Clinical Trial Results:
Single Arm Study of ALXN1210 in Complement Inhibitor Treatment-Naïve Adult And Adolescent Patients With Atypical Hemolytic Uremic Syndrome (aHUS)
Summary
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EudraCT number |
2016-002027-29 |
Trial protocol |
GB DE AT ES SE BE CZ IT |
Global end of trial date |
24 Jan 2023
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Results information
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Results version number |
v2(current) |
This version publication date |
09 Feb 2024
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First version publication date |
22 Jul 2022
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Other versions |
v1 |
Version creation reason |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
ALXN1210-aHUS-311
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02949128 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Alexion Pharmaceuticals Inc.
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Sponsor organisation address |
100 College Street, New Haven, CT, United States, 06510
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Public contact |
Alexion Europe SAS European Clinical Trial Information, Alexion Pharmaceuticals Inc., +33 787148158, clinicaltrials.eu@alexion.com
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Scientific contact |
Alexion Europe SAS European Clinical Trial Information, Alexion Pharmaceuticals Inc., +33 787148158, clinicaltrials.eu@alexion.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
12 Feb 2020
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
24 Jan 2023
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
The purpose of the study is to assess the safety and efficacy of ravulizumab to control disease activity in adolescent and adult participants with aHUS who had not previously used a complement inhibitor.
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Protection of trial subjects |
This trial was conducted in compliance with Good Clinical Practice.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
18 Mar 2017
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Australia: 4
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Country: Number of subjects enrolled |
Austria: 1
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Country: Number of subjects enrolled |
Belgium: 2
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Country: Number of subjects enrolled |
Canada: 1
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Country: Number of subjects enrolled |
France: 8
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Country: Number of subjects enrolled |
Germany: 9
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Country: Number of subjects enrolled |
Italy: 2
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Country: Number of subjects enrolled |
Japan: 3
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Country: Number of subjects enrolled |
Korea, Republic of: 8
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Country: Number of subjects enrolled |
Russian Federation: 2
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Country: Number of subjects enrolled |
Spain: 5
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Country: Number of subjects enrolled |
Taiwan: 3
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Country: Number of subjects enrolled |
United Kingdom: 5
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Country: Number of subjects enrolled |
United States: 5
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Worldwide total number of subjects |
58
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EEA total number of subjects |
27
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
49
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From 65 to 84 years |
9
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85 years and over |
0
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Recruitment
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Recruitment details |
- | ||||||||||||||||||||
Pre-assignment
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Screening details |
The study included 2 periods: Initial evaluation period and Extension period. | ||||||||||||||||||||
Period 1
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Period 1 title |
Initial Evaluation Period (26 Weeks)
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Is this the baseline period? |
Yes | ||||||||||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | ||||||||||||||||||||
Arms
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Arm title
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Ravulizumab | ||||||||||||||||||||
Arm description |
Participants received weight-based dosages of ravulizumab for 26 weeks during the Initial Evaluation Period. Participants received a loading dose of ravulizumab intravenously on Day 1, followed by maintenance dosing on Day 15 and once every 8 weeks thereafter. After the Initial Evaluation Period, participants entered an Extension Period and received ravulizumab until the product registration or approval (in accordance with country-specific regulations) or for up to 4.5 years, whichever occurs first. | ||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||
Investigational medicinal product name |
Ravulizumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Concentrate for solution for infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
Participants received ravulizumab at prespecified dose and timepoints.
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Period 2
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Period 2 title |
Extension Period (Up to 4.5 Years)
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Is this the baseline period? |
No | ||||||||||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | ||||||||||||||||||||
Arms
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Arm title
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Ravulizumab | ||||||||||||||||||||
Arm description |
Participants received weight-based dosages of ravulizumab for 26 weeks during the Initial Evaluation Period. Participants received a loading dose of ravulizumab intravenously on Day 1, followed by maintenance dosing on Day 15 and once every 8 weeks thereafter. After the Initial Evaluation Period, participants entered an Extension Period and received ravulizumab until the product registration or approval (in accordance with country-specific regulations) or for up to 4.5 years, whichever occurs first. | ||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||
Investigational medicinal product name |
Ravulizumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Concentrate for solution for infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
Participants received ALXN1210 at prespecified dose and timepoints.
