete | |
Greece | Novartis Investigative Site | Thessaloniki | GR |
India | Novartis Investigative Site | Chandigarh | Punjab |
India | Novartis Investigative Site | Chennai | Tamil Nadu |
India | Novartis Investigative Site | Hyderabad | Andhra Pradesh |
India | Novartis Investigative Site | Lucknow | Uttar Pradesh |
India | Novartis Investigative Site | Nagpur | Maharashtra |
India | Novartis Investigative Site | Pune | Maharashtra |
India | Novartis Investigative Site | Thiruvananthapuram | Kerala |
India | Novartis Investigative Site | Vellore | Tamil Nadu |
Japan | Novartis Investigative Site | Bunkyo ku | Tokyo |
Japan | Novartis Investigative Site | Iruma-gun | Saitama |
Japan | Novartis Investigative Site | Izumo-city | Shimane |
Korea, Republic of | Novartis Investigative Site | Seoul | |
Korea, Republic of | Novartis Investigative Site | Seoul | |
Korea, Republic of | Novartis Investigative Site | Seoul | |
Slovakia | Novartis Investigative Site | Bratislava | |
Slovakia | Novartis Investigative Site | Martin | |
Slovenia | Novartis Investigative Site | Ljubljana | |
Taiwan | Novartis Investigative Site | Taichung | |
Taiwan | Novartis Investigative Site | Taoyuan | |
United Kingdom | Novartis Investigative Site | London | |
United Kingdom | Novartis Investigative Site | Newcastle Upon Tyne | |
United States | University of New Mexico Clin and Transl Science Ctr | Albuquerque | New Mexico |
United States | Montefiore Medical Center . | Bronx | New York |
United States | Cleveland Clinic Foundation Nephrology and Hypertension | Cleveland | Ohio |
United States | Duke University Medical Center . | Durham | North Carolina |
United States | USC Norris Cancer Center | Los Angeles | California |
United States | Baylor Scott and White Research . | Temple | Texas |
United States | Harbor-UCLA Medical Center . | Torrance | California |
United States | Georgetown University Lombardi Cancer Center | Washington | District of Columbia |
Lead Sponsor | Collaborator |
---|---|
Novartis Pharmaceuticals |
United States, Austria, Brazil, China, Czechia, Greece, India, Japan, Korea, Republic of, Slovakia, Slovenia, Taiwan, United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Percentage of participants with complete TMA response without the use of PE/PI and anti-C5 antibody | The number/percentage of participants treated with iptacopan achieving complete thrombotic microangiopathy (TMA) response during 26 weeks of study treatment.
Complete TMA Response is defined as (1) hematological normalization in platelet count (platelet count =150 x 10^9/L) and LDH (below ULN), and (2) improvement in kidney function (= 25% serum creatinine reduction from baseline), maintained for two measurements obtained at least four weeks apart, and any measurement in between |
26 weeks of study treatment | |
Primary | Long term safety and efficacy evaluations | Long term (one year) safety, tolerability and efficacy of iptacopan via 1) safety evaluations including adverse events/serious adverse events, safety laboratory parameters, vital signs etc. after 52 weeks of study treatment, and 2) efficacy evaluations including complete TMA response, hematological parameters (platelets, LDH, hemoglobin), eGFR, PROs after 52 weeks of study treatment | 52 weeks of study treatment | |
Secondary | Time to achieve complete TMA response | Effect of study treatment iptacopan on time to complete TMA response during the first 26 weeks of study treatment | 26 weeks of study treatment | |
Secondary | Percentage of participants with increase from baseline in hemoglobin levels = 2 g/dL | Response is defined as the percentage of participants with an increase in hemoglobin of = 2 g/dL from baseline, observed at two measurements obtained at least 4 weeks apart and any measurement in between during 26 weeks of study treatment | 26 weeks of study treatment | |
Secondary | Change from baseline on hematologic parameters | Change from baseline in hematologic parameters (platelets, LDH, hemoglobin) at Week 26 | At week 26 | |
Secondary | Percentage of participants on dialysis | For participants requiring dialysis within 5 days prior to iptacopan treatment initiation, the number of participants who no longer require dialysis through 26 weeks of study treatment will be evaluated by means of proportion and corresponding confidence interval | 26 weeks of study treatment | |
