- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02966353
Efficacy and Safety of Ruxolitinib in the Treatment of Anemic Myelofibrosis Patients. (REALISE)
A Multicenter Phase II, Open Label, Single Arm Study to Evaluate the Efficacy and Safety of Ruxolitinib in the Treatment of Anemic Myelofibrosis Patients.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Vienna, Austria, A-1090
- Novartis Investigative Site
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Antwerpen, Belgium, 2060
- Novartis Investigative Site
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Leuven, Belgium, 3000
- Novartis Investigative Site
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Sofia, Bulgaria, 1756
- Novartis Investigative Site
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Sofia, Bulgaria, 1413
- Novartis Investigative Site
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British Columbia
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Vancouver, British Columbia, Canada, V5Z 1M9
- Novartis Investigative Site
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Halle S, Germany, 06120
- Novartis Investigative Site
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GR
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Athens, GR, Greece, 115 27
- Novartis Investigative Site
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BO
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Bologna, BO, Italy, 40138
- Novartis Investigative Site
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FI
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Firenze, FI, Italy, 50134
- Novartis Investigative Site
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PA
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Palermo, PA, Italy, 90127
- Novartis Investigative Site
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Tokyo
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Bunkyo ku, Tokyo, Japan, 113-8431
- Novartis Investigative Site
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Moscow, Russian Federation, 125167
- Novartis Investigative Site
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Moscow, Russian Federation, 129110
- Novartis Investigative Site
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Petrozavodsk, Russian Federation, 185019
- Novartis Investigative Site
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Catalunya
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Barcelona, Catalunya, Spain, 08036
- Novartis Investigative Site
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Comunidad Valenciana
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Alicante, Comunidad Valenciana, Spain, 03010
- Novartis Investigative Site
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Galicia
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Santiago de Compostela, Galicia, Spain, 15706
- Novartis Investigative Site
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Istanbul, Turkey, 34093
- Novartis Investigative Site
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Kocaeli, Turkey, 41380
- 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:
Written informed consent must be obtained prior to any screening procedures.
- Male or female patients aged ≥ 18 years of age.
- Patients must have been diagnosed with PMF, according to the 2016 revised International Standard Criteria, PPV MF or PET-MF, irrespective of JAK2 mutation status.
- Patients must have had palpable splenomegaly that is equal to or greater than 5 cm below the left costal margin.
- Patients must have had hemoglobin less than 10 g/dL
- Patients must have had a history of transfusions must have a documented transfusion record in the previous 12 weeks to baseline.
- Patients must have had ECOG performance status of 0, 1, or 2.
- Patients must have had a peripheral blood blast percentage count of < 10%.
- Patients must have recovered or stabilized sufficiently from any adverse drug reactions associated with prior treatments before beginning treatment with ruxolitinib.
Exclusion Criteria:
- Patients who had prior treatment with any JAK1 or JAK2 inhibitor.
- Patients who had known hypersensitivity to ruxolitinib or other JAK1/JAK2 inhibitors, or to their excipients.
- Patients who had been eligible for hematopoietic stem cell transplantation (suitable candidate and a suitable donor is available).
Patients who had inadequate bone marrow reserve at baseline as demonstrated by at least one of the following:
- ANC that is ≤ 1,000/µL.
- Platelet count that is <50,000/µL without the assistance of growth factors, thrombopoietic factors or platelet transfusions.
- Hemoglobin count that is ≤ 6.5 g/dL despite transfusions.
- Patients who had severely impaired renal function defined by: Creatinine clearance less than 30 mL/min.
Patients who had inadequate liver function defined by any of these:
- Total bilirubin ≥ 2.5 x ULN and subsequent determination of direct bilirubin ≥ 2.5 x ULN;
- Alanine aminotransferase (ALT) > 2.5 x ULN;
- Aspartate aminotransferase (AST) > 2.5 x ULN.
- Patients who were being treated concurrently with a strong (potent) systemic inhibitor or inducer of CYP3A4 at the time of Screening.
- Presence of active bacterial, fungal, parasitic, or viral infection which requires therapy.
- Known history of human immunodeficiency virus (HIV) infection or other immunodeficiency syndromes such as X-linked agammaglobulinemia and common variable immune deficiency.
- Acute viral hepatitis or active chronic hepatitis B or C infection. Patients with inactive chronic infection (without viral replication) can be enrolled
- History of progressive multifocal leuko-encephalopathy.
- Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of ruxolitinib .
History or current diagnosis of uncontrolled or significant cardiac disease, including any of the following:
- Myocardial infarction within last 6 months
- Uncontrolled congestive heart failure
- Unstable angina within last 6 months
- Clinically significant (symptomatic) cardiac arrhythmias (e.g. bradyarrhythmias, sustained ventricular tachycardia, and clinically significant second or third degree AV block without a pacemaker)
- Significant concurrent, uncontrolled medical condition which, in the investigator's opinion, would have jeopardized the safety of the patient or compliance with the protocol.
- Patients who were undergoing treatment with another investigational medication or had been treated with an investigational medication within 30 days or 5 half-lives (whichever is longer) prior to the first dose of study drug.
- Patients who had a history of malignancy in the past 3 years, except for treated early stage squamous or basal cell carcinoma.
- Patients who were unable to comprehend or are unwilling to sign an ICF.
- Pregnant or nursing (lactating) women
- Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they were using highly effective methods of contraception throughout the study duration inclusive of 30 day safety follow up.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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EXPERIMENTAL: All Subjects
10 mg BID (2 tablets of 5mg) was self-administered as starting dose for all patients.
This dose was maintained for the first 12 weeks and titrated up thereafter unless they had met criteria for dose hold or dose reduction.
Dose was to have been increased or decreased per standardized dosing paradigm and not to have exceeded 25 mg bid.
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Ruxolitinib was supplied in 5 mg tablets to be taken orally approximately 12 hours apart (morning and night)
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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 at Least 50% Reduction in Spleen Length From Baseline at Week 24
Time Frame: Baseline up to week 24
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Percentage of participants achieving a 50% reduction in spleen length at week 24.
For subjects with palpable spleen at baseline and non-palpable at post-baseline, the post-baseline spleen are imputed as 0. Subjects who had palpable, but missing spleen length at baseline is excluded from the analysis.
Subjects with missing spleen length at Week 24 or who withdraw earlier from the study are considered as a non-responder.
The 95% CI is computed using exact Clopper-Pearson method.
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Baseline up to week 24
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Percentage of Participants With at Least 50% Reduction in Spleen Length From Baseline at Week 48
Time Frame: Baseline up to week 48
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Percentage of participants achieving a 50% reduction in spleen length at week 48.
For subjects with palpable spleen at baseline and non-palpable at post-baseline, the post-baseline spleen is imputed as 0. Subjects who had palpable, but missing spleen length at baseline is excluded from the analysis.
Subjects with missing spleen length at Week 48 or who withdraw earlier from the study are considered as a non-responder.
The 95% CI is computed using exact Clopper-Pearson method.
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Baseline up to week 48
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Percentage of Participants by Spleen Length Reduction or no Increase From Baseline Category at Week 24 and Week 48
Time Frame: baseline, weeks 24 and 48
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Participants who achieved a ≤ 50% reduction in spleen length at week 24 and 48 (reduction) and participants who had no increase greater than or equal to 50% (increase).
The edge of the spleen shall be determined by palpation, measured in centimeters, using a soft ruler, from the costal margin to the point of greatest splenic protrusion.
For subjects with palpable spleen at baseline and non-palpable at post-baseline, the post-baseline spleen is imputed as 0.
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baseline, weeks 24 and 48
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Percentage of Participants With at Least a 50% Reduction in Myelofibrosis 7 Item Symptom Scale (MF-7) and Myelofibrosis Symptom Assessment Form (MFSAF) at Week 24
Time Frame: Baseline and week 24
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The MF-7 is a disease specific questionnaire comprised of 7 items that measures the severity of seven of the most prevalent associated symptoms including: tiredness, early satiety, abdominal discomfort, night sweats, itching (pruritus), bone pain (diffuse not joint or arthritis) and pain under ribs on left side.
Each item was scored on a scale ranging from 0 (absent) to 10 (worst imaginable).
The MF-7 score is computed as the sum of the observed scores in the individual items to achieve a 0 to 70 score.
There would be one recall period of 24 hours used in this questionnaire.
A separate question on Inactivity was to be measured for severity of this symptom on a scale from 0 (absent) to 10 (worst imaginable).
This would allow the computation of the MFSAF v2.0 questionnaire results, as 6 out of 7 items in the latter PRO are in overlap with MF7 (they also share same 0-10 range Likert scale and ascending order, absent to worst imaginable).
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Baseline and week 24
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Patient Global Impression of Change (PGIC) at Week 24 and Week 48
Time Frame: Baseline up to week 48
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The PGIC is comprised of a single question intended to measure a subject's perspective of improvement or deterioration over time relative to treatment.
The PGIC uses a seven-point scale where '1' equals very much improved and '7' equals very much worse.
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Baseline up to week 48
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Percentage of Participants Transfusion Independency From Baseline up to Week 96
Time Frame: Baseline up to week 96
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Percentage is based on number of subjects who are transfusion dependent at baseline. Transfusion dependence (TD) is defined as subjects receiving 6 or more units of transfusions 12 weeks prior to baseline. Transfusion independence (TI) rate is defined as subjects who are transfusion dependent at baseline and require no unit of transfusion for ≥ 12 weeks at any time during the study. Transfusion response rate is defined as subjects who are TD at baseline and have 5 or less units of transfusion for ≥ 12 weeks at any time during the study. |
Baseline up to week 96
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Collaborators and Investigators
Sponsor
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
Keywords
Additional Relevant MeSH Terms
- Neoplasms
- Neoplasms by Site
- Bone Marrow Diseases
- Hematologic Diseases
- Hemorrhagic Disorders
- Myeloproliferative Disorders
- Blood Coagulation Disorders
- Blood Platelet Disorders
- Bone Marrow Neoplasms
- Hematologic Neoplasms
- Primary Myelofibrosis
- Thrombocytosis
- Thrombocythemia, Essential
- Polycythemia Vera
- Polycythemia
Other Study ID Numbers
- CINC424A2411
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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