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    Clinical Trial Results:
    A phase 2a proof of concept, randomised, double-blind, placebo-controlled study to evaluate the safety/tolerability and efficacy of 4 subcutaneous injections of namilumab (150 mg) given over 10 weeks in subjects with moderate-to-severely active axial spondyloarthritis including those previously exposed to anti-TNF therapy (NAMASTE study)

    Summary
    EudraCT number
    2018-000176-15
    Trial protocol
    GB  
    Global end of trial date
    04 Feb 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    19 Feb 2021
    First version publication date
    19 Feb 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    IZN-101
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Izana Bioscience Ltd
    Sponsor organisation address
    11-12 St. James's Square, Suite 1, 3rd Floor, London, United Kingdom, SW1Y 4LB
    Public contact
    Simon Lowry, MD, Head of Clinical Development, Roivant Sciences, Inc., on behalf of Izana Bioscience Limited, 1 (973) 309-1394, simon.lowry@roivant.com
    Scientific contact
    Simon Lowry, MD, Head of Clinical Development, Roivant Sciences, Inc., on behalf of Izana Bioscience Limited, 1 (973) 309-1394, simon.lowry@roivant.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
    08 May 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    04 Feb 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    04 Feb 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess the efficacy of namilumab 150 mg subcutaneous (sc), given on weeks 0, 2, 6 and 10 in subjects with axSpA. The study consisted of a maximum four-week Screening period, followed by a 12-week double-blind treatment evaluation period, followed by a 16-week safety follow-up period.
    Protection of trial subjects
    Safety was evaluated based on adverse events (AEs), clinical laboratory tests, vital sign measurements, physical examinations, ECGs (screening only), concomitant medication review, injection-site reactions, allergic reactions, infections, and tuberculosis (TB) evaluations.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    10 Jul 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 42
    Worldwide total number of subjects
    42
    EEA total number of subjects
    0
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    41
    From 65 to 84 years
    1
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    42 were randomised (36 subjects to treatment and 6 subjects to placebo)

    Pre-assignment
    Screening details
    42 were randomised (36 subjects to treatment and 6 subjects to placebo)

    Period 1
    Period 1 title
    Randomised (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    namilumab 150 mg
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    namilumab (150 mg)
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection, Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    4 subcutaneous injections of namilumab (150 mg) given over 10 weeks

    Arm title
    Placebo
    Arm description
    -
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    4 subcutaneous injections given over 10 weeks

    Number of subjects in period 1
    namilumab 150 mg Placebo
    Started
    36
    6
    Completed
    36
    6

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    namilumab 150 mg
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Reporting group values
    namilumab 150 mg Placebo Total
    Number of subjects
    36 6 42
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    35 6 41
        From 65-84 years
    1 0 1
        85 years and over
    0 0 0
    Age continuous
    Units: years
        median (standard deviation)
    39 ( 13.93 ) 38 ( 9.2 ) -
    Gender categorical
    Units: Subjects
        Female
    15 2 17
        Male
    21 4 25
    Duration of disease
    Units: Subjects
        More than 2 years
    36 6 42
    Prior Use of Anti-TNF Treatment
    Units: Subjects
        Yes
    36 6 42
    Subject analysis sets

    Subject analysis set title
    Treatment
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The FAS contains all subjects in the RND who received at least one dose of study drug.

    Subject analysis set title
    Placebo
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The FAS contains all subjects in the RND who received at least one dose of study drug.

    Subject analysis sets values
    Treatment Placebo
    Number of subjects
    36
    6
    Age categorical
    Units: Subjects
        In utero
    0
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
    0
        Newborns (0-27 days)
    0
    0
        Infants and toddlers (28 days-23 months)
    0
    0
        Children (2-11 years)
    0
    0
        Adolescents (12-17 years)
    0
    0
        Adults (18-64 years)
    35
    6
        From 65-84 years
    1
    0
        85 years and over
    0
    0
    Age continuous
    Units: years
        median (standard deviation)
    39 ( 13.93 )
    38 ( 9.2 )
    Gender categorical
    Units: Subjects
        Female
    15
    2
        Male
    21
    4
    Duration of disease
    Units: Subjects
        More than 2 years
    20
    2
    Prior Use of Anti-TNF Treatment
    Units: Subjects
        Yes
    6
    1

    End points

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    End points reporting groups
    Reporting group title
    namilumab 150 mg
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Subject analysis set title
    Treatment
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The FAS contains all subjects in the RND who received at least one dose of study drug.

    Subject analysis set title
    Placebo
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The FAS contains all subjects in the RND who received at least one dose of study drug.

    Primary: ASAS20 Clinical Response at week 12

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    End point title
    ASAS20 Clinical Response at week 12
    End point description
    The primary endpoint was the proportion of subjects who achieved an ASAS20 clinical response at Week 12.
    End point type
    Primary
    End point timeframe
    Week 12
    End point values
    namilumab 150 mg Placebo
    Number of subjects analysed
    36
    6
    Units: percent
        number (not applicable)
    14
    3
    Statistical analysis title
    Bayesian analysis
    Comparison groups
    namilumab 150 mg v Placebo
    Number of subjects included in analysis
    42
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    > 0.927
    Method
    Bayesian
    Parameter type
    beta prior
    Confidence interval

    Secondary: Proportion of subjects who achieved Assessment in Ankylosing Spondylitis with 40% improvement (ASAS40), Week 12

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    End point title
    Proportion of subjects who achieved Assessment in Ankylosing Spondylitis with 40% improvement (ASAS40), Week 12
    End point description
    Proportion of subjects who achieved Assessment in Ankylosing Spondylitis with 40% improvement (ASAS40) response at Week 12
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    Number of subjects analysed
    Units: Number
    No statistical analyses for this end point

    Secondary: Proportion of Subjects Who Achieved ASAS20 Clinical Response at Week 6

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    End point title
    Proportion of Subjects Who Achieved ASAS20 Clinical Response at Week 6
    End point description
    Proportion of Subjects Who Achieved ASAS20 Clinical Response at Week 6
    End point type
    Secondary
    End point timeframe
    Week 6
    End point values
    Number of subjects analysed
    Units: Number
    No statistical analyses for this end point

    Secondary: Proportions of Subjects Who Achieved Clinically Important ASDAS-CRP Score at Week 6

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    End point title
    Proportions of Subjects Who Achieved Clinically Important ASDAS-CRP Score at Week 6
    End point description
    Proportions of Subjects Who Achieved Clinically Important ASDAS-CRP Score at Week 6
    End point type
    Secondary
    End point timeframe
    Week 6
    End point values
    Number of subjects analysed
    Units: Number
    No statistical analyses for this end point

    Secondary: Proportions of Subjects Who Achieved Clinically Important ASDAS-CRP Score at Week 12

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    End point title
    Proportions of Subjects Who Achieved Clinically Important ASDAS-CRP Score at Week 12
    End point description
    Proportions of Subjects Who Achieved Clinically Important ASDAS-CRP Score at Week 12
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    Number of subjects analysed
    Units: Number
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    28 weeks
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23
    Reporting groups
    Reporting group title
    placebo
    Reporting group description
    Subjects were given four sc injections of placebo over 10 weeks and followed up for 28 weeks

    Reporting group title
    Treatment
    Reporting group description
    All subjects that received at least one dose subcutaneous of namilumab 150 mg

    Serious adverse events
    placebo Treatment
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 36 (2.78%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Injury, poisoning and procedural complications
    Road traffic accident
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 36 (2.78%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Duodenitis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 36 (2.78%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    placebo Treatment
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    5 / 6 (83.33%)
    31 / 36 (86.11%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 36 (5.56%)
         occurrences all number
    0
    2
    General disorders and administration site conditions
    Chest discomfort
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 36 (2.78%)
         occurrences all number
    1
    1
    Reproductive system and breast disorders
    Polymenorrhoea
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    0 / 6 (0.00%)
    3 / 36 (8.33%)
         occurrences all number
    0
    3
    Dyspnoea
         subjects affected / exposed
    0 / 6 (0.00%)
    3 / 36 (8.33%)
         occurrences all number
    0
    3
    Pleuritic pain
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 36 (2.78%)
         occurrences all number
    1
    1
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 36 (5.56%)
         occurrences all number
    0
    2
    Investigations
    Protein urine present
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0
    Injury, poisoning and procedural complications
    Limb injury
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0
    Nervous system disorders
    Hypoaesthesia
         subjects affected / exposed
    0 / 6 (0.00%)
    3 / 36 (8.33%)
         occurrences all number
    0
    3
    Blood and lymphatic system disorders
    Macrocytosis
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    1 / 6 (16.67%)
    7 / 36 (19.44%)
         occurrences all number
    1
    7
    Diarrhoea
         subjects affected / exposed
    0 / 6 (0.00%)
    3 / 36 (8.33%)
         occurrences all number
    0
    3
    Vomiting
         subjects affected / exposed
    0 / 6 (0.00%)
    3 / 36 (8.33%)
         occurrences all number
    0
    3
    Gastritis
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 36 (5.56%)
         occurrences all number
    0
    2
    Frequent bowel movements
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    Urticaria
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 36 (5.56%)
         occurrences all number
    0
    2
    Pain in extremity
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 36 (2.78%)
         occurrences all number
    1
    1
    Neck pain
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0
    Osteopenia
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    0 / 6 (0.00%)
    9 / 36 (25.00%)
         occurrences all number
    0
    9
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 36 (5.56%)
         occurrences all number
    1
    2
    Urinary tract infection
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 36 (5.56%)
         occurrences all number
    1
    2
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 36 (2.78%)
         occurrences all number
    1
    1
    Infected cyst
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0
    Otitis externa
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 36 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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