Clinical trial • Phase III • Haematology

MITAPIVAT for Non-transfusion-dependent alpha thalassemia | Non-transfusion-dependent beta thalassemia

Phase III trial of MITAPIVAT for Non-transfusion-dependent alpha thalassemia | Non-transfusion-dependent beta thalassemia.

Overview

Trial Therapeutic Area
Haematology
Trial Disease
Non-transfusion-dependent alpha thalassemia | Non-transfusion-dependent beta thalassemia
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
25-06-2024
First CTIS Authorization Date
23-07-2024

Trial design

Randomised, placebo for mitapivat (oral placebo arm). dose and schedule not specified in the available data.-controlled Phase III trial in Denmark, Bulgaria, France and others.

Randomised
Yes
Comparator
Placebo for Mitapivat (oral placebo arm). Dose and schedule not specified in the available data.
Target Sample Size
86

Eligibility

Recruits 86 Vulnerable population selected. Written informed consent is required from each participant prior to any study-related procedures. There is a specific informed consent document for holders of parental authority (document: 'L1_SIS and ICF Holders of parental authority_Redacted'). Subjects who are institutionalized by regulatory or court order or who have conditions that could create undue influence (including incarceration and involuntary psychiatric confinement) are excluded..

Pregnancy Exclusion
Pregnant, breastfeeding, or parturient.
Vulnerable Population
Vulnerable population selected. Written informed consent is required from each participant prior to any study-related procedures. There is a specific informed consent document for holders of parental authority (document: 'L1_SIS and ICF Holders of parental authority_Redacted'). Subjects who are institutionalized by regulatory or court order or who have conditions that could create undue influence (including incarceration and involuntary psychiatric confinement) are excluded.

Inclusion criteria

  • {"criterion_text":"- ≥18 years of age at the time of providing informed consent."}
  • {"criterion_text":"- Documented diagnosis of thalassemia (β-thalassemia with or without α-globin gene mutations, HbE/β-thalassemia, or α-thalassemia/HbH disease) based on Hb electrophoresis, Hb high-performance liquid chromatography, and/or DNA analysis from the subject’s medical record. If this information is not available from the subject’s medical record, the test(s) can be performed by a local laboratory during the Screening Period. If a local laboratory is unable to perform the test(s), results from the comprehensive α- and β-globin genotyping performed by the study central laboratory can be used."}
  • {"criterion_text":"- Hb concentration ≤10.0 g/dL (100.0 g/L), based on an average of at least 2 Hb concentration measurements (separated by ≥7 days) collected during the Screening Period."}
  • {"criterion_text":"- Non–transfusion dependent, defined as: ≤5 red blood cell (RBC) units during the 24-week period before randomization and no RBC transfusions ≤8 weeks before providing informed consent and no RBC transfusions during the Screening Period."}
  • {"criterion_text":"- If taking hydroxyurea, the hydroxyurea dose must be stable for ≥16 weeks before randomization."}
  • {"criterion_text":"- Women of childbearing potential (WOCBP) must be abstinent of sexual activities that may result in pregnancy as part of their usual lifestyle or agree to use 2 forms of contraception, 1 of which must be considered highly effective, from the time of providing informed consent, throughout the study, and for 28 days after the last dose of study drug. The second form of contraception can be an acceptable barrier method."}
  • {"criterion_text":"- Written informed consent before any study-related procedures are conducted and willing to comply with all study procedures for the duration of the study."}

Exclusion criteria

  • {"criterion_text":"- Pregnant, breastfeeding, or parturient."}
  • {"criterion_text":"- Nonfasting triglycerides >440 mg/dL (5 mmol/L)."}
  • {"criterion_text":"- Active infection requiring systemic antimicrobial therapy at the time of providing informed consent. If antimicrobial therapy is required during the Screening Period, screening procedures should not be performed while antimicrobial therapy is being administered, and the last dose of antimicrobial therapy must be administered ≥7 days before randomization."}
  • {"criterion_text":"- Positive test for hepatitis C virus (HCV) antibody (Ab) with evidence of active HCV infection, or positive test for hepatitis B surface antigen."}
  • {"criterion_text":"- Positive test for HIV-1 Ab or HIV-2 Ab."}
  • {"criterion_text":"- History of major surgery (including splenectomy) ≤16 weeks before providing informed consent and/or a major surgical procedure planned during the study."}
  • {"criterion_text":"- Current enrollment or past participation (≤12 weeks before administration of the first dose of study drug or a time frame equivalent to 5 half-lives of the investigational study drug, whichever is longer) in any other clinical study involving an investigational treatment or device."}
  • {"criterion_text":"- Receiving strong cytochrome P450 (CYP)3A4/5 inhibitors that have not been stopped for ≥5 days or a time frame equivalent to 5 half-lives (whichever is longer), or strong CYP3A4 inducers that have not been stopped for ≥4 weeks or a time frame equivalent to 5 half-lives (whichever is longer), before randomization."}
  • {"criterion_text":"- Receiving anabolic steroids, that have not been stopped for at least 4 weeks before randomization. Testosterone replacement therapy to treat hypogonadism is allowed; the testosterone dose and preparation must be stable for ≥10 weeks before randomization."}
  • {"criterion_text":"- Known allergy, or other contraindication, to mitapivat or its excipients (microcrystalline cellulose, croscarmellose sodium, sodium stearyl fumarate, mannitol, magnesium stearate, and Opadry® II Blue [hypromellose, titanium dioxide, lactose monohydrate, triacetin, and FD&C Blue #2])."}
  • {"criterion_text":"- Any medical, hematological, psychological, or behavioral condition(s) or prior or current therapy that, in the opinion of the Investigator, may confer an unacceptable risk to participating in the study and/or could confound the interpretation of the study data. Also excluded are: • Subjects who are institutionalized by regulatory or court order • Subjects with any condition(s) that could create undue influence (including but not limited to incarceration, involuntary psychiatric confinement, and financial or familial affiliation with the Investigator or Sponsor)."}
  • {"criterion_text":"- Documented history of homozygous or heterozygous HbS or HbC."}
  • {"criterion_text":"- Prior exposure to gene therapy or prior bone marrow or stem cell transplantation."}
  • {"criterion_text":"- Currently receiving treatment with luspatercept; the last dose must have been administered ≥18 weeks before randomization."}
  • {"criterion_text":"- Currently receiving treatment with hematopoietic stimulating agents; the last dose must have been administered ≥18 weeks before randomization."}
  • {"criterion_text":"- History of malignancy (active or treated) ≤5 years before providing informed consent, except for nonmelanomatous skin cancer in situ, cervical carcinoma in situ, or breast carcinoma in situ."}
  • {"criterion_text":"- History of active and/or uncontrolled cardiac or pulmonary disease ≤6 months before providing informed consent, including but not limited to: a. New York Heart Association Class III or IV heart failure or clinically significant dysrhythmia b. Myocardial infarction or unstable angina pectoris; hemorrhagic, embolic, or thrombotic stroke; deep venous thrombosis; or pulmonary or arterial embolism c. Heart rate–corrected QT interval using Fridericia’s method ≥450 milliseconds (males) or ≥470 milliseconds (females), except for right or left bundle branch block d. Severe pulmonary fibrosis as defined by severe hypoxia, evidence of right-sided heart failure, and radiographic pulmonary fibrosis >50% e. Severe pulmonary hypertension as defined by severe symptoms associated with hypoxia, right-sided heart failure, and oxygen indicated"}
  • {"criterion_text":"- Hepatobiliary disorders, including but not limited to: a. Liver disease with histopathological evidence of cirrhosis or severe fibrosis b. Clinically symptomatic cholelithiasis or cholecystitis (prior cholecystectomy is not exclusionary) c. History of drug-induced cholestatic hepatitis d. Aspartate aminotransferase >2.5 × upper limit of normal (ULN); unless due to hemolysis and hepatic iron deposition) and alanine aminotransferase >2.5 × ULN (unless due to hepatic iron deposition)."}
  • {"criterion_text":"- Estimated glomerular filtration rate <45 mL/min/1.73 m2 by Chronic Kidney Disease Epidemiology Collaboration creatinine equation."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Hemoglobin (Hb) response, defined as a ≥1.0 g/dL increase in average Hb concentration from Week 12 through Week 24 compared with baseline","definition_or_measurement_approach":"Average Hb concentration measured from Week 12 through Week 24 compared with baseline; endpoint defined as ≥1.0 g/dL increase."}

Recruitment

Digital Remote Recruitment
Yes
Planned Sample Size
86
Recruitment Window Months
87
Consent Approach
Written informed consent required before any study-related procedures. Participant provides consent. There are country/language-specific ICFs and SIS documents (examples in the public documents list include English, Bulgarian, Dutch, French, Greek, Spanish, Italian versions). A specific ICF for holders of parental authority is present ('L1_SIS and ICF Holders of parental authority_Redacted'). eConsent support is provided (Medidata Solutions listed with duties 'ePRO, eConsent').

Geography

Total Number Of Sites
23
Total Number Of Participants
86

Denmark

Earliest CTIS Part Ii Submission Date
04-07-2024
Latest Decision Or Authorization Date
28-10-2025
Processing Time Days
481
Number Of Sites
1
Number Of Participants
6

Sites

Site Name
Rigshospitalet
Department Name
Department of Heamatology
Principal Investigator Name
Andreas Glenthøj
Principal Investigator Email
andreas.glenthoej@regionh.dk
Contact Person Name
Andreas Glenthøj
Contact Person Email
andreas.glenthoej@regionh.dk

Bulgaria

Earliest CTIS Part Ii Submission Date
04-07-2024
Latest Decision Or Authorization Date
03-11-2025
Processing Time Days
487
Number Of Sites
2
Number Of Participants
3

Sites

Site Name
National Specialised Hospital For Active Treatment Of Haematological Diseases
Department Name
Department of Hematopoietic Stem Cell Transplantation
Principal Investigator Name
Penka Ganeva
Principal Investigator Email
ganevapenka@yahoo.com
Contact Person Name
Penka Ganeva
Contact Person Email
ganevapenka@yahoo.com
Site Name
Multiprofile Hospital For Active Treatment Dr Nikola Vasiliev AD
Department Name
Department of Transfusion Hematology
Principal Investigator Name
Desislava Ilieva-Chiviyska
Principal Investigator Email
dr.desislava.ilieva.chiviyska@gmail.com
Contact Person Name
Desislava Ilieva-Chiviyska

France

Earliest CTIS Part Ii Submission Date
04-07-2024
Latest Decision Or Authorization Date
30-10-2025
Processing Time Days
483
Number Of Sites
2
Number Of Participants
6

Sites

Site Name
Hospices Civils De Lyon
Department Name
Hematology
Principal Investigator Name
Giovanna Cannas
Principal Investigator Email
giovanna.cannas@chu-lyon.fr
Contact Person Name
Giovanna Cannas
Contact Person Email
giovanna.cannas@chu-lyon.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Hematology
Principal Investigator Name
Pablo Bartolucci
Principal Investigator Email
pablo.bartolucci@aphp.fr
Contact Person Name
Pablo Bartolucci
Contact Person Email
pablo.bartolucci@aphp.fr

Italy

Earliest CTIS Part Ii Submission Date
04-07-2024
Latest Decision Or Authorization Date
29-10-2025
Processing Time Days
482
Number Of Sites
8
Number Of Participants
29

