The primary goal of the study is to assess the efficacy and safety of RPH-104 in subjects with Schnitzler Syndrome using Schnitzler Disease Activity Score (SDAS), which includes the Physician's Global Assessment (PGA) and the local laboratory C-reactive protein (CRP) result
The study will include a screening period (up to 28 days), a double blind, placebo controlled treatment period (14 days), followed by an 8 week safety follow up period after the second dose of study drug. Subjects with an established diagnosis of Schnitzler Syndrome (SchS) will participate in a Screening period of up to 28 days after signing an informed consent form (ICF). Subjects will be advised to schedule the Day 0 visit with the study staff as soon as the symptoms of SchS flare occur during the Screening period. If the subject does not meet the inclusion/exclusion criteria at the site visit during the screening period, other screening visits are allowed within this period until the subject meets the study criteria. A total of 14 subjects will be randomly assigned to 1 of 2 treatment groups (in a 1:1 ratio) to receive a double blind, single subcutaneous (SC) injection of study drug (80 mg RPH-104 or matching placebo) on Day 0. On Day 14, subjects will receive a second dose of randomized treatment as well as an additional dose of 80 mg RPH-104 or placebo based on response to treatment, such that responders (SDAS = 0) will receive a dose of placebo, and non responders defined as no response (no change in SDAS) or partial responders (SDAS ≥ 1, and activity reduction by 1 or more points of SDAS compared to baseline) will receive an 80 mg RPH 104 dose. (Schnitzler Disease Activity Score includes the PGA score and C-reactive protein (CRP) result: If the PGA and CRP grades are not of the same severity, the higher severity level of either PGA or CRP will be used to determine the SDAS) The study will be stopped after Data and Safety Monitoring Board (DSMB) review if: 1. Death is reported in 2 subjects assigned to the RPH 104 treatment arm or after receiving RPH 104 on Day 14 (i.e., non responder to the Day 0 study drug dose). 2. Two subjects assigned to the RPH 104 treatment arm or after receiving RPH 104 on Day 14 (ie, non responder to the Day 0 study drug dose) report liver function test abnormalities which meet Hy's Law criteria (ie, increased ALT and/or AST 3 fold or greater from upper limit of normal (ULN) combined with jaundice or weakness or hypochondrial pain/severity or increased Total Bilirubin (TBil) level 2 fold or greater from ULN, \[not explained by any other causative factors like virus\]). The severity of SchS symptoms will be assessed daily from Day 0 through Day 28 using the PR SchS Scale, at clinic visits on Day 0, Day 14, and Day 28 using the Patient Global Impression of Severity (PGIS), at clinic visits on Day 14 and Day 28 using the Patient Global Impression of Change (PGIC), and at each clinic visit using the PGA, CRP, SAA, and SDAS. Subjects will be followed through Day 70 for safety (A Data Safety Monitoring Board (DSMB) will periodically review and evaluate the accumulated study data for subject safety).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
solution for subcutaneous administration 40 mg/mL, 2 mL in the 4-mL glass vial
Normal Saline (0.9% Sodium Chloride solution for Injection), 2 mL in the 4 mL-glass vial
National Jewish Health
Denver, Colorado, United States
Mayo Clinic
Rochester, Minnesota, United States
Oregon Health & Science University
Portland, Oregon, United States
Penn State Health Hersey Medical Center
Hershey, Pennsylvania, United States
Proportion of subjects with complete response (Schnitzler Disease Activity Score (SDAS = 0)) to therapy on Day 14 in the RPH-104 group as compared to the placebo group
• Proportion of subjects with complete response (SDAS = 0) to therapy on Day 14 in the RPH 104 treated group as compared to the placebo group based on SDAS using the PGA and the local laboratory CRP result
Time frame: Day 14
Change from baseline to Day 14 in subject-reported symptom severity of SchS: Patient-reported Severity of Schnitzler Syndrome Scale (PR-SchS Scale)
Change from baseline to Day 14 in subject-reported symptom severity of SchS using the Patient-reported Severity of Schnitzler Syndrome Scale (PR-SchS Scale). The PR-SchS Scale includes 5 features that are the most common and important SchS symptoms. These include rash, fever, tiredness, joint pain, and bone/muscle pain.
Time frame: Baseline and Day 14
Proportion of subjects with normalized serum amyloid A (SAA) and C-reactive protein (CRP) at Days 14 and 28
Proportion of subjects with normalized SAA (\< 10 mg/L) and CRP (≤ 10 mg/L) at Days 14 and 28
Time frame: Day 14 and Day 28
Change from baseline to Day 14 and Day 28 in CRP and SAA
Change from baseline to Day 14 and Day 28 in C-reactive protein and serum amyloid A
Time frame: Baseline, Day 28 and Day 14
Proportion of subjects with complete response (SDAS = 0) to therapy on Day 28 by treatment sequence based on SDAS using the Physician's Global Assessment (PGA) and the CRP result
Proportion of subjects with complete response (SDAS = 0) to therapy on Day 28 by treatment sequence (placebo - placebo, placebo - 80 mg RPH 104, 80 mg RPH 104 80 mg RPH 104, and 80 mg RPH 104 - 160 mg RPH 104) based on SDAS using the PGA and the CRP result.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Baseline and Day 28
Proportion of subjects with partial response by treatment sequence on Days 14 and 28
Proportion of subjects with partial response (SDAS ≥ 1, and activity reduction by 1 or more points of SDAS compared to baseline) by treatment sequence (placebo - placebo, placebo 80 mg RPH 104, 80 mg RPH 104 80 mg RPH 104, and 80 mg RPH 104 160 mg RPH 104) on Days 14 and 28
Time frame: Baseline, Day 14 and Day 28