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Efficacy, Safety and Pharmacokinetics of Rilzabrutinib in Patients With Warm Autoimmune Hemolytic Anemia (wAIHA)

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: NCT05002777
Recruitment Status : Recruiting
First Posted : August 12, 2021
Last Update Posted : October 31, 2022
Information provided by (Responsible Party):

Brief Summary:

This is a single group treatment, Phase 2, open-label, study to evaluate the efficacy, safety and pharmacokinetics of rilzabrutinib in adult patients with wAIHA.

All participants will receive rilzabrutinib orally. The screening period is up to 28 days, followed by a treatment period of 24 weeks for Part A. Participants who complete Part A and are deemed eligible for Part B will continue to receive the study medication for 52 weeks following the Last Patient In (LPI-Part B). There will be a 7-day safety follow-up period after receiving the last dose of study drug either in Part A (for those not eligible for Part B or early terminated) or Part B. The estimated total duration of the study is approximately 137 weeks (Parts A and B), including the follow-up period. For participants deemed ineligible for Part B, the total length of the study will be 29 weeks (Part A only), including screening and the follow-up period. In Part B, participants who temporarily stop rilzabrutinib treatment and maintain a durable response from W50 to W74, will have their EOS visit at Week 75. In this case, participation will be for 79 weeks including the screening period.

Condition or disease Intervention/treatment Phase
Warm Autoimmune Hemolytic Anemia (wAIHA) Drug: rilzabrutinib Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Multicenter, Open-label, Phase IIb Study to Evaluate the Efficacy, Safety and Pharmacokinetics of Rilzabrutinib in Patients With Warm Autoimmune Hemolytic Anemia
Actual Study Start Date : December 7, 2021
Estimated Primary Completion Date : January 23, 2024
Estimated Study Completion Date : January 10, 2025

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anemia

Arm Intervention/treatment
Experimental: Rilzabrutinib
Oral rilzabrutinib 400 mg BID
Drug: rilzabrutinib
Pharmaceutical form: Tablet Route of administration: Oral
Other Name: PRN1008/SAR444671

Primary Outcome Measures :
  1. Part A: Proportion of participants with overall hemoglobin response [ Time Frame: By Week 24 in Part A ]

    Response is defined as an increase in hemoglobin (Hb) by ≥2 g/dL from baseline and an absence of transfusion in the last 7 days, without biochemical resolution of hemolysis at the time response is achieved and an absence of rescue medications during the last 4 weeks.

    Complete Response is defined as hemoglobin ≥11 g/dL (women) or ≥12 g/dL (men), no evidence of hemolysis (normal bilirubin, lactate dehydrogenase (LDH) , haptoglobin, and reticulocytes), and absence of transfusion in the last 7 days and an absence of rescue medications during the last 4 weeks.

  2. Part B: Proportion of participants who maintain durable response achieved during Part A or achieve a durable response during Part B and have a hemoglobin response [ Time Frame: At Week 50 in Part B ]
    Durable response (Part B) is defined as Hb level ≥10 g/dL with an increase from baseline (Part A) of ≥2 g/dL on three consecutive scheduled visits during Week 24 to Week 50; with absence of transfusion and no rescue medication during the period of 3 consecutive visits and for at least 7 days (transfusions) and 4 weeks (rescue medication) prior to the first consecutive visit.

Secondary Outcome Measures :
  1. Proportion of participants with durable hemoglobin response [ Time Frame: By Week 24 in Part A ]
    Durable response (Part A) is defined as Hb level ≥10 g/dL with an increase from baseline of ≥2 g/dL on three consecutive evaluable visits during the 24-week treatment period; with absence of transfusion and no rescue medication during the period of 3 consecutive visits and for at least 7 days (transfusions) and 4 weeks (rescue medication) prior to the first consecutive visit.

  2. Median time from baseline to first hemoglobin response [ Time Frame: From Day 1 to Week 24 in Part A ]
  3. Frequency of rescue therapy (any wAIHA-directed therapy other than predniso[lo]ne or transfusion) received [ Time Frame: After Week 1 of treatment to Week 24 in Part A and Week 75 in Part B ]
  4. Change from baseline in FACIT-Fatigue scale score [ Time Frame: Until Week 24 in Part A and Week 75 in Part B ]
    The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale is a 13-item questionnaire used to assesses self-reported fatigue and its impact on daily activities and function.

  5. Incidence of treatment emergent adverse events (TEAEs), serious TEAEs, adverse events of special interest (AESIs) [ Time Frame: Until Week 24 in Part A and Week 75 in Part B ]
    Safety assessment including clinical laboratory evaluations, vital sign measurements and ECG

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

Inclusion Criteria:

  • Male and female patients with a confirmed diagnosis of primary wAIHA or systemic lupus erythematosus (SLE)-associated wAIHA (without other SLE-related manifestations apart from cutaneous and musculoskeletal manifestations)
  • Participants who have previously failed to maintain a sustained response after treatment with corticosteroids.
  • Eastern Cooperative Oncology Group (ECOG) performance status grade 2 or lower.
  • Up-to-date vaccination status as per local guidelines.
  • Body mass index (BMI) >17.5 and <40 kg/m2
  • All contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.

Part B only

  • Evidence of treatment efficacy to rilzabrutinib as defined by achieving overall response during Part A.
  • Completion of Part A treatment period (24 weeks).

Exclusion Criteria:

  • Clinically significant medical history or ongoing chronic illness that would jeopardize the safety of the participant or compromise the quality of the data derived from his or her participation in the study as determined by the Investigator.
  • Participants with medical history of lymphoma, leukemia, or any malignancy within the past 5 years except for basal cell or squamous epithelial carcinomas of the skin that have been resected with no evidence of metastatic disease for the past 3 years.
  • Secondary wAIHA from any cause including drugs, lymphoproliferative disorders (low-count monoclonal B-cell lymphocytosis is allowed), infectious or autoimmune disease, or active hematologic malignancies. Participants with positive antinuclear antibodies but without a definitive diagnosis of an autoimmune disease are allowed.
  • Myelodysplastic syndrome.
  • Uncontrolled or active HBV infection: Patients with positive HBsAg and/or HBV DNA.
  • HIV infection.
  • Concurrent treatment with other experimental drugs or participation in another clinical trial with any investigational drug within 30 days or 5 half-lives, whichever is greater, prior to treatment start.
  • Known allergy to any of the study medications, their analogues, or excipients in the various formulations of any agent.

Part B only

  • Participants who receive any therapy during Part A known to be active in wAIHA.
  • Presence of unacceptable side effect(s) or toxicity associated with rilzabrutinib such that there is an unfavorable risk-benefit assessment for continued treatment with rilzabrutinib in the opinion of the Investigator and/or Sponsor.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

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): NCT05002777

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Contact: Trial Transparency email recommended (Toll free number for US & Canada) 800-633-1610 ext ext option 6 Contact-US@sanofi.com

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United States, District of Columbia
Investigational Site Number 8400003 Not yet recruiting
Washington, District of Columbia, United States, 20007
Contact: Jennifer Steffen    202-687-0116    js4936@georgetown.edu   
Principal Investigator: Catherine Broome         
United States, Florida
Investigational Site Number 8400002 Recruiting
Tamarac, Florida, United States, 33321
Contact: Nima Nagarajan    954-302-3163    nnagarajan@advancedresearchfl.com   
Principal Investigator: Sumit Sawhney         
United States, Massachusetts
Investigational Site Number 8400001 Not yet recruiting
Boston, Massachusetts, United States, 02114
Contact    617-724-4000      
Principal Investigator: David Kuter         
Investigational Site Number 1560002 Recruiting
Beijing, China, 100005
Contact: Dr. Bing Han    13601059938    hanbing_li@sina.com.cn   
Principal Investigator: Dr. Bing Han         
Investigational Site Number 2080001 Recruiting
Odense, Denmark, 5000
Principal Investigator: Henrik Fredriksen, Dr         
Investigational Site Number 3800002 Not yet recruiting
Avellino, Italy, 83100
Contact: Antonio Risitano       amrisita@unina.it   
Investigational Site Number 3800001 Recruiting
Milan, Italy, 20149
Contact: Wilma Barcellini       wilma.barcellini@policlinico.mi.it   
Investigational Site Number 7240001 Recruiting
Barcelona, Spain, 08036
Contact: Dr. Joan Cid    0034932275400    jcid@clinic.cat   
Principal Investigator: Dr. Joan Cid         
Investigational Site Number 7240003 Recruiting
Madrid, Spain, 28046
Contact: Dr. Marta Morado    0034917277000    marta.morado@gmail.com   
Principal Investigator: Dr. Marta Morado         
Investigational Site Number 7240002 Recruiting
Sevilla, Spain, 41013
Contact: Dr. Maria Eva Mingot    0034955012000    memingot@gmail.com   
Principal Investigator: Dr. Maria Eva Mingot         
United Kingdom
Investigational Site Number 8260001 Not yet recruiting
Leeds, United Kingdom, LS9 7TF
Investigational Site Number 8260005 Recruiting
London, United Kingdom, E1 1BB
Investigational Site Number 8260002 Not yet recruiting
London, United Kingdom, E1 2ES
Sponsors and Collaborators
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Responsible Party: Sanofi
ClinicalTrials.gov Identifier: NCT05002777    
Other Study ID Numbers: ACT17209
2021-001671-16 ( EudraCT Number )
U1111-1262-2929 ( Registry Identifier: ICTRP )
First Posted: August 12, 2021    Key Record Dates
Last Update Posted: October 31, 2022
Last Verified: October 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Anemia, Hemolytic
Anemia, Hemolytic, Autoimmune
Hematologic Diseases
Pathologic Processes
Autoimmune Diseases
Immune System Diseases