Clinical trial • Phase II • Haematology

AZACITIDINE for VEXAS syndrome

Phase II trial of AZACITIDINE for VEXAS syndrome. open-label, none/not specified-controlled. 60 participants.

Overview

Trial Therapeutic Area
Haematology
Trial Disease
VEXAS syndrome
Trial Stage
Phase II
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
13-02-2024
First CTIS Authorization Date
07-05-2024

Trial design

open-label, none/not specified-controlled Phase II trial across 12 sites in Denmark, Sweden, Norway and others.

Open Label
Yes
Comparator
None/Not specified
Target Sample Size
60

Eligibility

Recruits 60 Participants must be at least 18 years old and possess the cognitive capacity to provide informed consent. No vulnerable population selected (isVulnerablePopulationSelected = false)..

Pregnancy Exclusion
Patients who have a condition where Azacitidine is contraindicated, including hypersensitivity to Azacitidine, advanced malignant hepatic tumors, pregnancy, and breastfeeding individuals.
Vulnerable Population
Participants must be at least 18 years old and possess the cognitive capacity to provide informed consent. No vulnerable population selected (isVulnerablePopulationSelected = false).

Inclusion criteria

  • {"criterion_text":"- Participants must possess one of the currently described UBA1 mutations with a VAF > 10%. The currently described UBA1 mutations are: p.Met41Leu (c.121A.C), p.Met41Val (c.121A.G), p.Met41Thr (c.122T.C), p.Ser56Phe (c.167C>T), p.(splice)(c.118-1G>C) or intronic deletions like (c.118-9_118-2del) affecting the splice site\n- Participants must meet one of the following conditions: (1) Present with any degree of cytopenia, or (2) Exhibit inflammatory symptoms of VEXAS with/without cytopenia.\n- Participants must be at least 18 years old and possess the cognitive capacity to provide informed consent.\n- It is mandatory that male participants, who engage in sex with pre-menopausal (i.e. fertile) women, are willing to use barrier contraceptives (i.e condoms), during treatment with Azacitidine, and until three months after the last treatment. Additionally, it is highly recommended that their fertile partner also uses highly effective contraceptives during and for three months after the participants last treatment. Fertile female participants must exhibit a negative result on a pregnancy test before inclusion, demonstrate a commitment to monthly pregnancy testing and employment of safe contraceptive measures during treatment with Azacitidine, and until three months after the last treatment."}

Exclusion criteria

  • {"criterion_text":"- Patients having received Prior therapy with hypomethylating agents (i.e., Azacitidine, Decitabine).\n- Patients having received or is planned to receive alloHSCT.\n- Patients with active cancer requiring treatment are excluded from participation in this study. Active cancer is defined as a diagnosis of cancer for which the patient is currently receiving treatment, such as chemotherapy, radiation therapy, immunotherapy, targeted therapy, or any other curative or disease-controlling intervention.\n- Concomitant treatment with Disease modifying antirheumatic drugs (DMARDs), Chemotherapy/Cytostatic agents, Immunosuppressives, Radiotherapy any novel biological response modifying agents, is not allowed in the trials regardless of the underlying condition for which they are used. These treatments must be discontinued at least 14 days prior to inclusion.\n- Failure to obtain bone marrow examination maximum 8 weeks prior to initiating Azacitidine treatment.\n- Patients who are diagnosed with severe comorbidities including decompensated cirrhosis, end-stage kidney disease requiring dialysis, Severe cardiac disease (LVEF <30%), Severe pulmonary disease (FEV1 < 50% of predicted or DLCO < 40%), or a severe immunodeficiency including a diagnosis of HIV. If any of these conditions are suspected but undiagnosed, relevant tests will be ordered prior to screening based on clinical suspicion. However, diagnostic tests for all potential severe comorbidities will not be conducted systematically for every candidate; clinical suspicion will guide the decision to investigate further.\n- Patients with Eastern Cooperative Oncology Group (ECOG) Performance Status > 2\n- Patients who have a condition where Azacitidine is contraindicated, including hypersensitivity to Azacitidine, advanced malignant hepatic tumors, pregnancy, and breastfeeding individuals."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Primary endpoint: to assess the number and percentage of patients who experience a 50% relative reduction in VAF after completing six cycles of Azacitidine treatment.","definition_or_measurement_approach":"Assess number and percentage of patients achieving a 50% relative reduction in UBA1 Variant Allele Frequency (VAF) measured by comparing baseline VAF to VAF after completion of six cycles of Azacitidine."}

Recruitment

Planned Sample Size
60
Recruitment Window Months
114
Consent Approach
Participants (age ≥18) must have cognitive capacity to provide informed consent and must provide written informed consent. Country-specific subject information and informed consent form documents are included (examples: 'L1_SIS_and_ICF_description', 'L1_SIS_and_ICF_VEX-AZA_finland', 'D4_ Patient facing documents EORTC QLQ-C30 Norwegian', 'QLQ-C30 Danish'), indicating availability of country/language specific ICFs. No assent procedures for minors (study restricted to ≥18).

Geography

Total Number Of Sites
12
Total Number Of Participants
60

Denmark

Earliest CTIS Part Ii Submission Date
16-04-2024
Latest Decision Or Authorization Date
14-02-2025
Processing Time Days
304
Number Of Sites
3
Number Of Participants
30

Sites

Site Name
Rigshospitalet
Department Name
Department of Hematology
Principal Investigator Name
Jakob Werner Hansen
Principal Investigator Email
Jakob.werner.hansen.01@regionh.dk
Contact Person Name
Jakob Werner Hansen
Site Name
Aarhus Universitetshospital
Department Name
Dept. of Hematology
Principal Investigator Name
Marie Bill
Principal Investigator Email
maitof@rm.dk
Contact Person Name
Marie Bill
Contact Person Email
maitof@rm.dk
Site Name
Aalborg University Hospital
Department Name
Department of Hematology
Principal Investigator Name
Marianne Tang Severinsen
Principal Investigator Email
m.severinsen@rn.dk
Contact Person Name
Marianne Tang Severinsen
Contact Person Email
m.severinsen@rn.dk

Sweden

Earliest CTIS Part Ii Submission Date
18-05-2025
Latest Decision Or Authorization Date
05-06-2025
Processing Time Days
18
Number Of Sites
5
Number Of Participants
10

Sites

Site Name
Uppsala University Hospital
Department Name
Department of Hematology
Principal Investigator Name
Daniel Moreno Berggren
Principal Investigator Email
Daniel.moreno_berggren@medsci.uu.se
Contact Person Name
Daniel Moreno Berggren
Site Name
Sahlgrenska University Hospital-Vaestra Goetalandsregionen
Department Name
Department of Hematology
Principal Investigator Name
Lena Von Bahr
Principal Investigator Email
lena.von.bahr@vgregion.se
Contact Person Name
Lena Von Bahr
Contact Person Email
lena.von.bahr@vgregion.se
Site Name
Region Oestergoetland (Universitetssjukhuset I)
Department Name
Department of Hematology
Principal Investigator Name
Johanna Ungerstedt
Principal Investigator Email
region@regionostergotland.se
Contact Person Name
Johanna Ungerstedt
Contact Person Email
region@regionostergotland.se
Site Name
Lund University Hospital
Department Name
Department of Hematology
Principal Investigator Name
Lars Nilsson
Principal Investigator Email
Lars.Nilsson@skane.se
Contact Person Name
Lars Nilsson
Contact Person Email
Lars.Nilsson@skane.se
Site Name
Karolinska University Hospital
Department Name
Department of Hematology
Principal Investigator Name
Maria Creignou
Principal Investigator Email
kta.karolinska@regionstockholm.se
Contact Person Name
Maria Creignou

Norway

Earliest CTIS Part Ii Submission Date
05-03-2026
Latest Decision Or Authorization Date
23-03-2026
Processing Time Days
18
Number Of Sites
2
Number Of Participants
10

Sites

Site Name
Haukeland University Hospital
Department Name
Department of hematology
Principal Investigator Name
Håkon Reikvam
Principal Investigator Email
hakon.reikvam@helse-bergen.no
Contact Person Name
Håkon Reikvam
Contact Person Email
hakon.reikvam@helse-bergen.no
Site Name
Oslo Universitetssykehus HF
Department Name
Department of hematoloy
Principal Investigator Name
Synne Thorkildsen
Principal Investigator Email
xasyto@ous-hf.no
Contact Person Name
Synne Thorkildsen
Contact Person Email
xasyto@ous-hf.no

Finland

Earliest CTIS Part Ii Submission Date
29-04-2025
Latest Decision Or Authorization Date
01-04-2026
Processing Time Days
337
Number Of Sites
2
Number Of Participants
10

Sites

Site Name
Turku University Hospital
Department Name
Department of Hematology
Principal Investigator Name
Maija Valta Pauliina
Principal Investigator Email
maija.valta@tyks.fi
Contact Person Name
Maija Valta Pauliina
Contact Person Email
maija.valta@tyks.fi
Site Name
HUS-Yhtymae (Helsinki)
Department Name
Department of Hematology
Principal Investigator Name
Mikko Myllymäki
Principal Investigator Email
mikko.myllymaki@helsinki.fi
Contact Person Name
Mikko Myllymäki
Contact Person Email
mikko.myllymaki@helsinki.fi

Sponsor

Primary sponsor

Full Name
Rigshospitalet
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Denmark

Third parties

  • {"country":"Denmark","full_name":"Odense University Hospital","duties_or_roles":"code:1","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Denmark","full_name":"Frederiksberg Hospital","duties_or_roles":"code:1","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Denmark","full_name":"Aarhus Universitet","duties_or_roles":"code:1","organisation_type":"Educational Institution"}

Investigational products

Investigational Product Name
AZACITIDINE
Active Substance
AZACITIDINE
Modality
Small molecule
Routes Of Administration
SUBCUTANEOUS INJECTION
Route
SUBCUTANEOUS INJECTION
Authorisation Status
Authorised (SmPC provided)
Maximum Dose
200 mg (max daily dose amount 200 mg)

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