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Ravulizumab-kontrolleret non-inferioritetsundersøgelse for at evaluere effektiviteten og sikkerheden af ​​Pozelimab og Cemdisiran kombinationsterapi hos voksne patienter med paroxysmal natlig hæmoglobinuri, som er komplementhæmmer-naive eller ikke for nylig har modtaget komplementhæmmerbehandling (ACCESS-1)

4. november 2026 opdateret af: Regeneron Pharmaceuticals

En randomiseret, open-label, ravulizumab-kontrolleret, ikke-inferioritetsundersøgelse til evaluering af effektiviteten og sikkerheden af ​​Pozelimab og Cemdisiran kombinationsterapi hos patienter med paroksysmal natlig hæmoglobinuri, som er komplement-hæmmer-behandling-naive eller ikke har komplementeret inhibitor for nylig.

This study is researching a clinical treatment combination with two experimental drugs called pozelimab and cemdisiran. The study is focused on people with paroxysmal nocturnal hemoglobinuria (PNH). The aim of the study is to see how safe and effective the pozelimab + cemdisiran combination is for people with PNH and how the combination compares with 2 existing treatments: ravulizumab and eculizumab.

The pozelimab + cemdisiran combination may be referred to as "study drugs". Ravulizumab and eculizumab may also be called the "comparator drug".

The study is looking at several research questions, including:

  • How effective is the pozelimab + cemdisiran combination compared to ravulizumab?
  • How effective is pozelimab + cemdisiran combination compared to eculizumab?
  • What side effects may happen from taking the study drugs?
  • How much study drugs are in the blood at different times?
  • Whether the body makes antibodies against the study drugs (which could make the study drugs less effective or could lead to side effects)

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

202

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

      • São Paulo, Brasilien, 08270-070
        • Casa de Saude Santa Marcelina
      • São Paulo, Brasilien, 01321-001
        • A Beneficencia Portuguesa de Sao Paulo, BP Mirante
    • São Paulo
      • Santo André, São Paulo, Brasilien, 09060-650
        • Centro de Estudos e Pesquisas em Hematologia e Oncologia
    • Ontario
      • Toronto, Ontario, Canada, M5G 2C4
        • Toronto General Hospital
    • Antioquia
      • Medellín, Antioquia, Colombia, 050034
        • Hospital Pablo Tobon Uribe
      • Leeds, Det Forenede Kongerige, LS9 7TF
        • St James Hospital
    • Central Luzon
      • Quezon, Central Luzon, Filippinerne, 1011
        • St Lukes Medical Center
    • California
      • Whittier, California, Forenede Stater, 90602
        • The Oncology Institute of Hope & Innovation
      • Thessaloniki, Grækenland, 57010
        • George Papanikolaou Hospital
      • Jaipur, Indien, 302017
        • Bhagwan Mahaveer Cancer Hospital and Research Centre (BMCHRC)
    • Kerala
      • Kannur, Kerala, Indien, 670103
        • Malabar Cancer Center, Kerala
      • Kochi, Kerala, Indien, 682041
        • Amrita Institute of Medical Sciences (AIMS) and Research Centre Aims
    • Maharashtra
      • Mumbai, Maharashtra, Indien, 400022
        • K J Somaiya Super Specialty Hospital & Research Centre
    • National Capital Territory of Delhi
      • New Delhi, National Capital Territory of Delhi, Indien, 110085
        • Rajiv Gandhi Cancer Institute & Research Center (RGCIRC) - Rohini Campus
    • Punjab
      • Chandigarh, Punjab, Indien, 708248
        • Postgraduate Institute of Medical Education & Research (PGIMER)
    • Uttar Pradesh
      • Lucknow, Uttar Pradesh, Indien, 226014
        • Sanjay Gandhi Postgraduate Institute of Medical Sciences
      • Lucknow, Uttar Pradesh, Indien, 226003
        • King George Hospital
      • Turin, Italien, 10126
        • Hematology Citta della Salute e della Scienza di Torino
    • Firenze
      • Florence, Firenze, Italien, 50139
        • Aou Careggi
    • Roma
      • Rome, Roma, Italien, 00168
        • Fondazione Policlinico Universitario A. Gemelli - IRCCS
    • Aichi-ken
      • Nagoya, Aichi-ken, Japan, 466-8650
        • Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital
    • Gifu
      • Ōgaki, Gifu, Japan, 503-8502
        • Ogaki Municipal Hospital
    • Ibaraki
      • Tsukuba, Ibaraki, Japan, 305-8576
        • University of Tsukuba Hospital
    • Osaka
      • Moriguchi, Osaka, Japan, 570-8540
        • Matsushita Memorial Hospital
    • Tokyo
      • Shinagawa-ku, Tokyo, Japan, 141-8625
        • NTT Medical Center Tokyo
      • Amman, Jordan, 11942
        • Jordan University Hospital (JUH)
    • Beijing Municipality
      • Beijing, Beijing Municipality, Kina, 100032
        • Peking Union Medical College Hospital
    • Pahang
      • Kuantan, Pahang, Malaysia, 25200
        • Hospital Tg Ampuan Afzan
    • Sabah
      • Kota Kinabalu, Sabah, Malaysia, 88586
        • Hospital Queen Elizabeth
    • Selangor
      • Ampang, Selangor, Malaysia, 68000
        • Hospital Ampang
    • Nuevo León
      • Monterrey, Nuevo León, Mexico, 64460
        • Servicio de Hematologia del Hospital Universitario de la Uanl
      • Lima, Peru, 15072
        • Clinica San Felipe
      • Bydgoszcz, Polen, 85-168
        • Szpital Uniwersytecki Nr2 Bydgoszcz
      • Warsaw, Polen, 02-776
        • Institute of Hematology and Transfusion Medicine
    • Pomeranian Voivodeship
      • Gdansk, Pomeranian Voivodeship, Polen, 80-214
        • University Clinical Center Medical University of Gdansk
    • Cluj
      • Cluj-Napoca, Cluj, Rumænien, 400015
        • Ion Chiricuta Oncology Institute
    • Dolj
      • Craiova, Dolj, Rumænien, 200143
        • Municipal Hospital Filantropia
    • Mureș County
      • Târgu Mureş, Mureș County, Rumænien, 540136
        • Targu Mures Clinical County Emergency Hospital
      • Singapore, Singapore, 119074
        • National University Hospital
      • Barcelona, Spanien, 08036
        • Hospital Clinic de Barcelona
      • Murcia, Spanien, 30008
        • Hospital General JM Morales Meseguer
      • Salamanca, Spanien, 37007
        • Hospital Clinico Universitario de Salamanca
    • Vizcaya
      • Bilbao, Vizcaya, Spanien, 48013
        • Hospital Universitario Basurto
      • Busan, Sydkorea, 49241
        • Pusan National University Hospital
      • Seoul, Sydkorea, 06351
        • Samsung Medical Center
      • Seoul, Sydkorea, 03722
        • Severance Hospital
      • Seoul, Sydkorea, 07985
        • Ewha Womans University Mokdong Hospital
      • Seoul, Sydkorea, 02841
        • Korea University Hospital
      • Seoul, Sydkorea, 065791
        • Seoul St. Mary's Hospital - The Catholic University of Korea
    • Gyeonggi-do
      • Suwon, Gyeonggi-do, Sydkorea, 16247
        • St. Vincent Hospital
      • Suwon, Gyeonggi-do, Sydkorea, 16499
        • Ajou University Medical Center
    • Namdong-Gu
      • Incheon, Namdong-Gu, Sydkorea, 21565
        • Gachon University Gil Medical Center
      • Changhua, Taiwan, 500-06
        • Changhua Christian Hospital
      • Hualien City, Taiwan, 97002
        • Hualien Tzu Chi Hospital
      • Kaohsiung City, Taiwan, 80756
        • Kaohsiung Medical University Hospital
      • Taichung, Taiwan, 4070
        • Taichung Veterans General Hospital (VGHTC)
      • Tainan, Taiwan, 704
        • National Cheng Kung University Hospital
      • Taipei, Taiwan, 114
        • Tri-Service General Hospital
      • Taipei, Taiwan, 100229
        • National Taiwan University Hospital
    • Central Taiwan
      • Taichung, Central Taiwan, Taiwan, 40447
        • China Medical University Hospital
    • Hunan Province
      • Taoyuan, Hunan Province, Taiwan, 33305
        • Chang Gung Memorial Hospital - Linkou Branch
      • Bangkok, Thailand, 10330
        • King Chulalongkorn Memorial Hospital
      • Chiang Mai, Thailand, 50200
        • Chaing Mai University
      • Khon Kaen, Thailand, 40002
        • Faculty of Medicine Khon Kaen University
    • Changwat Songkhla
      • Hat Yai, Changwat Songkhla, Thailand, 90110
        • Clinical Research Center, Faculty of Medicine, Prince of Songkla University
      • Istanbul, Tyrkiet (Türkiye), 34418
        • Istanbul University
      • Izmir, Tyrkiet (Türkiye), 35100
        • Ege University
      • Budapest, Ungarn, 1083
        • Semmelweis University

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Key Inclusion Criteria:

  1. Diagnosis of PNH confirmed by high-sensitivity flow cytometry testing with PNH granulocytes or monocytes as described in the protocol
  2. Active disease, as defined by the presence of 1 or more PNH-related signs or symptoms as described in the protocol
  3. LDH level ≥2 × ULN at the screening visit
  4. Willing and able to comply with clinic/remote visits and study-related procedures, including completion of the full series of meningococcal vaccinations required per protocol

Key Exclusion Criteria:

  1. Prior treatment with eculizumab within 3 months prior to screening, ravulizumab within 6 months prior to screening, or other complement inhibitors within 5 half-lives of the respective agent prior to screening
  2. Receipt of an organ transplant, history of bone marrow transplantation or other hematologic transplant
  3. Body weight <40 kilograms at screening visit
  4. Planned use of any complement inhibitor therapy other than study drugs during the treatment period
  5. Not meeting meningococcal vaccination requirements and, at a minimum documentation of quadrivalent meningococcal vaccination within 5 years prior to the screening visit and serotype B vaccine within 3 years prior to the screening visit as described in the protocol.
  6. Any contraindication for receiving Neisseria meningitidis vaccinations (serotypes ACWY and B).
  7. Unable to take antibiotics for meningococcal prophylaxis (if required by local ravulizumab [Cohort A] or eculizumab [Cohort B] prescribing information, where available, or national guidelines/local practice, or if necessary when administration of the first dose of the quadrivalent meningococcal vaccine [serotype ACWY] or the second dose of the serotype B meningococcal vaccine [when available] is less than 2 weeks prior to study treatment initiation) as described in the protocol
  8. 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
  9. Documented history of active, uncontrolled, ongoing systemic autoimmune diseases

Note: Other protocol-defined Inclusion/ Exclusion Criteria apply

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Cohort A

Randomized 1:1

Administered Intravenous (IV) per the protocol

Andre navne:
  • Ultomiris
  • ALXN1210

Administered IV and subcutaneous (SC) per the protocol

Andre navne:
  • REGN3918

Administered SC per the protocol

Andre navne:
  • ALN-CC5
Eksperimentel: Cohort B

Randomized 1:1

Administered IV and subcutaneous (SC) per the protocol

Andre navne:
  • REGN3918

Administered SC per the protocol

Andre navne:
  • ALN-CC5

Administered IV per the protocol

Andre navne:
  • Soliris

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Percent change in lactate dehydrogenase (LDH)
Tidsramme: From baseline to week 26

Cohort A

From baseline to week 26
Transfusion avoidance
Tidsramme: From post-baseline day 1 through week 26

Cohort B Not requiring a red blood cell (RBC) transfusion per the protocol

From post-baseline day 1 through week 26
Adequate control of hemolysis
Tidsramme: From week 8 through week 26, inclusive

Cohort B LDH ≤1.5 × ULN at each visit

From week 8 through week 26, inclusive

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Maintenance of adequate control of hemolysis
Tidsramme: From week 8 through week 26, inclusive

Cohort A and B LDH ≤1.5 × ULN

From week 8 through week 26, inclusive
Breakthrough hemolysis
Tidsramme: From post-baseline day 1 through week 26

Cohort A and B LDH ≥2 × ULN per the protocol

From post-baseline day 1 through week 26
Adequate control of hemolysis
Tidsramme: From week 8 through week 26, inclusive

Cohort A LDH ≤1.5 × ULN

From week 8 through week 26, inclusive
Hemoglobin stabilization
Tidsramme: From day 1 (post-baseline) through week 26

Cohort A and B Patients who do not receive an RBC transfusion and have no decrease in hemoglobin level per the protocol

From day 1 (post-baseline) through week 26
Normalization of LDH
Tidsramme: Between week 8 through week 26, inclusive

Cohort A and B LDH ≤1.0 × ULN per the protocol

Between week 8 through week 26, inclusive
Transfusion avoidance
Tidsramme: Day 1 through week 26

Cohort A and B Not requiring an RBC transfusion as per protocol algorithm based on post-baseline hemoglobin values.

Day 1 through week 26
Change in fatigue as measured by the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale
Tidsramme: From baseline to week 26

Cohort A and B FACIT-Fatigue Scale is a 13-item, self-reported PRO 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). Scores range from 0 to 52, with higher scores indicating greater fatigue.

From baseline to week 26
Change in physical function (PF) scores on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30)
Tidsramme: From baseline to week 26

Cohort A and B EORTC-QLQ-C30 is a 30-item subject self-report questionnaire composed of both multi-item and single scales, including global health status/quality of life, functional Scales (physical, role, emotional, cognitive, and social), symptom scales (fatigue, nausea and vomiting, and pain), and 7 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, sleep and financial difficulties). Participants rate items on a 4-point scale, with 1 as "not at all" and 4 as "very much."

From baseline to week 26
Change in global health status (GHS)/QoL scale score on the EORTC-QLC-C30
Tidsramme: From baseline to week 26

Cohort A and B EORTC-QLQ-C30 is a 30-item subject self-report questionnaire composed of both multi-item and single scales, including global health status/quality of life, functional Scales (physical, role, emotional, cognitive, and social), symptom scales (fatigue, nausea and vomiting, and pain), and 7 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, sleep and financial difficulties). Participants rate items on a 4-point scale, with 1 as "not at all" and 4 as "very much."

From baseline to week 26
Percent change in LDH
Tidsramme: From baseline to week 26

Cohort B

From baseline to week 26
Rate of RBC transfused
Tidsramme: Post-baseline Day 1 through week 26

Cohort A and B Per protocol algorithm

Post-baseline Day 1 through week 26
Number of units of RBC transfused
Tidsramme: Post-baseline Day 1 through week 26

Cohort A and B Per protocol algorithm

Post-baseline Day 1 through week 26
Time to first LDH ≤1.5 × ULN
Tidsramme: Up to Week 26

Cohort A and B

Up to Week 26
Time to first LDH ≤1.0 × ULN
Tidsramme: Up to Week 26

Cohort A and B

Up to Week 26
Percentage of days with LDH ≤1.5 × ULN
Tidsramme: Between week 8 and week 26, inclusive

Cohort A and B

Between week 8 and week 26, inclusive
Change in hemoglobin levels
Tidsramme: From baseline to week 26

Cohort A and B

From baseline to week 26
Incidence and severity of treatment emergent serious adverse events (SAEs)
Tidsramme: Up to 26 weeks

Cohort A and B

Up to 26 weeks
Incidence and severity of treatment-emergent adverse events (TEAEs) of special interest
Tidsramme: Up to 26 weeks

Cohort A and B

Up to 26 weeks
Incidence and severity of TEAEs leading to treatment discontinuation
Tidsramme: Up to 26 weeks

Cohort A and B

Up to 26 weeks
Change in total CH50
Tidsramme: From baseline to week 26

Cohort A and B

From baseline to week 26
Percent change in total CH50
Tidsramme: From baseline to week 26

Cohort A and B

From baseline to week 26
Concentration of total C5 in plasma
Tidsramme: Up to 60 weeks

Cohort A and B

Up to 60 weeks
Concentrations of total pozelimab in serum
Tidsramme: Up to 60 weeks

Cohort A and B

Up to 60 weeks
Concentrations of cemdisiran in plasma
Tidsramme: Up to 60 weeks

Cohort A and B

Up to 60 weeks
Concentrations of total ravulizumab in serum
Tidsramme: Up to 34 weeks

Cohort A

Up to 34 weeks
Concentrations of total eculizumab in serum
Tidsramme: Up to 30 weeks

Cohort B

Up to 30 weeks
Incidence of treatment emergent anti-drug antibodies (ADAs) to pozelimab
Tidsramme: Up to 60 weeks

Cohort A and B

Up to 60 weeks
Incidence of treatment emergent ADAs to cemdisiran
Tidsramme: Up to 60 weeks

Cohort A and B

Up to 60 weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Studieleder: Clinical Trial Management, Regeneron Pharmaceuticals

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. august 2022

Primær færdiggørelse (Faktiske)

28. september 2026

Studieafslutning (Faktiske)

29. oktober 2026

Datoer for studieregistrering

Først indsendt

12. november 2021

Først indsendt, der opfyldte QC-kriterier

12. november 2021

Først opslået (Faktiske)

24. november 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • R3918-PNH-2021
  • 2020-004486-40 (EudraCT nummer)
  • 2023 (U.S. NIH-bevilling/kontrakt)
  • 2023-509657-31-00 (Ctis)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing

IPD-delingstidsramme

When Regeneron has:

  • received marketing authorization from major health authorities (e.g., FDA, European Medicines Agency (EMA), Pharmaceuticals and Medical Devices Agency (PMDA), etc.) for the product and indication or has globally discontinued development of the product for all indications on or after April 2020 and has no plans for future development
  • made the study results publicly available (e.g., scientific publication, scientific conference, clinical trial registry),
  • the legal authority to share the data, and
  • ensured the ability to protect participant privacy.

IPD-delingsadgangskriterier

Qualified researchers can submit a proposal for access to individual patient or aggregate level data from a Regeneron-sponsored clinical trial through Vivli. Regeneron's Independent Research Request Evaluation Criteria can be found at: https://www.regeneron.com/sites/default/files/Regeneron-External-Data-Sharing-Policy-and-Independent-Research-Request-Evaluation-Criteria.pdf

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • ANALYTIC_CODE
  • CSR

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .