Ravulizumab-kontrollierte Nichtunterlegenheitsstudie zur Bewertung der Wirksamkeit und Sicherheit der Kombinationstherapie mit Pozelimab und Cemdisiran bei erwachsenen Patienten mit paroxysmaler nächtlicher Hämoglobinurie, die keine Komplement-Inhibitor-Behandlung erhalten haben oder kürzlich keine Komplement-Inhibitor-Therapie erhalten haben (ACCESS-1)
Eine randomisierte, offene, Ravulizumab-kontrollierte Nichtunterlegenheitsstudie zur Bewertung der Wirksamkeit und Sicherheit der Kombinationstherapie mit Pozelimab und Cemdisiran bei Patienten mit paroxysmaler nächtlicher Hämoglobinurie, die nicht mit Komplement-Inhibitoren behandelt wurden oder kürzlich keine Komplement-Inhibitor-Therapie erhalten haben
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)
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Tatsächlich)
Einschreibung
Phase
Phase
- Phase 3
Kontakte und Standorte
Studienorte
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São Paulo, Brasilien, 08270-070
- Casa de Saude Santa Marcelina
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São Paulo, Brasilien, 01321-001
- A Beneficencia Portuguesa de Sao Paulo, BP Mirante
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São Paulo
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Santo André, São Paulo, Brasilien, 09060-650
- Centro de Estudos e Pesquisas em Hematologia e Oncologia
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Beijing Municipality
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Beijing, Beijing Municipality, China, 100032
- Peking Union Medical College Hospital
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Thessaloniki, Griechenland, 57010
- George Papanikolaou Hospital
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Jaipur, Indien, 302017
- Bhagwan Mahaveer Cancer Hospital and Research Centre (BMCHRC)
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Kerala
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Kannur, Kerala, Indien, 670103
- Malabar Cancer Center, Kerala
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Kochi, Kerala, Indien, 682041
- Amrita Institute of Medical Sciences (AIMS) and Research Centre Aims
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Maharashtra
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Mumbai, Maharashtra, Indien, 400022
- K J Somaiya Super Specialty Hospital & Research Centre
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National Capital Territory of Delhi
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New Delhi, National Capital Territory of Delhi, Indien, 110085
- Rajiv Gandhi Cancer Institute & Research Center (RGCIRC) - Rohini Campus
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Punjab
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Chandigarh, Punjab, Indien, 708248
- Postgraduate Institute of Medical Education & Research (PGIMER)
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Uttar Pradesh
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Lucknow, Uttar Pradesh, Indien, 226014
- Sanjay Gandhi Postgraduate Institute of Medical Sciences
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Lucknow, Uttar Pradesh, Indien, 226003
- King George Hospital
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Turin, Italien, 10126
- Hematology Citta della Salute e della Scienza di Torino
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Firenze
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Florence, Firenze, Italien, 50139
- Aou Careggi
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Roma
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Rome, Roma, Italien, 00168
- Fondazione Policlinico Universitario A. Gemelli - IRCCS
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Aichi-ken
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Nagoya, Aichi-ken, Japan, 466-8650
- Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital
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Gifu
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Ōgaki, Gifu, Japan, 503-8502
- Ogaki Municipal Hospital
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Ibaraki
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Tsukuba, Ibaraki, Japan, 305-8576
- University of Tsukuba Hospital
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Osaka
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Moriguchi, Osaka, Japan, 570-8540
- Matsushita Memorial Hospital
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Tokyo
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Shinagawa-ku, Tokyo, Japan, 141-8625
- NTT Medical Center Tokyo
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Amman, Jordanien, 11942
- Jordan University Hospital (JUH)
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Ontario
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Toronto, Ontario, Kanada, M5G 2C4
- Toronto General Hospital
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Antioquia
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Medellín, Antioquia, Kolumbien, 050034
- Hospital Pablo Tobon Uribe
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Pahang
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Kuantan, Pahang, Malaysia, 25200
- Hospital Tg Ampuan Afzan
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Sabah
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Kota Kinabalu, Sabah, Malaysia, 88586
- Hospital Queen Elizabeth
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Selangor
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Ampang, Selangor, Malaysia, 68000
- Hospital Ampang
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Nuevo León
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Monterrey, Nuevo León, Mexiko, 64460
- Servicio de Hematologia del Hospital Universitario de la Uanl
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Lima, Peru, 15072
- Clinica San Felipe
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Central Luzon
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Quezon, Central Luzon, Philippinen, 1011
- St Lukes Medical Center
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Bydgoszcz, Polen, 85-168
- Szpital Uniwersytecki Nr2 Bydgoszcz
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Warsaw, Polen, 02-776
- Institute of Hematology and Transfusion Medicine
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Pomeranian Voivodeship
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Gdansk, Pomeranian Voivodeship, Polen, 80-214
- University Clinical Center Medical University of Gdansk
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Cluj
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Cluj-Napoca, Cluj, Rumänien, 400015
- Ion Chiricuta Oncology Institute
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Dolj
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Craiova, Dolj, Rumänien, 200143
- Municipal Hospital Filantropia
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Mureș County
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Târgu Mureş, Mureș County, Rumänien, 540136
- Targu Mures Clinical County Emergency Hospital
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Singapore, Singapur, 119074
- National University Hospital
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Barcelona, Spanien, 08036
- Hospital Clinic de Barcelona
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Murcia, Spanien, 30008
- Hospital General JM Morales Meseguer
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Salamanca, Spanien, 37007
- Hospital Clinico Universitario de Salamanca
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Vizcaya
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Bilbao, Vizcaya, Spanien, 48013
- Hospital Universitario Basurto
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Busan, Südkorea, 49241
- Pusan National University Hospital
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Seoul, Südkorea, 06351
- Samsung Medical Center
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Seoul, Südkorea, 03722
- Severance Hospital
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Seoul, Südkorea, 07985
- Ewha Womans University Mokdong Hospital
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Seoul, Südkorea, 02841
- Korea University Hospital
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Seoul, Südkorea, 065791
- Seoul St. Mary's Hospital - The Catholic University of Korea
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Gyeonggi-do
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Suwon, Gyeonggi-do, Südkorea, 16247
- St. Vincent Hospital
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Suwon, Gyeonggi-do, Südkorea, 16499
- Ajou University Medical Center
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Namdong-Gu
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Incheon, Namdong-Gu, Südkorea, 21565
- Gachon University Gil Medical Center
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Changhua, Taiwan, 500-06
- Changhua Christian Hospital
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Hualien City, Taiwan, 97002
- Hualien Tzu Chi Hospital
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Kaohsiung City, Taiwan, 80756
- Kaohsiung Medical University Hospital
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Taichung, Taiwan, 4070
- Taichung Veterans General Hospital (VGHTC)
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Tainan, Taiwan, 704
- National Cheng Kung University Hospital
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Taipei, Taiwan, 114
- Tri-Service General Hospital
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Taipei, Taiwan, 100229
- National Taiwan University Hospital
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Central Taiwan
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Taichung, Central Taiwan, Taiwan, 40447
- China Medical University Hospital
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Hunan Province
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Taoyuan, Hunan Province, Taiwan, 33305
- Chang Gung Memorial Hospital - Linkou Branch
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Bangkok, Thailand, 10330
- King Chulalongkorn Memorial Hospital
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Chiang Mai, Thailand, 50200
- Chaing Mai University
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Khon Kaen, Thailand, 40002
- Faculty of Medicine Khon Kaen University
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Changwat Songkhla
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Hat Yai, Changwat Songkhla, Thailand, 90110
- Clinical Research Center, Faculty of Medicine, Prince of Songkla University
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Istanbul, Türkei (türkiye), 34418
- Istanbul University
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Izmir, Türkei (türkiye), 35100
- Ege University
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Budapest, Ungarn, 1083
- Semmelweis University
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California
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Whittier, California, Vereinigte Staaten, 90602
- The Oncology Institute of Hope & Innovation
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Leeds, Vereinigtes Königreich, LS9 7TF
- St James Hospital
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Key Inclusion Criteria:
- Diagnosis of PNH confirmed by high-sensitivity flow cytometry testing with PNH granulocytes or monocytes as described in the protocol
- Active disease, as defined by the presence of 1 or more PNH-related signs or symptoms as described in the protocol
- LDH level ≥2 × ULN at the screening visit
- 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:
- 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
- Receipt of an organ transplant, history of bone marrow transplantation or other hematologic transplant
- Body weight <40 kilograms at screening visit
- Planned use of any complement inhibitor therapy other than study drugs during the treatment period
- 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.
- Any contraindication for receiving Neisseria meningitidis vaccinations (serotypes ACWY and B).
