Clinical trial NCT06449001: Study of Danicopan as Add-on Treatment to Ravulizumab or Eculizumab in Pediatric Participants With PNH Who Have Clinically Significant Extravascular Hemolysis
Official title: A Phase 3 Open-Label Study of Danicopan as Add-on Treatment to Ravulizumab or Eculizumab in Pediatric Participants With Paroxysmal Nocturnal Hemoglobinuria Who Have Clinically Significant Extravascular Hemolysis
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE3
Conditions: Paroxysmal Nocturnal Hemoglobinuria
PNH
Extravascular Hemolysis
Keywords: Paroxysmal Nocturnal Hemoglobinuria
PNH
Extravascular Hemolysis
Ravulizumab
Danicopan
Lead sponsor: Alexion Pharmaceuticals, Inc.
Sponsor class: INDUSTRY
First posted: 2024-06-07
Enrollment: 6
Sex: ALL
Minimum age (years): 12
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The primary objective of this study is to evaluate efficacy of danicopan as add-on treatment to ravulizumab or eculizumab as assessed by hemoglobin (Hgb) change from Baseline at Week 12 in pediatric participants with paroxysmal nocturnal hemoglobinuria (PNH) and clinically significant extravascular hemolysis (CS-EVH).


Eligibility criteria: Inclusion Criteria:

* Confirmed diagnosis of PNH.
* CS-EVH defined by: Anemia: Hgb ≤ 10.5 g/dL, and absolute reticulocyte count ≥ 100 × 109/L
* Treated with ravulizumab or eculizumab for at least 12 weeks immediately preceding Day 1, the dose received should be stable during this period, and there should be no anticipated changes in dosage or interval during the first 12 weeks of this study.
* all participants must be vaccinated against meningococcal infection from serogroups A, C, W, and Y and serogroup B within 3 years prior to, or at least 14 days prior to Day 1
* vaccinated against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae

Exclusion Criteria:

* Platelet count \< 30000/μL or there is a need for platelet transfusions.
* ANC \< 500/μL.
* Clinically significant laboratory abnormalities related to liver function, including:

  * ALT \> 2 × ULN or ALT \> 3 × ULN for participants with documented liver iron overload defined by serum ferritin values ≥ 500 ng/mL.
  * Direct bilirubin \> 2 × ULN, unless, in the Investigator's opinion, is due to hemolysis or Gilbert's syndrome based on medical history.
* Current evidence of biliary cholestasis.
* Known aplastic anemia or other bone marrow failure that requires HSCT or other therapies, including anti-thymocyte globulin and immunosuppressants unless the dosage of immunosuppressant has been stable for at least 12 weeks before Day 1 and is expected to remain stable through Week 12.
* History of a major organ transplant (eg, heart, lung, kidney, liver) or HSCT.
* Known or suspected complement deficiency.
* Active bacterial or viral infection, a body temperature \> 38°C on 2 consecutive daily measures, evidence of other infection, or history of any febrile illness within 14 days prior to first study intervention administration.

Primary outcomes:
measure: Change From Baseline in Hemoglobin (Hgb) Concentration at Week 12
timeFrame: Baseline, Week 12
Secondary outcomes:
measure: Maximum Plasma Concentration (Cmax) of Danicopan
timeFrame: Day 1 up to Week 12
measure: Number of Participants With Transfusion Avoidance Through Weeks 12 and 24
timeFrame: Weeks 12 and 24
measure: Change From Baseline in Absolute Reticulocyte Count at Weeks 12 and 24
timeFrame: Baseline, Weeks 12 and 24
measure: Change From Baseline in Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales Score at Weeks 12 and 24
timeFrame: Baseline, Weeks 12 and 24
measure: Change from Baseline in Pediatric Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Score at Weeks 12 and 24
timeFrame: Baseline, Weeks 12 and 24
measure: Acceptability and Palatability Questionnaire Score
timeFrame: Week 2
measure: Change from Baseline in Hgb Concentration at Week 24
timeFrame: Baseline, Week 24
measure: Change from Baseline in Serum Alternative Pathway (AP) Activity
timeFrame: Baseline up to Week 64
measure: Change from Baseline in Plasma Bb Concentrations
timeFrame: Baseline up to Week 64
Other outcomes:
Locations:
city: Paris
country: France
facility: Research Site
Study officials:
References: