Clinical trial NCT06198712: A Study to Evaluate the Pharmacokinetics and Safety of Etavopivat in Pediatric Patients With Sickle Cell Disease
Official title: A Single Arm, Open Label, Phase 1/2 Study to Evaluate the Pharmacokinetics and Safety of Etavopivat in Pediatric Patients With Sickle Cell Disease
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE2
Conditions: Sickle Cell Disease
Lead sponsor: Novo Nordisk A/S
Sponsor class: INDUSTRY
Collaborators: name: Novo Nordisk A/S
First posted: 2024-01-10
Enrollment: 50
Sex: ALL
Minimum age (years): 12
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This study is being done to learn about etavopivat, a once a day medicine taken by mouth in adolescents with sickle cell disease. The main goals are to study safety and how long etavopivat stays in the bloodstream, while also studying if there are benefits from taking etavopivat. Eligible participants who enter the study will start a 96-week treatment period. At the end of the 96 weeks, participants will have an end of study visit that occurs 4 weeks later. The participants will receive etavopivat every day throughout the treatment period.


Eligibility criteria: Inclusion Criteria:

* Type of Participant and Disease Characteristics

  1. Patient has confirmed diagnosis of SCD

     • Documentation of SCD genotype (HbSS, HbSβ0-thalassemia or other sickle cell syndrome variants) based on prior history of laboratory testing. Molecular genotyping is not required. SCD genotype may be determined from the results of Hb electrophoresis, high-performance liquid chromatography (HPLC), or similar testing. Note that Hb electrophoresis is performed by the local laboratory at Screening.
  2. Hemoglobin greater than or equal to (≥) 5.5 and less than (\<) 10.5 grams per deciliter (g/dL)
  3. Adolescent patients with severe SCD, as defined by at least 1 of the following:

     * Two or more VOCs in the past 12 months, defined as a previously documented episode of acute chest syndrome (ACS) or acute painful crisis (for which there was no explanation other than VOC) which required prescription or healthcare professional-instructed use of analgesics for moderate to severe pain
     * Hospitalization for any SCD-related complication in the last 12 months
     * Proteinuria, defined as an albumin:creatinine ratio (ACR) \> 100 milligrams per gram (mg/g) on 2 measures (separated by ≥ 1 month) as an indicator of early renal disease
     * History of a conditional TCD in the last 12 months, but not currently being treated with chronic transfusion therapy. Conditional TCD is defined as a TAMMV of 170-199 centimeters per second (cm/s) by TCD or 155-184 cm/s by imaging TCD (TCDi).
  4. For participants taking hydroxyurea (HU), the dose of HU (mg/kg) must be stable (no more than a 20% change in dosing) for at least 90 days prior to start of study treatment with no anticipated need for dose adjustments during the study, in the opinion of the Investigator
  5. Patients on crizanlizumab or L-glutamine treatment at the time of consent may be eligible if they:

     * Have been on a stable dose for ≥ 12 months at the time of consent (ie, no changes to the dose except for changes to weight or for safety reasons)
     * For patients on crizanlizumab, have been ≥ 80% compliant with the planned regimen during the 12 months prior to the time of consent

Exclusion Criteria:

* Medical Conditions

  1. More than 10 VOCs within the past 12 months that required a hospital, emergency room (ER), or clinic visit
  2. Hospitalized for sickle cell crisis or other vaso-occlusive event within 14 days of Screening
  3. Abnormal TCD in the prior 12 months

     Prior/Concomitant Therapy
  4. Patients receiving regularly scheduled blood (RBC) transfusion therapy (also termed chronic, prophylactic, or preventive transfusion)
  5. Received any blood products within 30 days of starting study treatment
  6. Receiving or use of concomitant medications that are strong inducers of cytochrome P450 (CYP) 3A4/5 within 2 weeks of starting study treatment
  7. Use of voxelotor within 28 days prior to starting study treatment or anticipated need for this agent during the study
  8. Receipt of erythropoietin or other hematopoietic growth factor treatment within 28 days of starting study treatment or anticipated need for such agents during the study
  9. Receipt of prior cellular based therapy (eg, hematopoietic cell transplant, gene modification therapy)

Primary outcomes:
measure: Single-dose: maximum plasma concentration (Cmax)
timeFrame: During the 24-week primary treatment period
measure: Single-dose: area under the plasma concentration time curve from dosing (time 0) to time t ((AUC)0-t)
timeFrame: During the 24-week primary treatment period
measure: Single-dose: area under the plasma concentration time curve from zero to time infinity (AUC0-inf)
timeFrame: During the 24-week primary treatment period
measure: Steady-state maximum plasma concentration (Cmax,ss)
timeFrame: During the 24-week primary treatment period
measure: Steady-state area under the concentration time curve over the dosing interval (AUCtau,ss)
timeFrame: During the 24-week primary treatment period
measure: Steady-state average plasma concentration (Cavg,ss)
timeFrame: During the 24-week primary treatment period
measure: Steady-state minimum plasma concentration (Cmin,ss)
timeFrame: During the 24-week primary treatment period
measure: Incidence of adverse events (AEs), serious adverse events (SAEs), and AEs related to etavopivat
timeFrame: During the 24-week primary treatment period
measure: Number of premature discontinuations
timeFrame: During the 24-week primary treatment period
measure: Number of dose interruptions
timeFrame: During the 24-week primary treatment period
measure: Number of dose reductions
timeFrame: During the 24-week primary treatment period
Secondary outcomes:
measure: Incidence of AEs, SAEs, and AEs related to etavopivat
timeFrame: During the 72-week treatment extension period
measure: Number of premature discontinuations
timeFrame: During the 72-week treatment extension period
measure: Number of dose interruptions
timeFrame: During the 72-week treatment extension period
measure: Number of dose reductions
timeFrame: During the 72-week treatment extension period
measure: Hemoglobin (Hb) response rate
timeFrame: Baseline, week 12 and 24
measure: Change in Hb from baseline
timeFrame: Baseline, week 12 and 24
measure: Change from baseline in number of vaso-occlusive crises (VOCs)
timeFrame: Baseline and week 24
measure: Change from baseline in Annualized Rate of VOC
timeFrame: Baseline and week 24
measure: Change from baseline in Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Scale
timeFrame: Baseline, week 12 and 24
measure: Change from baseline in time-averaged mean of the maximum velocity (TAMMV) by transcranial Doppler ultrasonography (TCD)
timeFrame: Baseline, week 24, 48, and 96
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: The Hospital for Sick Children
state: Ontario
city: Kericho
country: Kenya
facility: KEMRI-Walter-Reed Kericho
city: Kisumu
country: Kenya
facility: Ahero Clinical Trials Unit, Kisumu, Kenya
city: Kisumu
country: Kenya
facility: Kombewa Clinical Research Centre
city: Siaya
country: Kenya
facility: Kenya Medical Research Institute-Centre for Respiratory Disease Research, Siaya Clinical Research Annexe
city: Beirut
country: Lebanon
facility: American University of Beirut Medical center
city: Tripoli
country: Lebanon
facility: Hospital Nini
city: Enugu
country: Nigeria
facility: University of Nigeria Teaching Hospital, Enugu
city: Lagos
country: Nigeria
facility: Lagos University Teaching Hospital, Lagos
city: Tarauni
country: Nigeria
facility: Aminu Kano Teaching Hospital (AKTH)
city: Ankara
country: Turkey
facility: Hacettepe University pediatric hematology
city: Seyhan
country: Turkey
facility: Acibadem Adana Hospital
city: London
country: United Kingdom
facility: Guys and St Thomas NHS Foundation Trust / Evelina Childrens Hospital
city: London
country: United Kingdom
facility: Kings College Hospital NHS Foundation Trust
city: Manchester
country: United Kingdom
facility: Manchester Royal Infirmary
Study officials:
affiliation: Novo Nordisk A/S
name: Clinical Transparency (dept. 2834)
role: STUDY_DIRECTOR
References: