Pozelimab and Cemdisiran Combination Therapy in Adult Participants With Paroxysmal Nocturnal Hemoglobinuria Who Switch From Eculizumab Therapy
A Single Arm, Open-Label Study to Assess the Safety, Efficacy, and Pharmacodynamic Effects of Pozelimab and Cemdisiran Combination Therapy in Patients With Paroxysmal Nocturnal Hemoglobinuria Who Switch From Eculizumab Therapy
The primary objective of the study is to evaluate the safety and tolerability of pozelimab and cemdisiran combination therapy in participants with PNH who switch from eculizumab therapy
The secondary objectives of the study are:
- To evaluate the effect of the combination treatment on the following parameters of intravascular hemolysis: lactate dehydrogenase (LDH) control, breakthrough hemolysis, and inhibition of CH50
- To evaluate the effect of the combination treatment on the stability of LDH during the transition period from eculizumab monotherapy to combination with pozelimab and cemdisiran
- To evaluate the effect of the combination treatment on red blood cell (RBC) transfusion requirements
- To evaluate the effect of the combination treatment on hemoglobin levels
- To evaluate the effect of the combination treatment on clinical outcome assessments (COAs) measuring fatigue and health related quality of life (HRQoL)
- To assess the concentrations of total pozelimab and eculizumab in serum; and total cemdisiran and C5 protein in plasma
- To assess the immunogenicity of pozelimab and cemdisiran
- To assess safety after dose intensification
- To evaluate the long-term safety and efficacy of the combination treatment in an optional open-label extension period (OLEP)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Leeds, United Kingdom, LS9 7TF
- Regeneron study Site
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Key Inclusion Criteria:
- Diagnosis of paroxysmal nocturnal hemoglobinuria confirmed by a history of high-sensitivity flow cytometry from prior testing
- Treated with stable (ie, no change in dose or frequency) eculizumab therapy at the labeled dosing regimen or a higher dose and/or more frequently administered than labeled for at least 12 weeks prior to screening visit
Key Exclusion Criteria:
- History of bone marrow transplantation or receipt of an organ transplant
- Body weight <40 kg at screening
- Current plans for modification of the following background concomitant medications, as applicable, during screening and treatment period: erythropoietin, immunosuppressive drugs, corticosteroids, anti-thrombotic agents, anticoagulants, iron supplements, and folic acid as described in the protocol
- Any use of complement inhibitor therapy other than eculizumab in the 12 weeks prior to the screening visit or planned use during the study
- Known hypocellular bone marrow based on a history of reduced age-adjusted bone marrow cellularity and/or bone marrow cellularity ≤25%
- No documented meningococcal vaccination within 5 years prior to screening visit unless it is documented that vaccination has been administered during the screening period and prior to initiation of study treatment
- Unable to take antibiotics for meningococcal prophylaxis, if required by local standard of care
- Any active, ongoing infection or a recent infection requiring ongoing systemic treatment with antibiotics, antivirals, or antifungals within 2 weeks of screening or during the screening period
- Documented positive polymerase chain reaction (PCR) or equivalent test based on regional recommendations for COVID-19 or suspected SARS-CoV-2 infection as described in the protocol
- Documented history of active, uncontrolled, ongoing systemic autoimmune diseases
- Recent, unstable medical conditions, excluding PNH and PNH-related complications, within the past 3 months prior to screening visit as described in the protocol
- Anticipated need for major surgery during the study
NOTE: Other protocol-defined Inclusion/ Exclusion Criteria apply.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Pozelimab+Cemdisiran
|
Intravenous (IV) loading dose (once) followed after 30 minutes by sub-cutaneous (SC) administration
Other Names:
SC administration
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
OLTP: Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Time Frame: Up to Day 225
|
Up to Day 225
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
OLTP: Percent Change in Lactate Dehydrogenase (LDH) From Pre-treatment to End-of-treatment Period
Time Frame: Screening (Day 1) through Day 225
|
Screening (Day 1) through Day 225
|
|
|
OLTP: Percent Change in LDH From Pre-treatment Through Day 29
Time Frame: Screening (Day 1) through Day 29
|
Screening (Day 1) through Day 29
|
|
|
OLTP: Percentage of Participants Who Were Transfusion-free From Baseline Through Week 32
Time Frame: Baseline through Week 32
|
Baseline through Week 32
|
|
|
OLTP: Percentage of Participants Who Were Transfusion-free From Week 4 Through Week 32
Time Frame: Week 4 through Week 32
|
Week 4 through Week 32
|
|
|
OLTP: Rate of Red Blood Cell (RBC) Transfusions From Baseline Through Week 32
Time Frame: Baseline through Week 32
|
The rate of units of transfusion for a participant was calculated based on the duration of treatment exposure of the participant.
|
Baseline through Week 32
|
|
OLTP: Rate of RBC Transfusions From Week 4 Through Week 32
Time Frame: Week 4 through Week 32
|
The rate of units of transfusion for a participant was calculated based on the duration of treatment exposure of the participant.
|
Week 4 through Week 32
|
|
OLTP: Number of RBC Units Transfused From Baseline Through Week 32
Time Frame: Baseline through Week 32
|
Baseline through Week 32
|
|
|
OLTP: Number of RBC Units Transfused From Week 4 Through Week 32
Time Frame: Week 4 through Week 32
|
Week 4 through Week 32
|
|
|
OLTP: Percentage of Participants With Breakthrough Hemolysis From Baseline Through Week 32
Time Frame: Baseline through Week 32
|
Breakthrough hemolysis was defined as having an LDH ≥ 2 x upper limit of normal (ULN) and having signs or symptoms.
|
Baseline through Week 32
|
|
OLTP: Percentage of Participants With Breakthrough Hemolysis From Week 4 Through Week 32
Time Frame: Week 4 through Week 32
|
Breakthrough hemolysis was defined as having an LDH ≥ 2 x ULN and having signs or symptoms.
|
Week 4 through Week 32
|
|
OLTP: Percentage of Participants Who Maintained Adequate Control of Hemolysis From Day 1 Through Week 32
Time Frame: Day 1 through Week 32
|
Adequate control was defined as LDH ≤ 1.5 x ULN from Day 1 through Week 32.
|
Day 1 through Week 32
|
|
OLTP: Percentage of Participants Who Maintained Adequate Control of Hemolysis From Week 8 Through Week 32
Time Frame: Week 8 through Week 32
|
Adequate control was defined as LDH ≤ 1.5 x ULN from Week 8 through Week 32.
|
Week 8 through Week 32
|
|
OLTP: Number of Participants With Adequate Control of Hemolysis at Each Visit
Time Frame: Days 1, 8, 15, 29, 43, 57, 71, 85, 113, 141, 169, 197, 225
|
Adequate control at a visit was defined as having LDH ≤1.5 x ULN at that visit.
|
Days 1, 8, 15, 29, 43, 57, 71, 85, 113, 141, 169, 197, 225
|
|
OLTP: Number of Participants With Normalization of Their LDH at Each Visit
Time Frame: Days 1, 8, 15, 29, 43, 57, 71, 85, 113, 141, 169, 197, 225
|
Normalization was defined as LDH ≤ 1.0 x ULN at that visit.
|
Days 1, 8, 15, 29, 43, 57, 71, 85, 113, 141, 169, 197, 225
|
|
OLTP: Average LDH From Baseline Through Week 32
Time Frame: Baseline through Week 32
|
The trapezoidal rule was used to calculate area under the curve (AUC).
Individual mean LDH is defined as AUC divided by (last assessment date of LDH - first assessment date of LDH) of specific period.
|
Baseline through Week 32
|
|
OLTP: Average LDH From Week 8 Through Week 32
Time Frame: Week 8 through Week 32
|
The trapezoidal rule was used to calculate AUC.
Individual mean LDH is defined as AUC divided by (last assessment date of LDH - first assessment date of LDH) of specific period.
|
Week 8 through Week 32
|
|
OLTP: Percentage of Participants With Hemoglobin Stabilization From Baseline Through Week 32
Time Frame: Baseline through Week 32
|
Hemoglobin stabilization was defined as not receiving an RBC transfusion and having no decrease in hemoglobin level of ≥ 2 grams per deciliter (g/dL).
|
Baseline through Week 32
|
|
OLTP: Percentage of Participants With Hemoglobin Stabilization From Week 4 Through Week 32
Time Frame: Week 4 through Week 32
|
Hemoglobin stabilization was defined as not receiving an RBC transfusion and having no decrease in hemoglobin level of ≥ 2 g/dL.
|
Week 4 through Week 32
|
|
OLTP: Change From Baseline in Hemoglobin Levels
Time Frame: Baseline, Week 32
|
Baseline, Week 32
|
|
|
OLTP: Change From Baseline in Fatigue as Measured by Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score
Time Frame: Baseline, Week 32
|
The FACIT-Fatigue is a 13-item, self-reported measure assessing an individual's level of fatigue during their usual daily activities over the past week.
This questionnaire is part of the FACIT measurement system, a compilation of questions measuring health-related quality of life (QoL) in participants with cancer and other chronic illnesses.
The FACIT-fatigue assesses the level of fatigue using a Likert scale ranging from 0 (not at all) to 4 (very much).
Total scores range from 0 to 52, with higher scores indicating a higher quality of life.
|
Baseline, Week 32
|
|
OLTP: Change From Baseline in Health Related Quality of Life (HRQoL) as Measured by the Global Health Status Subscale of the European Organization for Research and Treatment of Cancer (EORTC)- Quality of Life Cancer Patients Questionnaire (QLQ) - 30 Scale
Time Frame: Baseline, Week 32
|
EORTC-QLQ-C30 is a 30-item self-reported questionnaire composed of both multi-item and single scales, including a global health status/quality of life (GHS/QoL) scale.
The GHS subscale scores ranged from 0 to 100 with higher scores indicating better quality of life.
|
Baseline, Week 32
|
|
OLTP: Change From Baseline in Physical Function (PF) Scores on the EORTC QLQ-C30
Time Frame: Baseline, Week 32
|
EORTC-QLQ-C30 is a 30-item participant self-report questionnaire composed of both multi-item and single scales, including a PF scale.
PF subscale scores ranged from 0 to 100 with higher scores indicating better quality of life.
|
Baseline, Week 32
|
|
OLTP: Change From Baseline in Total Complement Hemolytic Activity Assay (CH50)
Time Frame: Baseline through Week 32
|
This assay assessed the activity of the classical pathway of complement to measure C5 activity.
|
Baseline through Week 32
|
|
OLTP and OLEP: Concentration of Total Pozelimab in Serum
Time Frame: Pre-dose Days 28, 56, 84, 112, 140, 168, 196, 224, 392, 588; Post-dose Day 28
|
Pre-dose Days 28, 56, 84, 112, 140, 168, 196, 224, 392, 588; Post-dose Day 28
|
|
|
OLTP: Concentration of Total Eculizumab in Serum
Time Frame: Pre-dose Days 0, 14, 28, 56, 84, 112, 140, 168, 196, 224
|
Pre-dose Days 0, 14, 28, 56, 84, 112, 140, 168, 196, 224
|
|
|
OLTP and OLEP: Concentration of Total Cemdisiran in Plasma
Time Frame: Pre-dose and Post-dose Days 0, 84, 196, 224, 588
|
Pre-dose and Post-dose Days 0, 84, 196, 224, 588
|
|
|
OLTP and OLEP: Concentration of Total C5 in Plasma
Time Frame: Pre-dose Days 0, 7, 14, 28, 56, 84, 112, 140, 168, 196, 224, 392, 588
|
Pre-dose Days 0, 7, 14, 28, 56, 84, 112, 140, 168, 196, 224, 392, 588
|
|
|
OLTP: Number of Participants With Pozelimab Anti-drug Antibodies (ADA)
Time Frame: Baseline through Week 32
|
Baseline through Week 32
|
|
|
OLTP: Number of Participants With Cemdisiran ADA
Time Frame: Baseline through Week 32
|
Baseline through Week 32
|
|
|
OLTP: Number of Participants Who Received Dose Intensification With TEAEs
Time Frame: Baseline through Week 32
|
Baseline through Week 32
|
|
|
OLEP: Number of Participants With TEAEs
Time Frame: Day 1 through Week 52 of the OLEP
|
Day 1 through Week 52 of the OLEP
|
|
|
OLEP: Percent Change in LDH From Day 1 Through Week 24 of the OLEP
Time Frame: Day 1 through Week 24 of the OLEP
|
Day 1 through Week 24 of the OLEP
|
|
|
OLEP: Percent Change in LDH From Day 1 Through Week 52 of the OLEP
Time Frame: Day 1 through Week 52 of the OLEP
|
Day 1 through Week 52 of the OLEP
|
|
|
OLEP: Percentage of Participants Who Were Transfusion-free From Day 1 Through Week 24 of the OLEP
Time Frame: Day 1 through Week 24 of the OLEP
|
Day 1 through Week 24 of the OLEP
|
|
|
OLEP: Percentage of Participants Who Were Transfusion-free From Day 1 Through Week 52 of the OLEP
Time Frame: Day 1 through Week 52 of the OLEP
|
Day 1 through Week 52 of the OLEP
|
|
|
OLEP: Rate of RBC Transfusions From Day 1 Through Week 24 of the OLEP
Time Frame: Day 1 through Week 24 of the OLEP
|
The rate of units of transfusion for a participants was calculated based on the duration of treatment exposure of the participant.
|
Day 1 through Week 24 of the OLEP
|
|
OLEP: Rate of RBC Transfusions From Day 1 Through Week 52 of the OLEP
Time Frame: Day 1 through Week 52 of the OLEP
|
The rate of units of transfusion for a participants was calculated based on the duration of treatment exposure of the participant.
|
Day 1 through Week 52 of the OLEP
|
|
OLEP: Number of RBC Units Transfused From Day 1 Through Week 24 of the OLEP
Time Frame: Day 1 through Week 24 of the OLEP
|
Day 1 through Week 24 of the OLEP
|
|
|
OLEP: Number of RBC Units Transfused From Day 1 Through Week 52 of the OLEP
Time Frame: Day 1 through Week 52 of the OLEP
|
Day 1 through Week 52 of the OLEP
|
|
|
OLEP: Percentage of Participants With Breakthrough Hemolysis From Day 1 Through Week 24 of the OLEP
Time Frame: Day 1 through Week 24 of the OLEP
|
Breakthrough hemolysis was defined as having an LDH ≥ 2 x ULN and having signs or symptoms.
|
Day 1 through Week 24 of the OLEP
|
|
OLEP: Percentage of Participants With Breakthrough Hemolysis From Day 1 Through Week 52 of the OLEP
Time Frame: Day 1 through Week 52 of the OLEP
|
Breakthrough hemolysis was defined as having an LDH ≥ 2 x ULN and having signs or symptoms.
|
Day 1 through Week 52 of the OLEP
|
|
OLEP: Percentage of Participants Who Maintained Adequate Control of Hemolysis From Day 1 Through Week 24 of the OLEP
Time Frame: Day 1 through Week 24 of the OLEP
|
Adequate control was defined as LDH ≤ 1.5 x ULN.
|
Day 1 through Week 24 of the OLEP
|
|
OLEP: Percentage of Participants Who Maintained Adequate Control of Hemolysis From Day 1 Through Week 52 of the OLEP
Time Frame: Day 1 through Week 52 of the OLEP
|
Adequate control was defined as LDH ≤ 1.5 x ULN.
|
Day 1 through Week 52 of the OLEP
|
|
OLEP: Number of Participants Who Maintained Adequate Control of Hemolysis at Each Visit in OLEP
Time Frame: Baseline, Days 57, 113, 169, 225, 281, 365 of the OLEP
|
Adequate control was defined as LDH ≤ 1.5 x ULN at that visit.
|
Baseline, Days 57, 113, 169, 225, 281, 365 of the OLEP
|
|
OLEP: Number of Participants With Normalization of Their LDH at Each Visit in OLEP
Time Frame: Baseline, Days 57, 113, 169, 225, 281, 365 of the OLEP
|
Normalization was defined as LDH ≤ 1.0 x ULN at that visit.
|
Baseline, Days 57, 113, 169, 225, 281, 365 of the OLEP
|
|
OLEP: Average LDH From Day 1 Through Week 24 of the OLEP
Time Frame: Day 1 through Week 24 of the OLEP
|
The trapezoidal rule was used to calculate AUC.
Individual mean LDH is defined as AUC divided by (last assessment date of LDH - first assessment date of LDH) of specific period.
|
Day 1 through Week 24 of the OLEP
|
|
OLEP: Average LDH From Day 1 Through Week 52 of the OLEP
Time Frame: Day 1 through Week 52 of the OLEP
|
The trapezoidal rule was used to calculate AUC.
Individual mean LDH is defined as AUC divided by (last assessment date of LDH - first assessment date of LDH) of specific period.
|
Day 1 through Week 52 of the OLEP
|
|
OLEP: Percentage of Participants With Hemoglobin Stabilization From Day 1 Through Week 24 of the OLEP
Time Frame: Day 1 through Week 24 of the OLEP
|
Hemoglobin stabilization was defined as not receiving an RBC transfusion and having no decrease in hemoglobin level of ≥ 2 g/dL.
|
Day 1 through Week 24 of the OLEP
|
|
OLEP: Percentage of Participants With Hemoglobin Stabilization From Day 1 Through Week 52 of the OLEP
Time Frame: Day 1 through Week 52 of the OLEP
|
Hemoglobin stabilization was defined as not receiving an RBC transfusion and having no decrease in hemoglobin level of ≥ 2 g/dL.
|
Day 1 through Week 52 of the OLEP
|
|
OLEP: Change From Baseline in Hemoglobin Levels
Time Frame: Day 1 and Week 24 of the OLEP
|
Day 1 and Week 24 of the OLEP
|
|
|
OLEP: Change From Baseline in Hemoglobin Levels
Time Frame: Day 1 and Week 52 of the OLEP
|
Day 1 and Week 52 of the OLEP
|
|
|
OLEP: Change From Baseline in FACIT-Fatigue Score
Time Frame: Day 1 and Week 52 of the OLEP
|
The FACIT-Fatigue is a 13-item, self-reported measure assessing an individual's level of fatigue during their usual daily activities over the past week.
This questionnaire is part of the FACIT measurement system, a compilation of questions measuring health-related quality of life (QoL) in patients with cancer and other chronic illnesses.
The FACIT-fatigue assesses the level of fatigue using a Likert scale ranging from 0 (not at all) to 4 (very much).
Total scores range from 0 to 52, with higher scores indicating a higher quality of life.
|
Day 1 and Week 52 of the OLEP
|
|
OLEP: Change From Baseline in HRQoL as Measured by the Global Health Status Subscale of the EORTC-QLQ-30 Scale
Time Frame: Day 1 and Week 52 of the OLEP
|
EORTC-QLQ-C30 is a 30-item self-reported questionnaire composed of both multi-item and single scales, including a global health status/quality of life (GHS/QoL) scale.
GHS subscale scores ranged from 0 to 100 with higher scores indicating better quality of life.
|
Day 1 and Week 52 of the OLEP
|
|
OLEP: Change From Baseline in PF Scores on the EORTC QLQ-C30
Time Frame: Day 1 and Week 52 of the OLEP
|
EORTC-QLQ-C30 is a 30-item participant self-report questionnaire composed of both multi-item and single scales, including a PF scale.
PF subscale scores ranged from 0 to 100 with higher scores indicating better quality of life.
|
Day 1 and Week 52 of the OLEP
|
|
OLEP: Change From Baseline in CH50
Time Frame: Baseline, Week 16, Week 32, Week 52 of the OLEP
|
This assay assessed the activity of the classical pathway of complement to measure C5 activity.
|
Baseline, Week 16, Week 32, Week 52 of the OLEP
|
|
OLEP: Number of Participants With Pozelimab ADA
Time Frame: Day 1 through Week 52 of the OLEP
|
Day 1 through Week 52 of the OLEP
|
|
|
OLEP: Number of Participants With Cemdisiran ADA
Time Frame: Day 1 through Week 52 of the OLEP
|
Day 1 through Week 52 of the OLEP
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Clinical Trial Management, Regeneron Pharmaceuticals
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
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 (Estimated)
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
- R3918-PNH-20105
- 2020-005006-25 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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