Clinical trial • Phase III • Respiratory | Haematology

TOCILIZUMAB for Sickle cell disease

Phase III trial of TOCILIZUMAB for Sickle cell disease.

Overview

Trial Therapeutic Area
Respiratory | Haematology
Trial Disease
Sickle cell disease
Trial Stage
Phase III
Drug Modality
Monoclonal antibody | Small molecule
Paediatric Trial
Yes

Key dates

Initial CTIS Submission Date
17-06-2024
First CTIS Authorization Date
08-10-2024

Trial design

Randomised, tocilizumab: single intravenous infusion at 8 mg/kg for patients ≥ 30 kg (up to a maximum of 800 mg) and 12 mg/kg for patients < 30 kg; comparator: placebo (chlorure de sodium 0,9 % b. braun, solution injectable en ampoule) administered as an intravenous infusion (single infusion to match active treatment).-controlled Phase III trial in France.

Randomised
Yes
Comparator
Tocilizumab: single intravenous infusion at 8 mg/kg for patients ≥ 30 kg (up to a maximum of 800 mg) and 12 mg/kg for patients < 30 kg; Comparator: placebo (CHLORURE DE SODIUM 0,9 % B. BRAUN, solution injectable en ampoule) administered as an intravenous infusion (single infusion to match active treatment).
Target Sample Size
130
Trial Duration For Participant
90

Eligibility

Recruits 130 paediatric patients.

Pregnancy Exclusion
Pregnancy or breastfeeding
Vulnerable Population
Children are included (age ≥ 2 years). The trial requires freely given, informed and written consent of the patient or legal representatives. Age-specific subject information and informed consent forms are provided (documents referencing ages 6-11 and 12-17, parental/guardian authorization forms and assent/consent materials are included), indicating procedures for parental/guardian authorization and minor assent.

Inclusion criteria

  • {"criterion_text":"- SCD patient of all genotypes (SS, SC, S/β0 and S/β+) or other major SCD syndrome\n- Age ≥ 2 years old\n- Hospitalised for ACS, defined by the WHO as the association of fever and/or acute respiratory symptoms with a new pulmonary infiltrate on chest imaging, (X-ray, lung ultrasound, or CT scan)\n- Requiring supplemental oxygen ≥ 2 L/min for SpO2 ≥ 95% or non-invasive respiratory support (high flow nasal oxygen or continuous positive airway pressure or bilevel non-invasive ventilation) or invasive mechanical ventilation or ECMO, for less than 48 hours\n- Negative pregnancy test for girls or women of childbearing age (15-50 years old)\n- Freely given, informed and written consent of patient or legal representatives\n- Affiliation to the social security (or health insurance)\n- Effective contraception up to 6 months after treatment administration"}

Exclusion criteria

  • {"criterion_text":"- Impossibility to perform tocilizumab/placebo injection within the first 48 hours of supplemental oxygen ≥2L/min or for SpO2≥95% and/or respiratory support (as defined in inclusion criteria n°4). If exchange transfusion is indicated at inclusion, it has to be performed before the injection of tocilizumab/placebo.\n- Imminent and inevitable progression towards death in the opinion of the investigator\n- Absolute neutrophil count < 1.0 G/L or platelets < 50 G/L\n- ALT or AST > 5 fold the upper limit of normal\n- Glomerular Filtration rate (GFR) < 60 mL/min/1,73 m²)\n- History of bowel diverticulitis or gastrointestinal perforation\n- Immunomodulatory or anti-rejection therapy within the last 3 months\n- Current enrolment in another interventional research concerning a medicinal product for human use\n- Known hypersensitivity to tocilizumab or its excipients\n- Known active current severe bacterial, viral, fungal, mycobacterial, or other infections (including but not limited to tuberculosis and atypical mycobacterial disease, hepatitis B and C, and herpes zoster)\n- Immunization with a live/attenuated vaccine within the last 4 weeks\n- Immunomodulatory therapy, anti-rejection therapy, cell depleting therapies and investigational agents within the last 3 months\n- History of severe allergic or anaphylactic reactions to human, humanized, or murine monoclonal antibodies\n- History of diverticulitis, diverticulosis requiring antibiotic treatment, or chronic ulcerative lower gastrointestinal disease such as Crohn's disease, ulcerative colitis, or other symptomatic lower gastrointestinal conditions that might predispose a patient to perforations\n- Evidence of malignant disease or malignancies diagnosed within the last 3 years\n- Pregnancy or breastfeeding"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Time to successful weaning from both supplemental oxygen and any respiratory support, defined as SpO2 ≥ 95% without oxygen during the next 24 hours, and spontaneous breathing without any respiratory support (non-invasive or invasive) during the next 48 hours.","definition_or_measurement_approach":"Time-to-event endpoint: time from randomisation/investigational injection to achievement of the defined weaning criteria (SpO2 ≥ 95% without oxygen for 24 hours and spontaneous breathing without respiratory support for 48 hours)."}

Recruitment

Planned Sample Size
130
Recruitment Window Months
27
Consent Approach
Informed and written consent required from the patient or legal representatives. Age-specific subject information and consent/assent forms are provided (including forms for ages 6-11 and 12-17, parental/guardian authorization forms, adult ICF and proxy forms). The documentation set includes multiple subject information and informed consent form versions and parental authorization forms indicating procedures for assent and parental consent.

Geography

Total Number Of Sites
38
Total Number Of Participants
130

France

Earliest CTIS Part Ii Submission Date
29-08-2024
Latest Decision Or Authorization Date
13-03-2026
Processing Time Days
561
Number Of Sites
38
Number Of Participants
130

Sites

Site Name
Assistance Publique Hopitaux De Paris
Department Name
Internal Medicine
Principal Investigator Name
Aline SANTIN
Principal Investigator Email
aline.santin@aphp.fr
Contact Person Name
Aline SANTIN
Contact Person Email
aline.santin@aphp.fr
Site Name
Centre Hospitalier Universitaire Rouen
Department Name
Paediatric intensive care
Principal Investigator Name
Aurélie LABARRE
Principal Investigator Email
aurelie.labarre@chu-rouen.fr
Contact Person Name
Aurélie LABARRE
Contact Person Email
aurelie.labarre@chu-rouen.fr
Site Name
Centre Hospitalier Universitaire De Toulouse
Department Name
Internal Medicine
Principal Investigator Name
Pierre COUGOUL
Principal Investigator Email
cougoul.pierre@iuct-oncopole.fr
Contact Person Name
Pierre COUGOUL
Site Name
Centre Hospitalier Universitaire Rouen
Department Name
Paediatric Haematology
Principal Investigator Name
Cécile DUMESNIL
Principal Investigator Email
cecile.dumesnil@chu-rouen.fr
Contact Person Name
Cécile DUMESNIL
Contact Person Email
cecile.dumesnil@chu-rouen.fr
Site Name
Centre Hospitalier Universitaire Rouen
Department Name
Intensive care
Principal Investigator Name
Maximilien GRALL
Principal Investigator Email
maximilien.grall@chu-rouen.fr
Contact Person Name
Maximilien GRALL
Contact Person Email
maximilien.grall@chu-rouen.fr
Site Name
Centre Hospitalier Intercommunal Creteil
Department Name
Intensive care
Principal Investigator Name
Francesca SANTI
Principal Investigator Email
francesca.santi@chicreteil.fr
Contact Person Name
Francesca SANTI
Contact Person Email
francesca.santi@chicreteil.fr
Site Name
Centre Hospitalier Universitaire Rouen
Department Name
Internal Medicine
Principal Investigator Name
Maximilien GRALL
Principal Investigator Email
maximilien.grall@chu-rouen.fr
Contact Person Name
Maximilien GRALL
Contact Person Email
maximilien.grall@chu-rouen.fr
Site Name
Centre Hospitalier Intercommunal Creteil
Department Name
Internal Medicine
Principal Investigator Name
Isabelle GENTY
Principal Investigator Email
isabelle.genty@chicreteil.fr
Contact Person Name
Isabelle GENTY
Contact Person Email
isabelle.genty@chicreteil.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Intensive care
Principal Investigator Name
Armand MEKONTSO DESSAP
Principal Investigator Email
armand.dessap@aphp.fr
Contact Person Name
Armand MEKONTSO DESSAP
Contact Person Email
armand.dessap@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Internal Medicine
Principal Investigator Name
Jean-Benoit ARLET
Principal Investigator Email
jean-benoit.arlet@aphp.fr
Contact Person Name
Jean-Benoit ARLET
Contact Person Email
jean-benoit.arlet@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Paediatric intensive care
Principal Investigator Name
Jordi MIATELLO
Principal Investigator Email
jordi.matiello@aphp.fr
Contact Person Name
Jordi MIATELLO
Contact Person Email
jordi.matiello@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Intensive care
Principal Investigator Name
Damien ROUX
Principal Investigator Email
damien.roux@aphp.fr
Contact Person Name
Damien ROUX
Contact Person Email
damien.roux@aphp.fr
Site Name
Centre Hospitalier Universitaire De Toulouse
Department Name
Paediatric intensive care
Principal Investigator Name
Sonia PELLUAU
Principal Investigator Email
pelluau.s@chu-toulouse.fr
Contact Person Name
Sonia PELLUAU
Contact Person Email
pelluau.s@chu-toulouse.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Downstream Emergency department
Principal Investigator Name
Henri GUILLET
Principal Investigator Email
henri.guillet@aphp.fr
Contact Person Name
Henri GUILLET
Contact Person Email
henri.guillet@aphp.fr
Site Name
Hospices Civils De Lyon
Department Name
Internal Medicine
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
Intensive care
Principal Investigator Name
Laurent GUERIN
Principal Investigator Email
laurent.geurin@aphp.fr
Contact Person Name
Laurent GUERIN
Contact Person Email
laurent.geurin@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Internal Medicine
Principal Investigator Name
Stéphanie GUILLET
Principal Investigator Email
stephanie.guillet@aphp.fr
Contact Person Name
Stéphanie GUILLET
Contact Person Email
stephanie.guillet@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Genetic Red Blood Cell Disease/ Internal Medicine
Principal Investigator Name
Anoosha HABIBI
Principal Investigator Email
anoosha.habibi@aphp.fr
Contact Person Name
Anoosha HABIBI
Contact Person Email
anoosha.habibi@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Internal Medicine
Principal Investigator Name
Christelle CHANTALAT AUGER
Principal Investigator Email
christelle.chantalat@aphp.fr
Contact Person Name
Christelle CHANTALAT AUGER
Contact Person Email
christelle.chantalat@aphp.fr
Site Name
Centre Hospitalier Universitaire De Toulouse
Department Name
Paediatric Haematology
Principal Investigator Name
Marie-Pierre CASTEX
Principal Investigator Email
castex.mp@chu-toulouse.fr
Contact Person Name
Marie-Pierre CASTEX
Contact Person Email
castex.mp@chu-toulouse.fr
Site Name
Centre Hospitalier Regional De Marseille
Department Name
Internal Medicine
Principal Investigator Name
Estelle JEAN-MIGNARD
Principal Investigator Email
estelle.jean@ap-hm.fr
Contact Person Name
Estelle JEAN-MIGNARD
Contact Person Email
estelle.jean@ap-hm.fr
Site Name
Centre Hospitalier Intercommunal Creteil
Department Name
Paediatrics
Principal Investigator Name
Céline DELESTRAIN
Principal Investigator Email
celine.delestrain@chicreteil.fr
Contact Person Name
Céline DELESTRAIN
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Paediatrics
Principal Investigator Name
Corinne GUITTON
Principal Investigator Email
corinne.guitton@aphp.fr
Contact Person Name
Corinne GUITTON
Contact Person Email
corinne.guitton@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Infectious and tropical disease/Clinical Immunology
Principal Investigator Name
William VINDRIOS
Principal Investigator Email
william.vindrios@aphp.fr
Contact Person Name
William VINDRIOS
Contact Person Email
william.vindrios@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Paediatric intensive care
Principal Investigator Name
Pierre-Louis LEGER
Principal Investigator Email
pierre-louis.leger@aphp.fr
Contact Person Name
Pierre-Louis LEGER
Contact Person Email
pierre-louis.leger@aphp.fr
Site Name
Centre Hospitalier Universitaire De Toulouse
Department Name
Intensive care
Principal Investigator Name
Jean RUIZ
Principal Investigator Email
ruiz.jean@chu-toulouse.fr
Contact Person Name
Jean RUIZ
Contact Person Email
ruiz.jean@chu-toulouse.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Paediatrics
Principal Investigator Name
Bérengère KOEHL
Principal Investigator Email
berengere.koehl@aphp.fr
Contact Person Name
Bérengère KOEHL
Contact Person Email
berengere.koehl@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Internal Medicine
Principal Investigator Name
Louis AFFO
Principal Investigator Email
louis.affo@aphp.fr
Contact Person Name
Louis AFFO
Contact Person Email
louis.affo@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Intensive care
Principal Investigator Name
Johanna OZIEL
Principal Investigator Email
johanna.oziel@aphp.fr
Contact Person Name
Johanna OZIEL
Contact Person Email
johanna.oziel@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Intensive care
Principal Investigator Name
Jean-Benoit ARLET
Principal Investigator Email
jean-benoit.arlet@aphp.fr
Contact Person Name
Jean-Benoit ARLET
Contact Person Email
jean-benoit.arlet@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Paediatric intensive care
Principal Investigator Name
Claire HEILBRONNER
Principal Investigator Email
claire.heilbronner@aphp.fr
Contact Person Name
Claire HEILBRONNER
Contact Person Email
claire.heilbronner@aphp.fr
Site Name
Hospices Civils De Lyon
Department Name
Intensive care
Principal Investigator Name
Marion CALMETTES
Principal Investigator Email
marion.calmettes@chu-lyon.fr
Contact Person Name
Marion CALMETTES
Contact Person Email
marion.calmettes@chu-lyon.fr

Sponsor

Primary sponsor

Full Name
Assistance Publique Hopitaux De Paris
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
France

Investigational products

Investigational Product Name
TOCILIZUMAB
Active Substance
TOCILIZUMAB
Modality
Monoclonal antibody
Routes Of Administration
Intravenous infusion
Route
Intravenous infusion
Starting Dose
8 mg/kg (patients ≥ 30 kg, up to a maximum of 800 mg) and 12 mg/kg (patients < 30 kg)
Dose Levels
Single-dose weight-based: 8 mg/kg (≥30 kg) / 12 mg/kg (<30 kg)
Frequency
Single infusion
Maximum Dose
800 mg
Investigational Product Name
CHLORURE DE SODIUM 0,9 % B. BRAUN, solution injectable en ampoule
Active Substance
SODIUM CHLORIDE
Modality
Small molecule
Routes Of Administration
Intravenous infusion
Route
Intravenous infusion
Authorisation Status
Marketing authorisation number: 34009 560 232 4 0
Frequency
Single infusion (placebo)
Maximum Dose
20 ml

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