- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02059291
Study of Efficacy and Safety of Canakinumab in Patients With Hereditary Periodic Fevers
A Randomized, Double-blind, Placebo Controlled Study of Canakinumab in Patients With Hereditary Periodic Fevers (TRAPS, HIDS, or crFMF), With Subsequent Randomized Withdrawal/Dosing Frequency Reduction and Open-label Long-term Treatment Epochs
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study consists of 3 randomized cohorts (one per condition of colchicine resistant/intolerant Familial Mediterranean Fever (crFMF), Hyper Immunoglobulin D Syndrome (also known as mevalonate kinase deficiency (HIDS/MKD), and Tumor Necrosis Factor Receptor Associated Periodic Syndrome (TRAPS), and 4 study epochs:
- Epoch 1: a screening epoch to assess participant's eligibility;
Epoch 2: a randomized treatment epoch of 16 weeks where participants are randomized to canakinumab 150 mg every 4 weeks (q4w) or to placebo to obtain efficacy and safety data in a double-blind placebo controlled parallel-arm setting. This epoch contained 2 possible escape options :
- early blinded escape option for non responders from Day 8 to Day 28 with here an add-on dose of 150mg canakinumab followed by blinded uptitration at the next scheduled visit (Day 29)
- late unblinded escape option for non responders from Day 29 to Day 112; with open-label uptitration
- Epoch 3: a randomized withdrawal epoch of 24 weeks where canakinumab responders from the randomized treatment epoch were re-randomized to canakinumab 150mg q8w or placebo to assess the potential for canakinumab to maintain clinical efficacy at a reduced dosing frequency;
- Epoch 4: an open-label treatment epoch of 72 weeks to collect long-term
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Bruxelles, Belgium, 1200
- Novartis Investigative Site
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Hasselt, Belgium, 3500
- Novartis Investigative Site
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Leuven, Belgium, 3000
- Novartis Investigative Site
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Liege, Belgium, 4000
- Novartis Investigative Site
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Antwerpen
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Edegem, Antwerpen, Belgium, 2650
- Novartis Investigative Site
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Alberta
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Calgary, Alberta, Canada, T3B 6A8
- Novartis Investigative Site
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British Columbia
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Vancouver, British Columbia, Canada, V6H 3V4
- Novartis Investigative Site
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Bron Cedex, France, 69677
- Novartis Investigative Site
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Le Kremlin Bicetre, France, 94275
- Novartis Investigative Site
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Nimes Cedex, France, 30029
- Novartis Investigative Site
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Paris, France, 75015
- Novartis Investigative Site
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Berlin, Germany, 10117
- Novartis Investigative Site
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Berlin, Germany, 13353
- Novartis Investigative Site
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Essen, Germany, 45147
- Novartis Investigative Site
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Germering, Germany, 82110
- Novartis Investigative Site
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Hamburg, Germany, 20246
- Novartis Investigative Site
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Hamburg, Germany, 22081
- Novartis Investigative Site
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Muenchen, Germany, 80337
- Novartis Investigative Site
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Saint Augustin, Germany, 53757
- Novartis Investigative Site
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Tübingen, Germany, 72076
- Novartis Investigative Site
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Budapest, Hungary, 1023
- Novartis Investigative Site
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Budapest, Hungary, 1094
- Novartis Investigative Site
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Galway, Ireland
- Novartis Investigative Site
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Haifa, Israel, 3525408
- Novartis Investigative Site
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Haifa, Israel, 3339419
- Novartis Investigative Site
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Jerusalem, Israel, 9103102
- Novartis Investigative Site
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Petach-Tikva, Israel, 49202
- Novartis Investigative Site
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Ramat Gan, Israel, 5266202
- Novartis Investigative Site
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Napoli, Italy, 80131
- Novartis Investigative Site
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Roma, Italy, 00168
- Novartis Investigative Site
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AG
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Sciacca, AG, Italy, 92019
- Novartis Investigative Site
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BS
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Brescia, BS, Italy, 25123
- Novartis Investigative Site
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FI
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Firenze, FI, Italy, 50139
- Novartis Investigative Site
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GE
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Genova, GE, Italy, 16147
- Novartis Investigative Site
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ME
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Messina, ME, Italy, 98125
- Novartis Investigative Site
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PV
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Pavia, PV, Italy, 27100
- Novartis Investigative Site
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RM
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Roma, RM, Italy, 00165
- Novartis Investigative Site
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TS
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Trieste, TS, Italy, 34137
- Novartis Investigative Site
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Niigata, Japan, 951-8520
- Novartis Investigative Site
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Fukuoka
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Fukuoka city, Fukuoka, Japan, 812-8582
- Novartis Investigative Site
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Kanagawa
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Yokohama-city, Kanagawa, Japan, 236-0004
- Novartis Investigative Site
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Kyoto
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Sakyo-ku, Kyoto, Japan, 606 8507
- Novartis Investigative Site
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Nijmegen, Netherlands, 6500 HB
- Novartis Investigative Site
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Utrecht, Netherlands, 3508 GA
- Novartis Investigative Site
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Moscow, Russian Federation, 115522
- Novartis Investigative Site
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Moscow, Russian Federation, 117198
- Novartis Investigative Site
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Moscow, Russian Federation, 119991
- Novartis Investigative Site
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Rostov on Don, Russian Federation, 344022
- Novartis Investigative Site
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Saint-Petersburg, Russian Federation, 194100
- Novartis Investigative Site
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Madrid, Spain, 28034
- Novartis Investigative Site
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Madrid, Spain, 28046
- Novartis Investigative Site
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Barcelona
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Esplugues de Llobregat, Barcelona, Spain, 08950
- Novartis Investigative Site
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Catalunya
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Barcelona, Catalunya, Spain, 08035
- Novartis Investigative Site
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Comunidad Valenciana
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Valencia, Comunidad Valenciana, Spain, 46026
- Novartis Investigative Site
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Murcia
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El Palmar, Murcia, Spain, 30120
- Novartis Investigative Site
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Lausanne, Switzerland, 1011
- Novartis Investigative Site
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Ankara, Turkey, 06100
- Novartis Investigative Site
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Istanbul, Turkey, 34093
- Novartis Investigative Site
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TUR
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Istanbul, TUR, Turkey, 34098
- Novartis Investigative Site
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Leeds, United Kingdom, LS9 7TF
- Novartis Investigative Site
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London, United Kingdom, NW3 2QG
- Novartis Investigative Site
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London, United Kingdom, WC1N 1EH
- Novartis Investigative Site
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California
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Los Angeles, California, United States, 90027
- Novartis Investigative Site
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Michigan
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Ann Arbor, Michigan, United States, 48109
- Novartis Investigative Site
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Ohio
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Cleveland, Ohio, United States, 44195
- Novartis Investigative Site
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria: - Patient's written informed consent (or parent's written informed consent in case of pediatric patient) at screening - Male and female patients at least 2 years of age at the time of the screening visit. Male and female patients >28 days but <2 years eligible for open label treatment only. - Confirmed diagnosis and active flare at randomization - CRP >10mg/L at randomization
Exclusion Criteria: - Use of the following therapies (within varying protocol defined timeframes): Corticosteroids, anakinra, canakinumab, rilonacept, tocilizumab, TNF inhibitors, abatacept, tofacitinib, rituximab, leflunomide, thalidomide, cyclosporine, intravenous immunoglobulin, 6-Merceptopurine, azathioprine, cyclophosphamide, or chlorambucil, any other investigational biologics - History of malignancy of any organ system (other than localized basal cell carcinoma of the skin or in - situ cervical cancer), treated or untreated - Significant medical diseases, including but not limited to the following: a. History of organ transplantation b. Elevated liver enzymes ≥3x ULN d. Increase in total bilirubin e. Serious hepatic disorder (Child-Pugh scores B or C) f. Chronic Kidney Disease g. Thyroid disease h. Diagnosis of active peptic ulcer disease i. Coagulopathy j. Significant CNS effects including vertigo and dizziness - Any conditions or significant medical problems which immunecompromise the patient and/or places the patient at unacceptable risk for immunomodulatory therapy - Live vaccinations within 3 months prior to the start of the trial, during the trial, and up to 3 months following the last dose
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: crFMF: 150 mg
During Epoch 2, participants received canakinumab 150mg (or 2mg/kg for participants weighing <= 40kg) q4w for 16 weeks.
If participants were eligible for blinded escape, they received a single add-on dose of canakinumab (150 mg or 2mg/kg for participants weighing <= 40kg) between day 8 and day 28, and then received blinded uptitration to canakinumab 300 mg q4w from day 29 through day 112.
If patients on the highest allowed canakinumab dose of 300 mg (or 4 mg/kg for patients weighing ≤ 40 kg) q4w and re-flared (PGA ≥ 2 and CRP ≥ 30 mg/L) were not eligible for further up-titration.
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Canakinumab solution for subcutaneous injection in vial which contained 150mg/mL canakinumab in 1 mL solution.
Other Names:
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Placebo Comparator: crCMF: placebo
During epoch 2, participants received matching placebo to canakinumab 150 mg Participants who required blinded escape,they received a single add-on dose of canakinumab (150 mg or 2mg/kg for participants weighing <= 40kg) between day 8 and day 28, and then received blinded one dose of placebo and one dose of canakinumab q4w from day 29 through day 112. If flare or re-flare still occurred after receipt of canakinumab. 150mg, participants were uptitrated to open-label canakinumab 300 mg. |
Matching placebo to canakinumab solution for subcutaneous injection
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Experimental: HIDS/MKD: 150 mg
During Epoch 2, participants received canakinumab 150mg (or 2mg/kg for participants weighing <= 40kg) q4w for 16 weeks.
If participants were eligible for blinded escape, they received a single add-on dose of canakinumab (150 mg or 2mg/kg for participants weighing <= 40kg) between day 8 and day 28, and then received blinded uptitration to canakinumab 300 mg q4w from day 29 through day 112.
If patients on the highest allowed canakinumab dose of 300 mg (or 4 mg/kg for patients weighing ≤ 40 kg) q4w and re-flared (PGA ≥ 2 and CRP ≥ 30 mg/L) were not eligible for further up-titration.
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Canakinumab solution for subcutaneous injection in vial which contained 150mg/mL canakinumab in 1 mL solution.
Other Names:
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Placebo Comparator: HIDS/MKD: placebo
During epoch 2, participants received matching placebo to canakinumab 150 mg qw4.
Participants who required blinded escape, they received a single add-on dose of canakinumab (150 mg or 2mg/kg for participants weighing <= 40kg) between day 8 and day 28 and then received blinded one dose of placebo and one dose of canakinumab q4w from day 29 through day 112.
If flare or re-flare still occurred after receipt of canakinumab 150mg, participants were uptitrated to open-label canakinumab 300 mg.
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Matching placebo to canakinumab solution for subcutaneous injection
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Experimental: TRAPS: 150 mg
During Epoch 2, participants received canakinumab 150mg (or 2mg/kg for participants weighing <= 40kg) q4w for 16 weeks.
If participants were eligible for blinded escape, they received a single add-on dose of canakinumab (150 mg or 2mg/kg for participants weighing <= 40kg) between day 8 and day 28, and then received blinded uptitration to canakinumab 300 mg q4w from day 29 through day 112.
If patients on the highest allowed canakinumab dose of 300 mg (or 4 mg/kg for patients weighing ≤ 40 kg) q4w and re-flared (PGA ≥ 2 and CRP ≥ 30 mg/L) were not eligible for further up-titration
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Canakinumab solution for subcutaneous injection in vial which contained 150mg/mL canakinumab in 1 mL solution.
Other Names:
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Placebo Comparator: TRAPS: placebo
During epoch 2, participants received matching placebo to canakinumab 150 mg qw4.
Participants who required blinded escape,they received a single add-on dose of canakinumab (150 mg or 2mg/kg for participants weighing <= 40kg) between Day 8 and 28 and then received blinded one dose of placebo and one dose of canakinumab q4w from day 29 through day 112.
If flare or re-flare still occurred after receipt of canakinumab 150mg, participants were uptitrated to open-label canakinumab 300 mg.
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Matching placebo to canakinumab solution for subcutaneous injection
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Percentage of Participants With Resolution of Initial Flare and Absence of New Flares up to the End of the Randomized Treatment Epoch (16 Weeks)
Time Frame: 16 weeks
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Resolution of the initial disease flare is defined as: Physician's Global Assessment of Disease activity (PGA) <2 and C-reactive protein (CRP) within normal range (<= 10 mg/L) or reduction by at least 70% from baseline.
The PGA was evaluated by the investigator based on a 5-point scale: 0 = None (no) disease associated with clinical signs and symptoms; 1 = minimal disease associated signs and symptoms; 2 = mild disease associated signs and symptoms; 3 = moderate disease associated signs and symptoms; and 5 = severe disease associated signs and symptoms.
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16 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Percentage of Participants Who Achieve Physician's Global Assessment (PGA) < 2
Time Frame: 16 weeks
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The PGA was evaluated by the investigator based on a 5-point scale: 0 = None (no) disease associated with clinical signs and symptoms; 1 = minimal disease associated signs and symptoms; 2 = mild disease associated signs and symptoms; 3 = moderate disease associated signs and symptoms; and 5 = severe disease associated signs and symptoms.
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16 weeks
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Percentage of Participants With the Serologic Remission
Time Frame: 16 weeks
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Serologic remission was defined as C-reactive protein <= 10 mg/L.
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16 weeks
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Percentage of Participants With Normalized Serum Amyloid A (SAA) Level
Time Frame: 16 weeks
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Normalized SAA was defined as SAA <= 10 mg/L.
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16 weeks
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Percentage of Participants of Canakinumab Responders From Epoch 2 Who Maintained a Clinically Meaningful Response (Absence of New Flares) (40 Weeks)
Time Frame: 40 weeks
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A responder was defined as a participant who had no flare between week 16 and week 40.
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40 weeks
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Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Jeyaratnam J, Simon A, Calvo I, Constantin T, Shcherbina A, Hofer M, Gattorno M, Martini A, Bader-Meunier B, Vastert B, Levy J, Dekker E, de Benedetti F, Frenkel J. Long-term efficacy and safety of canakinumab in patients with mevalonate kinase deficiency: results from the randomised Phase 3 CLUSTER trial. Rheumatology (Oxford). 2022 May 5;61(5):2088-2094. doi: 10.1093/rheumatology/keab696.
- De Benedetti F, Gattorno M, Anton J, Ben-Chetrit E, Frenkel J, Hoffman HM, Kone-Paut I, Lachmann HJ, Ozen S, Simon A, Zeft A, Calvo Penades I, Moutschen M, Quartier P, Kasapcopur O, Shcherbina A, Hofer M, Hashkes PJ, Van der Hilst J, Hara R, Bujan-Rivas S, Constantin T, Gul A, Livneh A, Brogan P, Cattalini M, Obici L, Lheritier K, Speziale A, Junge G. Canakinumab for the Treatment of Autoinflammatory Recurrent Fever Syndromes. N Engl J Med. 2018 May 17;378(20):1908-1919. doi: 10.1056/NEJMoa1706314.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CACZ885N2301
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.
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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