Sites

Site Name
Azienda Sanitaria Locale Br
Department Name
U.O.C di Ematologia
Principal Investigator Name
Domenico Pastore
Principal Investigator Email
domenico.pastore0@gmail.com
Contact Person Name
Domenico Pastore
Contact Person Email
domenico.pastore0@gmail.com
Site Name
Azienda Ospedaliero-Universitaria San Luigi Gonzaga
Department Name
SSD Microcitemie
Principal Investigator Name
Giovanni Battista Ferrero
Principal Investigator Email
giovannibattista.ferrero@unito.it
Contact Person Name
Giovanni Battista Ferrero
Site Name
Ente Ospedaliero Ospedali Galliera Di Genova
Department Name
S.S.D. Microcitemia Anemie Congenite e Dismetabolismo del ferro
Principal Investigator Name
Manuela Balocco
Principal Investigator Email
manuela.balocco@galliera.it
Contact Person Name
Manuela Balocco
Contact Person Email
manuela.balocco@galliera.it
Site Name
Azienda Ospedaliera Universita' Degli Studi Della Campania Luigi Vanvitelli
Department Name
DAI Materno Infantile
Principal Investigator Name
Silverio Perrotta
Principal Investigator Email
roberto.alfano@unicampania.it
Contact Person Name
Silverio Perrotta
Contact Person Email
roberto.alfano@unicampania.it
Site Name
Azienda Ospedaliera Di Rilievo Nazionale Antonio Cardarelli
Department Name
UOSD Malattie Rare del Globulo Rosso
Principal Investigator Name
Paolo Ricchi
Principal Investigator Email
paolo.ricchi@aocardarelli.it
Contact Person Name
Paolo Ricchi
Contact Person Email
paolo.ricchi@aocardarelli.it
Site Name
Azienda Socio Sanitaria Locale N. 8 Di Cagliari
Department Name
SC Microcitemie e Anemie Rare
Principal Investigator Name
Raffaella Origa
Principal Investigator Email
raffaella.origa@unica.it
Contact Person Name
Raffaella Origa
Contact Person Email
raffaella.origa@unica.it
Site Name
Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico
Department Name
Attività Diurne Malattie Rare Internistiche - Medicina Generale
Principal Investigator Name
Elena Cassiniero
Principal Investigator Email
elena.cassinerio@policlinico.mi.it
Contact Person Name
Elena Cassiniero
Site Name
University Hospital Of Ferrara
Department Name
Day Hospital della Talassemia e delle Emoglobinopatie
Principal Investigator Name
Filonema Longo
Principal Investigator Email
filomena.longo@ospfe.it
Contact Person Name
Filonema Longo
Contact Person Email
filomena.longo@ospfe.it

Netherlands

Earliest CTIS Part Ii Submission Date
04-07-2024
Latest Decision Or Authorization Date
29-10-2025
Processing Time Days
482
Number Of Sites
2
Number Of Participants
4

Sites

Site Name
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Department Name
Department of Hematology, office Na 810
Principal Investigator Name
Anita Rijneveld
Principal Investigator Email
a.rijneveld@erasmusmc.nl
Contact Person Name
Anita Rijneveld
Contact Person Email
a.rijneveld@erasmusmc.nl
Site Name
Universitair Medisch Centrum Utrecht
Department Name
Hematology
Principal Investigator Name
Eduard van Beers
Principal Investigator Email
E.J.vanBeers-3@umcutrecht.nl
Contact Person Name
Eduard van Beers
Contact Person Email
E.J.vanBeers-3@umcutrecht.nl

Greece

Earliest CTIS Part Ii Submission Date
04-07-2024
Latest Decision Or Authorization Date
30-10-2025
Processing Time Days
483
Number Of Sites
4
Number Of Participants
23

Sites

Site Name
Ippokratio General Hospital Of Thessaloniki
Department Name
Mediterranean Anemia Adult Unit,B' Pathology Clinic
Principal Investigator Name
Efthymia Vlachaki
Principal Investigator Email
efivlachaki@yahoo.gr
Contact Person Name
Efthymia Vlachaki
Contact Person Email
efivlachaki@yahoo.gr
Site Name
General University Hospital Of Patras
Department Name
Hematology Department, Unit of Mediterranean Anemia & Hemoglobinopathies
Principal Investigator Name
Alexandros Spryridonidis
Principal Investigator Email
spyridonidis@upatras.gr
Contact Person Name
Alexandros Spryridonidis
Contact Person Email
spyridonidis@upatras.gr
Site Name
Nosokomeio Paidon I Agia Sofia
Department Name
A’ Pediatric Clinic of NKUA, Unit of Mediterranean Anemia
Principal Investigator Name
Antonis Kattamis
Principal Investigator Email
ankatt@med.uoa.gr
Contact Person Name
Antonis Kattamis
Contact Person Email
ankatt@med.uoa.gr
Site Name
Laiko General Hospital Of Athens
Department Name
Center for Mediterranean Anemia
Principal Investigator Name
Maria Dimopoulou
Principal Investigator Email
mdimkma@gmail.com
Contact Person Name
Maria Dimopoulou
Contact Person Email
mdimkma@gmail.com

Spain

Earliest CTIS Part Ii Submission Date
04-07-2024
Latest Decision Or Authorization Date
26-01-2026
Processing Time Days
571
Number Of Sites
4
Number Of Participants
15

Sites

Site Name
Hospital Universitario La Paz
Department Name
Hematology
Principal Investigator Name
Ana Mendoza Martínez
Principal Investigator Email
amendozam.externo@salud.madrid.org
Contact Person Name
Ana Mendoza Martínez
Site Name
Hospital Universitari Vall D Hebron
Department Name
Hematology
Principal Investigator Name
David Beneitez Pastor
Principal Investigator Email
david.beneitez@vallhebron.cat
Contact Person Name
David Beneitez Pastor
Contact Person Email
david.beneitez@vallhebron.cat
Site Name
University Clinical Hospital Virgen De La Arrixaca
Department Name
Hematology
Principal Investigator Name
Eduardo Salido Fierrez
Principal Investigator Email
eduardoj.salido@carm.es
Contact Person Name
Eduardo Salido Fierrez
Contact Person Email
eduardoj.salido@carm.es
Site Name
University Hospital Virgen Del Rocio S.L.
Department Name
Hematology
Principal Investigator Name
Salvador Payán-Pernía
Principal Investigator Email
sppayan@gmail.com
Contact Person Name
Salvador Payán-Pernía
Contact Person Email
sppayan@gmail.com

Sponsor

Primary sponsor

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

Contract research organisations

Name
Fortrea Development Ltd. Branch Of Foreign Company
Responsibilities
CRO

Third parties

  • {"country":"United States","full_name":"Intrinsic Lifesciences LLC","duties_or_roles":"Exploratory biomarkers","organisation_type":"Pharmaceutical company"}
  • {"country":"Greece","full_name":"Fortrea Development Ltd. Branch Of Foreign Company","duties_or_roles":"CRO","organisation_type":"Pharmaceutical company"}
  • {"country":"Belgium","full_name":"PPD Global Central Labs","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"Fortrea Development Limited","duties_or_roles":"IDMC","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"FCB Health New York","duties_or_roles":"Patient recruitment materials","organisation_type":"Industry"}
  • {"country":"United States","full_name":"Medidata Solutions","duties_or_roles":"ePRO, eConsent","organisation_type":"Health care"}
  • {"country":"United States","full_name":"Bioclinica Inc.","duties_or_roles":"Medical image analysis","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Endpoint Clinical Inc.","duties_or_roles":"IVRS – treatment randomisation","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Lumanity Patient Centered Outcomes LLC","duties_or_roles":"Exit Interview","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"Germany","full_name":"Centogene GmbH","duties_or_roles":"Targeted Genotyping","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"Belgium","full_name":"AAC/Proximus","duties_or_roles":"24 Hour Medical support Coverage","organisation_type":"Industry"}
  • {"country":"United States","full_name":"CPC","duties_or_roles":"6-minute Walk Test","organisation_type":"Industry"}
  • {"country":"United States","full_name":"Firma Clinical Research","duties_or_roles":"Home health nursing","organisation_type":"Industry"}
  • {"country":"United Kingdom (Northern Ireland)","full_name":"Almac Pharma Services Limited","duties_or_roles":"Drug Depot/Investigational Product Supply","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"QPS LLC","duties_or_roles":"pharmacokinetics and pharmacodynamics","organisation_type":"Pharmaceutical company"}
  • {"country":"Philippines","full_name":"Pharmaceutical Product Development","duties_or_roles":"","organisation_type":"Industry"}

Investigational products

Investigational Product Name
MITAPIVAT
Active Substance
MITAPIVAT
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
ORAL USE
Authorisation Status
Authorised
Investigational Product Name
Placebo for Mitapivat
Modality
Other
Routes Of Administration
ORAL USE
Route
ORAL USE

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