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    Clinical Trial Results:
    A randomized, double-blind, placebo controlled multiple dose study of subcutaneous ACZ885 for the treatment of abdominal aortic aneurysm

    Summary
    EudraCT number
    2013-002088-25
    Trial protocol
    SE   NL   DK   GB   DE  
    Global end of trial date
    21 Oct 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Oct 2016
    First version publication date
    15 Oct 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CACZ885X2201
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02007252
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    21 Oct 2015
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    21 Oct 2015
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The primary objective was to assess the effect of ACZ885 on AAA size and growth rate as measured with ultrasound at 12 months.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    09 Dec 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Denmark: 33
    Country: Number of subjects enrolled
    United Kingdom: 3
    Country: Number of subjects enrolled
    Netherlands: 7
    Country: Number of subjects enrolled
    Sweden: 21
    Worldwide total number of subjects
    64
    EEA total number of subjects
    64
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    10
    From 65 to 84 years
    53
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 65 participants were randomized in a 1:1 ratio to one of the two treatment groups. One participant discontinued prior to taking any study medication. As such, the participant flow is based on 64 randomized participants.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    ACZ885
    Arm description
    Participants received ACZ885 150 mg subcutaneously (s.c.) once per month for 12 months.
    Arm type
    Experimental

    Investigational medicinal product name
    ACZ885
    Investigational medicinal product code
    ACZ885
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    150 mg once per month for 12 months

    Arm title
    Placebo
    Arm description
    Participants received matching placebo to ACZ885 s.c. once per month for 12 months.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Matching placebo to ACZ885 once per month for 12 months

    Number of subjects in period 1
    ACZ885 Placebo
    Started
    31
    33
    Safety analysis set
    31
    33
    Pharmacodynamic analysis set
    31
    33
    Completed
    20
    22
    Not completed
    11
    11
         Abnormal laboratory value(s)
    1
    -
         Adverse event, non-fatal
    7
    4
         Administrative problems
    3
    7

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    ACZ885
    Reporting group description
    Participants received ACZ885 150 mg subcutaneously (s.c.) once per month for 12 months.

    Reporting group title
    Placebo
    Reporting group description
    Participants received matching placebo to ACZ885 s.c. once per month for 12 months.

    Reporting group values
    ACZ885 Placebo Total
    Number of subjects
    31 33 64
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    6 4 10
        From 65-84 years
    24 29 53
        85 years and over
    1 0 1
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    69.4 ( 7.44 ) 70.8 ( 5.84 ) -
    Gender, Male/Female
    Units: Subjects
        Female
    4 7 11
        Male
    27 26 53

    End points

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    End points reporting groups
    Reporting group title
    ACZ885
    Reporting group description
    Participants received ACZ885 150 mg subcutaneously (s.c.) once per month for 12 months.

    Reporting group title
    Placebo
    Reporting group description
    Participants received matching placebo to ACZ885 s.c. once per month for 12 months.

    Primary: Change from baseline (BL) in Abdominal Aortic Aneurysm (AAA) size per year

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    End point title
    Change from baseline (BL) in Abdominal Aortic Aneurysm (AAA) size per year
    End point description
    Size of the AAA was determined using an abdominal ultrasound technique at baseline, 3 months, and 12 months after treatment with study drug. Growth rate (in mm/year) was calculated from the change in AAA size compared to baseline
    End point type
    Primary
    End point timeframe
    month 3, month 12
    End point values
    ACZ885 Placebo
    Number of subjects analysed
    31
    33
    Units: millimeter/year
    least squares mean (confidence interval 90%)
        Month 3 (n=23,31)
    0.781 (-0.942 to 5.504)
    2.519 (1.03 to 4.008)
        Month 12 (n=20,23)
    2.538 (1.465 to 3.612)
    2.581 (1.612 to 3.549)
    Statistical analysis title
    Change from BL in AAA size per year at month 3
    Comparison groups
    ACZ885 v Placebo
    Number of subjects included in analysis
    64
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.1037
    Method
    ANCOVA
    Confidence interval
    Statistical analysis title
    Change from BL in AAA size per year at month 12
    Comparison groups
    ACZ885 v Placebo
    Number of subjects included in analysis
    64
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.4806
    Method
    ANCOVA
    Confidence interval

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All adverse events reported in this record are from date of First Patient First Treatment until Last Patient Last Visit.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.1
    Reporting groups
    Reporting group title
    ACZ885 150 mg
    Reporting group description
    ACZ885 150 mg

    Reporting group title
    Placebo
    Reporting group description
    Placebo

    Serious adverse events
    ACZ885 150 mg Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 31 (6.45%)
    0 / 33 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Injury, poisoning and procedural complications
    Hip fracture
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Aortic aneurysm
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    ACZ885 150 mg Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    28 / 31 (90.32%)
    28 / 33 (84.85%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Bladder cancer stage 0, with cancer in situ
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Vascular disorders
    Hot flush
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Hypertension
         subjects affected / exposed
    4 / 31 (12.90%)
    3 / 33 (9.09%)
         occurrences all number
    4
    3
    Aortic aneurysm
         subjects affected / exposed
    1 / 31 (3.23%)
    2 / 33 (6.06%)
         occurrences all number
    1
    2
    Intermittent claudication
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Thrombophlebitis
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    General disorders and administration site conditions
    Energy increased
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Fatigue
         subjects affected / exposed
    2 / 31 (6.45%)
    0 / 33 (0.00%)
         occurrences all number
    2
    0
    Injection site hypersensitivity
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Influenza like illness
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Impaired healing
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 33 (3.03%)
         occurrences all number
    1
    1
    Injection site pain
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 33 (3.03%)
         occurrences all number
    1
    1
    Oedema peripheral
         subjects affected / exposed
    0 / 31 (0.00%)
    4 / 33 (12.12%)
         occurrences all number
    0
    5
    Malaise
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Injection site swelling
         subjects affected / exposed
    3 / 31 (9.68%)
    2 / 33 (6.06%)
         occurrences all number
    4
    3
    Reproductive system and breast disorders
    Breast cyst
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 31 (3.23%)
    2 / 33 (6.06%)
         occurrences all number
    1
    2
    Cough
         subjects affected / exposed
    3 / 31 (9.68%)
    1 / 33 (3.03%)
         occurrences all number
    3
    1
    Oropharyngeal pain
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Haemoptysis
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Epistaxis
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Dyspnoea
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Psychiatric disorders
    Depression
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Insomnia
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 33 (3.03%)
         occurrences all number
    1
    1
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    0 / 31 (0.00%)
    2 / 33 (6.06%)
         occurrences all number
    0
    2
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 31 (0.00%)
    2 / 33 (6.06%)
         occurrences all number
    0
    2
    Blood creatinine increased
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Blood glucose increased
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    International normalised ratio increased
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Occult blood positive
         subjects affected / exposed
    2 / 31 (6.45%)
    0 / 33 (0.00%)
         occurrences all number
    2
    0
    Prostatic specific antigen increased
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 33 (3.03%)
         occurrences all number
    1
    1
    Foot fracture
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Ligament sprain
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 33 (3.03%)
         occurrences all number
    1
    1
    Wound
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    2 / 31 (6.45%)
    0 / 33 (0.00%)
         occurrences all number
    2
    0
    Angina pectoris
         subjects affected / exposed
    0 / 31 (0.00%)
    2 / 33 (6.06%)
         occurrences all number
    0
    2
    Atrioventricular block second degree
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Nervous system disorders
    Amnesia
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Dizziness
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Headache
         subjects affected / exposed
    2 / 31 (6.45%)
    0 / 33 (0.00%)
         occurrences all number
    2
    0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Syncope
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Sciatica
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 33 (3.03%)
         occurrences all number
    1
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Eye disorders
    Cataract
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Gastrointestinal disorders
    Gastric ulcer
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Diarrhoea
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 33 (3.03%)
         occurrences all number
    1
    1
    Abdominal pain upper
         subjects affected / exposed
    2 / 31 (6.45%)
    0 / 33 (0.00%)
         occurrences all number
    2
    0
    Abdominal pain
         subjects affected / exposed
    3 / 31 (9.68%)
    1 / 33 (3.03%)
         occurrences all number
    3
    1
    Vomiting
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Oesophagitis
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Nausea
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Haematochezia
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Gastrooesophageal reflux disease
         subjects affected / exposed
    0 / 31 (0.00%)
    2 / 33 (6.06%)
         occurrences all number
    0
    2
    Skin and subcutaneous tissue disorders
    Night sweats
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Blister
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Telangiectasia
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Renal and urinary disorders
    Urinary retention
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 33 (3.03%)
         occurrences all number
    1
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 31 (6.45%)
    2 / 33 (6.06%)
         occurrences all number
    2
    2
    Back pain
         subjects affected / exposed
    4 / 31 (12.90%)
    3 / 33 (9.09%)
         occurrences all number
    4
    3
    Groin pain
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Musculoskeletal pain
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Myalgia
         subjects affected / exposed
    1 / 31 (3.23%)
    1 / 33 (3.03%)
         occurrences all number
    2
    2
    Osteoarthritis
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Osteoporosis
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Pain in extremity
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Infections and infestations
    Erysipelas
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Gastroenteritis
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Influenza
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Tooth infection
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Sinusitis
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Rhinitis
         subjects affected / exposed
    2 / 31 (6.45%)
    1 / 33 (3.03%)
         occurrences all number
    2
    1
    Respiratory tract infection
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Pneumonia
         subjects affected / exposed
    2 / 31 (6.45%)
    1 / 33 (3.03%)
         occurrences all number
    3
    1
    Nasopharyngitis
         subjects affected / exposed
    5 / 31 (16.13%)
    3 / 33 (9.09%)
         occurrences all number
    8
    5
    Upper respiratory tract infection
         subjects affected / exposed
    2 / 31 (6.45%)
    1 / 33 (3.03%)
         occurrences all number
    2
    1
    Vestibular neuronitis
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Urinary tract infection
         subjects affected / exposed
    2 / 31 (6.45%)
    1 / 33 (3.03%)
         occurrences all number
    2
    1
    Metabolism and nutrition disorders
    Diabetes mellitus
         subjects affected / exposed
    0 / 31 (0.00%)
    1 / 33 (3.03%)
         occurrences all number
    0
    1
    Hyperlipidaemia
         subjects affected / exposed
    1 / 31 (3.23%)
    0 / 33 (0.00%)
         occurrences all number
    1
    0
    Hypercholesterolaemia
         subjects affected / exposed
    1 / 31 (3.23%)
    2 / 33 (6.06%)
         occurrences all number
    1
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 Nov 2013
    The primary purpose of this protocol amendment was to clarify the exclusion criteria for patients with immune disorders or thrombocytopenia. An exclusion criterion was added to prevent patients with neutropenia, leukopenia, or thrombocytopenia from entering the study. Also, the individual stopping rules within this study have been modified to reflect this criterion. The other modifications were provided below: 1. A greater clarification was provided regarding the use of clopidogrel in patients with vascular stents. Specific language was added to allow the use of clopidogrel in this situation. 2. At sites in the USA where CT scans were performed, the use of historical CT scans was proposed in order to reduce the radiation exposure to patients who had recently undergone an abdominal CT scan prior to their entry into this clinical trial. The protocol was modified to allow the use of an abdominal CT scan obtained within 60 days of first dose to be used in place of the Screening CT scan. 3. Additional details regarding the planned statistical analysis of trial data were added and a few typographical inconsistencies in the protocol were corrected.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    This study was terminated prematurely because the results of a third interim analysis (ad hoc) indicated a lack of efficacy and futility in continuing the trial.
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
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