Primary Objective: To evaluate the effect of caplacizumab on prevention of recurrence of aTTP (proportion of participants with a recurrence of aTTP) during the overall study period. Secondary Objectives: * To evaluate effect of caplacizumab on * prevention of recurrence of TTP (the number of recurrences of TTP) during overall study period. * a composite endpoint consisting of aTTP-related mortality, recurrence of aTTP and major thromboembolic events during study drug treatment * restoring platelet counts as a measure of prevention of further microvascular thrombosis * refractory disease * biomarkers of organ damage: LDH, cardiac troponin I, serum creatinine * plasma exchange (PE) parameters (days of PE and volume of plasma used), days in intensive care unit, days in hospital * cognitive status of Japanese patients * To evaluate safety profile of caplacizumab in Japanese patients * To evaluate effect of caplacizumab on pharmacodynamic (PD) markers in Japanese patients * To evaluate pharmacokinetic (PK) profile of caplacizumab in Japanese patients * To evaluate immunogenicity of caplacizumab in Japanese patients
Study duration per participant is approximately 2 months up to approximately 6 months in case of treatment extension and recurrence during the study drug treatment period.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
21
Pharmaceutical form:Lyophilized powder for solution for injection Route of administration: IV (first dose), SC (all subsequent doses)
Pharmaceutical form:Plasma (e.g. fresh frozen plasma) Route of administration: Plasma exchange
Pharmaceutical form:Solution for injection or Tablet Route of administration: IV or Oral
Pharmaceutical form:Solution for injection (depending on product) Route of administration: IV (depending on product)
Investigational Site Number 3920009
Iruma-Gun, Japan
Investigational Site Number 3920014
Kanazawa, Japan
Investigational Site Number 3920007
Kashihara-shi, Japan
Investigational Site Number 3920013
Kawasaki-Shi, Japan
Investigational Site Number 3920001
Kitakyushu-Shi, Japan
Investigational Site Number 3920002
Kumamoto, Japan
Investigational Site Number 3920003
Kurashiki-Shi, Japan
Investigational Site Number 3920010
Kyoto, Japan
Investigational Site Number 3920005
Maebashi, Japan
Investigational Site Number 3920015
Nagoya, Japan
...and 2 more locations
Proportion of participants with a recurrence of acquired thrombotic thrombocytopenic purpura (aTTP)
Proportion of participants with a recurrence of aTTP during the overall study period. The success criterion for this study is proportion of evaluable participants (per-protocol population) with a recurrence of aTTP during the overall study period to be 20% or less.
Time frame: Approximately 2 months up to approximately 6 months
Number of recurrences of TTP
Number of recurrences of TTP during study drug treatment (including extensions) and follow-up, as well as during overall study period.
Time frame: Approximately 2 months up to approximately 6 months
Proportion of participants with composite endpoint consisting of aTTP-related mortality, recurrence of aTTP and major thromboembolic events
Proportion of participants with TTP-related death, a recurrence of TTP, or at least one treatmentemergent major thromboembolic event (eg, myocardial infarction, cerebrovascular accident, pulmonary embolism or deep venous thrombosis \[DVT\]) during the overall treatment period (including extensions).
Time frame: Approximately 2 months up to approximately 6 months
Time to platelet count response
Time to platelet count response, defined as initial platelet count ≥150,000/μL with subsequent stop of daily plasma exchange (PE) within 5 days.
Time frame: Approximately 2 months up to approximately 6 months
Proportion of participant who have a platelet count ≥150,000/μL
Proportion of participant who have a platelet count ≥150,000/μL on Day 1, 2, 3, 4, 5 and Day 10 and end of study drug treatment (ie, last weekly visit during the overall treatment period).
Time frame: Approximately 2 months up to approximately 6 months
Proportion of participants with refractory TTP
Proportion of participant with refractory TTP, defined as persistent thrombocytopenia, lack of sustained platelet count increment or platelet counts \<50,000/μL and persistently elevated LDH (\>1.5 x upper limit of normal \[ULN\]) despite 5 PEs and steroid treatment.
Time frame: Approximately 2 months up to approximately 6 months
Time to normalization of 3 organ damage marker levels
Time to normalization of all 3 of the following organ damage marker levels: Time to LDH ≤ 1 x ULN, and cTnI ≤ 1 x ULN, and serum creatinine ≤ 1 x ULN and time to individual organ damage marker level.
Time frame: Approximately 2 months up to approximately 6 months
Time to stop of daily plasma exchnage (PE)
Time to stop of daily PE
Time frame: Approximately 2 months up to approximately 6 months
Number of days to plasma exchange
The endpoint will be assessed in 4 time periods: daily PE period (the first daily PE period only), overall treatment period, follow-up period (of 4 weeks after stop of study drug treatment), and overall study period
Time frame: Approximately 2 months up to approximately 6 months
Total volume of plasma
The endpoint will be assessed in 4 time periods: daily PE period (the first daily PE period only), overall treatment period, follow-up period (of 4 weeks after stop of study drug treatment), and overall study period
Time frame: Approximately 2 months up to approximately 6 months
Number of days in ICU and in hospital
Number of days in ICU and in hospital in 4 time periods: daily PE period (the first daily PE period only), overall treatment period, in the Follow-up period (of 4 weeks after stop of study drug treatment) and overall study period.
Time frame: Approximately 2 months up to approximately 6 months
Change from baseline in the standardized mini mental state exam (SMMSE) total score
Change from baseline in SMMSE total score on Day 1, (Day 2, 3, 4 as optional) and Day 5 of daily Plasma Exchange (PE) period, and Weeks 1 and 5 of the 30-day postdaily PE period, and the first (7 days after last dosing) and final follow-up (28 days after last dosing) visit.
Time frame: Approximately 2 months up to approximately 6 months
Proportion of participants with at least one treatment emergent thromboembolic event
The treatment-emergent major thromboembolic event (eg, myocardial infarction, cerebrovascular accident, pulmonary embolism or deep venous thrombosis \[DVT\]) during the overall treatment period (including extensions) will be evaluated.
Time frame: Approximately 2 months up to approximately 6 months
Number of patients with treatment emergent adverse events
Number of Patients with treatment emergent Adverse events (AEs) and serious adverse events (SAEs) and bleeding events
Time frame: Approximately 2 months up to approximately 6 months
Pharmacodynamic (PD) markers
PD parameters: von Willebrand factor antigen(vWF:Ag), coagulation factor VIII clotting activity (FVIII:C), von Willebrand factor ristocetin cofactor activity (vWF:RICO)
Time frame: Approximately 2 months up to approximately 6 months
Pharmacokineticks: plasma concentration
Total caplacizumab plasma concentrations
Time frame: Approximately 2 months up to approximately 6 months
Immunogenicity of caplacizumab
Anti-drug antibodies
Time frame: Approximately 2 months up to approximately 6 months
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