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NAI for Sepsis With Persistent Lymphopenia

5 maj 2026 uppdaterad av: ImmunityBio, Inc.

Phase 2, Randomized, Open-Label Clinical Trial Evaluating Nogapendekin Alfa Inbakicept in Combination With Standard of Care Versus Standard of Care Alone in Critically Ill Adults With Sepsis and Persistent Lymphopenia

This is a Phase 2, randomized, open-label study evaluating the safety and efficacy of nogapendekin alfa inbakicept (NAI, ANKTIVA®) in combination with standard of care versus standard of care alone in critically ill adults with sepsis and persistent lymphopenia. The study aims to determine whether NAI can improve 28-day mortality by addressing the immunosuppressive phase of sepsis characterized by persistent lymphopenia (absolute lymphocyte count <1,000 cells/µL). Participants will be randomized 1:1 to receive either NAI 1.2 mg subcutaneous injection on Days 3 (or earlier if ALC <700 cells/µL), Day 14, and potentially Day 21 if ALC remains <1,000 cells/µL, plus standard of care, or standard of care alone. The study will enroll approximately 50 participants (25 per arm) with persistent lymphopenia.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Sepsis is characterized by a biphasic immune response: an initial hyperinflammatory phase followed by a prolonged immunosuppressive phase with persistent lymphopenia. The majority of sepsis deaths (>70%) occur during the immunosuppressive phase rather than the initial hyperinflammatory phase. This acquired immunosuppression correlates with markedly increased 28-day mortality rates exceeding 40% and significantly elevated risk of secondary infections.

This study evaluates NAI, an IL-15 receptor agonist that promotes proliferation and activation of NK cells and CD8+ T cells, as a potential therapy to restore immune function in critically ill adults with sepsis and persistent lymphopenia (ALC <1,000 cells/µL on two consecutive measurements within 72 hours of sepsis diagnosis).

Study Arms:

  • Experimental Arm: NAI 1.2 mg subcutaneous injection administered on Days 3 (or earlier than Day 3 if ALC is <700 cells/µL), Day 14, and Day 21 if needed for ALC <1,000 cells/µL, plus institutional standard of care for sepsis
  • Control Arm: Institutional standard of care for sepsis alone Standard of care may include antimicrobial therapy, fluid resuscitation, vasopressor support, organ support, and mechanical ventilation as clinically indicated. Treatment will be discontinued if a participant has unacceptable toxicity, withdraws consent, or if the Investigator feels it is no longer in the participant's best interest to continue.

All participants will be followed for 90 days post the first dose of study treatment to capture late adverse events, rehospitalization, or mortality.

Studietyp

Interventionell

Inskrivning (Beräknad)

50

Fas

  • Fas 2

Kontakter och platser

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Studiekontakt

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Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  1. Age 18 years or older at the time of informed consent
  2. Admitted to the ICU with a diagnosis of sepsis as defined by Sepsis-3 criteria: life-threatening organ dysfunction caused by a dysregulated host response to infection, operationalized as a Sequential Organ Failure Assessment (SOFA) score increase of 2 or more points
  3. Documented persistent lymphopenia defined as ALC <1,000 cells/µL on at least two consecutive measurements within 72 hours of sepsis diagnosis (measurements must be separated by at least 12 hours)
  4. Prior initiation of appropriate antimicrobial therapy per institutional guidelines
  5. Ability to obtain written informed consent from the participant or legally authorized representative
  6. Agreement to practice effective contraception for female participants of child-bearing potential and non-sterile males (for up to 7 months after completion of therapy)

Exclusion Criteria:

  1. Hematologic malignancies including leukemia, lymphoma, and myelodysplastic syndromes
  2. Prior CAR-T cell therapy or hematopoietic stem cell transplant (HSCT) within 3 months of screening
  3. Active cytokine release syndrome (CRS) at screening
  4. Current or recent (within 7 days) use of colony stimulating factors (G-CSF, GM-CSF)
  5. Lymphopenia attributable to chemotherapy, radiation therapy, or immunosuppressive medications administered within 30 days prior to screening
  6. High-dose immunosuppressive therapy (>0.5 mg/kg prednisone equivalent daily), excluding physiologic replacement and stress-dose hydrocortisone for septic shock
  7. Life expectancy less than 24 hours as assessed by the treating physician
  8. Active uncontrolled bleeding requiring >2 units of packed red blood cells in the preceding 24 hours
  9. Known HIV infection with CD4 count <350 cells/µL and detectable viral load
  10. Known active viral hepatitis (hepatitis B or C with detectable viral load)
  11. Advanced dementia or other conditions precluding meaningful participation
  12. Known hypersensitivity to any component of the investigational products
  13. Participation in another interventional trial with an investigational immunomodulatory agent within 30 days prior to screening
  14. Pregnant or breastfeeding

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: NAI + Standard of Care
NAI 1.2 mg subcutaneous injection administered on Days 3 (or earlier if ALC <700 cells/µL), Day 14, and Day 21 if needed for ALC <1,000 cells/µL, plus institutional standard of care for sepsis
Läkemedel: Nogapendekin alfa inbakicept (NAI)
IL-15 receptor agonist complex; 1.2 mg subcutaneous injection administered on Days 3 (or earlier if ALC <700 cells/µL), Day 14, and Day 21 if needed for ALC <1,000 cells/µL
Andra namn:
  • N-803
  • ANKTIVA
  • Nogapendekin alfa-inbakicept
Övrig: Standard of Care (SOC)
Institutional standard of care for sepsis including antimicrobial therapy, fluid resuscitation, vasopressor support, organ support, and mechanical ventilation as clinically indicated
Aktiv komparator: Standard of Care Alone
Institutional standard of care for sepsis including antimicrobial therapy, fluid resuscitation, vasopressor support, and mechanical ventilation as clinically indicated
Övrig: Standard of Care (SOC)
Institutional standard of care for sepsis including antimicrobial therapy, fluid resuscitation, vasopressor support, organ support, and mechanical ventilation as clinically indicated

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
28-day all-cause mortality rate
Tidsram: 28 days
Proportion of participants who die from any cause within 28 days of randomization
28 days

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in absolute lymphocyte count (ALC)
Tidsram: Baseline through Day 28
Change in ALC from baseline (Day 1 pre-dose) through Day 28
Baseline through Day 28
ICU re-admission rate
Tidsram: Up to Day 90
Proportion of participants re-admitted to ICU after discharge by Day 90
Up to Day 90
Secondary infections
Tidsram: Up to Day 90
Proportion of participants with secondary infections after discharge by Day 90
Up to Day 90
90-day all-cause mortality rate
Tidsram: 90 days
Proportion of participants who die from any cause within 90 days of randomization
90 days
Safety and tolerability
Tidsram: Through Day 30 after last dose
Incidence and severity of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), and Grade ≥3 TEAEs graded per NCI CTCAE v6.0
Through Day 30 after last dose

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

ImmunityBio, Inc.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

6 juli 2026

Primärt slutförande (Beräknad)

3 augusti 2027

Avslutad studie (Beräknad)

4 oktober 2027

Studieregistreringsdatum

Först inskickad

5 maj 2026

Först inskickad som uppfyllde QC-kriterierna

5 maj 2026

Första postat (Faktisk)

11 maj 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

11 maj 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

5 maj 2026

Senast verifierad

1 maj 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • ResQ2204-SEPSIS

Plan för individuella deltagardata (IPD)

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NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

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Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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