A Study to Investigate Efficacy, Safety, and Tolerability of Remibrutinib Compared With Placebo in Adults With CINDU Inadequately Controlled by H1-antihistamines
A 52-week Multi-center, Randomized, Double-blind, Placebo Controlled, Basket Study With an Open-label Extension to Investigate the Efficacy, Safety, and Tolerability of Remibrutinib (LOU064) in Chronic Inducible Urticaria (CINDU) in Adults Inadequately Controlled by H1-antihistamines
This is a Phase 3, parallel group, placebo-controlled, double-blind, confirmatory study in patients with CINDU, with an optional Open-label Extension (OLE).
The purpose of the core period (52 weeks of treatment) of this study is to evaluate the efficacy, safety, and tolerability of remibrutinib (LOU064) vs. placebo in adults suffering from CINDU inadequately controlled by H1-antihistamines (H1-AHs).
The purpose of the OLE period is to collect long-term efficacy, safety, and tolerability data on remibrutinib in participants after having completed the Core period
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This study consists of a core and extension periods.
The Core period (6 arms) has a total duration of up to 60 weeks including a double-blind placebo-controlled treatment period until Week 24 followed by open-label treatment with remibrutinib up to Week 52. The primary endpoint for all CINDU subtypes is assessed at Week 12.
The Core period consists of:
- Screening period (up to 4 weeks): During the screening period, participants who have provided informed consent will be assessed for study eligibility.
- Double-blind, placebo-controlled treatment period (24 weeks): 24 weeks of double-blind treatment with remibrutinib or placebo.
- Open-label treatment period (28 weeks): 28 weeks of open-label treatment with remibrutinib.
- Follow-up period: 4 weeks of treatment free follow-up. The open-label extension period consists of observation and treatment period. At the end of the core period of the study, if participants continue to experience symptoms, they will transition to the treatment period in OLE. If they do not experience symtpoms they will transition to the observation period in the OLE.
The duration of the Open-label Extension period will be approximately 3 years where participants can switch from observation to treatment depending on if they start developing symptoms. Only those participants participating in the Open-label Extension Treatment period will receive remibrutinib. The participants in the Open-label Extension Observation period will not receive remibrutinib
Study Type
Study Type
Enrollment (Actual)
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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CABA, Argentina, C1181ACH
- Novartis Investigative Site
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Buenos Aires
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CABA, Buenos Aires, Argentina, C1414AIF
- Novartis Investigative Site
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Caba, Buenos Aires, Argentina, C1121ABE
- Novartis Investigative Site
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Santa Fe Province
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Rosario, Santa Fe Province, Argentina, 2000
- Novartis Investigative Site
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Queensland
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Woolloongabba, Queensland, Australia, 4102
- Novartis Investigative Site
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Victoria
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Carlton, Victoria, Australia, 3053
- Novartis Investigative Site
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Melbourne, Victoria, Australia, 3004
- Novartis Investigative Site
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São Paulo
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Alphaville Barueri, São Paulo, Brazil, 06454-010
- Novartis Investigative Site
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Santo André, São Paulo, Brazil, 09060-870
- Novartis Investigative Site
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Sorocaba, São Paulo, Brazil, 18040-425
- Novartis Investigative Site
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Manitoba
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Winnipeg, Manitoba, Canada, R3J 0S9
- Novartis Investigative Site
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Ontario
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Hamilton, Ontario, Canada, L8L 3C3
- Novartis Investigative Site
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Quebec
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Trois-Rivières, Quebec, Canada, G8T 7A1
- Novartis Investigative Site
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Beijing, China, 100730
- Novartis Investigative Site
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Beijing, China, 100050
- Novartis Investigative Site
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Jinan, China, 250012
- Novartis Investigative Site
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Shanghai, China, 200040
- Novartis Investigative Site
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Tianjin, China, 300052
- Novartis Investigative Site
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Fujian
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Fuzhou, Fujian, China, 350025
- Novartis Investigative Site
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Guangdong
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Guangzhou, Guangdong, China, 510630
- Novartis Investigative Site
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Guangzhou, Guangdong, China, 510091
- Novartis Investigative Site
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Hunan
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Changsha, Hunan, China, 410008
- Novartis Investigative Site
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Jiangsu
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Wuxi, Jiangsu, China, 214002
- Novartis Investigative Site
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Jilin
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Changchun, Jilin, China, 130021
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Shandong
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Jinan, Shandong, China, 250022
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Sichuan
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Chengdu, Sichuan, China, 610041
- Novartis Investigative Site
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Chengdu, Sichuan, China, 610072
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Xinjiang
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Ürümqi, Xinjiang, China, 830001
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Zhejiang
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Hangzhou, Zhejiang, China, 310001
- Novartis Investigative Site
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Yiwu, Zhejiang, China, 322000
- Novartis Investigative Site
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Atlántico
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Barranquilla, Atlántico, Colombia, 080002
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Barranquilla, Atlántico, Colombia, 080020
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Clermont-Ferrand, France, 63003
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Grenoble, France, 38043
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Montpellier, France, 34295
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Nantes, France, 44093
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Paris, France, 75970
- Novartis Investigative Site
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Pierre-Bénite, France, 69495
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Rouen, France, 76031
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Toulouse, France, 31400
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Berlin, Germany, 13353
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Mainz, Germany, 55131
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Münster, Germany, 48149
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Tübingen, Germany, 72076
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Lower Saxony
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Göttingen, Lower Saxony, Germany, 37075
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Stade, Lower Saxony, Germany, 21682
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Saxony
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Dresden, Saxony, Germany, 01307
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Hong Kong, Hong Kong, 999077
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Hajdu Bihar Megye
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Debrecen, Hajdu Bihar Megye, Hungary, 4032
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Hajdú-Bihar
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Debrecen, Hajdú-Bihar, Hungary, 4031
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Jász-Nagykun-Szolnok
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Szolnok, Jász-Nagykun-Szolnok, Hungary, 5000
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Karnataka
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Bangalore, Karnataka, India, 560004
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Mysore, Karnataka, India, 570001
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Haifa, Israel, 3104802
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Jerusalem, Israel, 9112001
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Ramat Gan, Israel, 5265601
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Tel Aviv, Israel, 6423906
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AN
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Ancona, AN, Italy, 60126
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MI
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Milan, MI, Italy, 20122
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Rozzano, MI, Italy, 20089
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Hiroshima, Japan, 7308518
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Fukuoka
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Kitakyushu, Fukuoka, Japan, 8078556
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Hokkaido
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Sapporo, Hokkaido, Japan, 0608543
- Novartis Investigative Site
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Kumamoto
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Kamimashi-gun, Kumamoto, Japan, 861-3106
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Osaka
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Habikino, Osaka, Japan, 5838588
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Takatsuki, Osaka, Japan, 5698686
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Shiga
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Ohtsu, Shiga, Japan, 5202192
- Novartis Investigative Site
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Shimane
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Izumo, Shimane, Japan, 6938501
- Novartis Investigative Site
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Tokyo
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Bunkyo-ku, Tokyo, Japan, 1138519
- Novartis Investigative Site
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Itabashi-ku, Tokyo, Japan, 1738610
- Novartis Investigative Site
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Shinjuku Ku, Tokyo, Japan, 160-0023
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Tachikawa, Tokyo, Japan, 1900023
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Johor
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Muar town, Johor, Malaysia, 84000
- Novartis Investigative Site
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Perak
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Ipoh, Perak, Malaysia, 30450
- Novartis Investigative Site
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Pulau Pinang
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George Town, Pulau Pinang, Malaysia, 10450
- Novartis Investigative Site
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Utrecht, Netherlands, 3584 CX
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Bydgoszcz, Poland, 85-094
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Warsaw, Poland, 02-962
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Coimbra, Portugal, 3004-561
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Lisbon, Portugal, 1649-035
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Vila Nova de Gaia, Portugal, 4434 502
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District 2
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Bucharest, District 2, Romania, 020762
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Singapore, Singapore, 308205
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Kežmarok, Slovakia, 060 01
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Trnava, Slovakia, 917 02
- Novartis Investigative Site
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Žilina, Slovakia, 012 07
- Novartis Investigative Site
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Seoul, South Korea, 03722
- Novartis Investigative Site
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Gyeonggi-do
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Suwon, Gyeonggi-do, South Korea, 16499
- Novartis Investigative Site
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Alicante, Spain, 03010
- Novartis Investigative Site
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Barcelona, Spain, 08035
- Novartis Investigative Site
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Madrid, Spain, 28041
- Novartis Investigative Site
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Madrid, Spain, 280796
- Novartis Investigative Site
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Valencia, Spain, 46015
- Novartis Investigative Site
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A Coruna
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Santiago, A Coruna, Spain, 15702
- Novartis Investigative Site
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Andalusia
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Granada, Andalusia, Spain, 18014
- Novartis Investigative Site
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Catalonia
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Barcelona, Catalonia, Spain, 08003
- Novartis Investigative Site
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Bangkok, Thailand, 10700
- Novartis Investigative Site
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Bangkok, Thailand, 10400
- Novartis Investigative Site
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Chiang Mai, Thailand, 50200
- Novartis Investigative Site
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Adapazari
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Sakarya, Adapazari, Turkey (Türkiye), 54290
- Novartis Investigative Site
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Basaksehir
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Istanbul, Basaksehir, Turkey (Türkiye), 34480
- Novartis Investigative Site
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Fatih
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Istanbul, Fatih, Turkey (Türkiye), 34093
- Novartis Investigative Site
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Melikgazi
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Kayseri, Melikgazi, Turkey (Türkiye), 38039
- Novartis Investigative Site
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Uskudar
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Istanbul, Uskudar, Turkey (Türkiye), 34662
- Novartis Investigative Site
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Oxford, United Kingdom, OX3 7LE
- Novartis Investigative Site
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Alabama
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Birmingham, Alabama, United States, 35209
- Allervie Clinical Research
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Arkansas
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Little Rock, Arkansas, United States, 72205
- Acuro Research Inc
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California
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Bakersfield, California, United States, 93301
- Kern Research
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Huntington Beach, California, United States, 92647
- Allergy and Asthma Specialists Group
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Lancaster, California, United States, 93534
- Antelope Valley Clinical Trials
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Colorado
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Colorado Springs, Colorado, United States, 80907
- Asthma and Allergy Associates P C
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Florida
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Aventura, Florida, United States, 33180
- Florida Ctr Allergy Asthma Research
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Sarasota, Florida, United States, 34233
- Sarasota Clinical Research
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Tampa, Florida, United States, 33613
- Univ of South Florida Asthma Allergy and Immunology CRU
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Georgia
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Savannah, Georgia, United States, 31406
- Aeroallergy Research Laboratories
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Idaho
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Boise, Idaho, United States, 83706
- Treasure Valley Medical Research
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Illinois
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Glenview, Illinois, United States, 60077
- Endeavor Health
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River Forest, Illinois, United States, 60305
- Asthma and Allergy Center of Chicago S C
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Indiana
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Plainfield, Indiana, United States, 46168
- The Indiana Clinical Trials Center
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Kentucky
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Owensboro, Kentucky, United States, 42301
- Allergy and Asthma Specialist P S C
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Maryland
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Baltimore, Maryland, United States, 21204
- John Hopkins University
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Oklahoma
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Oklahoma City, Oklahoma, United States, 73120
- Allergy Asthma and Clinical Research
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Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15241
- Allergy and Clinical Immunology Associates
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South Carolina
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North Charleston, South Carolina, United States, 29420
- National Allergy and Asthma Research LLS
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Texas
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Brownsville, Texas, United States, 78520
- PanAmerican Clinical Research
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El Paso, Texas, United States, 79924
- Western Sky Medical Research
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San Antonio, Texas, United States, 78229
- STAAMP Research LLC
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San Antonio, Texas, United States, 78213
- RFSA Dermatology
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Sugar Land, Texas, United States, 77479
- Complete Dermatology
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Utah
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Sandy City, Utah, United States, 84093
- Allergy Associates of Utah
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Hanoi, Vietnam, 100000
- Novartis Investigative Site
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria for core period:
- Male and female participants ≥18 years of age at the time of signing of the ICFs
- Confirmed CINDU diagnosis (as per guidelines) for symptomatic dermographism, cold urticaria or cholinergic urticaria for ≥ 4 months (defined as onset of CINDU with supporting documentation (e.g medical record, clinical history, photographs)) and inadequate control with H1-AH at local label approved doses at the time of randomization
The following response to the provocation test for each subtype is required at the randomization visit :
- Symptomatic Dermographism: A Total Fric Score of ≥3 using the FricTest® 4.0 and a numerical rating scale score of ≥5 for itch after the provocation test.
- Cold Urticaria: A Critical Threshold Temperature of ≥15°C using the TempTest® 4.0 and a numerical rating scale score of ≥5 for itch after the provocation test.
- Cholinergic Urticaria: A physician global assessment of severity of hives ≥ 2 using the Pulse-controlled ergometry test and a numerical rating scale score of ≥5 for itch after the provocation test.
- Cold Urticaria: Positive ice-cube test resulting in hives at the provocation site for participants at Screening.
- Cholinergic urticaria: Participants must show sweating in performing the pulse-controlled ergometry test on day of randomization. Participants with anhidrosis must not be included.
Inclusion criteria for the OLE:
Participants who have completed the Core period up to Week 52 and are willing to enter the OLE period
Exclusion Criteria for core period:
- 1. Previous use of remibrutinib or other BTK inhibitors.
- Participants who have concomitant CSU at screening. Participants with resolved CSU at the time of screening can be included in the study.
- Participants who have a familial form (e.g familial cold autoinflammatory syndrome, familial cold urticaria) of the target CINDU that is being considered for the participant's inclusion in this study.
- Participants having a more defined other form of inducible urticaria than the target CINDU that is being considered for the participant's inclusion in this study.
- Diseases, other than chronic inducible urticaria, with urticaria or angioedema symptoms including but not limited to urticarial vasculitis, erythema multiforme, cutaneous mastocytosis (urticaria pigmentosa) and hereditary or acquired angioedema
- Any other skin disease associated with chronic itching that might influence, in the investigator's opinion, the study evaluations and results (e.g., atopic dermatitis, bullous pemphigoid, dermatitis herpetiformis, senile pruritus, etc.) or skin diseases associated with only wheals and no itch e.g asymptomatic dermographism
There are no exclusion criteria for OLE
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: Remibrutinib, symptomatic dermographism group
Remibrutinib oral twice daily in participants with symptomatic dermographism
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Remibrutinib treated groups and arms
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Placebo Comparator: Placebo, symptomatic dermographism group
Placebo oral twice daily, symptomatic dermographism
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Placebo treated groups and arms
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Experimental: Remibrutinib, cold urticaria group
Remibrutinib oral twice daily, cold urticaria
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Remibrutinib treated groups and arms
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Placebo Comparator: Placebo, cold urticaria group
Placebo oral twice daily, cold urticaria
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Placebo treated groups and arms
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Experimental: Remibrutinib, cholinergic urticaria group
Remibrutinib oral twice daily, cholinergic urticaria
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Remibrutinib treated groups and arms
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Placebo Comparator: Placebo, cholinergic urticaria
Placebo oral twice daily, cholinergic urticaria
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Placebo treated groups and arms
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Proportion of participants with complete response in Total Fric Score; symptomatic dermographism
Time Frame: Week 12
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Total Fric score (a scale from 0-4 where a positive response with all of the four pins is TFS = 4, while a positive response with only one pin - the largest pin is TFS = 1)
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Week 12
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Proportion of participants with complete response in critical temperature threshold; cold urticaria
Time Frame: Week 12
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The Temptest is used to induce itch and hives in participants with cold urticaria.
Critical temperature threshold (CTT), as measured by the Temptest, determines the highest temperature that induces symptoms.
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Week 12
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Proportion of participants with itch numerical rating scale =0; cholinergic urticaria
Time Frame: Week 12
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Itch numerical rating scale, a scale from 0 to 10 Patients are asked to rate itching severity based on the worst level of itching in the past 24 h using an 11-point scale from 0 ("no itch") to 10 ("worst itch imaginable") |
Week 12
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline in Total Fric score; symptomatic dermographism
Time Frame: Week 12
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Total Fric score, a scale from 0-4 where a positive response with all four pins is TFS=4, while a positive only 1 pin - the largest pin is TFS=1
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Week 12
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Change from baseline in criticial temperature threshold following Temptest; cold urticaria
Time Frame: Week 12
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Critical temperature threshold, as measured by the Temptest, determines the highest temperature that induces symptoms
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Week 12
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Change from baseline in itch numerical rating scale; cholinergic urticaria
Time Frame: Week 12
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Itch numerical rating scale (NRS), scale from 0 to 10. 0 ("no itch") to 10 ("worst imaginable itch").
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Week 12
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proportion of participants with Physician Global Assessment (PGA) severity of hives =0; cholinergic urticaria
Time Frame: Week 12
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Physician global assessment of severity of hives.
This assessment is scored 0 to 4 with 0=no hives, 1=mild hives, 2=moderate hives, 3=severe hives and 4=very severe hives
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Week 12
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Proportion of participants with complete response in TFS; symptomatic dermographism
Time Frame: Week 24
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Total Fric score (a scale from 0-4 where a positive response with all of the four pins is TFS = 4, while a positive response with only one pin - the largest pin is TFS = 1)
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Week 24
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Proportion of participants with complete response in Critical Temperature threshold; cold urticaria
Time Frame: Week 24
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Critical Temperature Threshold, as measured by the Temptest, is the highest temperature that induces symptoms
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Week 24
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Proportion of participants with complete response in itch numerical rating scale; cholinergic urticaria
Time Frame: Week 24
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Itch numerical rating scale (NRS), scale from 0 to 10. 0 ("no itch") to 10 ("worst imaginable itch").