Secondary | Change from baseline on estimated glomerular filtration rate | Change from baseline in eGFR after 26 weeks of study treatment. | At week 26 | |
Secondary | Change from baseline in chronic kidney disease (CKD) stage | Change from baseline in CKD stage (1-5) based on eGFR categories at Week 26 | At week 26 | |
Secondary | Change from baseline in patient-reported outcomes score as measured by the Functional Assessment Of Chronic Illness Therapy (FACIT)-Fatigue Questionnaire | Change from baseline in patient-reported outcomes scores for FACIT-Fatigue Questionnaire at Week 26 | At week 26 | |
Secondary | Change from baseline in patient-reported outcomes score as measured by the EuroQol 5-level EQ-5D version (EQ-5D-5L) Questionnaire | Change from baseline in patient-reported outcomes scores for the EuroQol 5-level EQ-5D version (EQ-5D-5L) Questionnaire at Week 26 | At Week 26 | |
Secondary | Change from baseline in patient-reported outcomes score as measured by the Patient Global Impression of Severity (PGIS) questionnaire | Change from baseline in patient-reported outcomes scores for Patient Global Impression of Severity (PGIS) at Week 26 | At Week 26 | |
Secondary | Change from baseline in patient-reported outcomes score as measured by the Short-form 36 health survey questionnaire version 2 (SF-36 v2) | Change from baseline in patient-reported outcomes scores for Short-form 36 health survey questionnaire version 2 (SF-36 v2) at Week 26 | At Week 26 |
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT03605511 -
TTP and aHUS in Complicated Pregnancies
|
||
Withdrawn |
NCT03303313 -
A Study of an Investigational Drug, Cemdisiran (ALN-CC5), in Patients With Atypical Hemolytic Uremic Syndrome
|
Phase 2 | |
Recruiting |
NCT04861259 -
A Study Evaluating the Efficacy, Safety, Pharmacokinetics and Pharmacodynamics of Crovalimab in Adult and Adolescent Participants With Atypical Hemolytic Uremic Syndrome (aHUS)
|
Phase 3 | |
Recruiting |
NCT06065852 -
National Registry of Rare Kidney Diseases
|
||
Terminated |
NCT02614898 -
Evaluation of Potential Predictors of Disease Progression in Participants With Atypical Hemolytic Uremic Syndrome (aHUS) Including Genetics, Biomarkers, and Treatment
|
||
Completed |
NCT02574403 -
Study Assessing an Algorithm-based Strategy of Eculizumab Discontinuation in Children and Adults With aHUS
|
Phase 4 | |
Recruiting |
NCT04958265 -
A Study Evaluating the Efficacy, Safety, Pharmacokinetics and Pharmacodynamics of Crovalimab in Pediatric Participants With Atypical Hemolytic Uremic Syndrome (aHUS)
|
Phase 3 | |
Recruiting |
NCT05795140 -
Evaluate Long-term Safety, Tolerability and Efficacy of Iptacopan in Study Participants With aHUS
|
Phase 3 | |
Completed |
NCT00844844 -
Open Label Controlled Trial of Eculizumab in Adolescent Patients With Plasma Therapy-Resistant aHUS
|
Phase 2 | |
Completed |
NCT00844545 -
Open Label Controlled Trial of Eculizumab in Adult Patients With Plasma Therapy-Resistant aHUS
|
Phase 2 | |
Terminated |
NCT01522170 -
aHUS Observational Long Term Follow-Up
|
N/A | |
Terminated |
NCT02464891 -
Complement Inhibition in aHUS Dialysis Patients
|
Phase 2 | |
Withdrawn |
NCT02626663 -
The Role of Microparticles as a Biomarker
|
||
Recruiting |
NCT01793168 -
Rare Disease Patient Registry & Natural History Study - Coordination of Rare Diseases at Sanford
|
||
Completed |
NCT00838513 -
Open Label Controlled Trial of Eculizumab in Adult Patients With Plasma Therapy-sensitive Atypical Hemolytic Uremic Syndrome (aHUS)
|
Phase 2 | |
Completed |
NCT00844428 -
Open Label Controlled Trial of Eculizumab in Adolescent Patients With Plasma Therapy-Sensitive aHUS
|
Phase 2 | |
Withdrawn |
NCT03999840 -
Eculizumab to Cemdisiran Switch in aHUS
|
Phase 2 | |
Recruiting |
NCT05935215 -
Efficacy and Safety of Switching From Anti-C5 Antibody Treatment to Iptacopan Treatment in Study Participants With Atypical Hemolytic Uremic Syndrome (aHUS)
|
Phase 3 | |
Recruiting |
NCT03205995 -
Safety and Efficacy Study of OMS721 in Patients With Atypical Hemolytic Uremic Syndrome
|
Phase 3 | |
Recruiting |
NCT05996731 -
Developing a Pipeline to Employ RNA-Seq as a Complementary Diagnostic Tool in Rare Diseases
|
N/A |