Clinical trial • Phase III • Haematology

CEMDISIRAN for Paroxysmal nocturnal hemoglobinuria

Phase III trial of CEMDISIRAN for Paroxysmal nocturnal hemoglobinuria. open-label, none/not specified-controlled. 185 participants.

Overview

Trial Therapeutic Area
Haematology
Trial Disease
Paroxysmal nocturnal hemoglobinuria
Trial Stage
Phase III
Drug Modality
Monoclonal antibody|Oligonucleotide
Orphan Drug
Yes

Key dates

Initial CTIS Submission Date
29-10-2024
First CTIS Authorization Date
27-11-2024

Trial design

open-label, none/not specified-controlled Phase III trial in Italy, Hungary, Poland and others.

Open Label
Yes
Comparator
None/Not specified
Target Sample Size
185

Eligibility

Recruits 185 The trial record flags vulnerable population selection (isVulnerablePopulationSelected = true). The public documentation and submitted materials include subject information and informed consent forms (multiple country/language versions) and recruitment/informed consent procedure documents. Consent is obtained from adult participants using subject information and informed consent forms provided in country-specific languages (and English versions where provided); no pediatric assent procedures are indicated in the public materials..

Vulnerable Population
The trial record flags vulnerable population selection (isVulnerablePopulationSelected = true). The public documentation and submitted materials include subject information and informed consent forms (multiple country/language versions) and recruitment/informed consent procedure documents. Consent is obtained from adult participants using subject information and informed consent forms provided in country-specific languages (and English versions where provided); no pediatric assent procedures are indicated in the public materials.

Inclusion criteria

  • {"criterion_text":"- Patients Entering from the Parent Study: Patients with PNH who have completed, without permanent discontinuation, study treatment in the parent study (R3918-PNH-2021[NCT05133531]), including the post-Open-label treatment period (OLTP) transition period, if applicable.\n- Patients Entering from the Parent Study: Willing and able to comply with clinic visits and study-related procedures, including meningococcal vaccinations required per protocol\n- Patients Entering with C5 polymorphism: Patients with PNH who have a documented C5 polymorphism rendering them refractory to eculizumab or ravulizumab (eg, p.Arg885His, p.Arg885Cys), as described in the protocol\n- Patients Entering with C5 polymorphism: Diagnosis of PNH confirmed by high-sensitivity flow cytometry testing with PNH granulocytes or monocytes\n- Patients Entering with C5 polymorphism: Active disease, as defined by the presence of 1 or more PNH-related sign or symptom as described in the protocol\n- Patients Entering with C5 polymorphism: LDH level ≥2 × upper limit of normal (ULN) at the screening visit\n- Patients Entering with C5 polymorphism: Willing and able to comply with clinic visits and study-related procedures, including meningococcal vaccinations required per protocol"}

Exclusion criteria

  • {"criterion_text":"- Patients Entering from the Parent Study: Significant protocol deviation(s) in the parent study based on the investigator’s judgment and to the extent that these would (if continued) impact the study objectives and/or safety of the patient\n- Patients Entering with C5 polymorphism: Documented history of liver cirrhosis or patients with liver disease with evidence of current impaired liver function or patients with elevations in Alanine aminotransferase (ALT) or Aspartate aminotransferase (AST) (unrelated to PNH or its complications) as described in the protocol Note: Other protocol-defined Inclusion/ Exclusion Criteria apply\n- Patients Entering from the Parent Study: Any new condition or worsening of an existing condition which, in the opinion of the investigator, would make the patient unsuitable for enrollment or could interfere with the patient participating in or completing the study\n- Patients Entering with C5 polymorphism: Prior treatment with complement inhibitors within 5 half-lives of the respective agent prior to screening, except for prior eculizumab or ravulizumab which are not exclusionary\n- Patients Entering with C5 polymorphism: Receipt of an organ transplant, history of bone marrow transplantation or other hematologic transplant\n- Patients Entering with C5 polymorphism: Not meeting meningococcal vaccination requirements and, at a minimum, documentation of quadrivalent meningococcal vaccination within 5 years prior to enrollment and serotype B vaccine within 3 years prior to enrollment as described in the protocol\n- Patients Entering with C5 polymorphism: Positive hepatitis B surface antigen or hepatitis C virus Ribonucleic acid (RNA) during screening\n- Patients Entering with C5 polymorphism: Patients with known HIV with history of opportunistic infections in the last 1 year as described in the protocol\n- Patients Entering with C5 polymorphism: Known hereditary complement deficiency\n- Patients Entering with C5 polymorphism: Documented history of active, uncontrolled, ongoing systemic autoimmune diseases"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Incidence of treatment-emergent serious adverse events (SAEs)\n- Severity of treatment-emergent SAEs\n- Incidence of treatment emergent adverse events of special interest (AESIs)\n- Severity of treatment emergent AESIs\n- Incidence of adverse events (AEs) leading to permanent treatment discontinuation\n- Severity of adverse events (AEs) leading to permanent treatment discontinuation\n- Percent change from baseline in lactate dehydrogenase (LDH)","definition_or_measurement_approach":""}

Secondary endpoints

  • {"endpoint_text":"- Adequate control of hemolysis (LDH ≤1.5 × ULN)\n- Transfusion avoidance\n- Breakthrough hemolysis (defined as LDH ≥2 × ULN [subsequent to initial achievement of LDH ≤1.5 × ULN] concomitant with signs or symptoms associated with hemolysis)\n- Hemoglobin stabilization\n- Percent change in LDH\n- Change in fatigue\n- Change in physical function (PF) scores on the EORTC QLQ-C30\n- Change in GHS/quality of life (QOL) scale on the EORTC QLQ-C30\n- Normalization of LDH\n- Rate of red blood cell (RBC) transfusion\n- Number of units of RBC transfusion\n- Percentage of days with LDH ≤1.5x upper limit of normal (ULN)\n- Change in hemoglobin levels\n- Change in total complement hemolytic activity assay (CH50)\n- Percent change in CH50\n- Concentrations of total pozelimab in serum\n- Concentrations of cemdisiran in plasma\n- Incidence of treatment-emergent anti-drug antibodies to pozelimab\n- Incidence of treatment-emergent anti-drug antibodies to cemdisiran\n- Concentration of total complement component 5 (C5) in plasma\n- Percent change of concentration of total C5 in plasma","definition_or_measurement_approach":"- Adequate control of hemolysis: LDH ≤1.5 × ULN\n- Breakthrough hemolysis: defined as LDH ≥2 × ULN (subsequent to initial achievement of LDH ≤1.5 × ULN) concomitant with signs or symptoms associated with hemolysis\n- Percentage/Percent change endpoints: measured using LDH laboratory values as specified in the endpoint text\n- PRO endpoints (fatigue, PF, GHS/QOL): measured using EORTC QLQ-C30 or specified PRO instruments\n- PK/PD and immunogenicity endpoints (pozelimab, cemdisiran, anti-drug antibodies, C5, CH50): measured by serum/plasma assays as described in the protocol"}

Recruitment

Planned Sample Size
185
Recruitment Window Months
71
Consent Approach
Informed consent is obtained from adult participants via subject information and informed consent forms (multiple country- and language-specific versions are provided). Materials include Main ICFs and variant ICF documents (e.g., FBR, PGX, PP) and recruitment/informed consent procedure documents (K1) for participating countries. Emergency/safety patient cards and translations (English plus local languages such as Italian, Hungarian, Polish, Romanian, Spanish, Greek) are provided. No pediatric assent process is indicated (trial population described as adults).

Methods

  • Patients entering from the parent study R3918-PNH-2021 (NCT05133531) (explicitly stated as source of participants).
  • Site-based recruitment per country-specific recruitment arrangements (recruitment arrangements documents (K1) and ICFs available for Italy, Hungary, Poland, Romania, Spain, Greece).

Geography

Total Number Of Sites
15
Total Number Of Participants
17

Italy

Earliest CTIS Part Ii Submission Date
12-11-2024
Latest Decision Or Authorization Date
03-11-2025
Processing Time Days
356
Number Of Sites
3
Number Of Participants
5

Sites

Site Name
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Department Name
Hematology
Contact Person Name
Simona Sica
Contact Person Email
simona.sica@unicatt.it
Site Name
Azienda Ospedaliera Universitaria Citta Della Salute E Della Scienza Di Torino
Department Name
Hematology
Contact Person Name
Chiara Frairia
Site Name
Azienda Ospedaliero Universitaria Careggi
Department Name
Hematology
Contact Person Name
Barbara Scappini

Hungary

Earliest CTIS Part Ii Submission Date
12-11-2024
Latest Decision Or Authorization Date
04-11-2025
Processing Time Days
357
Number Of Sites
1
Number Of Participants
1

Sites

Site Name
Semmelweis University
Department Name
Hematology
Contact Person Name
Zsolt Nagy

Poland

Earliest CTIS Part Ii Submission Date
12-11-2024
Latest Decision Or Authorization Date
03-11-2025
Processing Time Days
356
Number Of Sites
3
Number Of Participants
4

Sites

Site Name
Instytut Hematologii I Transfuzjologii
Department Name
Klinika Hematologii
Contact Person Name
Bozena Katarzyna Budziszewska
Contact Person Email
bbudziszewska@ihit.waw.pl
Site Name
Uniwersyteckie Centrum Kliniczne
Department Name
Klinika Hematologii i Transplantologii
Contact Person Name
Agnieszka Piekarska
Site Name
In Vivo Sp. z o.o.
Department Name
In Vivo Sp. z o.o.
Contact Person Name
Jaroslaw Czyz
Contact Person Email
jczyz@onet.pl

Romania

Earliest CTIS Part Ii Submission Date
12-11-2024
Latest Decision Or Authorization Date
04-11-2025
Processing Time Days
357
Number Of Sites
3
Number Of Participants
2

Sites

Site Name
Spitalul Clinic Judetean De Urgenta Targu Mures
Department Name
Hematology
Contact Person Name
Ioan Macarie
Contact Person Email
ioan.macarie@umfst.ro
Site Name
Spitalul Clinic Municipal Filantropia Craiova
Department Name
Hematology
Contact Person Name
Luminita Ocroteala
Contact Person Email
diaconu_luminita@yahoo.com
Site Name
Institute Of Oncology Prof. Dr. Ion Chiricuta Cluj-Napoca
Department Name
Hematology
Contact Person Name
IOANA- CODRUTA RUS
Contact Person Email
codruta_21@yahoo.com

Spain

Earliest CTIS Part Ii Submission Date
12-11-2024
Latest Decision Or Authorization Date
04-11-2025
Processing Time Days
357
Number Of Sites
4
Number Of Participants
4

Sites

Site Name
Hospital Clinic De Barcelona
Department Name
Hematology
Contact Person Name
Anna Gaya Valls
Contact Person Email
agayav@clinic.cat
Site Name
Hospital Universitario Basurto
Department Name
Hematology
Contact Person Name
Cristina Barrenetxea
Contact Person Email
cristina.barrene@gmail.com
Site Name
Hospital General Universitario Morales Meseguer
Department Name
Hematology Service
Contact Person Name
Maria Luisa Lozano Almela
Contact Person Email
mllozano@um.es
Site Name
Hospital Universitario De Salamanca
Department Name
Hematology Service
Contact Person Name
Maria Belén Vidriales Vicente
Contact Person Email
mbvidri@usal.es

Greece

Earliest CTIS Part Ii Submission Date
12-11-2024
Latest Decision Or Authorization Date
04-11-2025
Processing Time Days
357
Number Of Sites
1
Number Of Participants
1

Sites

Site Name
Geniko Nosokomeio Thessalonikis George Papanikolaou
Department Name
Hematology
Contact Person Name
Chrysavgi Lalayanni
Contact Person Email
luizana6@gmail.com

Sponsor

Primary sponsor

Full Name
Regeneron Pharmaceuticals Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
Ppd Inc.
Responsibilities
CRO
Name
PPD Global Ltd.
Responsibilities
CRO
Name
Pharmaceutical Product Development LLC
Name
Parexel International (IRL) Limited
Responsibilities
Sites contract management

Third parties

  • {"country":"United States","full_name":"Yprime LLC","duties_or_roles":"","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Iqvia Holdings Inc.","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Fisher Clinical Services Inc.","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Jumo Health USA Inc.","duties_or_roles":"Study logo creation, design, branding, site toolkit and 2D animation.","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"United States","full_name":"Signant Health LLC","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Yourway Transport Inc.","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Charles River Laboratories Inc.","duties_or_roles":"Specialty Lab Services","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Labcorp Early Development Laboratories Inc.","duties_or_roles":"Specialty Lab Services","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Pharmaceutical Product Development LLC","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
  • {"country":"Ireland","full_name":"Parexel International (IRL) Limited","duties_or_roles":"Sites contract management","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Ppd Inc.","duties_or_roles":"CRO","organisation_type":"Pharmaceutical company"}
  • {"country":"Greece","full_name":"PPD Global Ltd.","duties_or_roles":"CRO","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
Cemdisiran
Active Substance
CEMDISIRAN
Modality
Oligonucleotide
Routes Of Administration
SUBCUTANEOUS INJECTION
Route
SUBCUTANEOUS INJECTION
Authorisation Status
Authorised
Orphan Designation
Yes
Investigational Product Name
Pozelimab
Active Substance
POZELIMAB
Modality
Monoclonal antibody
Routes Of Administration
SUBCUTANEOUS USE
Route
SUBCUTANEOUS USE
Authorisation Status
Authorised
Combination Treatment
Yes

Related trials

Other published trials that may interest you.