|
Week 24
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Change from baseline in itch numerical rating scale in participants with symptomatic dermographism
Time Frame: Week 12
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Itch numerical rating scale (NRS), scale from 0 to 10. 0 ("no itch") to 10 ("worst imaginable itch").
|
Week 12
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Change from baseline in itch numerical rating scale in participants with cold urticaria
Time Frame: Week 12
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Itch numerical rating scale (NRS), scale from 0 to 10. 0 ("no itch") to 10 ("worst imaginable itch").
|
Week 12
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Proportion of participants with complete response in Total Fric score; symptomatic dermographism
Time Frame: Week 2
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Total Fric score (a scale from 0-4 where a positive response with all of the four pins is TFS = 4, while a positive response with only one pin - the largest pin is TFS = 1)
|
Week 2
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Proportion of participants with complete response in Critical Temperature Threshold; cold urticaria
Time Frame: Week 2
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Critical temperature threshold (CTT), as measured by the Temptest, determines the highest temperature that induces symptoms.
|
Week 2
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Proportion of participants with itch NRS=0; cholinergic urticaria
Time Frame: Week 2
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Itch numerical rating scale (NRS), scale from 0 to 10. 0 ("no itch") to 10 ("worst imaginable itch").
|
Week 2
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Change from baseline in TFS in participants with symptomatic dermographism
Time Frame: Week 2
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Total Fric score (a scale from 0-4 where a positive response with all of the four pins is TFS = 4, while a positive response with only one pin - the largest pin is TFS = 1)
|
Week 2
|
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Change from baseline in Critical Temperature Threshold in participants with cold urticaria
Time Frame: Week 2
|
Critical temperature threshold (CTT), as measured by the Temptest, determines the highest temperature that induces symptoms.
|
Week 2
|
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Change from baseline in itch NRS in participants with cholinergic urticaria
Time Frame: Week 2
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Itch numerical rating scale (NRS), scale from 0 to 10. 0 ("no itch") to 10 ("worst imaginable itch").
|
Week 2
|
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Change from baseline in itch NRS in participants with symptomatic dermographism
Time Frame: Week 2
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Total Fric score (a scale from 0-4 where a positive response with all of the four pins is TFS = 4, while a positive response with only one pin - the largest pin is TFS = 1)
|
Week 2
|
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Change from baseline in itch NRS in participants with cold urticaria
Time Frame: Week 2
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Itch numerical rating scale (NRS), scale from 0 to 10. 0 ("no itch") to 10 ("worst imaginable itch").
|
Week 2
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Proportion of participants with cholinergic urticaria with PGA=0
Time Frame: Week 2
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Physician global assessment of severity of hives is a 4-point scale (0 = no active disease, 1 = mild disease, 2 = moderate disease, 3 = severe disease).
|
Week 2
|
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Change from baseline in weekly most bothersome symptom NRS score on the USDD
Time Frame: Week 12
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Urtricara symptom daily diary (USDD).
This daily diary records if the participant experiences any symptoms or avoided the triggers
|
Week 12
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Proportion of participants with DLQI=0-1
Time Frame: Week 12
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The Dermatology Life Quality Index (DLQI) is a 10-item dermatology-specific quality of life (QoL) measure.
Subjects rate their dermatology symptoms as well as the impact of their skin condition on various aspects of their lives thinking about the previous 7 days.
An overall score is calculated and ranges from 0 to 30 (higher score meaning worse disease-related QoL).
A DLQI score of 0 or 1 means that there is no impact of a skin disease on the patient's life.
|
Week 12
|
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Occurrence of treatment emergent adverse events and serious adverse events during the study
Time Frame: Week 52
|
Treatment emergent adverse events and serious adverse events are those that occur at any time only after treatment has started
|
Week 52
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Novartis Pharmaceuticals, Novartis Pharmaceuticals
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
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
- Chronic Urticaria
- Pathologic Processes
- Chronic Disease
- Disease Attributes
- Immune System Diseases
- Hypersensitivity, Immediate
- Hypersensitivity
- Skin Diseases
- Urticaria
- Skin Diseases, Vascular
- Pathological Conditions, Signs and Symptoms
- Skin and Connective Tissue Diseases
- Chronic Inducible Urticaria
- Cold Urticaria
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Protein Kinase Inhibitors
- remibrutinib
Other Study ID Numbers
Other Study ID Numbers
- CLOU064M12301
- 2023-505739-12-00 (Registry Identifier: EU CT NUMBER)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Novartis is committed to sharing access to patient-level data and supporting clinical documents from eligible studies with qualified external researchers. Requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to protect 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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