Clinical Trial Results:
A Phase 2a Proof-of-Mechanism, Open-Label Study to Determine the Effect of ACH-0144471 on C3 Levels in Participants With Low C3 Levels Due to Either C3 Glomerulopathy (C3G) or Immune-Complex Membranoproliferative Glomerulonephritis (IC-MPGN)
Summary
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EudraCT number |
2016-003525-42 |
Trial protocol |
BE NL |
Global end of trial date |
09 Jan 2019
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Results information
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Results version number |
v1(current) |
This version publication date |
07 Jul 2021
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First version publication date |
07 Jul 2021
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Other versions |
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 |
ACH471-201
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT03124368 | ||
WHO universal trial number (UTN) |
U1111-1203-9016 | ||
Sponsors
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Sponsor organisation name |
Alexion Pharmaceuticals, Inc
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Sponsor organisation address |
121 Seaport Boulevard, Boston, MA, United States, 02210
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Public contact |
European Clinical Trial Information, Alexion Pharmaceuticals, Inc., +33 147100606, clinicaltrials.eu@alexion.com
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Scientific contact |
European Clinical Trial Information, Alexion Pharmaceuticals, Inc., +33 147100606, 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 |
09 Jan 2019
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
21 Dec 2018
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Global end of trial reached? |
Yes
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Global end of trial date |
09 Jan 2019
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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 primary objective of this study was to determine whether ACH-0144471 (danicopan) increases blood C3 complement protein (C3) levels in participants with low C3 levels due to either C3G or IC-MPGN.
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Protection of trial subjects |
This study was conducted in accordance with International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) Good Clinical Practice, and the principles of the Declaration of Helsinki, in addition to following the laws and regulations of the country or countries in which a study is conducted.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
11 Jul 2017
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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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 |
Netherlands: 1
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Country: Number of subjects enrolled |
Belgium: 1
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Country: Number of subjects enrolled |
Australia: 4
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Worldwide total number of subjects |
6
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EEA total number of subjects |
2
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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) |
6
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From 65 to 84 years |
0
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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 |
Participants were recruited from 5 study centers total in Australia, Belgium, and The Netherlands. Only 3 study centers, 1 in each country, treated participants. | ||||||||||||
Period 1
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Period 1 title |
Overall (overall period)
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Is this the baseline period? |
Yes | ||||||||||||
Allocation method |
Non-randomised - controlled
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Blinding used |
Not blinded | ||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Group 1: Danicopan 100 mg TID (Sentinel) | ||||||||||||
Arm description |
Participants received 100 milligrams (mg) of danicopan three times daily (TID) during the Treatment Period. | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
Danicopan
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Investigational medicinal product code |
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Other name |
ACH-0144471, ACH-4471, ACH4471, 4471, ALXN2040
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Participants received study drug for 14 days (Treatment Period), followed by a taper over the next 7 days (Taper Period).
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Arm title
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Group 2: Danicopan up to 200 mg TID | ||||||||||||
Arm description |
Participants received not more than 200 mg of danicopan TID during the Treatment Period. | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
Danicopan
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Investigational medicinal product code |
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Other name |
ACH-0144471, ACH-4471, ACH4471, 4471, ALXN2040
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Participants received study drug for 14 days (Treatment Period), followed by a taper over the next 7 days (Taper Period).
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Baseline characteristics reporting groups
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Reporting group title |
Group 1: Danicopan 100 mg TID (Sentinel)
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Reporting group description |
Participants received 100 milligrams (mg) of danicopan three times daily (TID) during the Treatment Period. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Group 2: Danicopan up to 200 mg TID
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Reporting group description |
Participants received not more than 200 mg of danicopan TID during the Treatment Period. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Group 1: Danicopan 100 mg TID (Sentinel)
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Reporting group description |
Participants received 100 milligrams (mg) of danicopan three times daily (TID) during the Treatment Period. | ||
Reporting group title |
Group 2: Danicopan up to 200 mg TID
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Reporting group description |
Participants received not more than 200 mg of danicopan TID during the Treatment Period. | ||
Subject analysis set title |
Total
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
All participants who received at least 1 dose of ALXN2040.
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Subject analysis set title |
Group 1: Danicopan 100 mg TID
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Subject analysis set type |
Sub-group analysis | ||
Subject analysis set description |
Participants received 100 mg of danicopan TID during the Treatment Period.
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Subject analysis set title |
Group 2: Danicopan 150 mg TID
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Subject analysis set type |
Sub-group analysis | ||
Subject analysis set description |
Participants received 150 mg of danicopan TID during the Treatment Period.
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Subject analysis set title |
Group 2: Danicopan 200 mg TID
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Subject analysis set type |
Sub-group analysis | ||
Subject analysis set description |
Participants received 200 mg of danicopan TID during the Treatment Period.
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End point title |
Change From Baseline In Serum C3 Complement Protein (C3) Levels On Day 15 [1] | ||||||||||||||||||||||||||||
End point description |
Serum C3 levels were measured by conventional Roche immunoturbidimetric assay method. Change from Baseline = Serum C3 levels on Day 15 - Baseline Serum C3 levels.
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End point type |
Primary
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End point timeframe |
Baseline, Day 15
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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: Quantitative statistical analysis was not performed for this end point, per protocol. Descriptive statistics are included (mean and standard deviation). |
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Plasma Intact C3 Level On Day 15 [2] | ||||||||||||||||||||||||||||
End point description |
Plasma Intact C3 level were measured by a novel multiplex assay method. Change from Baseline = Plasma Intact C3 levels on Day 15 - Baseline Plasma Intact C3 levels.
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End point type |
Primary
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End point timeframe |
Baseline, Day 15
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Notes [2] - 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: Quantitative statistical analysis was not performed for this end point, per protocol. Descriptive statistics are included (mean and standard deviation). |
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Total Complement Classical Pathway (CP) Activity On Day 14 | ||||||||||||||||||||||||||||
End point description |
Serum CP activity was measured by a functional immunoassay method.
Change from Baseline = Total Complement CP Activity on Day 14 - Baseline Total Complement CP Activity
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End point type |
Secondary
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End point timeframe |
Baseline, Day 14
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Total Complement Alternative Pathway (AP) Functional Activity (AP Wieslab) On Day 15 | ||||||||||||||||||||||||||||
End point description |
Serum AP functional activity was measured by the Wieslab functional immunoassay method.
Change from Baseline = Total Complement AP Functional Activity on Day 15 - Baseline Total Complement AP Functional Activity
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End point type |
Secondary
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End point timeframe |
Baseline, Day 15
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No statistical analyses for this end point |
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End point title |
Time To Achieving Peak Serum C3 Levels | ||||||||||||||||
End point description |
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End point type |
Secondary
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End point timeframe |
From The First Day Of Dosing through Day 14
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No statistical analyses for this end point |
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End point title |
Serious Adverse Events (SAEs), Grade 3 And Grade 4 Treatment-emergent Adverse Events (TEAEs), And Adverse Events (AEs) Leading To Discontinuation | ||||||||||||||||||||||||||||
End point description |
An AE was as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An SAE was an AE that met at least 1 of the following criteria: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization for the AE, persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), important medical event or reaction. The intensity of an AE was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) Adverse Event Severity Grading Table. A summary of SAEs and other non-serious AEs regardless of causality is located in the Reported Adverse Events module.
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End point type |
Secondary
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End point timeframe |
Up to Day 49
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No statistical analyses for this end point |
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End point title |
Pharmacokinetics (PK): Area Under The Plasma Concentration-time Curve From Time Of Administration To 8 Hours Postdose (AUC0-8) | ||||||||||||||||||||||||
End point description |
Serial blood samples were collected predose and up to 8 hours postdose on Days 1 and 7.
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End point type |
Secondary
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End point timeframe |
Days 1 and 7
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No statistical analyses for this end point |
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End point title |
PK: Maximum Plasma Concentration (Cmax) | ||||||||||||||||||||||||
End point description |
Serial blood samples were collected predose and up to 8 hours postdose on Days 1 and 7.
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End point type |
Secondary
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End point timeframe |
Days 1 and 7
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No statistical analyses for this end point |
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End point title |
PK: Time To Maximum Concentration (Tmax) | ||||||||||||||||||||||||
End point description |
Serial blood samples were collected predose and up to 8 hours postdose on Days 1 and 7.
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End point type |
Secondary
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End point timeframe |
Days 1 and 7
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Bb Fragment Of Complement Factor B (Bb) At Day 15 | ||||||||||||||||||||||||||||
End point description |
Plasma Bb was measured by enzyme-linked immunosorbent assay (ELISA).
Change from Baseline = Complement Bb on Day 15 - Baseline
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End point type |
Secondary
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End point timeframe |
Baseline, Day 15
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No statistical analyses for this end point |
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End point title |
Change From Baseline In Soluble Terminal Complement Complex (sC5b-9) At Day 15 | ||||||||||||||||||||||||||||
End point description |
Plasma sC5b-9 was measured by ELISA.
Change from Baseline = sC5b-9 on Day 15 - Baseline sC5b-9
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End point type |
Secondary
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End point timeframe |
Baseline, Day 15
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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 |
After the first dose of study medication (following Day 0) through the follow-up visit at Day 49.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
12.1
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Reporting groups
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Reporting group title |
Group 1: Danicopan 100 mg TID (Sentinel)
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Reporting group description |
Participants received 100 mg of danicopan TID during the Treatment Period. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Group 2: Danicopan up to 200 mg TID
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Reporting group description |
Participants received not more than 200 mg of danicopan TID during the Treatment Period. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 0% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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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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07 Apr 2017 |
• Dose was increased based on current PK modeling and clinical safety in healthy volunteers. In Group 1, participants were given 100 mg TID instead of 75 mg TID. For Group 2, the maximum dose was changed from 125 mg TID to 150 mg TID.
• Circumstances under which an early dosing taper would be initiated were modified. Two consecutive C3 levels >125% upper limit of normal (ULN) or >3× a participant’s baseline value and greater than or equal to the lower limit of normal triggered initiation of the taper period, rather than >125% ULN after 7 days.
• Potential long-term follow-up visits were added to allow collection of longitudinal observational data. Participants were asked, but not required, to visit the clinic every 45 days for up to 1 year.
• AE definitions were clarified.
• Grading of AEs was changes from Division of AIDS criteria to CTCAE.
• The phase of the study was changed from 1b to 2a. |
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09 Jun 2017 |
• Dose levels were updated based on current PK modeling and clinical safety in healthy volunteers. The maximum dose level for Group 2 was changed from 150 mg to 200 mg TID.
• The eGFR calculation method was revised. The Modified Diet for Renal Disease equation was used for participants ≥18 years of age, and the Schwartz equation was used for participants <18 years of age.
• Blood volumes for clinical laboratory tests were updated to include blood drawn at the optional long-term follow-up visits.
• AE definitions were further clarified.
• The previous human experience was updated. |
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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. | |||
Sample size was based on very limited clinical cases of C3G and IC-MPGN. Plasma intact C3 values should be regarded with caution as they were generated using a new multiplex assay method with limited historical experience and unexplained variation. |