E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Paroxysmal Nocturnal Hemoglobinuria (PNH) |
Hémoglobinurie paroxystique nocturne (HPN) |
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E.1.1.1 | Medical condition in easily understood language |
Blood disorder |
Maladie du sang |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10034042 |
E.1.2 | Term | Paroxysmal nocturnal haemoglobinuria |
E.1.2 | System Organ Class | 10038359 - Renal and urinary disorders |
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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 |
Proportion of participants achieving a sustained increase in hemoglobin levels of ≥ 2 g/dL in the absence of red blood cell transfusion |
Evaluer l'effet de l'iptacopan (LNP023) sur la proportion de patients traités par l’iptacopan ayant atteint une augmentation durable par rapport à la baseline des taux d'hémoglobine ≥ 2 g/dl en l'absence de transfusion de globules rouges |
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E.2.2 | Secondary objectives of the trial |
- Proportion of participants achieving sustained hemoglobin levels ≥ 12 g/dL in the absence of red blood cell transfusions - Transfusion avoidance (TA) defined as the proportion of participants who remain free from transfusions - Change from baseline in hemoglobin - Percent change from baseline in LDH - Rate of breakthrough hemolysis (BTH) - Change from baseline in reticulocyte counts - Change in fatigue score, using the FACIT-Fatigue questionnaire - Rates of Major Adverse Vascular Events (MAVEs incl. thrombosis) |
- Evaluer l'effet de l'iptacopan sur la proportion de patients atteignant des taux d'hémoglobine durables ≥ 12 g/dl en absence de transfusions de globules rouges. - Evaluer l'effet de l'iptacopan sur l'évitement des transfusions défini comme la proportion de patients exempts de transfusions. - Evaluer l'effet de l'iptacopan sur la variation moyenne de l’hémoglobine - Evaluer l'effet de l'iptacopan sur le pourcentage moyen de variation du LDH - Evaluer l'effet de l'iptacopan sur le taux d’épisodes hémolytiques intercurrents - Evaluer l'effet de l'iptacopan sur la variation moyenne du nombre de réticulocytes - Evaluer l'effet de l'iptacopan sur l'amélioration de la fatigue, à l'aide du questionnaire FACIT-Fatigue - Evaluer les taux d'événements vasculaires majeurs (y compris thromboses) - Evaluer la sécurité d'emploi et la tolérance de l’iptacopan.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Male and female participants ≥ 18 years of age with a diagnosis of PNH confirmed by high-sensitivity flow cytometry with RBCs and WBCs clone size ≥ 10% - Mean hemoglobin level <10 g/dL • LDH > 1.5 x Upper Limit of Normal (ULN) - Vaccination against Neisseria meningitidis infection is required prior to the start of study treatment - If not received previously, vaccination against Streptococcus pneumoniae and Haemophilus influenzae infections should be given
Other protocol defined inclusion/exclusion criteria may apply. |
-Patients masculins et féminins ≥ 18 ans avec un diagnostic d’HPN confirmé par cytométrie de flux à haute sensibilité avec quantification de la taille du clone monocytaire ou granulocytaire des globules rouges et blancs ≥ 10%. -Taux d'hémoglobine moyen <10 g/dL confirmé par l'évaluation du laboratoire central pendant la sélection et avant de commencer le traitement -LDH > 1,5 x limite supérieure de la normale (LSN) -La vaccination contre l'infection par Neisseria meningitidis est requise avant le début du traitement par iptacopan. -Si elle n‘a pas été réalisée auparavant, la vaccination contre les infections à Streptococcus pneumoniae et Haemophilus influenzae doit être administrée,
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E.4 | Principal exclusion criteria |
- Prior treatment with a complement inhibitor, including anti-C5 antibody - Known or suspected hereditary complement deficiency - History of hematopoietic stem cell transplantation - Patients with laboratory evidence of bone marrow failure (reticulocytes <100x109/L; platelets <30x109/L; neutrophils <0.5x109/L). - Active systemic bacterial, viral (incl. COVID-19)or fungal infection within 14 days prior to study drug administration - History of recurrent invasive infections caused by encapsulated organisms, e.g. meningococcus or pneumococcus. - Major concurrent comorbidities including but not limited to severe kidney disease (e.g., dialysis), advanced cardiac disease (e.g., NYHA class IV heart failure), severe pulmonary disease (e.g., severe pulmonary hypertension (WHO class IV)), or hepatic disease (e.g., active hepatitis) that in the opinion of the investigator precludes participant's participation in the study.
Other protocol defined inclusion/exclusion criteria may apply. |
-Traitement antérieur par un inhibiteur du complément, y compris par anticorps anti-C5 -Déficit héréditaire en complément connu ou suspecté -Antécédents de greffe de cellules souches hématopoïétiques -Signes biologiques d'aplasie médullaire (réticulocytes < 100x109/L, plaquettes < 30x109/L, neutrophiles < 0,5x109/L) -Infection systémique bactérienne, virale (incluant COVID-19) ou fongique active dans les 14 jours précédant l'administration du médicament à l'étude -Antécédents d'infections invasives récurrentes provoquées par des organismes encapsulés, par ex. méningocoque ou pneumocoque -Comorbidités concomitantes majeures, y compris, mais sans s'y limiter, une maladie rénale sévère (par exemple, dialyse), une maladie cardiaque sévère (par ex Insuffisance cardiaque, New York Heart Association-NYHA classe IV), une maladie pulmonaire sévère (par ex., hypertension pulmonaire sévère - classe IV de l'Organisation Mondiale de la Santé-OMS) ou une maladie hépatique (par ex., hépatite active) qui, de l'avis de l'investigateur, exclut la participation du patient à l'étude
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of participants achieving a sustained increase from baseline in hemoglobin levels of ≥ 2 g/dL assessed between Day 126 and Day 168, in the absence of packed red blood cell (pRBC) transfusions between Day 14 and Day 168 |
Proportion de patients ayant obtenu une augmentation durable des taux d'hémoglobine par rapport à la baseline ≥ 2 g/dL entre le jour 126 et le jour 168 en l'absence de transfusion entre le jour 14 et le jour 168 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Between Day 126 and Day 168 |
Entre le jour 126 et le jour 168 |
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E.5.2 | Secondary end point(s) |
1. Proportion of participants achieving sustained hemoglobin levels ≥ 12 g/dL between Day 126 and Day 168 in absence of red blood cell transfusion between Day 14 and Day 168 2. Transfusion avoidance (TA) defined as the proportion of participants who remain free from transfusions 3. Change from baseline in hemoglobin (g/dL) as mean of visits between Day 126 and Day 168 4. Percent change from baseline in LDH levels (U/L) as mean of visits between Day 126 and Day 168 5. Occurrences of breakthrough hemolysis reported between Day 1 and Day 168 6. Change from baseline in reticulocyte counts as mean of visits between Day 126 and Day 168 7. Change from baseline in FACIT-Fatigue scores as mean of visits between Day 126 and Day 168 8. Occurrences of MAVEs occurring between Day 1 and Day 168 |
1. Réponse définie par un taux d'hémoglobine ≥ 12 g/dL entre le jour 126 et le jour 168, en l'absence de transfusions de globules rouges entre le jour 14 et le jour 168. 2. Absence d’administration de transfusions de culot globulaire (pRBC) entre le jour 14 et le jour 168. 3. Variation par rapport à la baseline de l'hémoglobine (g/dL) moyenne aux visites entre le jour 126 et le jour 168. 4. Pourcentage de variation par rapport à la baseline des taux de LDH (U/L) moyenne aux visites entre le jour 126 et le jour 168. 5. Occurrence d’épisodes hémolytiques intercurrents entre le jour 1 et le jour 168. 6. Variation par rapport à la baseline du nombre de réticulocytes (109/L) moyen aux visites entre le jour 126 et le jour 168. 7. Variation par rapport à la baseline des scores FACIT-Fatigue moyens aux visites entre le jour 126 et le jour 168. 8. Occurrence d’événements indésirables vasculaires majeurs (MAVE) survenant entre le jour 1 et le jour 168. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Between Day 126 and Day 168 2. Between Day 14 and Day 168 3. Between Day 126 and Day 168 4. Between Day 126 and Day 168 5. Between Day 1 and Day 168 6. Between Day 126 and Day 168 7. Between Day 126 and Day 168 8. Between Day 1 and Day 168 |
1. Entre le jour 126 et le jour 168 2. Entre le jour 14 et le jour 168 3. Entre le jour 126 et le jour 168 4. Entre le jour 126 et le jour 168 5. Entre le premier jour et le jour 168 6. Entre le jour 126 et le jour 168 7. Entre le jour 126 et le jour 168 8. Entre le premier jour and le jour 168
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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 | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
tolerability |
tolérabilité |
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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
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 12 |
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 |
China |
Japan |
Korea, Republic of |
Malaysia |
Singapore |
United States |
France |
Germany |
Italy |
United Kingdom |
Czechia |
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E.8.7 | Trial has a data monitoring committee | Yes |
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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LVLS |
La Dernière visite du dernièr patient |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |