Efficacy and Safety of ACZ885 in Patients With the Following Cryopyrin-associated Periodic Syndromes: Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, or Neonatal Onset Multisystem Inflammatory Disease

An Open-label, Long-term Safety and Efficacy Study of ACZ885 (Anti-interleukin-1β Monoclonal Antibody) Administered for at Least 6 Months in Patients With the Following Cryopyrin-associated Periodic Syndromes: Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, or Neonatal Onset Multisystem Inflammatory Disease

This will provided long-term safety and efficacy data for ACZ885 (a fully human anti-interleukin-1β [anti-IL-1β] monoclonal antibody) given as an injection subcutaneously in patients who participated in the CACZ885A2102 (NCT00487708), CACZ885D2201 (NCT00685373) or CACZ885D2304(NCT00465985) studies or newly identified patients with the following cryopyrin-associated periodic syndromes: Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome or Neonatal Onset Multisystem Inflammatory Disease.

The duration of this study was 6 months with a maximum duration of 2 years

Study Overview

• Status: Completed
• Conditions: Familial Cold Autoinflammatory Syndrome; Cryopyrin-Associated Periodic Syndromes; Neonatal Onset Multisystem Inflammatory Disease; Muckle Wells Syndrome
• Intervention / Treatment: Drug: Canakinumab (ACZ885)

• Study Type: Interventional
• Enrollment (Actual): 166
• Phase: Phase 3

Contacts and Locations

Study Locations

• Belgium
  • Laeken, Belgium
    • Novartis Investigative Site
• France
  • Le Kremlin Bicetre, France
    • Novartis Investigative Site
  • Lille Cedex, France
    • Novartis Investigative Site
  • Montpelier Cedex, France
    • Novartis Investigative Site
  • Nantes, France
    • Novartis Investigative Site
• Germany
  • Berlin, Germany
    • Novartis Investigative Site
  • Hamburg, Germany
    • Novartis Investigative Site
  • Heidelburg, Germany
    • Novartis Investigative Site
  • Herne, Germany
    • Novartis Investigative Site
  • Marburg, Germany
    • Novartis Investigative Site
  • Tubingen, Germany
    • Novartis Investigative Site
• India
  • New Delhi, India
    • Novartis Investigative Site
• Italy
  • Genova, Italy
    • Novartis Investigative Site
  • Napoli, Italy
    • Novartis Investigative Site
  • Padova, Italy
    • Novartis Investigative Site
  • Rome, Italy
    • Novartis Investigative Site
  • Trieste, Italy
    • Novartis Investigative Site
• Spain
  • Madrid, Spain
    • Novartis Investigative Site
  • Oviedo, Spain
    • Novartis Investigative Site
  • Vigo, Spain
    • Novartis Investigative Site
• Turkey
  • Istanbul, Turkey
    • Novartis Investigative Site
• United Kingdom
  • London, United Kingdom
    • Novartis Investigative Site
• United States
  • Arkansas
    • Little Rock, Arkansas, United States, 72205
      • Little Rock Allergy and Asthma Clinic
  • California
    • San Francisco, California, United States, 94118
      • UCSF School of Medicine
  • Georgia
    • Columbus, Georgia, United States, 31904
      • Allergy Center at Brookstone
  • Illinois
    • Chicago, Illinois, United States, 60612
      • Rush-Presbyterian St. Lukes Medical Center
  • Ohio
    • Cleveland, Ohio, United States, 44195
      • Cleveland Clinic
  • Wisconsin
    • Madison, Wisconsin, United States, 53792
      • University of Wisconsin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 3 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Male and female patients at least 3 years of age
2. Diagnosis of Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome or Neonatal Onset Multisystem Inflammatory Disease. Prior agreement between the Investigator and Novartis for study eligibility is required for patients who do not have a molecular diagnosis of NALP3 mutations available (either testing not performed, or testing performed but negative)upon study entry. For those patients who have not been molecularly tested for NALP3 mutations, molecular testing should be performed during the course of the study
3. For patients under anakinra therapy or any other investigational IL-1 blocking therapy, these treatments should be discontinued prior to the baseline visit.
4. Patients from the CACZ885A2102 study may enter this study. However, dosing at Visit 2 (Baseline Visit) can only occur if either 1) the patient is experiencing disease flare or 2) at least two months have elapsed from their last injection even in the absence of flare, whichever is earlier.
5. Patients who completed the CACZ885D2304 study may enter this study
6. Patients who completed the CACZ885D2201 study may enter this study
7. Patients who discontinued from the CACZ885A2102, CACZ885D2201 or CACZ885D2304 studies and for whom in the Investigator's judgment (with prior agreement from Novartis) continued treatment with ACZ885 in this study is considered appropriate.

Exclusion Criteria:

1. Participation in any clinical investigation within 4 weeks prior to dosing or longer if required by local regulation with the exception of trials with anakinra, other investigational IL-1 blocking therapies, and/or ACZ885.
2. History of being immunocompromised, including a positive HIV at screening (ELISA and Western blot) test result.
3. A positive Hepatitis B surface antigen (HBsAg) or Hepatitis C antibody test result is not allowed.
4. No live vaccinations within 3 months prior to the start of the trial, during the trial, and up to 3 months following the last dose.
5. History of recurrent and/or evidence of active bacterial, fungal, or viral infections.
6. Positive tuberculin skin test reaction (PPD 5 tuberculin units or as according to local standard practice) (>= 5 mm induration) at 48 to 72 hours after administration at the screening visit or within 2 months prior to the screening visit. Patients who have a positive PPD skin test with a documentation of BCG vaccination, who are at low environmental risk for tuberculosis (TB) infection or reactivation, and have a negative chest X-ray can be included.

Other protocol-defined inclusion/exclusion criteria may 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

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Canakinumab (ACZ885); Subcutaneous injection every 8 weeks based on participant's body weight. Body weight >40 kilogram (kg): 150 milligrams (mg) per injection and body weight <= 40 kg: 2 mg/kg per injection. For participants who did not experience sufficient symptomatic relief, an up-titration to the dose and/or more frequent doses were permitted as per protocol.	Drug: Canakinumab (ACZ885); 6 mL glass vial containing 150 mg lyophilized Canakinumab reconstituted with water for a subcutaneous injection every 8 weeks. Dosage based on body weight.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Number of Participants With Adverse Events (AEs), Death, Serious Adverse Events (SAEs), Discontinuation of Study Drug Due to an AE, Infections and Infestations and Injection Site Reactions	The number of participants with Adverse Events and Infections & Infestations are regardless of study drug relationship by primary system organ class preferred term equal and/or greater than 2% in any group. The number of participants with mild injection site reactions= mild reactions observed on at least one occasion but no moderate or severe reactions. The number of participants with moderate injection site reactions= moderate reactions observed on at least one occasion but no severe reactions.	2 years depending on when the participant enters the study

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Percentage of Participants Without Disease Relapse as Determined by the Physician's Global Assessment of Autoinflammatory Disease Activity, Assessment of Skin Disease and Inflammation Markers.	Disease relapse following complete response is defined as inflammation markers: C-Reactive Protein (CRP) and/or Serum Amyloid A (SAA) result > 30 mg/L AND Physician's Global Assessment of Autoinflammatory Disease Activity > minimal or Physician's Global Assessment >= minimal AND Skin Disease Assessment > minimal. Physician's Global Assessment of Autoinflammatory Disease Activity and Skin Disease Assessment (urticarial skin rash) are completed by the investigator using a 5 point rating scale: absent, minimal, mild, moderate and severe.	Every 8 weeks during the course of the trial for at least 6 months with a maximum duration of 2 years
Immunogenicity of Canakinumab (ACZ885)	The number of participants who tested positive for anti-ACZ885 antibodies using the Biacore Assay at the end of the study.	Every 8 weeks during the course of the trial for at least 6 months with a maximum duration of 2 years
Pharmacokinetics	Mean Clearance from serum in Liter per Day (CLD) in adult participants >=18, pediatric participants <18 with body weight >40 kg and pediatric participants <18 with body weight <=40 kg.	Every 8 weeks during the course of the trial for at least 6 months with a maximum duration of 2 years

Collaborators and Investigators

• Sponsor: Novartis

Publications and helpful links

General Publications

• Kuemmerle-Deschner JB, Hachulla E, Cartwright R, Hawkins PN, Tran TA, Bader-Meunier B, Hoyer J, Gattorno M, Gul A, Smith J, Leslie KS, Jimenez S, Morell-Dubois S, Davis N, Patel N, Widmer A, Preiss R, Lachmann HJ. Two-year results from an open-label, multicentre, phase III study evaluating the safety and efficacy of canakinumab in patients with cryopyrin-associated periodic syndrome across different severity phenotypes. Ann Rheum Dis. 2011 Dec;70(12):2095-102. doi: 10.1136/ard.2011.152728. Epub 2011 Aug 21.

Study record dates

Study Major Dates

• Study Start: May 1, 2008
• Primary Completion (Actual): April 1, 2010
• Study Completion (Actual): April 1, 2010

Study Registration Dates

• First Submitted: May 27, 2008
• First Submitted That Met QC Criteria: May 27, 2008
• First Posted (Estimate): May 28, 2008

Study Record Updates

• Last Update Posted (Estimate): November 4, 2016
• Last Update Submitted That Met QC Criteria: November 3, 2016
• Last Verified: September 1, 2016

More Information

Terms related to this study

• Keywords: children,; familial autoinflammatory syndrome; antibody,; Cryopyrin-associated periodic syndromes (CAPS):; Familial Cold Autoinflammatory Syndrome (FCAS),; Muckle-Wells Syndrome (MWS),; MWS with overlapping symptoms of Neonatal Onset Multisystem Inflammatory Disease (NOMID) or Neonatal Onset Multisystem Inflammatory Disease (NOMID),; systemic autoinflammatory disease,; CIAS-1 gene,; NALP-3,; ACZ885,; human monoclonal anti-human interleukin-1beta (IL-1beta),; autosomal dominant,
• Additional Relevant MeSH Terms: Pathologic Processes; Skin Diseases; Infections; Inflammation; Disease; Hematologic Diseases; Genetic Diseases, Inborn; Connective Tissue Diseases; Hereditary Autoinflammatory Diseases; Skin Diseases, Genetic; Skin Diseases, Infectious; Leukocyte Disorders; Suppuration; Syndrome; Cellulitis; Eosinophilia; Cryopyrin-Associated Periodic Syndromes
• Other Study ID Numbers: CACZ885D2306