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    Clinical Trial Results:
    An Open-label Extension to the Phase 2 Randomized, Double-blind, Placebo-controlled, Crossover Multicenter Study to Evaluate the Safety and Efficacy of KZR-616 in the Treatment of Patients with Active Polymyositis or Dermatomyositis

    Summary
    EudraCT number
    2020-004382-39
    Trial protocol
    CZ  
    Global end of trial date
    12 Jun 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    27 Jun 2024
    First version publication date
    27 Jun 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    KZR-616-003E
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04628936
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Kezar Life Sciences, Inc.
    Sponsor organisation address
    4000 Shoreline Court, Suite 300, South San Francisco, United States, 94080
    Public contact
    Regulatory Affairs, Kezar Life Sciences, Inc., 001 6508225600, PRESIDIO@kezarbio.com
    Scientific contact
    Clinical Science, Kezar Life Sciences, Inc., 001 6508225600, PRESIDIO@kezarbio.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
    27 Jul 2023
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    10 Mar 2023
    Global end of trial reached?
    Yes
    Global end of trial date
    12 Jun 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Efficacy: To evaluate the long-term efficacy of zetomipzomib (KZR-616) in patients with PM or DM. Safety: To evaluate the long-term safety and tolerability of zetomipzomib (KZR-616) in patients with PM or DM.
    Protection of trial subjects
    Investigators and all parties involved in this study conducted the study in adherence to the ethical principles based on the Declaration of Helsinki, ICH guidelines for cGCP, and the applicable laws and regulatory requirements. IRB/IEC approval of the study and relevant study information (e.g. protocol, informed consent form (ICF), patient-facing materials) was obtained before initiation of study sites or releasing study drug to sites. Extensions/renewals of the approval were obtained as necessary. Written informed consent (signed and dated) was obtained before any study-related procedures were performed. Patients were given every opportunity to ask for clarification and were given ample time to consider the study. Patients may refuse to enter the study or to withdraw from the study at any time, without consequences for their further care or penalty or loss of benefits to which the patient is otherwise entitled. All Investigators promptly reported any new information that may have adversely affected patient safety or the study conduct and submitted study status summaries to the IRB/IEC as required. Patients were informed about new information available that was relevant to their willingness to continue participation in the study and were reconsented to the IRB/IEC/regulatory authorities currently approved ICF. Patients’ identity remained confidential in any presentations or publications of the study results. All personal data collected and processed for the purposes of this study were managed with adequate precautions to ensure confidentiality of data, and in accordance with the applicable laws and regulations on personal data protection. A study-specific Data Monitoring Committee met to review accumulating safety data, study conduct and progress and to make recommendations about the study progress on a regular basis. Each voting member provided their recommendation at the conclusion of each meeting.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    04 Nov 2020
    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 States: 17
    Country: Number of subjects enrolled
    Czechia: 1
    Worldwide total number of subjects
    18
    EEA total number of subjects
    1
    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)
    15
    From 65 to 84 years
    3
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    This was an optional open-label extension to Study KZR-616-003 (EudraCT Number: 2019-002605-22). Twenty patients completed the KZR-616-003 study and were eligible to enroll in the open-label extension.

    Pre-assignment period milestones
    Number of subjects started
    18
    Number of subjects completed
    18

    Period 1
    Period 1 title
    Open Label Extension (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    KZR-616 45 mg + Standard Therapy (Open-label)
    Arm description
    All patients received SC injections of KZR-616 QW at doses of 30 mg on day 1 and 45 mg thereafter for up to 96 weeks. Study drug administration ended when the last enrolled patient completed 48 weeks of dosing in the OLE. Patients had an end of study visit 12 weeks after the last dose of KZR-616. KZR-616: zetomipzomib subcutaneous injection
    Arm type
    Experimental

    Investigational medicinal product name
    zetomipzomib
    Investigational medicinal product code
    Other name
    KZR-616
    Pharmaceutical forms
    Powder for solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All patients received a SC injection of 30 mg KZR-616 at Visit 1 (Day 1), followed by weekly SC injections of 45 mg KZR-616 up to a maximum of 96 weeks. Study drug administration ended for all patients in Study KZR-616-003E when the last patient enrolled completed 48 weeks of dosing.

    Number of subjects in period 1
    KZR-616 45 mg + Standard Therapy (Open-label)
    Started
    18
    Completed
    8
    Not completed
    10
         Consent withdrawn by subject
    9
         Adverse event, non-fatal
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Open Label Extension
    Reporting group description
    -

    Reporting group values
    Open Label Extension Total
    Number of subjects
    18 18
    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)
    15 15
        From 65-84 years
    3 3
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    52.7 ( 14.3 ) -
    Gender categorical
    Units: Subjects
        Female
    13 13
        Male
    5 5

    End points

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    End points reporting groups
    Reporting group title
    KZR-616 45 mg + Standard Therapy (Open-label)
    Reporting group description
    All patients received SC injections of KZR-616 QW at doses of 30 mg on day 1 and 45 mg thereafter for up to 96 weeks. Study drug administration ended when the last enrolled patient completed 48 weeks of dosing in the OLE. Patients had an end of study visit 12 weeks after the last dose of KZR-616. KZR-616: zetomipzomib subcutaneous injection

    Subject analysis set title
    KZR-616 45 mg + Standard Therapy (Open-label)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All patients received SC injections of KZR-616 QW at doses of 30 mg on day 1 and 45 mg thereafter for up to 96 weeks. Study drug administration ended when the last enrolled patient completed 48 weeks of dosing in the OLE. Patients had an end of study visit 12 weeks after the last dose of KZR-616. KZR-616: zetomipzomib subcutaneous injection

    Primary: Mean Total Improvement Score (TIS) at OLE Week 48

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    End point title
    Mean Total Improvement Score (TIS) at OLE Week 48 [1]
    End point description
    The mean Total Improvement Score (TIS) at OLE Week 48, which ranges from 0 to 100 [low of 0 to high of 100, where higher scores are better]. The timeframe of 48 weeks was selected because it represented the maximum timeframe of dosing for the last patient enrolled as the study drug administration ended when the last patient enrolled completed 48 weeks of dosing.
    End point type
    Primary
    End point timeframe
    48 weeks
    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: Study KZR-616-003E was an open-label extension study which was descriptive in nature, and no formal hypothesis testing was performed. No formal statistical sample size estimation was performed, since the number of patients in this study was determined by the number of patients who completed Study KZR-616-003 and enrolled in the OLE study.
    End point values
    KZR-616 45 mg + Standard Therapy (Open-label)
    Number of subjects analysed
    9
    Units: score on a scale
        arithmetic mean (standard deviation)
    36.4 ( 23.2 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to 108 weeks
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.1
    Reporting groups
    Reporting group title
    KZR-616 45 mg + Standard Therapy (Open-label)
    Reporting group description
    All patients received SC injections of KZR-616 QW at doses of 30 mg on day 1 and 45 mg thereafter for up to 96 weeks. Study drug administration ended when the last enrolled patient completed 48 weeks of dosing in the OLE. Patients had an end of study visit 12 weeks after the last dose of KZR-616. KZR-616: zetomipzomib subcutaneous injection

    Serious adverse events
    KZR-616 45 mg + Standard Therapy (Open-label)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 18 (5.56%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Cardiac disorders
    Wellens' syndrome
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholecystitis acute
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    KZR-616 45 mg + Standard Therapy (Open-label)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    17 / 18 (94.44%)
    Vascular disorders
    Hot flush
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Hypertension
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    3
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Chest pain
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Chills
         subjects affected / exposed
    4 / 18 (22.22%)
         occurrences all number
    14
    Fatigue
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    41
    Influenza like illness
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Infusion site reaction
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Injection site bruising
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    47
    Injection site erythema
         subjects affected / exposed
    4 / 18 (22.22%)
         occurrences all number
    98
    Injection site exfoliation
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Injection site induration
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    6
    Injection site inflammation
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Injection site irritation
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Injection site pain
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    10
    Injection site pruritus
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    24
    Injection site rash
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Injection site reaction
         subjects affected / exposed
    8 / 18 (44.44%)
         occurrences all number
    177
    Injection site swelling
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    33
    Injection site urticaria
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Injection site vesicles
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Oedema peripheral
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Pain
         subjects affected / exposed
    5 / 18 (27.78%)
         occurrences all number
    38
    Pyrexia
         subjects affected / exposed
    5 / 18 (27.78%)
         occurrences all number
    18
    Vaccination site pain
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    3
    Reproductive system and breast disorders
    Menopausal symptoms
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Epistaxis
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Nasal congestion
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Investigations
    Reticulocyte count increased
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    White blood cell count decreased
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Administration related reaction
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Contusion
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    4
    Fall
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Injection related reaction
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Ligament sprain
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Post vaccination syndrome
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    4
    Underdose
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Diastolic dysfunction
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Pericardial effusion
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Headache
         subjects affected / exposed
    5 / 18 (27.78%)
         occurrences all number
    9
    Migraine
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Eye disorders
    Dry eye
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Keratitis
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Abdominal pain
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Abdominal pain upper
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Constipation
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Diarrhoea
         subjects affected / exposed
    5 / 18 (27.78%)
         occurrences all number
    6
    Diverticulum intestinal
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Dysphagia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Hiatus hernia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    6 / 18 (33.33%)
         occurrences all number
    31
    Vomiting
         subjects affected / exposed
    4 / 18 (22.22%)
         occurrences all number
    8
    Hepatobiliary disorders
    Biliary dilatation
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Cholelithiasis
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Hyperbilirubinaemia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Jaundice
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Dermatomyositis
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    4
    Pruritus
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    10
    Rash papular
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Skin hyperpigmentation
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Urticaria
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Hydronephrosis
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Ureterolithiasis
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    4
    Costochondritis
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Joint swelling
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Muscular weakness
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Myalgia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Pain in extremity
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Infections and infestations
    Adenovirus infection
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    COVID-19
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Gastroenteritis viral
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    3
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    3
    Viral upper respiratory tract infection
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Vulvovaginal mycotic infection
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Urinary tract infection
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Urinary tract infection bacterial
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Abnormal weight gain
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Hyperkalaemia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Hypoglycaemia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 Sep 2021
    Protocol amended to extend weekly KZR-616 administration until the last patient enrolled completed 48 weeks of dosing, and to support optional at-home KZR-616 administration by patients and caregivers.

    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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