a multicenter, open-label phase 3 study: ambulatory blood pressure monitoring in adult patients with chronic spontaneous urticaria inadequately controlled by h1-antihistamines treated with remibrutinib up to 12 weeks.

Conditions: Chronic Spontaneous Urticaria

Summary: the purpose of this study was to assess the effect of remibrutinib 25 mg twice a day (b.i.d.) open-label on systolic blood pressure (sbp) measured as a change in 24-hour weighted average sbp from baseline to week 4 assessed by ambulator blood pressure monitoring (abpm); and to assess overall safety and efficacy over 12 weeks in adult participants with chronic spontaneous urticaria (csu) inadequately controlled with second generation h1 antihistamines (h1-ah) treatment. abpm was chosen for the blood pressure assessment in this trial as recommended by the fda for drugs intended for chronic use (assessment of pressor effects of drugs guidance for industry (fda 2022)).

this study consisted of a screening period of up to 4 weeks, a 12-week open-label treatment period and a treatment-free follow-up period of 4 weeks, with a total study duration of up to 20 weeks. at the end of the treatment phase, participants had the option to continue in an extension study (clou064a2303b (nct05513001)) if approved in the country and at the site.

Eligibility criteria:
key inclusion criteria: * signed informed consent obtained prior to participation in the study * male and female adult participants \>= 18 years of age * csu duration for \>= 6 months prior to screening (defined as the onset of csu determined by the investigator based on all available supporting documentation). * diagnosis of csu inadequately controlled by second generation h1-ah at the time of baseline (day 1) * documentation of hives within three months before baseline (either at screening and/or at baseline (day 1); or documented in the participants' medical history). * willing and able to complete an urticaria patient daily diary (updd) for the duration of the study and adhere to the protocol * participants had no more than 2 missing updd entries (either morning or evening) in the 7 days prior to baseline (day 1). key exclusion criteria: * participants unable to tolerate 24-hour ambulatory blood pressure measurement using automatic abpm device * ongoing or past history of hypertension and/or sbp \>= 140 or =\ = 90 or =\< 60 mmhg at screening * participants working night shifts * participants taking/requiring medications prohibited by the protocol (including those known to interfere with blood pressure assessments in the study) * evidence of clinically significant cardiovascular, neurological, psychiatric, pulmonary, renal, hepatic, endocrine, metabolic, hematological disorders, gastrointestinal disease or immunodeficiency that, in the investigator's opinion, would compromise the safety of the participant, interfere with the interpretation of the study results or otherwise preclude participation or protocol adherence of the participant.

Keywords: chronic spontaneous urticaria (csu) remibrutinib systolic blood pressure (sbp) diastolic blood pressure (dbp) ambulator blood pressure monitoring (abpm) h1 antihistamines (h1-ah) treatment