E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Paroxysmal nocturnal hemoglobinuria |
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E.1.1.1 | Medical condition in easily understood language |
Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by the destruction of red blood cells. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10055629 |
E.1.2 | Term | Paroxysmal nocturnal hemoglobinuria |
E.1.2 | System Organ Class | 100000004857 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of the study is to evaluate the long-term safety, tolerability, and effect on intravascular hemolysis (ie, proportion of patients achieving lactate dehydrogenase (LDH) ≤ 1.5× upper limit of normal (ULN) over 26 weeks) of REGN3918 in patients with paroxysmal nocturnal hemoglobinuria (PNH). |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives of the study are: •To evaluate the long-term effect of REGN3918 on intravascular hemolysis. •To assess the concentrations of total REGN3918 in serum. •To evaluate the occurrence of the immunogenicity of REGN3918.
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
There are optional future biomedical research and pharmacogenomic analysis sub-studies . Subjects will be required to sign separate sub-study ICFs before collection of samples. There is no separate protocol. The purpose of the pharmacogenomic analyses is to identify genomic associations with clinical (safety or efficacy) or biomarker response to REGN3918, the complement pathway, PNH and related complement mediated diseases, clinical outcome measures, and possible AEs. There will not be separate sub-study protocols. |
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E.3 | Principal inclusion criteria |
1. Patients with PNH who have completed, without discontinuation, study treatment in one of the parent studies in which they participated 2. Willing and able to comply with clinic visits and study related procedures 3. Provide informed consent signed by study patient
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E.4 | Principal exclusion criteria |
1. Significant protocol deviation(s) in the parent study based on the investigator’s judgment and to the extent that these would (if continued) impact the study objectives and/or safety of the patient (for example, repetitive non-compliance with dosing by the patient). 2. Any new condition or worsening of an existing condition which, in the opinion of the investigator, would make the patient unsuitable for enrollment or could interfere with the patient participating in or completing the study.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary safety endpoint is incidence and severity of treatment-emergent adverse events (TEAEs) and other safety variables during the 2-year open-label treatment period of the study in patients treated with REGN3918. The primary efficacy endpoint is the proportion of patients achieving LDH ≤1.5×ULN over week 26, defined as LDH ≤1.5×ULN at every scheduled time point up to week 26 (inclusive) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
2 years for the primary safety endpoint 26 weeks for the primary efficacy endpoint |
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E.5.2 | Secondary end point(s) |
The secondary endpoints include: •The proportion of patients with breakthrough hemolysis over week 26 •The rate and number of units of transfusion over week 26
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 24 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Canada |
Germany |
Hong Kong |
Hungary |
Italy |
Korea, Democratic People's Republic of |
Malaysia |
Netherlands |
Poland |
Romania |
Singapore |
South Africa |
Taiwan |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |