- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT05669014
Et Fase 2 Proof of Concept-studie for at evaluere effektiviteten og sikkerheden af Daxdilimab hos deltagere med dermatomyositis (DM) eller anti-syntetase inflammatorisk myositis (ASIM)
En fase 2, randomiseret, dobbeltblind, placebokontrolleret, effektivitet og sikkerhed undersøgelse af Daxdilimab subkutan injektion hos voksne deltagere med utilstrækkeligt kontrolleret dermatomyositis eller anti-syntetase inflammatorisk myositis.
Det primære effektivitetsmål:
For at evaluere effekten af daxdilimab sammenlignet med placebo til at reducere sygdomsaktivitet i uge 24.
De sekundære effektivitetsmål omfatter:
- For at evaluere effekten af daxdilimab sammenlignet med placebo til at reducere sygdomsaktivitet i uge 24.
- For at evaluere effekten af daxdilimab sammenlignet med placebo på hudsymptomer i uge 24.
- For at evaluere effekten af daxdilimab på at reducere brugen af kortikosteroid i uge 24.
Andre sekundære mål omfatter:
- At karakterisere farmakokinetikken (PK) og immunogeniciteten af daxdilimab hos deltagere.
- At evaluere sikkerheden og tolerabiliteten af daxdilimab hos deltagere.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsen vil indskrive 96 deltagere med 2 idiopatiske inflammatoriske myositis-populationer:
- Population 1 eller dermatomyositis (DM): deltagere med DM med sikker eller sandsynlig myositis ifølge American College of Rheumatology/European League Against Rheumatism 2017 (ACR/EULAR 2017) kriterier og et DM-udslæt.
- Population 2 eller anti-syntetase inflammatorisk myositis (ASIM): deltagere med ASIM med sikker eller sandsynlig myositis i henhold til ACR/EULAR 2017 kriterier og et positivt ASIM-associeret antistof.
Deltagerne vil blive randomiseret efter population i et 1:1-forhold og modtage forsøgsprodukt (IP) daxdilimab eller placebo ved subkutan injektion.
Den estimerede samlede studievarighed vil være op til 60 uger.
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
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Minas Gerais
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Juiz de Fora, Minas Gerais, Brasilien, 36010-570
- Centro Mineiro de Pesquisa - CMiP
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Rio Grande do Sul
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Porto Alegre, Rio Grande do Sul, Brasilien, 90480-000
- LMK Servicos Medicos SS
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Merseyside
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Liverpool, Merseyside, Det Forenede Kongerige, L9 7AL
- Aintree University Hospital - NWCRN - PPDS
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Midlothian
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Edinburgh, Midlothian, Det Forenede Kongerige, EH4 2XU
- Western General Hospital Edinburgh - PPDS
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California
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Anaheim, California, Forenede Stater, 92805-5854
- Advanced Research Center, Inc.
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Mexico City, Mexico
- Unidad de Investigacion de las Enfermedades Reumaticas S.A. De C.V.
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Monterrey, Mexico, 64000
- Accelerium, S. de R.L. de C.V. - PPDS
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Seville, Spanien, 41010
- Hospital Quironsalud Infanta Luisa
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Praha, Hlavní Mesto
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Prague, Praha, Hlavní Mesto, Tjekkiet, 128 00
- Revmatologicky Ustav
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Nøgleinklusionskriterier:
- Voksne mænd eller kvinder 18 og ≤ 75 år på tidspunktet for underskrivelsen af det informerede samtykke (ICF).
En diagnose af sikker eller sandsynlig myositis ifølge American College of Rheumatology/European League Against Rheumatism 2017 (ACR/EULAR 2017) kriterier:
Befolkning 1: DM
- Diagnose af DM med DM udslæt nuværende eller historisk, eller
Population 2: ASIM
- Anti-histidyl tRNA syntetase-(Anti-Jo-1) antistoffer skal være positive under screening ved central laboratorietest, eller
- Et af følgende antistoffer skal være positivt ved historisk test: rettet mod anti-alanyl- (anti-PL-12), anti-threonyl-(anti PL-7), anti-asparaginyl-(anti-KS), anti-glycyl- (anti-EJ), anti-isoleucyl-(anti-OJ), anti-phenylalanyl-transfer RNA-syntetase-(anti-ZO), anti-tyrosil-YRS(HA).
Aktuelt aktiv myositis med alle følgende (a, b og c) under screening:
- Manuel muskeltestning (MMT 8) score < 142
Mindst 2 andre unormale kernesætmål (CSM) fra følgende liste:
- Patient global sygdomsaktivitet (PtGDA) ≥ 2 cm i en 10 cm visuel analog skala (VAS)
- Physician's Global Disease Activity (PhGDA) ≥ 2 cm i en 10 cm VAS
- Ekstramuskulær aktivitet ≥ 2 cm i et 10 cm VAS
- Mindst ét muskelenzym 1,5 gange øvre normalgrænse (ULN)
- Sundhedsvurdering spørgeskema-invaliditetsindeks (HAQ-DI) ≥ 0,5
- Global muskelskadescore ≤ 5 på en 10 cm VAS på myositisskadeindekset (MDI).
- Deltagerne bør være i stabil standardbehandling, hvis de tolereres; hvis de ikke er i stand til at tolerere det eller har svigtet standardbehandling, bør medicin have en udvasket periode.
- Deltagerne bør være villige til at nedtrappe kortikosteroiddosis pr. protokol, når de er stabile eller i bedring.
Ekskluderingskriterier:
- Enhver tilstand, der efter investigatorens eller sponsorens mening ville forstyrre evalueringen af forsøgsproduktet (IP) eller fortolkningen af deltagernes sikkerhed eller undersøgelsesresultater.
- Vægt > 160 kg (352 pund) ved screening.
- Ammende eller gravide kvinder eller kvinder, der har til hensigt at blive gravide, når som helst fra underskrivelse af ICF til 6 måneder efter at have modtaget den sidste dosis IP.
- Anamnese med klinisk betydningsfuld hjertesygdom, herunder ustabil angina, myokardieinfarkt, kongestiv hjerteinsufficiens inden for 6 måneder før randomisering; arytmi, der kræver aktiv terapi, bortset fra klinisk ubetydelige ekstra systoler eller mindre ledningsabnormiteter; eller tilstedeværelse af klinisk betydningsfuld abnormitet på elektrokardiogram (EKG), hvis det efter investigator ville øge risikoen for undersøgelsesdeltagelse.
Anamnese med kræft inden for de seneste 5 år, undtagen som følger:
- In situ carcinom i livmoderhalsen behandlet med tilsyneladende succes med helbredende behandling > 12 måneder før screening, eller
- Kutan basalcelle- eller pladecellecarcinom behandlet med helbredende terapi.
- Enhver underliggende tilstand, der efter efterforskerens opfattelse i væsentlig grad disponerer deltageren for infektion.
- Kendt historie med en primær immundefekt eller en underliggende tilstand, såsom kendt human immundefekt virus (HIV) infektion eller et positivt resultat for HIV infektion pr. centrallaboratorium.
- Bekræftet positiv test for hepatitis B-virusserologi som defineret i protokollen.
- Aktiv tuberkulose (TB) eller en positiv interferon gamma (IFN-γ) frigivelsesassay (IGRA) test ved screening, medmindre der er dokumenteret anamnese med passende behandling for aktiv eller latent TB i henhold til lokale retningslinjer.
- Enhver alvorlig herpesvirusfamilieinfektion (herunder Epstein-Barr-virus, cytomegalovirus [CMV]) på et hvilket som helst tidspunkt før randomisering.
- Opportunistisk infektion, der kræver hospitalsindlæggelse eller parenteral antimikrobiel behandling inden for 2 år før randomisering.
- Betydelig organsysteminvolvering eller myositis-skade (global muskelskadescore > 5 på en 10 cm VAS-skala på MDI), der udgør risici i undersøgelsen eller hindrer vurderinger.
- Diagnose af immunmedieret nekrotiserende myopati (IMNM) [(positiv 3-hydroxy-3-methylglutaryl-coenzym A-reduktase (anti-HMGR), anti-signalgenkendelsespartikel (anti-SRP) eller antistof negativ)], inklusionslegememyositis (IBM) (herunder positiv anti-cytosolisk 5'-nukleotidase 1A (anti cN1A) eller lægemiddelinduceret myositis.
- Aktuel muskel-, led- eller inflammatorisk sygdom, herunder betydelige ledkontrakturer eller calcinose, som efter investigatorens mening kan forstyrre muskelstyrkevurderingerne og forvirre vurderingerne af sygdomsaktiviteten.
- Kørestolsbundne deltagere.
- Aktuel inflammatorisk hudsygdom, bortset fra DM eller ASIM, som efter investigators opfattelse kunne forstyrre de inflammatoriske hudvurderinger eller forvirre vurderingerne af sygdomsaktiviteten.
- Alvorlig interstitiel lungesygdom, hvor luftvejssymptomer begrænser deltagerens funktion eller progressiv lungefibrose.
- Myositis i overlap med en anden bindevævssygdom, der udelukker en nøjagtig vurdering af en behandlingsrespons (f.eks. vanskeligheder med at vurdere muskelstyrke hos en sklerodermipatient med tilhørende myositis).
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Eksperimentel: Daxdilimab
Daxdilimab vil blive administreret som subkutan (SC) injektion i løbet af den 24-ugers behandlingsperiode efterfulgt af en 8-ugers sikkerhedsopfølgning. Før ændring 2 kunne deltagere indgå i en åben forlængelsesperiode fra uge 24-48. For de deltagere, der allerede er i den åbne udvidelse, vil de stoppe doseringen og gå ind i sikkerhedsopfølgningen. |
Deltagerne vil blive administreret med daxdilimab ved subkutan (SC) injektion.
Andre navne:
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Placebo komparator: Placebo
Matchende placebo vil blive indgivet ved SC-injektion i løbet af den 24-ugers behandlingsperiode efterfulgt af en 8-ugers sikkerhedsopfølgning. Før ændring 2 kunne deltagere gå ind i en åben forlængelsesperiode fra uge 24-48 og modtage daxdilimab. For de deltagere, der allerede er i den åbne udvidelse, vil de stoppe doseringen og gå ind i sikkerhedsopfølgningen. |
Deltagerne vil blive administreret med daxdilimab ved subkutan (SC) injektion.
Andre navne:
Deltagerne vil blive administreret identisk matchende placebo ved SC-injektion.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Mean Total Improvement Score (TIS) at Week 24
Tidsramme: At Week 24
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Total improvement score was derived from standardized clinical response criteria which was calculated by sum of improvement scores of 6 core set measures (CSMs) included physician global disease activity (PhGDA), patient global disease activity (PtGDA), manual muscle testing 8 (MMT8) bilateral, health assessment questionnaire-disability index (HAQ-DI), extramuscular global assessment (EGA), and laboratory muscle enzymes (LME).
Total improvement score was ranged from 0 to 100, where higher scores indicated greater improvement.
The TIS improvement categories are defined as minimal (TIS greater than or equal to [≥]20), moderate (TIS ≥40) and major improvement (TIS ≥60).
Mean TIS at week 24 was reported in this outcome measure.
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At Week 24
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Percentage of Participants With Improvement of TIS ≥ 40 and Without Deterioration at 2 Consecutive Visits at 24 Weeks
Tidsramme: Up to Week 24
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The percentage of participants who achieved moderate improvement (TIS ≥ 40), and do not experience confirmed disease deterioration at two consecutive visits through Week 24 were reported. Confirmed deterioration is defined as any of the following occurred at two consecutive visits compared with baseline: (i) Worsening of PhGDA by ≥ 2 cm and worsening of MMT8 by ≥ 20%, or (ii) Worsening of EGA by ≥ 2 cm, or (iii) Worsening of ≥ 3 of 5 core set measures (excluding laboratory enzymes) by ≥ 30%. |
Up to Week 24
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Percentage of Participants With Improvement of TIS ≥ 20 and Without Deterioration at 2 Consecutive Visits at 24 Weeks
Tidsramme: Up to Week 24
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The percentage of participants who achieved minimal improvement (TIS ≥ 20), and do not experience confirmed disease deterioration at two consecutive visits through Week 24 were reported. Confirmed deterioration is defined as any of the following occurred at two consecutive visits compared with baseline: (i) Worsening of PhGDA by ≥ 2 cm and worsening of MMT8 by ≥ 20%, or (ii) Worsening of EGA by ≥ 2 cm, or (iii) Worsening of ≥ 3 of 5 core set measures (excluding laboratory enzymes) by ≥ 30%. |
Up to Week 24
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Change in the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) Activity Score From Baseline (Day 1) to Week 24
Tidsramme: From Baseline (Day 1) to Week 24
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The CDASI activity score used to assess the severity of cutaneous DM and detect the improvement in disease activity.
The CDASI activity score evaluates erythema, scale, and erosion/ulceration across 15 different body areas including the presence and severity of Gottron's papules on the hands, periungual changes and alopecia.
The CDASI activity score ranges from 0 to 100 and higher scores indicate greater disease severity.
A negative change from baseline indicates a reduction in disease severity.
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From Baseline (Day 1) to Week 24
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Percentage of Participants With Clinically Meaningful Oral Corticosteroid (OCS) Reduction at Week 24
Tidsramme: Up to Week 24
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The percentage of participants who received OCS dose ≥ 10 milligram per day (mg/day) of prednisone or equivalent at baseline and who achieved a clinically meaningful reduction in oral corticosteroid dose either: a 25% reduction or an OCS dose of 7.5 mg/day of prednisone or equivalent at Week 24 were reported.
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Up to Week 24
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Serum Concentration of Daxdilimab During Stage I
Tidsramme: Stage I: Day 1 (predose and 2 hours postdose), predose on Weeks 4, 8, 12, 16, and any time on Week 24
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Mean concentrations of DAX were reported.
Values below the lower limit of quantitation (LLOQ) were set to zero before calculation of the descriptive statistics.
If the calculated mean concentration from observed values was less than the LLOQ of the assay, the mean value was set to " below the limit of quantification (BLQ)".
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Stage I: Day 1 (predose and 2 hours postdose), predose on Weeks 4, 8, 12, 16, and any time on Week 24
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Serum Concentration of Daxdilimab During Stage II
Tidsramme: Stage II: Predose on Week 36 and Week 48
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Mean concentrations of DAX were reported.
Values below the lower limit of quantitation (LLOQ) were set to zero before calculation of the descriptive statistics.
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Stage II: Predose on Week 36 and Week 48
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Number of Participants Who Developed Anti-drug Antibodies (ADA)
Tidsramme: Up to Week 56
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Number of participants who developed ADAs were reported.
The ADA status was summarized by the categories included; ADA prevalence: ADA positive observed at least once during the trial (baseline included); Only baseline positive: ADA positive observed at baseline but not observed at any post-baseline; Only post-baseline positive (treatment-induced): ADA positive not observed at baseline but observed at least once post-baseline; Both baseline and post-baseline positive: ADA positive observed at both baseline and at least once post-baseline; Incidence (treatment emergent ADA): ADA positive post-baseline only or boosted their pre-existing ADA titer (≥ 4-fold increase) during the trial period.
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Up to Week 56
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Number of Participants Who Experienced Treatment-emergent Adverse Events (TEAEs), Treatment-emergent Serious AEs (TESAEs), and Treatment-emergent AEs of Special Interest (TEAESIs) During Stage I
Tidsramme: From first dose of trial intervention in stage I, to first dose of trial intervention in stage II or study end for non-stage II participants; median (min, max) duration was 24 (3, 34) weeks
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An AE is any untoward medical occurrence in a clinical trial participant, temporally associated with the use of trial intervention, whether or not considered related to the trial intervention.
If an AE occurs on or after the first dose of trial intervention, the AE was considered as a TEAE.
An SAE is defined as any untoward medical occurrence that, at any dose results in death or is life-threatening or requires inpatient hospitalization or prolongation of existing hospitalization or results in persistent or significant disability/incapacity or is a congenital anomaly/birth defect.
An AESI is an AE of scientific or medical concern specific to the trial intervention that requires ongoing monitoring and prompt communication by the investigator.
AESIs in this trial were hypersensitivity reaction, including anaphylaxis, herpes zoster infection, severe viral infection/reactivation (CTCAE Grade 3 or higher), opportunistic infection, and malignancy (except non-melanoma skin cancer).
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From first dose of trial intervention in stage I, to first dose of trial intervention in stage II or study end for non-stage II participants; median (min, max) duration was 24 (3, 34) weeks
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Number of Participants Who Experienced TEAEs, TESAEs, and TEAESIs During Stage II
Tidsramme: From first dose of trial intervention in stage II to study end; median (min, max) duration was 24 (18, 33) weeks
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An AE is any untoward medical occurrence in a clinical trial participant, temporally associated with the use of trial intervention, whether or not considered related to the trial intervention.
If an AE occurs on or after the first dose of trial intervention, the AE was considered as a TEAE.
An SAE is defined as any untoward medical occurrence that, at any dose results in death or is life-threatening or requires inpatient hospitalization or prolongation of existing hospitalization or results in persistent or significant disability/incapacity or is a congenital anomaly/birth defect.
An AESI is an AE of scientific or medical concern specific to the trial intervention that requires ongoing monitoring and prompt communication by the investigator.
AESIs in this trial were hypersensitivity reaction, including anaphylaxis, herpes zoster infection, severe viral infection/reactivation (CTCAE Grade 3 or higher), opportunistic infection, and malignancy (except non-melanoma skin cancer).
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From first dose of trial intervention in stage II to study end; median (min, max) duration was 24 (18, 33) weeks
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Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Studieleder: MD, Amgen
Publikationer og nyttige links
Hjælpsomme links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- HZNP-DAX-205
- 2022-502810-10-00 (Anden identifikator: EU CT Number)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
IPD-delingstidsramme
IPD-delingsadgangskriterier
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
- SAP
- ICF
- CSR
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