A Study to Evaluate the Efficacy and Safety of Concomitant Use of Eplontersen and ALXN2220 Compared With Eplontersen and Placebo for Adults Participants With ATTR-CM (ATTRiumph)
A Phase IIb, Randomised, Double-blind, Placebo-controlled, Multicentre Study to Evaluate the Efficacy and Safety of Concomitant Use of Eplontersen and ALXN2220 Compared With Eplontersen and Placebo in Adult Participants With Transthyretin-Mediated Amyloid Cardiomyopathy (ATTR-CM)
調査の概要
詳細な説明
研究の種類
入学 (推定)
段階
- フェーズ2
連絡先と場所
研究場所
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California
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La Jolla、California、アメリカ、92037
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San Francisco、California、アメリカ、94115
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Stanford、California、アメリカ、94305
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Colorado
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Aurora、Colorado、アメリカ、80045
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District of Columbia
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Washington D.C.、District of Columbia、アメリカ、20010
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Florida
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Jacksonville、Florida、アメリカ、32224
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Miami、Florida、アメリカ、33176
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Weston、Florida、アメリカ、33331
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Illinois
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Chicago、Illinois、アメリカ、60637
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Massachusetts
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Boston、Massachusetts、アメリカ、02115
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Missouri
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Kansas City、Missouri、アメリカ、64111
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St Louis、Missouri、アメリカ、63110
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New York
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New York、New York、アメリカ、10032
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North Carolina
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Chapel Hill、North Carolina、アメリカ、27599
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Durham、North Carolina、アメリカ、27710
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Ohio
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Cleveland、Ohio、アメリカ、44195
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Oregon
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Portland、Oregon、アメリカ、97239
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Pennsylvania
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Danville、Pennsylvania、アメリカ、17822
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Philadelphia、Pennsylvania、アメリカ、19104
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Tennessee
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Germantown、Tennessee、アメリカ、38138
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Texas
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Dallas、Texas、アメリカ、75390
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Houston、Texas、アメリカ、77030
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Utah
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Salt Lake City、Utah、アメリカ、84132
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Virginia
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Falls Church、Virginia、アメリカ、22042
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London、イギリス、NW3 2QG
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London、イギリス、NW10 2PB
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Bologna、イタリア、40138
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Florence、イタリア、50134
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Milan、イタリア、20138
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Padova、イタリア、35128
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Pavia、イタリア、27100
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Pisa、イタリア、56124
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Torino、イタリア、10154
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Torrette - Ancona、イタリア、60126
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Trieste、イタリア、IT-34149
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Alberta
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Calgary、Alberta、カナダ、T2N 4Z6
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British Columbia
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Vancouver、British Columbia、カナダ、V6Z 1Y6
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Nova Scotia
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Halifax、Nova Scotia、カナダ、B3H 3A7
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Ontario
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London、Ontario、カナダ、N6A 5A5
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Toronto、Ontario、カナダ、M5G 2C4
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Quebec
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Montreal、Quebec、カナダ、H1T 1C8
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Gothenburg、スウェーデン、413 45
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Lund、スウェーデン、22242
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Stockholm、スウェーデン、171 64
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Uppsala、スウェーデン、751 85
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Barcelona、スペイン、08035
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Jaén、スペイン、23007
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L'Hospitalet de Llobregat、スペイン、08907
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Majadahonda、スペイン、28222
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Málaga、スペイン、29010
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Pamplona、スペイン、31008
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Salamanca、スペイン、37007
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Valencia、スペイン、46010
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Berlin、ドイツ、10117
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Cologne、ドイツ、50937
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Essen、ドイツ、45147
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Hamburg、ドイツ、22767
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Heidelberg、ドイツ、69120
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Homburg、ドイツ、66421
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München、ドイツ、81377
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Münster、ドイツ、48149
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Créteil、フランス、94010
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Marseille、フランス、13005
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Rennes、フランス、35033
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Toulouse、フランス、31059
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Beijing、中国、100730
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Beijing、中国、100034
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Changsha、中国、410012
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Chongqing、中国、400042
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Guangzhou、中国、510080
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Hangzhou、中国、310009
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Bunkyō City、日本、113-8431
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Kurume-shi、日本、830-0011
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Sapporo、日本、060-8543
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Shinjuku-ku、日本、160-8582
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Suita、日本、565-8565
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Capable of giving informed consent.
Inclusion Criteria:
- Participant must be ≥ 18 years to ≤ 85 years at the time of signing the informed consent.
Participants who have a diagnosis of ATTR-CM with either wild-type or variant TTR genotype based on 1 of the following:
- Endomyocardial biopsy with confirmatory TTR amyloid typing OR
- Grade 2 or 3 cardiac uptake on 99mTc scintigraphy in the absence of monoclonal gammopathy OR
- Grade 2 or 3 cardiac uptake on 99mTc scintigraphy AND confirmatory TTR amyloid typing in the presence of monoclonal gammopathy.
- NYHA Class I to III at Screening and life expectancy of ≥ 1 year as per the Investigator's judgement.
- End-diastolic IVST ≥ 12 mm on echocardiography.
- NT-proBNP ≥ 600pg/mL for participants without ongoing atrial fibrillation/flutter at Screening or NT-proBNP ≥ 1200pg/mL for participants with ongoing atrial fibrillation/flutter at Screening.
Able to complete symptom-limited maximal CPET at Screening based on the following test criteria:
- Able to exercise to near exhaustion during CPET as exhibited by RER ≥ 1.0 during symptom-limited CPET conducted during screening.
- If participant does not achieve RER ≥1.0, the CPET may be repeated once, at least 48 hours but less than 2 weeks (but before randomization) after the initial test.
- Treated according to locally recognised guidelines on standard-of-care treatment for patients with HF. Therapy should have been individually optimised and stable for ≥ 4 weeks (except diuretics) and include, unless contraindicated or not tolerated, treatment of high BP (targeting SBP < 130 mmHg as suggested in 2022 American College of Cardiology/American Heart Association/Heart Failure Society of America HF guidelines), and ischaemic heart disease.
- Willingness to adhere to daily self-administered vitamin A supplementation (3000 IU).
Exclusion Criteria:
- Known leptomeningeal amyloidosis.
- Known light chain (AL) or secondary (amyloid A) amyloidosis, or any other form of systemic amyloidosis.
- Cardiomyopathy not primarily caused by ATTR-CM, for example, cardiomyopathy primarily due to hypertension, valvular heart disease, or ischaemic heart disease per Investigator's assessment.
- Acute coronary syndrome, unstable angina, stroke, transient ischaemic attack, coronary revascularisation, cardiac device implantation, cardiac valve repair, or major surgery within 12 weeks of Screening.
- Uncontrolled hypertension (average resting SBP > 160 mmHg or DBP > 100 mmHg at Screening).
- Average resting SBP < 90 mmHg or symptomatic orthostatic hypotension, despite appropriate treatment, at Screening per Investigator's assessment.
- Uncontrolled ventricular clinically significant cardiac arrhythmia, per Investigator's assessment.
- Left ventricular ejection fraction < 30% on echocardiography measured locally at Screening.
- Severe pulmonary impairment (SpO₂ < 92%) defined as resting SpO₂ below 92% on room air, measured by pulse oximetry, indicative of severe lung disease. Participants requiring supplemental oxygen to maintain SpO₂ ≥ 92%.
- Participants with renal failure requiring dialysis.
- History of solid organ transplantation or ventricular assist device or listing for heart transplantation at Screening. Note: prior history of planned corneal transplant is not an exclusion criterion.
- Suspected or known intolerance/allergy to proteins or any components of the study intervention.
Any of the following results conducted at screening:
i) Haemoglobin <8g/dL for women or <9g/dL for men. ii) Platelet count <125 X10*9/L or other disorder associated with clinically significant thrombocytopenia.
iii) ALT >2.0 X ULN iv) TBL >2.5 X ULN (participants with known Gilbert's syndrome can be included with TBL >2.5 X ULN as long as direct bilirubin is ≤ 1.5 X ULN) v) Serum retinol level < LLN vi) By CKD-EPI formula, eGFR <20 mL/min/1.73 m2 measured by the central laboratory at Screening.
- Current unstable liver or biliary disease per Investigator's assessment.
- Multiple myeloma, lymphoma, leukemia, or any malignancy or clonal stem cell disorder within the past 5 years (except basal cell or squamous epithelial carcinomas of the skin, melanoma in situ or cervical carcinoma in situ that have been curatively resected, Stage I cancer in remission, or adequately treated prostate cancer stage I, IIA, or IIB with Gleason score ≤ 3+4 and prostate-specific antigen < 20 ng/mL).
- Any prior treatment with an ATTR amyloid depleter or a TTR gene silencing agent approved or in clinical development.
- Participated in a structured exercise training programme within the 1 month prior to Screening or planned to start during the trial.
- Participation in another investigational clinical study or intake of another investigational drug within 30 calendar days or 5 half-lives of the IMP, whichever is longer before signing the ICF.
- Judgement by the Investigator that the participant should not participate in the study if the participant has a known medical or psychological condition or other risk factor that might interfere with the participant's full participation in the study, pose any additional risk for the participant, or confound the assessment of the participant or outcome of the study.
- Previous enrolment or randomisation in the present study.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Eplontersen and ALXN2220
Subcutaneous eplontersen and intravenous ALXN2220 every 4 weeks
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Eplontersen delivered subcutaneously, once every 4 weeks
ALXN2220 delivered intravenously, once every 4 weeks
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プラセボコンパレーター:Eplontersen and placebo
Subcutaneous eplontersen and intravenous placebo every 4 weeks
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Eplontersen delivered subcutaneously, once every 4 weeks
Placebo delivered intravenously, once every 4 weeks
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Cardiopulmonary exercise test peak VO2
時間枠:52 week
|
Change from baseline in Cardiopulmonary exercise test peak VO2 at week 52
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52 week
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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NT-proBNP
時間枠:52 week
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Change from baseline in NT-proBNP at week 52
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52 week
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Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score
時間枠:52 week
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Change from baseline in Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score at week 52. The minimum score is 0 and maximum score is 100. Higher scores indicate better health status. |
52 week
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Extracellular volume
時間枠:52 week
|
Change from baseline in Extracellular volume (subgroup) at week 52
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52 week
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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.
IPD 共有時間枠
IPD 共有アクセス基準
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。