- 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
- 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
- Documented history of active, uncontrolled, ongoing systemic autoimmune diseases
Note: Other protocol-defined Inclusion/ Exclusion Criteria apply
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
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Experimental: Cohort A
Randomized 1:1 |
Administered Intravenous (IV) per the protocol
Andere Namen:
Administered IV and subcutaneous (SC) per the protocol
Andere Namen:
Administered SC per the protocol
Andere Namen:
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Experimental: Cohort B
Randomized 1:1 |
Administered IV and subcutaneous (SC) per the protocol
Andere Namen:
Administered SC per the protocol
Andere Namen:
Administered IV per the protocol
Andere Namen:
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Percent change in lactate dehydrogenase (LDH)
Zeitfenster: From baseline to week 26
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Cohort A |
From baseline to week 26
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Transfusion avoidance
Zeitfenster: From post-baseline day 1 through week 26
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Cohort B Not requiring a red blood cell (RBC) transfusion per the protocol |
From post-baseline day 1 through week 26
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Adequate control of hemolysis
Zeitfenster: From week 8 through week 26, inclusive
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Cohort B LDH ≤1.5 × ULN at each visit |
From week 8 through week 26, inclusive
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Maintenance of adequate control of hemolysis
Zeitfenster: From week 8 through week 26, inclusive
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Cohort A and B LDH ≤1.5 × ULN |
From week 8 through week 26, inclusive
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Breakthrough hemolysis
Zeitfenster: From post-baseline day 1 through week 26
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Cohort A and B LDH ≥2 × ULN per the protocol |
From post-baseline day 1 through week 26
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Adequate control of hemolysis
Zeitfenster: From week 8 through week 26, inclusive
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Cohort A LDH ≤1.5 × ULN |
From week 8 through week 26, inclusive
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Hemoglobin stabilization
Zeitfenster: From day 1 (post-baseline) through week 26
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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
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Normalization of LDH
Zeitfenster: Between week 8 through week 26, inclusive
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Cohort A and B LDH ≤1.0 × ULN per the protocol |
Between week 8 through week 26, inclusive
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Transfusion avoidance
Zeitfenster: Day 1 through week 26
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Cohort A and B Not requiring an RBC transfusion as per protocol algorithm based on post-baseline hemoglobin values. |
Day 1 through week 26
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Change in fatigue as measured by the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale
Zeitfenster: 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
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Change in physical function (PF) scores on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30)
Zeitfenster: From baseline to week 26
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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
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Change in global health status (GHS)/QoL scale score on the EORTC-QLC-C30
Zeitfenster: From baseline to week 26
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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
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Percent change in LDH
Zeitfenster: From baseline to week 26
|
Cohort B |
From baseline to week 26
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Rate of RBC transfused
Zeitfenster: Post-baseline Day 1 through week 26
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Cohort A and B Per protocol algorithm |
Post-baseline Day 1 through week 26
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Number of units of RBC transfused
Zeitfenster: Post-baseline Day 1 through week 26
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Cohort A and B Per protocol algorithm |
Post-baseline Day 1 through week 26
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Time to first LDH ≤1.5 × ULN
Zeitfenster: Up to Week 26
|
Cohort A and B |
Up to Week 26
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Time to first LDH ≤1.0 × ULN
Zeitfenster: Up to Week 26
|
Cohort A and B |
Up to Week 26
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Percentage of days with LDH ≤1.5 × ULN
Zeitfenster: Between week 8 and week 26, inclusive
|
Cohort A and B |
Between week 8 and week 26, inclusive
|
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Change in hemoglobin levels
Zeitfenster: From baseline to week 26
|
Cohort A and B |
From baseline to week 26
|
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Incidence and severity of treatment emergent serious adverse events (SAEs)
Zeitfenster: Up to 26 weeks
|
Cohort A and B |
Up to 26 weeks
|
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Incidence and severity of treatment-emergent adverse events (TEAEs) of special interest
Zeitfenster: Up to 26 weeks
|
Cohort A and B |
Up to 26 weeks
|
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Incidence and severity of TEAEs leading to treatment discontinuation
Zeitfenster: Up to 26 weeks
|
Cohort A and B |
Up to 26 weeks
|
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Change in total CH50
Zeitfenster: From baseline to week 26
|
Cohort A and B |
From baseline to week 26
|
|
Percent change in total CH50
Zeitfenster: From baseline to week 26
|
Cohort A and B |
From baseline to week 26
|
|
Concentration of total C5 in plasma
Zeitfenster: Up to 60 weeks
|
Cohort A and B |
Up to 60 weeks
|
|
Concentrations of total pozelimab in serum
Zeitfenster: Up to 60 weeks
|
Cohort A and B |
Up to 60 weeks
|
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Concentrations of cemdisiran in plasma
Zeitfenster: Up to 60 weeks
|
Cohort A and B |
Up to 60 weeks
|
|
Concentrations of total ravulizumab in serum
Zeitfenster: Up to 34 weeks
|
Cohort A |
Up to 34 weeks
|
|
Concentrations of total eculizumab in serum
Zeitfenster: Up to 30 weeks
|
Cohort B |
Up to 30 weeks
|
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Incidence of treatment emergent anti-drug antibodies (ADAs) to pozelimab
Zeitfenster: Up to 60 weeks
|
Cohort A and B |
Up to 60 weeks
|
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Incidence of treatment emergent ADAs to cemdisiran
Zeitfenster: Up to 60 weeks
|
Cohort A and B |
Up to 60 weeks
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Studienleiter: Clinical Trial Management, Regeneron Pharmaceuticals
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Tatsächlich)
Primärer Abschluss
Studienabschluss (Tatsächlich)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- R3918-PNH-2021
- 2020-004486-40 (EudraCT-Nummer)
- 2023 (US NIH Stipendium/Vertrag)
- 2023-509657-31-00 (Ctis)
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
Beschreibung des IPD-Plans
All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing
IPD-Sharing-Zeitrahmen
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-Sharing-Zugriffskriterien
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
Art der unterstützenden IPD-Freigabeinformationen
- STUDIENPROTOKOLL
- SAFT
- ICF
- ANALYTIC_CODE
- CSR
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .