Study of Efficacy and Safety of Iptacopan in Patients With C3 Glomerulopathy. (APPEAR-C3G)
A Multicenter, Randomized, Double-blind, Parallel Group, Placebo-controlled Study to Evaluate the Efficacy and Safety of Iptacopan (LNP023) in Complement 3 Glomerulopathy.
The Primary Completion Date and Study Completion Date have been updated to reflect completion of the adolescent cohort, which has been added to the protocol.
The study is designed as a multicenter, randomized, double-blind, parallel group, placebo-controlled study to evaluate the efficacy and safety of iptacopan (LNP023) in complement 3 glomerulopathy.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Novartis Pharmaceuticals
- Phone Number: 1-888-669-6682
- Email: novartis.email@novartis.com
Study Contact Backup
- Name: Novartis Pharmaceuticals
- Phone Number: +41613241111
Study Locations
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Buenos Aires, Argentina, W3400ABH
- Completed
- Novartis Investigative Site
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CABA, Argentina, C1181ACH
- Withdrawn
- Novartis Investigative Site
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Córdoba Province
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Córdoba, Córdoba Province, Argentina, 5000
- Withdrawn
- Novartis Investigative Site
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Edegem, Belgium, 2650
- Withdrawn
- Novartis Investigative Site
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Leuven, Belgium, 3000
- Withdrawn
- Novartis Investigative Site
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Salvador, Brazil, 40323-010
- Recruiting
- Novartis Investigative Site
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Minas Gerais
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Belo Horizonte, Minas Gerais, Brazil, 30150-221
- Recruiting
- Novartis Investigative Site
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Pernambuco
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Recife, Pernambuco, Brazil, 50740-900
- Recruiting
- Novartis Investigative Site
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Rio Grande do Sul
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Passo Fundo, Rio Grande do Sul, Brazil, 99010-260
- Recruiting
- Novartis Investigative Site
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Santa Catarina
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Joinville, Santa Catarina, Brazil, 893227-680
- Withdrawn
- Novartis Investigative Site
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São Paulo
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Santo André, São Paulo, Brazil, 09090-790
- Withdrawn
- Novartis Investigative Site
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São Paulo, São Paulo, Brazil, 04038-002
- Recruiting
- Novartis Investigative Site
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São Paulo, São Paulo, Brazil, 05403 000
- Withdrawn
- Novartis Investigative Site
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Ontario
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London, Ontario, Canada, N6A 5W9
- Completed
- Novartis Investigative Site
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Toronto, Ontario, Canada, M5G 2C4
- Completed
- Novartis Investigative Site
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Quebec
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Montreal, Quebec, Canada, H3T 1C5
- Withdrawn
- Novartis Investigative Site
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Beijing, China, 100730
- Recruiting
- Novartis Investigative Site
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Beijing, China, 100034
- Active, not recruiting
- Novartis Investigative Site
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Shanghai, China, 200040
- Active, not recruiting
- Novartis Investigative Site
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Guangdong
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Guangzhou, Guangdong, China, 510030
- Active, not recruiting
- Novartis Investigative Site
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Hubei
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Wuhan, Hubei, China, 430022
- Withdrawn
- Novartis Investigative Site
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Prague, Czechia, 128 08
- Completed
- Novartis Investigative Site
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Lille, France, 59037
- Completed
- Novartis Investigative Site
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Marseille, France, 13005
- Withdrawn
- Novartis Investigative Site
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Montpellier, France, 34295
- Withdrawn
- Novartis Investigative Site
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Paris, France, 75015
- Completed
- Novartis Investigative Site
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Paris, France, 75019
- Withdrawn
- Novartis Investigative Site
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Aachen, Germany, 52074
- Withdrawn
- Novartis Investigative Site
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Erlangen, Germany, 91054
- Completed
- Novartis Investigative Site
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Essen, Germany, 45147
- Completed
- Novartis Investigative Site
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Hamburg, Germany, 20246
- Completed
- Novartis Investigative Site
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Hanover, Germany, 30625
- Withdrawn
- Novartis Investigative Site
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Heidelberg, Germany, 69120
- Active, not recruiting
- Novartis Investigative Site
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Mainz, Germany, 55131
- Completed
- Novartis Investigative Site
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North Rhine-Westphalia
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Cologne, North Rhine-Westphalia, Germany, 50937
- Active, not recruiting
- Novartis Investigative Site
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Athens, Greece, 115 27
- Withdrawn
- Novartis Investigative Site
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Heraklion Crete., Greece, 715 00
- Completed
- Novartis Investigative Site
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Thessaloniki, Greece, 546 42
- Withdrawn
- Novartis Investigative Site
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Thessaloniki, Greece, 546 42
- Completed
- Novartis Investigative Site
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National Capital Territory of Delhi
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New Delhi, National Capital Territory of Delhi, India, 110029
- Active, not recruiting
- Novartis Investigative Site
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New Delhi, National Capital Territory of Delhi, India, 110017
- Active, not recruiting
- Novartis Investigative Site
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Telangana
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Hyderabad, Telangana, India, 500058
- Withdrawn
- Novartis Investigative Site
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Uttar Pradesh
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Lucknow, Uttar Pradesh, India, 226014
- Active, not recruiting
- Novartis Investigative Site
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Uttarakhand
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Dehradun, Uttarakhand, India, 248001
- Withdrawn
- Novartis Investigative Site
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Petah Tikva, Israel, 4920235
- Completed
- Novartis Investigative Site
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Petah Tikva, Israel, 4941492
- Completed
- Novartis Investigative Site
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BG
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Ranica, BG, Italy, 24020
- Active, not recruiting
- Novartis Investigative Site
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MI
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Milan, MI, Italy, 20122
- Withdrawn
- Novartis Investigative Site
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RM
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Roma, RM, Italy, 00165
- Active, not recruiting
- Novartis Investigative Site
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Niigata, Japan, 9518520
- Completed
- Novartis Investigative Site
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Aichi-ken
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Nagoya, Aichi-ken, Japan, 4668560
- Completed
- Novartis Investigative Site
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Hokkaido
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Asahikawa, Hokkaido, Japan, 0788510
- Completed
- Novartis Investigative Site
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Sapporo, Hokkaido, Japan, 0608543
- Completed
- Novartis Investigative Site
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Osaka
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Takatsuki, Osaka, Japan, 5691192
- Completed
- Novartis Investigative Site
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Shiga
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Ohtsu, Shiga, Japan, 5202192
- Completed
- Novartis Investigative Site
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Gelderland
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Nijmegen, Gelderland, Netherlands, 6500HB
- Withdrawn
- Novartis Investigative Site
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South Holland
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Leiden, South Holland, Netherlands, 2333 ZA
- Completed
- Novartis Investigative Site
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Barcelona, Spain, 08035
- Withdrawn
- Novartis Investigative Site
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Madrid, Spain, 28041
- Completed
- Novartis Investigative Site
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Málaga, Spain, 29010
- Withdrawn
- Novartis Investigative Site
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Seville, Spain, 41009
- Completed
- Novartis Investigative Site
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Catalonia
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Barcelona, Catalonia, Spain, 08025
- Withdrawn
- Novartis Investigative Site
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Valencia
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Port de Sagunt, Valencia, Spain, 46520
- Withdrawn
- Novartis Investigative Site
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Bern, Switzerland, 3010
- Active, not recruiting
- Novartis Investigative Site
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Lausanne, Switzerland, 1011
- Withdrawn
- Novartis Investigative Site
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Fatih
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Istanbul, Fatih, Turkey (Türkiye), 34093
- Withdrawn
- Novartis Investigative Site
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Istanbul, Fatih, Turkey (Türkiye), 34098
- Withdrawn
- Novartis Investigative Site
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Melikgazi
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Kayseri, Melikgazi, Turkey (Türkiye), 38039
- Completed
- Novartis Investigative Site
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Yenimahalle
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Ankara, Yenimahalle, Turkey (Türkiye), 06500
- Completed
- Novartis Investigative Site
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Ankara, Yenimahalle, Turkey (Türkiye), 06500
- Withdrawn
- Novartis Investigative Site
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London, United Kingdom, WC1N 3JH
- Active, not recruiting
- Novartis Investigative Site
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London, United Kingdom, W12 0HS
- Completed
- Novartis Investigative Site
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Scotland
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Glasgow, Scotland, United Kingdom, G51 4TF
- Withdrawn
- Novartis Investigative Site
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Tyne and Wear
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Newcastle upon Tyne, Tyne and Wear, United Kingdom, NE1 4LP
- Active, not recruiting
- Novartis Investigative Site
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Colorado
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Aurora, Colorado, United States, 80045
- Recruiting
- Childrens Hospital Colorado
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Principal Investigator:
- Bradley Dixon
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Contact:
- Kati Dugan
- Phone Number: +1 720 777 1234
- Email: Kati.Dugan@childrenscolorado.org
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Florida
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Miami, Florida, United States, 33155
- Recruiting
- Nicklaus Childrens Hospital
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Principal Investigator:
- Ana Paredes
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Contact:
- Jorge Haddad
- Phone Number: +1 305 661 1515
- Email: Jorge.Haddad@Nicklaushealth.org
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Georgia
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Lawrenceville, Georgia, United States, 30046
- Completed
- Georgia Nephrology Research Inst
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Indiana
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Indianapolis, Indiana, United States, 46202-5111
- Withdrawn
- IN University School of Med
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Iowa
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Iowa City, Iowa, United States, 52242
- Recruiting
- University of Iowa Health Care
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Principal Investigator:
- Carla Nester
-
Contact:
- Nikki Gerot
- Phone Number: +1 (319) 335-0348
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Iowa City, Iowa, United States, 52242-1091
- Recruiting
- University of Iowa Health Care
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Principal Investigator:
- Carla Nester
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Contact:
- Nicole Gerot
- Phone Number: +1 319 335 7555
- Email: nicole-gerot@uiowa.edu
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Maryland
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Baltimore, Maryland, United States, 21287
- Withdrawn
- Johns Hopkins Hospital
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Withdrawn
- Brigham and Womens Hosp Harvard Med School
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New Jersey
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Hackensack, New Jersey, United States, 07601
- Withdrawn
- Hackensack Uni Medical Center
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New York
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Albany, New York, United States, 12208
- Withdrawn
- Albany Medical Center
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New York, New York, United States, 10032
- Completed
- Col Uni Med Center New York Presby
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Texas
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Temple, Texas, United States, 76502
- Withdrawn
- Baylor Scott and White Research
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Wisconsin
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Madison, Wisconsin, United States, 53792
- Recruiting
- University of Wisconsin
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Principal Investigator:
- Sharon Bartosh
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Contact:
- Alana Quackenbush
- Phone Number: +1 608 265 6020
- Email: akquackenbus@wisc.edu
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male and female participants age ≥ 12 and ≤ 60 years at screening.
- Diagnosis of C3G as confirmed by renal biopsy within 12 months prior to enrollment in adults and within 3 years in adolescents.
- Prior to randomization, all participants must have been on a maximally recommended or tolerated dose of an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) for at least 90 days. The doses of other antiproteinuric medications including mycophenolic acid, corticosteroids and mineralocorticoid receptor antagonists should be stable for at least 90 days prior to randomization.
- Reduced serum C3 (defined as less than 0.85 x lower limit of the central laboratory normal range) at Screening.
- UPCR ≥ 1.0 g/g sampled from the first morning void urine sample at Day -75 and Day -15.
- Estimated GFR (using the CKD-EPI formula for ages ≥ 18 years and modified Schwartz formula for ages 12 to 17 years) or measured GFR ≥ 30 ml/min/1.73m2 at screening and Day -15.
- Mandatory vaccination against Neisseria meningitidis and Streptococcus pneumoniae prior to the start of study treatment.
- If not previously vaccinated or if a booster is required, vaccination against Haemophilus influenzae infections should be given, if available and according to local regulations, at least 2 weeks prior to the first study treatment administration. If study treatment has to start earlier than 2 weeks post vaccination, prophylactic antibiotic treatment should be initiated.
Exclusion Criteria:
- Participants who have received any cell or organ transplantation, including a kidney transplantation.
- Rapidly progressive crescentic glomerulonephritis defined as a 50% decline in the eGFR within 3 months with renal biopsy findings of glomerular crescent formation seen in at least 50% of glomeruli.
- Renal biopsy showing interstitial fibrosis/tubular atrophy (IF/TA) of more than 50%
- Monoclonal gammopathy of undetermined significance (MGUS) confirmed by the measurement of serum free light chains or other investigation as per local standard of care.
- Participants with an active systemic bacterial, viral or fungal infection within 14 days prior to study treatment administration
- The presence of fever ≥ 38°C (100.4°F) within 7 days prior to study treatment administration.
- A history of recurrent invasive infections caused by encapsulated organisms, e.g., N. meningitidis and S. pneumoniae.
- The use of inhibitors of complement factors (e.g., Factor B, Factor D, C3 inhibitors, anti C5 antibodies, C5a receptor antagonists) within 6 months prior to the Screening visit.
- The use of immunosuppressants (except mycophenolic acids), cyclophosphamide or systemic corticosteroids at a dose >7.5 mg/day (or equivalent for a similar medication) within 90 days of study drug administration.
- Acute post-infectious glomerulonephritis at screening based upon the opinion of the investigator.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: iptacopan 200mg
iptacopan 200 mg b.i.d.
|
iptacopan 200 mg b.i.d.
(Adults 200mg b.i.d; Adolescents 2x 100mg b.i.d)
Other Names:
|
|
Placebo Comparator: Placebo to iptacopan 200mg
Placebo to iptacopan 200mg b.i.d.
|
Placebo to iptacopan 200mg b.i.d.
(Adults 200mg b.i.d; Adolescents 2x 100mg b.i.d)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Adult cohort: Log-transformed ratio to baseline in UPCR (sampled from a 24-hour urine collection)
Time Frame: 6 months (double-blind)
|
To demonstrate the superiority of iptacopan compared to placebo in reducing proteinuria at 6 months of treatment.
|
6 months (double-blind)
|
|
Adolescent cohort: Log-transformed ratio to baseline in UPCR (sampled from a 24-hour urine collection)
Time Frame: 6 months (double-blind)
|
To evaluate the effect of iptacopan on proteinuria at 6 months.
|
6 months (double-blind)
|
|
Change from baseline in log-transformed UPCR at the 12-month visit (both study treatment arms).
Time Frame: 12 months (double-blind and open-label)
|
To evaluate the effect of iptacopan on proteinuria at 12 months.
|
12 months (double-blind and open-label)
|
|
Change in log-transformed UPCR from the 6-month visit to the 12-month visit in the placebo arm
Time Frame: From month 6 to month 12 (open-label)
|
To evaluate the effect of iptacopan on proteinuria at 12 months.
|
From month 6 to month 12 (open-label)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline in eGFR.
Time Frame: 6 months (double-blind)
|
To demonstrate the superiority of iptacopan vs. placebo in improving eGFR.
|
6 months (double-blind)
|
|
Proportion of participants who meet the criteria for achieving a composite renal endpoint
Time Frame: 6 months (double-blind)
|
To demonstrate the superiority of iptacopan vs. placebo in the proportion of participants who meet the criteria for achieving a composite renal endpoint. A participant meets the requirements of the composite renal endpoint if he/she satisfies: (1) a stable or improved eGFR compared to the baseline visit (≤15% reduction in eGFR), and (2) a ≥50% reduction in UPCR compared to the baseline visit. |
6 months (double-blind)
|
|
Adult cohort: Change from baseline in disease total activity score in a renal biopsy.
Time Frame: 6 months (double-blind)
|
To demonstrate the effect of iptacopan vs placebo in reducing glomerular inflammation in the kidney.
|
6 months (double-blind)
|
|
Change from baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) score.
Time Frame: 6 months (double-blind)
|
To assess the effect of iptacopan compared to placebo in improvement of patient reported fatigue.
|
6 months (double-blind)
|
|
Number of participants with abnormal clinically significant vital signs, ECGs and safety laboratory measurements
Time Frame: 6 months (double-blind)
|
To evaluate the safety and tolerability of iptacopan compared to placebo.
|
6 months (double-blind)
|
|
Number of participants with study drug discontinuation due to an AE
Time Frame: 6 months (double-blind)
|
To evaluate the safety and tolerability of iptacopan compared to placebo
|
6 months (double-blind)
|
|
Proportion of participants who meet the criteria for achieving a composite renal endpoint
Time Frame: 12 months (double-blind and open-label)
|
To evaluate the effect at 12 months of iptacopan on a composite renal endpoint.
A participant meets the requirements of the composite renal endpoint if he/she satisfies: (1) a stable or improved eGFR compared to the baseline visit (≤15% reduction in eGFR), and (2) a ≥50% reduction in UPCR compared to the baseline visit.
|
12 months (double-blind and open-label)
|
|
Proportion of patients achieving a composite renal endpoint from the 6-month visit to the 12-month visit of the placebo arm
Time Frame: month 6, month 12 (open-label)
|
To evaluate the effect at 12 months of iptacopan on a composite renal endpoint.
A participant meets the requirements of the composite renal endpoint if he/she satisfies: (1) a stable or improved eGFR compared to the baseline visit (≤15% reduction in eGFR), and (2) a ≥50% reduction in UPCR compared to the 6 months visit.
|
month 6, month 12 (open-label)
|
|
Change from baseline in the total activity score in a renal biopsy at 12 months
Time Frame: Baseline, month 12 (double-blind and open-label)
|
To evaluate the effect at 12 months of iptacopan in reducing glomerular inflammation in the kidney.
|
Baseline, month 12 (double-blind and open-label)
|
|
Change in the total activity score in a renal biopsy from the 6-month visit to the 12-month visit of the placebo arm.
Time Frame: month 6, month 12 (open-label)
|
To evaluate the effect at 12 months of iptacopan in reducing glomerular inflammation in the kidney.
|
month 6, month 12 (open-label)
|
|
Change from baseline in the FACIT-Fatigue score at 12 months
Time Frame: Baseline, month 12 (double-blind and open-label)
|
To evaluate the effect at 12 months of iptacopan in improvement of patient reported fatigue
|
Baseline, month 12 (double-blind and open-label)
|
|
Change in the FACIT-Fatigue score from the 6-month visit to the 12-month visit of the placebo arm
Time Frame: month 6, month 12 (open-label)
|
To evaluate the effect at 12 months of iptacopan in improvement of patient reported fatigue
|
month 6, month 12 (open-label)
|
|
Number of participants with abnormal clinically significant vital signs, ECGs and safety laboratory measurements
Time Frame: 12 months (double-blind and open-label)
|
To evaluate the safety and tolerability of iptacopan during the 6-month open-label treatment period as well as the entire 12- month treatment period
|
12 months (double-blind and open-label)
|
|
Number of participants with study drug discontinuation due to an AE
Time Frame: 12 months (double-blind and open-label)
|
To evaluate the safety and tolerability of iptacopan during the 6-month open-label treatment period as well as the entire 12- month treatment period.
|
12 months (double-blind and open-label)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Novartis Pharmaceuticals, Novartis Pharmaceuticals
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CLNP023B12301
- 2020-004589-21 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.
This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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