Clinical trial • Phase III • Immunology

CANAKINUMAB for PAPA syndrome

Phase III trial of CANAKINUMAB for PAPA syndrome.

Overview

Trial Therapeutic Area
Immunology
Trial Disease
PAPA syndrome
Trial Stage
Phase III
Drug Modality
Monoclonal antibody
Paediatric Trial
Yes

Key dates

Initial CTIS Submission Date
04-09-2024
First CTIS Authorization Date
19-11-2024

Trial design

Randomised, ilaris (canakinumab) 150 mg/ml solution for injection administered every 4 weeks (test product) versus matching placebo solution for injection (150 mg/ml) provided by novartis; placebo appears identical to test product.-controlled Phase III trial in Italy.

Randomised
Yes
Comparator
Ilaris (canakinumab) 150 mg/ml solution for injection administered every 4 weeks (test product) versus matching placebo solution for injection (150 mg/ml) provided by Novartis; placebo appears identical to test product.
Target Sample Size
24

Eligibility

Recruits 24 paediatric patients.

Pregnancy Exclusion
Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test.
Vulnerable Population
Vulnerable populations include children (<18 years). Consent/assent handling: adults (≥18 years) must provide written informed consent; for patients <18 years, parent or legal guardian written informed consent and the child's assent, if appropriate, are required before any assessments. Study documents for consent/assent are provided (Subject information and informed consent forms: Adult, Parent, Assent 12-16 yrs, Assent 6-11 yrs).

Inclusion criteria

  • {"criterion_text":"- Clinical diagnosis of PAPA with active flare at the time of enrolment.\n- Mutation of the PSTPIP1 gene.\n- Patient’s written informed consent from those ≥ 18 years of age must be obtained before any assessment is performed. Parent or legal guardian’s written informed consent and child’s assent, if appropriate, are required before any assessment is performed for patients < 18 years of age.\n- Male and female patients."}

Exclusion criteria

  • {"criterion_text":"- Use of the following therapies: a. Glucocorticoids (prednisone equivalent > 0.2 mg/kg/day [or greater than the maximum of 10 mg/ day for children over 60 kg]) within 1 week prior to Baseline b. Anakinra within 72 hours prior to Baseline c. Other biologics (including canakinumab) or immunosuppressants 2 half-life prior to Baseline.\n- Female adolescents (≤18 years of age) of childbearing potential who do not agree to abstinence or, if sexually active, do not agree to the use of contraception as defined in the exclusion criterion for women of child bearing potential.\n- Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using effective methods of contraception during dosing of study treatment.\n- Known allergy or hypersensitivity to any component the IMP\n- History of malignancy of any organ system (other than localized basal cell carcinoma of the skin or in-situ cervical cancer), treated or untreated, within the past 5 years, regardless of whether there is evidence of local recurrence or metastases.\n- Any conditions or significant medical problems which in the opinion of the investigator immunocompromises the patient and/ or places the patient at unacceptable risk for immunomodulatory therapy such as: a. Absolute neutrophil count <1.0 x 109/L or below b. Thrombocytopenia Platelets <10.0 x 109/L c. Any active or recurrent bacterial, fungal (with exception of onychomycosis) or viral infection. At least 1 month should elapse between the complete resolution of a severe infection, requiring hospitalization or systemic antibiotic therapy before the inclusion in the study d. Presence of Human Immunodeficiency Virus (HIV) infection, Hepatitis B (HBsAg) or Hepatitis C (HCV) infections based on screening lab results specific hepatitis serology that leads to exclusion. e. Clinical evidence or history of multiple sclerosis or other demyelinating diseases, or Felty’s syndrome\n- History or evidence of tuberculosis (TB) (active or latent) infection or one of the risk factors TB such as but not limited or exclusive to: a. History of any of the following: residence in a congregate setting (e.g. jail or prison, homeless shelter, or chronic care facility), substance abuse (e.g. injection or non-injection); health-care workers with unprotected exposure to patients who are at high risk of TB or patients with TB disease before the identification and correct airborne precautions of the patient, or b. Close contact (i.e. share the same air space in a household or other enclosed environment for a prolonged period (days or weeks, not minutes or hours) with a person with active pulmonary TB disease within the last year, or c. Evidence of TB infection (active or latent) determined by positive QuantiFERON (QFT-TB G In-Tube) test or positive Purified Protein Derivative (PPD) test (≥5 mm induration) at screening or within 2 months prior to the screening visit, according to the national guidelines. If presence of TB infection (active or latent) is established then treatment for TB as per national guidelines must have been initiated or completed prior to randomization. In the absence of national guidelines, the following has been demonstrated: TB has been treated adequately by antibiotics, cure can be demonstrated and risk factors resulting in TB exposure and contracting have been removed.\n- Elevated alanine aminotransferase (ALT) ≥3x ULN (if ALT at screening is >3x but <5x ULN, a re-test will be allowed. If ALT at re-test is <3x ULN and confirmed at another re-test, the patient will be eligible for participation).\n- Elevated aspartate aminotransferase (AST) ≥3x ULN (if AST at screening is >3x but <5x ULN, a re-test will be allowed. If AST at re-test is <3x ULN and confirmed at another re-test, the patient will be eligible for participation).\n- Increase in total bilirubin (TBL) defined as per CTC Grade ≥2: TBL >1.5x ULN\n- Administration of any investigational drug or implantation of investigational device, or participation in another trial, within 30 days before screening.\n- Live vaccinations within 3 months prior to the start of the trial, during the trial, and up to 3 months following the last dose\n- Donation or loss of blood (amount depending on age and weight, 10-20% or more of volume, within 8 weeks prior to first dosing, or longer if required by local regulation). Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- To determine whether canakinumab administered every 4 weeks is able to prevent disease flares when compared to placebo in canakinumab-responder patients.","definition_or_measurement_approach":""}

Recruitment

Planned Sample Size
24
Recruitment Window Months
42
Consent Approach
Adults (≥18 years) provide written informed consent. For patients <18 years, parent or legal guardian written informed consent and child assent where appropriate are required. Study documents available for publication include Subject information and informed consent forms: L1_SIS and ICF_Adult, L1_SIS and ICF_Parent, and assent forms L1_SIS and ICF_Assent_12-16_yrs and L1_SIS and ICF_Assent_6-11_yrs. Languages of consent documents not specified in the record.

Geography

Total Number Of Sites
3
Total Number Of Participants
24

Italy

Earliest CTIS Part Ii Submission Date
13-09-2024
Latest Decision Or Authorization Date
19-11-2024
Processing Time Days
67
Number Of Sites
3
Number Of Participants
24

Sites

Site Name
Ospedale Pediatrico Bambino Gesu
Department Name
Reumatologia
Principal Investigator Name
Antonella Insalaco
Principal Investigator Email
antonella.insalaco@opbg.net
Contact Person Name
Antonella Insalaco
Contact Person Email
antonella.insalaco@opbg.net
Site Name
IRCCS Istituto Giannina Gaslini
Department Name
U.O.C. Reumatologia e Malattie Autoinfiammatorie
Principal Investigator Name
Marco Gattorno
Principal Investigator Email
marcogattorno@gaslini.org
Contact Person Name
Marco Gattorno
Contact Person Email
marcogattorno@gaslini.org
Site Name
Azienda Socio Sanitaria Locale N 2 Della Gallura
Department Name
Servizio di Reumatologia del Distretto Socio Sanitario di Tempio Pausania
Principal Investigator Name
Daniela Marotto
Principal Investigator Email
daniela.marotto@tiscali.it
Contact Person Name
Daniela Marotto
Contact Person Email
daniela.marotto@tiscali.it

Sponsor

Primary sponsor

Full Name
IRCCS Istituto Giannina Gaslini
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Italy

Third parties

  • {"country":"","full_name":"Academic study; IMP donated by Novartis (Canakinumab) with a funding of 30.000 €","duties_or_roles":"IMP donated by Novartis (Canakinumab); funding of 30.000 €","organisation_type":""}

Investigational products

Investigational Product Name
Ilaris 150 mg/ml solution for injection
Active Substance
CANAKINUMAB
Modality
Monoclonal antibody
Routes Of Administration
SUBCUTANEOUS
Route
SUBCUTANEOUS
Authorisation Status
Authorised (marketing authorisation EU/1/09/564/004)
Frequency
Every 4 weeks
Maximum Dose
450 mg
Investigational Product Name
Placebo is solution for injection (150 mg/ml) contained in vials equal to those of Canakinumab and appears identical to the Test product. Placebo is provided by Novartis pharma.
Modality
Other

Related trials

Other published trials that may interest you.