The purpose of the study is to evaluate the efficacy of IFX-1 treatment as replacement for glucocorticoid (GC) therapy in subjects with polyangiitis (GPA) or microscopic polyangiitis (MPA).
Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a group of potentially life-threatening autoimmune diseases. Preclinical data demonstrate that primed neutrophils are activated by anti-neutrophil cytoplasmic antibody (ANCA) and generate C5a that engages C5a receptors on neutrophils. Patients with ANCA-related disease have elevated plasma and urine levels of C5a in active disease but not in remission. IFX-1 is as a monoclonal antibody specifically binding to the soluble human complement split product C5a, which results in nearly complete blockade of C5a induced biological effects. Therefore, IFX-1 may be effective in the treatment of subjects with AAV. In this Phase II study of 20 to 55 subjects with granulomatosis with GPA and MPA, IFX-1 will be administered in combination with reduced dose glucocorticoids or a placebo glucocorticoid compared with standard dose glucocorticoids.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
57
Percentage of Subjects Achieving Clinical Response
Efficacy Endpoint: Percentage of subjects achieving clinical response (reduction in Birmingham Vasculitis Activity Score version 3 \[BVASv3\] of ≥50% compared to baseline and no worsening in any body system). Subjects who received rescue therapy after Day 1 or discontinued due to related adverse event, lack of efficacy or progressive disease are considered as non-responders at all subsequent visits. The BVASv3 score ranges from 0 to 63 with higher values representing higher disease activity.
Time frame: Baseline, Week 16
Percentage of Subjects With Clinical Remission
Efficacy endpoint: Percentage of subjects with clinical remission, defined as having a BVASv3 = 0. Subjects who received rescue therapy after Day 1 or discontinued due to related adverse event, lack of efficacy or progressive disease are considered as non-responders at all subsequent visits. The BVASv3 score ranges from 0 to 63 with higher values representing higher disease activity.
Time frame: Week 16
Change From Baseline in BVASv3 Total Score
Efficacy endpoint: Absolute Change from baseline (= screening assessment) in Birmingham Vasculitis Activity Score version 3 (BVASv3) total score; The BVASv3 score ranges from 0 to 63 with higher values representing higher disease activity. The total score is derived by summing up item scores according to the scoring manual for the BVASv3.
Time frame: Baseline, Week 16
Vasculitis Damage Index (VDI)
Efficacy endpoint: Absolute values of VDI; The VDI total score ranges from 0 to 64 with higher scores indicating more organ damage since the onset of vasculitis. The total score is the number of present damage items.
Time frame: Week 16
Physician Global Assessment (PGA)
Efficacy endpoint: Absolute values in PGA; Physician global assessment scale: 0 = Remission to 10 = Maximum activity;
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orally administered
Clinical Site
Leuven, Belgium
Clinical Site
Liège, Belgium
Clinical Site
Hradec Králové, Czechia
Clinical Site
Prague, Czechia
Clinical Site
Prague, Czechia
Clinical Site
Prague, Czechia
Clinical Site
Angers, France
Clinical Site
Brest, France
Clinical Site
Créteil, France
Clinical Site
Grenoble, France
...and 66 more locations
Time frame: Week 16
Estimated Glomerular Filtration Rate
Efficacy endpoint: Absolute values of estimated glomerular filtration rate (eGFR) in mL/min/1.73 m²; The eGFR was calculated by the central laboratory according to the Modified Diet in Renal Disease equation: eGFR = 175 x (serum creatinine, mg/dL)-1.154 x (age, years)-0.203 x (0.742 if female) x (1.212 if black)
Time frame: Week 16
Number and Percentage of Subjects Who Had a Treatment-emergent Adverse Event (TEAE)
Safety endpoint: Number and percentage of subjects who had a treatment-emergent adverse event (TEAE)
Time frame: Week 24
Glucocorticoid Toxicity Index (GTI)
Safety endpoint: The GTI total score ranges from -35 to 410 (because the bone domain is excluded in this study) with higher score indicating greater Glucocorticoid toxicity. Scoring was performed in the electronic case report form according to the corresponding scoring manual in "Development of a Glucocorticoid Toxicity Index (GTI) using multicriteria decision analysis." by Miloslavsky EM, Naden RP, Bijlsma JW, Brogan PA, Brown ES, Brunetta P, et al.
Time frame: Week 16
IFX-1 Plasma Concentrations (Pre-dose)
Pharmacokinetics endpoint: IFX-1 plasma concentrations assessed prior to study drug administration at corresponding visit.
Time frame: Week 16 (pre-dose)
Plasma Concentrations of C5a
Pharmacodynamics endpoint: Plasma concentrations of C5a
Time frame: Week 16
IFX-1 Blocking Activity 10 nM
Pharmacodynamics endpoint: IFX-1 blocking activity 10 nM
Time frame: Week 16
IFX-1 Blocking Activity 2.5 nM
Pharmacodynamics endpoint: IFX-1 blocking activity 2.5 nM
Time frame: Week 16