The purpose of this study is to evaluate the platelet count change from baseline and safety of OMS721 (narsoplimab) in adults and adolescents with atypical hemolytic uremic syndrome (aHUS). The study will also evaluate pharmacokinetics (PK), pharmacodynamics (PD), and anti-drug antibody response (ADA).
This is a Phase 3, uncontrolled, open-label study to evaluate the effect of OMS721 in subjects with aHUS. The primary outcome to be measured is platelet count change from baseline. The secondary outcomes to be measured are other efficacy measures, safety, PK, PD, and immunogenicity (i.e., presence of anti-drug antibody \[ADA\] response. Subjects with plasma therapy-resistant aHUS and plasma therapy-responsive aHUS will be eligible. The efficacy endpoints, including the primary efficacy endpoint, may not be relevant for plasma therapy-responsive subjects because these subjects may enter the study with normal markers of aHUS activity due to successful treatment with plasma therapy. Therefore, efficacy analyses will be performed separately in the plasma therapy-resistant and plasma therapy responsive subjects. The principal efficacy analyses will be the analyses in the plasma therapy resistant cohort and efficacy analyses of the plasma therapy-responsive cohort will be supportive. Safety analyses will be conducted in all subjects.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Intravenous loading dose followed by daily subcutaneous injections
Omeros Investigational Site
Chicago, Illinois, United States
Omeros Investigational Site
Vilnius, Lithuania
Omeros Investigational Site
Lodz, Poland
Omeros Investigational Site
New Taipei City, Taiwan
Platelet Count (10^9 Platelets/L) Change From Baseline at Week 26
The primary outcome to be measured is platelet count change from baseline.
Time frame: Week 26
Safety as Measured by Incidences of Adverse Events, Vital Signs, ECG, and Clinical Laboratory Tests
Assessment of safety of OMS721 (narsoplimab) in participants with aHUS by incidence of Adverse Events, clinically significant vital sign abnormalities, ECG abnormalities, and clinical laboratory test abnormalities
Time frame: Pre-dose and up to 771 days post-dose
Thrombotic Microangiopathies (TMA) Response
Complete TMA response defined as normalization of platelet count, normalization of serum lactate dehydrogenase (LDH), and \> 25% decrease in serum creatinine by at least 2 consecutive measures over at least 4 consecutive weeks, within the initial 26-week period
Time frame: 26 weeks
TMA Event-free Status
No decrease in platelet count of \> 25% from baseline, no plasma exchange or plasma infusion, and no initiation of new dialysis over at least 12 consecutive weeks, within the initial 26-week period
Time frame: 26 weeks
Increase in Estimated Glomerular Filtration Rate (eGFR)
Increase of greater than 15 ml/min/1.73 m2 in eGFR calculated by the modification of diet in renal disease (MDRD) Equation
Time frame: 26 weeks
Hematological Normalization
Normalization of platelet count and normalization of serum LDH by 2 consecutive measurements over at least 4 weeks, within the initial 26-week period
Time frame: 26 weeks
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TMA Remission
Platelet count greater than or equal to 150,000/μL on at least 2 consecutive measures over at least 2 consecutive weeks, within the initial 26-week period
Time frame: 26 weeks
Incidence of Antidrug Antibodies (ADA)
Incidences of ADA in participants with aHUS, administered OMS721 (narsoplimab)
Time frame: 771 days post-dose
Change From Baseline in Serum Creatinine (mg/dL)
Assessment of subject's change from baseline in serum creatinine.
Time frame: 26 weeks
Change From Baseline in Serum LDH (U/L)
Assessment of subject's change from baseline in serum LDH
Time frame: 26 weeks
Change From Baseline in Haptoglobin (mg/dL)
Assessment of subject's change from baseline in haptoglobin
Time frame: 26 weeks
Pharmacokinetics (PK): Trough Plasma Concentration, Lower Limit of Quantification (LLOQ)
Pharmacokinetics (PK): Trough plasma concentration, lower limit of quantification (LLOQ)
Time frame: Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (RT) (if occurs): RT Days 1-4; Follow-Up at Day 771
Pharmacokinetics (PK): Maximum Plasma Concentrations (Cmax)
Pharmacokinetics (PK): Maximum plasma concentrations (Cmax)
Time frame: Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (if occurs): RT Days 1-4; Follow-Up at Day 771
Pharmacokinetics (PK): Area Under Time-concentration Curve (AUC)
Pharmacokinetics (PK): Area under time-concentration curve (AUC)
Time frame: Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (if occurs): RT Days 1-4; Follow-Up at Day 771
Pharmacodynamics (PD): Inhibition of C3 Activity (%)
Pharmacodynamics (PD): Inhibition of C3 activity
Time frame: Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (if occurs): RT Days 1-4; Follow-Up at Day 771
Pharmacodynamics (PD): Inhibition of C4 Activity (%)
Pharmacodynamics (PD): Inhibition of C4 activity
Time frame: Days 1-4; Treatment Maintenance (103 weeks): 17 visits; Rescue Therapy (if occurs): RT Days 1-4; Follow-Up at Day 771