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Treatment of Bullous Pemphigoid With Avdoralimab (IPH5401), an Anti-C5aR1 Monoclonal Antibody (IPH)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04563923
Recruitment Status : Not yet recruiting
First Posted : September 25, 2020
Last Update Posted : September 25, 2020
Sponsor:
Information provided by (Responsible Party):
Centre Hospitalier Universitaire de Nice

Brief Summary:

The development of Auto Immune bullous Diseases (AIBD) results from a complex interaction between innate and adaptive immune systems. Bullous pemphigoid (BP), the most frequently encountered AIBD, predominantly affects elderly patients above 70 with an estimated incidence of 21.7 new cases/million/year in France.Interestingly, coversin, an anti-C5a and -leukotriene B4 small molecule, is currently used in a phase IIA clinical trial in BP patients (NCT04035733). However, although overall C5-blocking drugs are potentially interesting, they are likely to interfere with C5a-C5aR2-axis activation as well, a pathway that has recently proved protective in BP 12. The main objective is to investigate the clinical efficacy of an anti-C5aR1 antibody in addition to superpotent topical steroids compared to superpotent topical steroids alone in BP patients at 3 months.It is a case-controlled, randomized, open-labelled, and multicenter phase II clinical trial. Four Dermatologic French centers (Nice, Marseille Nord, Marseille Timone and Montpellier university hospitals) specialized in the in the care of BP patients will be participating in the study. It is expected that forty subjects will be included in this trial.

Conversely, a more targeted inhibition of C5a-C5aR1 axis might be more effective in BP, sparing the potentially protective effect of C5a-C5aR2 interaction.

Avdoralimab (IPH5401), a specific anti-C5aR1 monoclonal antibody, has already been credited of a good safety profile in the treatment of solid tumors and rheumatoid arthritis. The investigators hypothesize that avdoralimab might be a safe and effective treatment in BP patients


Condition or disease Intervention/treatment Phase
Bullous Pemphigoid Drug: Avdoralimab (IPH5401) Other: Control Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 40 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: It is a case-controlled, randomized, open-labelled, and multicenter phase II clinical trial. Four Dermatologic French centers (Nice, Marseille Nord, Marseille Timone and Montpellier university hospitals) specialized in the in the care of BP patients will be participating in the study. It is expected that forty subjects will be included in this trial.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Treatment of Bullous Pemphigoid With Avdoralimab (IPH5401), an Anti-C5aR1 Monoclonal Antibody
Estimated Study Start Date : October 1, 2020
Estimated Primary Completion Date : April 30, 2021
Estimated Study Completion Date : December 31, 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Pemphigus

Arm Intervention/treatment
Experimental: Drug

Patients in this group will additionally receive 3 s.c. injections of avdoralimab every week during 12 weeks

They receive 0.05% Clobetasol propionate cream as follows:

  • Patients of less than 45kg of body weight: 2 tubes of 10g/d
  • Patients of 45kg and above of body weight: 3 tubes of 10g/d Topical steroids will be applied every day until 15 days after the healing of the last bullous lesions
Drug: Avdoralimab (IPH5401)
Preparation of avdoralimab and preparation of the syringes are to be performed aseptically by site pharmacy qualified personnel.

Conventional therapy

Superpotent topical steroids are the gold standard treatment for BP. All patients will receive 0.05% Clobetasol propionate cream as follows:

  • Patients of less than 45kg of body weight: 2 tubes of 10g/d
  • Patients of 45kg and above of body weight: 3 tubes of 10g/d Topical steroids will be applied every day until 15 days after the healing of the last bullous lesions
Other: Control

Superpotent topical steroids are the gold standard treatment for BP. All patients will receive 0.05% Clobetasol propionate cream as follows:

  • Patients of less than 45kg of body weight: 2 tubes of 10g/d
  • Patients of 45kg and above of body weight: 3 tubes of 10g/d Topical steroids will be applied every day until 15 days after the healing of the last bullous lesion




Primary Outcome Measures :
  1. Complete Clinical Remission [ Time Frame: At 3 Months ]
    To investigate the clinical efficacy of an anti-C5aR1 antibody in addition to superpotent topical steroids compared to superpotent topical steroids alone in BP patients.The efficacy will be evaluated through the proportion of patients in complete clinical remission (CCR) at 3 months without any relapse during the study period. The CCR will be defined as the absence of new bullous and skin inflammatory lesions and absence of pruritus for at least 2 weeks.


Secondary Outcome Measures :
  1. The delay [ Time Frame: At 3 months ]
    To compare between the treatment groups the delay to complete clinical remission (CCR)

  2. Initial Clinical Remission [ Time Frame: At 3 months ]
    To compare between the treatment groups the delay to initial clinical remission (ICR)



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female
  • ≥ 18 years of age at the time of signing the informed consent document
  • Clinical diagnosis of BP confirmed by histology, immunohistochemistry and/or ELISA data
  • Patient requiring a treatment by superpotent topical steroids
  • Patients hospitalized for the treatment of their BP
  • For female, only post-menopaused patients
  • For male patients included in the study with partners of child bearing potential should agree to use highly effective contraception for the duration of the study and 6 months after the last dose of avdoralimab
  • Signed informed consent document prior to any study related assessments/procedures being conducted
  • Patient able to adhere to the study visit schedule and other protocol requirements
  • Patient registered to the French Social Security

Exclusion Criteria:

  • Patients requiring systemic steroids according to the physician in charge
  • Contra indication to topical steroid
  • Use of systemic steroids or any immunosuppressive drugs in the past 4 weeks
  • Use of doxycycline or minocycline in the past 4 weeks
  • Use of systemic rituximab or omalizumab or dupilimumab in the past 12 weeks
  • Use of intravenous immunoglobulmins (IVIG) in the past 4 weeks
  • Impossibility to come every week to receive the injection
  • Participants in other clinical therapeutic studies involving a drug that could interfere with the present evaluation
  • Vulnerable people: pregnant or breast-feeding women, minors, adult under guardianship or deprived of freedom

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04563923


Contacts
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Contact: Passeron Thierry, PhD +33492039224 passeron.t@chu-nice.fr

Locations
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France
CHU de Nice- Dermatologie
Nice, Alpes-Maritimes, France, 06200
Contact: Passeron Thierry, PhD    +33492039224    passeron.t@chu-nice.fr   
Principal Investigator: Passeron Thierry, PhD         
APHM, Timone
Marseille, Bouche Du Rhône, France, 13005
Contact: Richard Marie-Aneth, PhD       mrichard@aph-hm.fr   
Sub-Investigator: Richard Marie-Aleth, PhD         
APHM, Hôpital Nord
Marseille, Bouches Du Rhône, France, 13000
Contact: Delaporte Emmanuel, PhD       emmanuel.delaporte@ap-hm.fr   
Sub-Investigator: Delaporte Emmanuel, PhD         
CHU Montpellier, Dermatologie
Montpellier, Herault, France, 34005
Contact: Dereure Olivier, PhD       o-dereure@chu-montpellier.fr   
Sub-Investigator: Dereure Olivier, PhD         
Sponsors and Collaborators
Centre Hospitalier Universitaire de Nice
Investigators
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Principal Investigator: Passeron Thierry, PhD CHU de Nice, Dermatologie
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Responsible Party: Centre Hospitalier Universitaire de Nice
ClinicalTrials.gov Identifier: NCT04563923    
Other Study ID Numbers: 20-PP-13
First Posted: September 25, 2020    Key Record Dates
Last Update Posted: September 25, 2020
Last Verified: September 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Pemphigoid, Bullous
Skin Diseases, Vesiculobullous
Skin Diseases
Autoimmune Diseases
Immune System Diseases