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    Clinical Trial Results:
    An open-label, non-randomized extension study to evaluate the long term safety, tolerability, efficacy and pharmacokinetics of CDZ173 (leniolisib) in patients with APDS/PASLI (Activated phosphoinositide 3-kinase delta syndrome/p110δ-activating mutation causing senescent T cells, lymphadenopathy and immunodeficiency)

    Summary
    EudraCT number
    2016-000468-41
    Trial protocol
    CZ   NL   IE   GB   FR   DE   IT  
    Global end of trial date
    30 Jan 2025

    Results information
    Results version number
    v1(current)
    This version publication date
    16 Aug 2025
    First version publication date
    16 Aug 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CCDZ173X2201E1
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02859727
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Pharming Technologies B.V.
    Sponsor organisation address
    Darwinweg 24, Leiden, Netherlands, 2333 CR
    Public contact
    Clinical Department, Pharming Technologies B.V., +31 71 5247400, clinical@pharming.com
    Scientific contact
    Clinical Department, Pharming Technologies B.V., +31 71 5247400, clinical@pharming.com
    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
    30 Jan 2025
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Jan 2025
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Jan 2025
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    • To evaluate the long term safety and tolerability of CDZ173 in patients with APDS/PASLI.
    Protection of trial subjects
    Discontinuation of study treatment for a patient occurred when study treatment was stopped earlier than the protocol planned duration. Discontinuation of study treatment could be decided by either the patient or the investigator. Study treatment was required to be discontinued under the following circumstances: • Patient decision – patients could choose to discontinue study treatment for any reason at any time. • The investigator believed that continuation would negatively impact the safety of the patient or the risk/benefit ratio of study participation. • Any protocol deviation that resulted in a significant risk to the patient’s safety. • Pregnancy (see protocol Section 8.6.7 and Section 9.7 [Appendix 16.1.1]). • The patient experienced a drug-related SAE. • Diarrhea of common terminology criteria for AE (CTCAE) Grade 2 or higher on 3 consecutive days. • Diarrhea of CTCAE Grade 3 or higher. • Diarrhea or abdominal pain with accompanying fever assessed to be related to a gastrointestinal infection. • Grade 4 skin rashes as per protocol Section 6.8 (Appendix 16.1.1). • Use of prohibited treatment as per protocol Section 5.2 (Appendix 16.1.1). If discontinuation of study treatment occurred, investigator determined the primary reason for the patient’s premature discontinuation of study treatment and recorded this information on the dosage administration CRF. Resumption of study treatment after a full safety review of the patient was possible, pending agreement between the investigator and the Sponsor.
    Background therapy
    -
    Evidence for comparator
    NA
    Actual start date of recruitment
    08 Sep 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 2
    Country: Number of subjects enrolled
    Czechia: 4
    Country: Number of subjects enrolled
    Germany: 3
    Country: Number of subjects enrolled
    Italy: 5
    Country: Number of subjects enrolled
    Russian Federation: 2
    Country: Number of subjects enrolled
    Belarus: 1
    Country: Number of subjects enrolled
    United States: 20
    Worldwide total number of subjects
    37
    EEA total number of subjects
    14
    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)
    13
    Adults (18-64 years)
    24
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    37 participants were enrolled in the extension study . Of these, 26 participants received leniolisib in study CCDZ173X2201 and 11 participants had no previous exposure to leniolisib (9 participants received placebo in study CCDZ173X2201 and 2 participants were previously treated with PI3Kδ inhibitors other than leniolisib

    Pre-assignment
    Screening details
    Patients could be enrolled in this extension study either directly at the end of treatment (EOT) or end of study (EOS) visit of Study CCDZ173X2201 (Part 1 or Part 2) or later in time. Patients who were treated previously with PI3Kδ inhibitors other than leniolisib could be enrolled if they met the eligibility criteria at the screening visit.

    Period 1
    Period 1 title
    Open Label extension (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Open label study
    Arm description
    Open label treatment for total duration of study
    Arm type
    Experimental

    Investigational medicinal product name
    CDZ173
    Investigational medicinal product code
    Other name
    leniolisib
    Pharmaceutical forms
    Capsule, hard + tablet
    Routes of administration
    Oral use
    Dosage and administration details
    HGC or FCT 70 mg twice daily

    Number of subjects in period 1
    Open label study
    Started
    37
    Completed
    3
    Not completed
    34
         Adverse event, serious fatal
    1
         Physician decision
    3
         Consent withdrawn by subject
    2
         Adverse event, non-fatal
    1
         Study termination
    25
         Lost to follow-up
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Open Label extension
    Reporting group description
    -

    Reporting group values
    Open Label extension Total
    Number of subjects
    37 37
    Age categorical
    Units: Subjects
        Adolescents (12-17 years)
    13 13
        Adults (18-64 years)
    24 24
    Age continuous
    Units: years
        arithmetic mean (full range (min-max))
    22.7 (12 to 55) -
    Gender categorical
    Units: Subjects
        Female
    16 16
        Male
    21 21

    End points

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    End points reporting groups
    Reporting group title
    Open label study
    Reporting group description
    Open label treatment for total duration of study

    Primary: Safety

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    End point title
    Safety [1]
    End point description
    To evaluate the long-term safety and tolerability of leniolisib in patients with APDS. All safety parameters (including adverse events [AEs], physical examination, vital signs, electrocardiogram [ECG], and safety laboratory [hematology, blood chemistry, urinalysis]).
    End point type
    Primary
    End point timeframe
    Duration of study
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: This is a one-arm trial for which no statistical analysis or hypotheses testing was planned. All Serious Adverse Events and Adverse Events experienced by 2 or more participants are added in the Adverse Events section.
    End point values
    Open label study
    Number of subjects analysed
    37
    Units: number of patients with adverse event
        Number of patients with Serious Adverse Events
    10
        Number of patients with Adverse Events
    34
    No statistical analyses for this end point

    Secondary: To evaluate the long-term efficacy of leniolisib to modify health-related quality of life in patients with APDS.

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    End point title
    To evaluate the long-term efficacy of leniolisib to modify health-related quality of life in patients with APDS.
    End point description
    Short form-36 (SF-36) survey and work productivity activity impairment and classroom impairment questionnaire (WPAI-CIQ), visual analogue scales for physician’s global assessment (PGA) and patient’s global assessment (PtGA), and patient narratives by the investigator.
    End point type
    Secondary
    End point timeframe
    duration of study participation
    End point values
    Open label study
    Number of subjects analysed
    37 [2]
    Units: scores
    median (full range (min-max))
        SF-36 general health score baseline
    36.540 (18.95 to 60.32)
        SF-36 general health score after 1 year
    46.050 (26.08 to 66.50)
        SF-36 general health score after 3 years
    48.430 (29.41 to 60.70)
        SF-36 general health score after 4 years
    48.430 (34.17 to 62.70)
        SF general health score after 5 years
    47.240 (36.54 to 57.94)
    Notes
    [2] - baseline N= 37, 1 year N=37, 3 year N=27, 4 year N=22, 5 year N=10
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were reported from time of signing Informed Consent until the End of Study visit.
    Adverse event reporting additional description
    The occurrence of AEs must be sought by non-directive questioning of the patient at each visit during the study. AEs also may be detected when they are volunteered by the patient during or between visits or through physical examination finding, laboratory test finding, or other assessments. Study patients will be instructed to take notes of any AE
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    27.0
    Reporting groups
    Reporting group title
    Number of patients with adverse event
    Reporting group description
    The long-term safety data with leniolisib included 37 participants with APDS treated for at least one year 31 participants (83.8%) for at least 2 years, and 10 participants (27.0%) had at least 5 years of leniolisib exposure.

    Serious adverse events
    Number of patients with adverse event
    Total subjects affected by serious adverse events
         subjects affected / exposed
    10 / 37 (27.03%)
         number of deaths (all causes)
    1
         number of deaths resulting from adverse events
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Hodgkin's disease
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Transitional cell carcinoma
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Orthostatic hypotension
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Facial pain
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Anaphylactic reaction
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Aspiration
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Asthma
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory disorder
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Suicidal ideation
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Nervous system disorders
    Paraesthesia
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Leukopenia
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphadenopathy
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Anal fissure
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthritis reactive
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Flank pain
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Muscular weakness
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Abscess
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Acute sinusitis
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    COVID-19
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Parotitis
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Periorbital cellulitis
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sinusitis
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Staphylococcal bacteraemia
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Viral infection
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 37 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Number of patients with adverse event
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    34 / 37 (91.89%)
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    9 / 37 (24.32%)
         occurrences all number
    9
    Influenza like illness
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Non-cardiac chest pain
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Immune system disorders
    Seasonal allergy
         subjects affected / exposed
    3 / 37 (8.11%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Oropharyngeal pain
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Cough
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Epistaxis
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Dysphonia
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Dyspnoea
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Productive cough
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Psychiatric disorders
    Illusion
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Investigations
    Weight increased
         subjects affected / exposed
    5 / 37 (13.51%)
         occurrences all number
    5
    Alanine aminotransferase increased
         subjects affected / exposed
    3 / 37 (8.11%)
         occurrences all number
    3
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    SARS-CoV-2 test negative
         subjects affected / exposed
    15 / 37 (40.54%)
         occurrences all number
    15
    Injury, poisoning and procedural complications
    Joint injury
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Ligament sprain
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Limb injury
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Nervous system disorders
    Headache
         subjects affected / exposed
    8 / 37 (21.62%)
         occurrences all number
    8
    Migraine
         subjects affected / exposed
    3 / 37 (8.11%)
         occurrences all number
    3
    Paraesthesia
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Lymphadenopathy
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    5
    Vomiting
         subjects affected / exposed
    5 / 37 (13.51%)
         occurrences all number
    5
    Abdominal pain
         subjects affected / exposed
    5 / 37 (13.51%)
         occurrences all number
    5
    Gastrooesophageal reflux disease
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Dental caries
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Abdominal pain upper
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Haematochezia
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Nausea
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Anal fissure
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    4
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Seborrhoeic dermatitis
         subjects affected / exposed
    3 / 37 (8.11%)
         occurrences all number
    3
    Rash
         subjects affected / exposed
    3 / 37 (8.11%)
         occurrences all number
    3
    Keratosis pilaris
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Skin papilloma
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    5 / 37 (13.51%)
         occurrences all number
    5
    Back pain
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Flank pain
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Myalgia
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Infections and infestations
    COVID-19
         subjects affected / exposed
    12 / 37 (32.43%)
         occurrences all number
    12
    Upper respiratory tract infection
         subjects affected / exposed
    10 / 37 (27.03%)
         occurrences all number
    10
    Sinusitis
         subjects affected / exposed
    6 / 37 (16.22%)
         occurrences all number
    6
    Otitis externa
         subjects affected / exposed
    7 / 37 (18.92%)
         occurrences all number
    7
    Nasopharyngitis
         subjects affected / exposed
    6 / 37 (16.22%)
         occurrences all number
    6
    Rhinitis
         subjects affected / exposed
    5 / 37 (13.51%)
         occurrences all number
    5
    Gastroenteritis
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Pneumonia
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Respiratory tract infection
         subjects affected / exposed
    5 / 37 (13.51%)
         occurrences all number
    5
    Bronchitis
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Oral herpes
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Pharyngitis
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Urinary tract infection
         subjects affected / exposed
    4 / 37 (10.81%)
         occurrences all number
    4
    Herpes zoster
         subjects affected / exposed
    3 / 37 (8.11%)
         occurrences all number
    3
    Otitis media
         subjects affected / exposed
    3 / 37 (8.11%)
         occurrences all number
    3
    Conjunctivitis
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Conjunctivitis allergic
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Folliculitis
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Herpes simplex
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Influenza
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Lyme disease
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Otitis media acute
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Paronychia
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Metabolism and nutrition disorders
    Hypokalaemia
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2
    Obesity
         subjects affected / exposed
    2 / 37 (5.41%)
         occurrences all number
    2

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 Mar 2017
    Amendment 1: Minumum age lowered form 16 to 12, prolong the treatment period of patients beyond 9 months (up to 3 years)
    20 Oct 2017
    Amendment 2: Change of study purpose to provide access to the extension study not only for patients who participated in study CCDZ173X2201 but also for patients previously treated with PI3Kδ inhibitors other than CDZ173
    26 Mar 2018
    Amendment 3: introduce a film-coated tablets (FCT) formulation of CDZ173
    18 Jun 2018
    Amendment 4: incorporate health authority recommendations for: 1) the management of potentially occurring skin rashes, 2) pregnancy monitoring, and 3) additional screening assessments and eligibility criteria for patients who did not participate in the core study CCDZ173X2201
    15 Mar 2019
    Amendment 5: eligibility criteria; prohibited medication and the option to use a low dose CT scan in adolescents between 12-15 years of age (inclusive) in sites when approved, Treatment period is extended to 5 years
    24 Jun 2020
    Amendment 6: address changes to trial conduct in the case of an epidemic or pandemic that limits or prevents on-site visits (eg COVID-19 pandemic).
    22 Oct 2020
    Amendment 7: align CCDZ173X2201E1 (extension study) with changes that were made to CCDZ173X2201 (core study)
    07 Jun 2021
    Amendment 8: the individual treatment period to 6 years duration
    25 Aug 2021
    Amendment 9: Administrative update
    20 Dec 2021
    Amendment 10: Transfer Sponsorship form Novartis to Pharming Technologies B.V.
    13 Dec 2022
    Amendment 11: results of an interim analysis of the CCDZX2210E1 and the update of the Investigators Brochure

    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.
    None reported
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