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Baseline characteristics reporting groups
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Reporting group title |
Ravulizumab
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Reporting group description |
Participants received weight-based dosages of ravulizumab for 26 weeks during the Initial Evaluation Period. Participants received a loading dose of ravulizumab intravenously on Day 1, followed by maintenance dosing on Day 15 and once every 8 weeks thereafter. After the Initial Evaluation Period, participants entered an Extension Period and received ravulizumab until the product registration or approval (in accordance with country-specific regulations) or for up to 4.5 years, whichever occurs first. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Ravulizumab
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Reporting group description |
Participants received weight-based dosages of ravulizumab for 26 weeks during the Initial Evaluation Period. Participants received a loading dose of ravulizumab intravenously on Day 1, followed by maintenance dosing on Day 15 and once every 8 weeks thereafter. After the Initial Evaluation Period, participants entered an Extension Period and received ravulizumab until the product registration or approval (in accordance with country-specific regulations) or for up to 4.5 years, whichever occurs first. | ||
Reporting group title |
Ravulizumab
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Reporting group description |
Participants received weight-based dosages of ravulizumab for 26 weeks during the Initial Evaluation Period. Participants received a loading dose of ravulizumab intravenously on Day 1, followed by maintenance dosing on Day 15 and once every 8 weeks thereafter. After the Initial Evaluation Period, participants entered an Extension Period and received ravulizumab until the product registration or approval (in accordance with country-specific regulations) or for up to 4.5 years, whichever occurs first. |
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End point title |
Percentage Of Participants With Complete Thrombotic Microangiopathy (TMA) Response at Week 26 [1] | ||||||||||||||||
End point description |
Complete TMA response during 26-week Initial Evaluation Period is a composite endpoint that required normalization of hematological parameters and improvement in kidney function (≥25% reduction in serum creatinine from baseline); for participants on dialysis, baseline was established at least 6 days after end of dialysis. Participants had to meet these criteria for 2 separate assessments obtained at least 4 weeks apart, and any measurement in between. For a responder, latest time point a participant could first meet response criteria was 28 days before the Week 26 assessment. % was based on responders among treated participants. 95% CI: based on asymptotic Gaussian approximation method with a continuity correction. Full Analysis Set (FAS): all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, and met pre-specified eligibility criteria. Number of Participants Analyzed signifies participants evaluable for this endpoint.
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End point type |
Primary
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End point timeframe |
Week 26
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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: Only descriptive analyses was planned to be reported for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Time To Complete TMA Response | ||||||||
End point description |
Participants that did not have a response were censored at the date of last visit or study discontinuation at the time when the analysis was performed. The time to complete TMA Response is reported in days. The time of the event of a confirmed complete TMA response was considered the first time point at which all the criteria for complete TMA response were met. Full Analysis Set (FAS): all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, and met pre-specified eligibility criteria. Here, Overall Number of Participants analyzed (N) signifies those who were evaluable for this endpoint. 99999 signifies that the data were not available.
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End point type |
Secondary
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End point timeframe |
Baseline through Week 114
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No statistical analyses for this end point |
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End point title |
Proportion Of Participants With Complete TMA Response At Week 52 | ||||||||||||||||
End point description |
The proportion of participants considered responders, along with a 2-sided 95% CI for the Week 52 time point, is reported. To be considered a responder during the 26-week Initial Evaluation Period, the latest time point a participant could first meet the response criteria was 28 days before the Week 26 (Day 183) assessment (components of the response maintained for at least 28 days). Full Analysis Set (FAS): all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at specified timepoint (Week 52).
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End point type |
Secondary
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End point timeframe |
Week 52
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Estimated Glomerular Filtration Rate (eGFR) At Weeks 26 and 52 | ||||||||||||||
End point description |
Kidney function evaluated by eGFR was summarized at baseline and Week 26 and Week 52 time points using descriptive statistics for continuous variables for the observed value, as well as change from baseline. Baseline value was defined as average of values from assessments performed prior to first study drug infusion (these could include results from Screening and Day 1 visit). A value of 10 mL/min/1.73 meters squared (m^2) for eGFR was imputed for participants requiring dialysis for acute kidney injury. The observed value and change from baseline are reported in mL/min/1.73 m^2. An increase indicated improvement in kidney function. FAS: all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at the specified timepoint (Week 26 or Week 52). Here,"N" signifies those who were evaluable for this endpoint and "n" signifies participants evaluable for specified categories.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26 and Week 52
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No statistical analyses for this end point |
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End point title |
Participants Who Do Not Require Dialysis at Weeks 26 and 52 | ||||||||||
End point description |
For participants requiring dialysis within 5 days prior to ALXN1210 treatment initiation, the number of participants no longer requiring dialysis is reported. Full Analysis Set (FAS): all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at specified timepoint. Here, Overall Number of Participants analyzed (N) signifies those who were evaluable for this endpoint and Number Analyzed (n) signifies participants evaluable at specified time points.
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End point type |
Secondary
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End point timeframe |
Week 26 and Week 52
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No statistical analyses for this end point |
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End point title |
Participants With Change From Baseline In CKD Stage At Weeks 26 and 52 | ||||||||||||||||||
End point description |
The CKD stage is presented as change from baseline in participants that Improved (excluding those with Stage 1 [normal renal function] at baseline as they cannot improve), Worsened (excluding those with Stage 5 at baseline as they cannot worsen), and Stayed the Same, compared to CKD stage at baseline. Baseline was derived based on the last available eGFR before starting treatment. Stage 5 was considered worst category, while Stage 1 was considered best category. A 2-sided 95% CI for the proportion, based on exact confidence limits using the Clopper-Pearson method, was provided for each category. FAS: all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at the specified timepoint (Week 26 or Week 52). Here, "N" signifies those who were evaluable for this endpoint and “n” signifies participants evaluable for specified categories.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26, and Week 52
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Platelet Count At Weeks 26 and 52 | ||||||||||||||
End point description |
The hematologic TMA parameter of platelet count was summarized at baseline and at Week 26 and Week 52 using descriptive statistics for continuous variables for the change from baseline. Results are reported in platelets*10^9/liter (L) blood. Full Analysis Set (FAS): all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at the specified timepoints (Week 26 or 52). Here, "N" signifies those who were evaluable for this endpoint and “n” signifies participants evaluable for specified categories.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26 and Week 52
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No statistical analyses for this end point |
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End point title |
Change From Baseline In LDH At Weeks 26 and 52 | ||||||||||||||
End point description |
The hematologic TMA parameter of serum LDH was summarized at baseline and at Week 26 and Week 52 using descriptive statistics for continuous variables for the change from baseline. Results are reported in units (U)/L. Full Analysis Set (FAS): all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at the specified timepoints (Week 26 or 52). Here, "N" signifies those who were evaluable for this endpoint and “n” signifies participants evaluable for specified categories.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26 and Week 52
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Hemoglobin At Weeks 26 and 52 | ||||||||||||||
End point description |
The hematologic TMA parameter of hemoglobin level was summarized at baseline and at Week 26 and Week 52 using descriptive statistics for continuous variables for the change from baseline. Results are reported in grams (g)/L. Full Analysis Set (FAS): all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at the specified timepoints (Week 26 or 52). Here, "N" signifies those who were evaluable for this endpoint and “n” signifies participants evaluable for specified categories.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26 and Week 52
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No statistical analyses for this end point |
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End point title |
Percentage Of Complement Inhibitor Treatment-naïve Participants With An Increase From Baseline In Hemoglobin ≥20 g/L Through Week 26 and Week 52 | ||||||||||||
End point description |
The percentage of participants with an increase from baseline in hemoglobin ≥20 g/L, observed at 2 separate assessments obtained at least 4 weeks apart, and any measurement in between, was assessed through Week 26 and Week 52 and is presented as the percentage of responders, along with a 2-sided 95% CI. To be considered a responder during the 26-week and 52-week Extension Periods, the latest time point a participant could first meet the response criteria was 28 days before the respective Week 26 and Week 52 assessments (components of the response maintained for at least 28 days). FAS: all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at the specified timepoints (Week 26 or 52). Here, "N" signifies those who were evaluable for this endpoint.
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End point type |
Secondary
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End point timeframe |
Baseline through Week 26 and through Week 52
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Quality Of Life As Measured By The EuroQol 5-Dimension 3-Level (EQ-5D-3L) At Weeks 26 and 52 | ||||||||||||||
End point description |
The EQ-5D-3L is a participant-answered questionnaire that scores 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression (scored as a 1, 2, or 3, with 3 being the worst health state), as well as health state on a visual analogue scale (0 to 100, with 100 representing the best health state). From these scores, a summary index score is derived using the time trade-off valuation set for the United States and ranges from -1 to 1, where a score above 0.94 indicates full health. An increase in score from baseline indicates improvement in quality of life. Full Analysis Set (FAS): all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at the specified timepoint (Week 26 or Week 52). Here, "N" signifies those who were evaluable for this endpoint and “n” signifies participants evaluable for specified categories.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26 and Week 52
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Quality Of Life As Measured By The Functional Assessment Of Chronic Illness Therapy (FACIT)-Fatigue Version 4 Questionnaire At Weeks 26 and 52 | ||||||||||||||
End point description |
Quality of life was evaluated in part using FACIT Fatigue Version 4. The data were summarized at baseline and at the Week 26 and Week 52 time point using descriptive statistics for continuous variables. The FACIT Fatigue Version 4 questionnaire at baseline and the Week 52 timepoint was scored using standard scoring algorithms. The score ranges from 0-52, with a higher score indicating less Fatigue. An increase in score indicated an improvement in quality of life. Full Analysis Set (FAS): all participants who received at least 1 dose of ravulizumab, had at least 1 post-baseline efficacy assessment, met pre-specified eligibility criteria, and had evaluable data at the specified timepoint (Week 26 or Week 52). Here, "N" signifies those who were evaluable for this endpoint and “n” signifies participants evaluable for specified categories.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 26 and Week 52
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
From the beginning of the initial evaluation period (Day1) up to 4.5 years
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
25.1
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Reporting groups
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Reporting group title |
Ravulizumab
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Reporting group description |
Participants received weight-based dosages of ravulizumab for 26 weeks during the Initial Evaluation Period. Participants received a loading dose of ravulizumab intravenously on Day 1, followed by maintenance dosing on Day 15 and once every 8 weeks thereafter. After the Initial Evaluation Period, participants entered an Extension Period and received ravulizumab until the product registration or approval (in accordance with country-specific regulations) or for up to 4.5 years, whichever occurs first. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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28 Sep 2016 |
Ravulizumab loading and maintenance doses were lowered for all body weight groups. |
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23 Jan 2017 |
• Added clarification to primary endpoint description that participants must meet all Complete TMA Response criteria at 2 separate assessments obtained at least 4 weeks (28 days) apart, and any measurement in between. • Added clarification to secondary objectives (CKD stage as evaluated by eGFR; hemoglobin increase observed at 2 separate assessments obtained at least 4 weeks [28 days] apart, and any measurement in between). • Revised Exclusion Criteria 2 to allow administration of the first dose of study drug while awaiting the results of stool Shiga toxin test results. • Removed the requirement of systolic blood pressure ≤ 140 millimeters of mercury (mmHg) for at least 4 days. • Added benefit/risk assessment text. • Clarified withdrawal criteria to specify serious infusion reaction, severe uncontrolled infection, and pregnancy. • Minor corrections and clarifications were made to the schedule of assessments and language describing drug packaging, storage, and preparation; prior/concomitant medications/procedures; prohibited medications; vaccination; contraception; medical history; vital signs; immunogenicity; suspected unexpected serious adverse reaction (SUSAR) reporting, adverse events; pharmacokinetic (PK)/pharmacodyanamic (PD) assessment; genetics; statistical analysis; data monitoring committee (DMC); regulatory considerations; references; appendices. |
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19 Jul 2017 |
• Revised Inclusion Criteria to include platelet count, LDH, and hemoglobin laboratory results during the Screening Period or within 28 days prior to the start of the Screening Period from a local laboratory; these changes allow participants with recent plasma exchange/plasma infusion (which alters laboratory results) to enter the study based on laboratory results prior to plasma exchange/plasma infusion. • Continued to require that serum creatinine results for Inclusion Criterion must be based on central laboratory results from a specimen collected during the Screening Period. Since the primary endpoint is a change from baseline in creatinine, it is important to have both baseline and on-treatment serum samples from the same laboratory. • Provided clarification that eligibility may be determined using results from tests carried out as standard of care for the treatment of the current TMA prior to a participant giving informed consent, including tests noted in Exclusion Criteria. • Removed the requirement for culture/antigen test. • Clarified participants with genetic defects in vitamin B12 metabolism (a rare cause of HUS not related to complement), rather than a deficit in vitamin B12, were excluded. • Provided Sponsor opportunity to exclude participants on basis of risk to participant or impact on the interpretation of the efficacy or safety results for the study. • Added a requirement to have at least 30 participants enrolled who met all 4 TMA requirements at Day 1 (platelet count of < 150,000/microliter (μL), LDH ≥ 1.5 × upper limit of normal (ULN), hemoglobin ≤ lower limit of normal (LLN), and serum creatinine level ≥ ULN) to ensure that a majority of participants enrolled had abnormal baseline laboratory values. • Provided the option for serum pregnancy tests to be used at any time points. • Removed the option for “a designee” to perform the physical examination. |
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19 Jul 2017 |
• Added pregnancy test assessment prior to first dose in Extension Period; removed requirement for pregnancy test to use urine (serum may now be used at all indicated timepoints). • Clarified terminology on “meeting” vs “satisfying” inclusion and exclusion criteria and added option for the participant’s legally authorized representative to provide informed consent. • Corrected use of “assent” vs “consent”. • Clarified that there were separate tests for urine chemistry and urinalysis. |
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07 May 2019 |
• Increased duration of the Extension Period from 2 years to 4.5 years or until the product is registered or approved (in accordance with country-specific regulations), whichever occurs first, to allow additional safety, PK/PD, and immunogenicity evaluations. • Revised schedule of assessments to align with the increased duration of the Extension Period. • Information on discontinuation of participants was clarified by differentiating early termination of participants from study versus discontinuation of ravulizumab treatment with continuation in the study for monitoring visit. • Added criteria on TMA recurrence and guidance on retreatment with ravulizumab for participants who discontinue ravulizumab and remain in the study. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |