This clinical trial is a Phase 2/3 study that will evaluate the efficacy and safety of etavopivat and test how well etavopivat works compared to placebo to improve the amount of hemoglobin in the blood and to reduce the number of vaso-occlusive crises (times when the blood vessels become blocked and cause pain).
Etavopivat is designed to activate PKR and thereby modulate RBC metabolism by impacting two critical pathways in RBCs. The etavopivat clinical development program will investigate whether decreasing 2,3-DPG may help oxygen bind to hemoglobin (i.e. increasing oxygen affinity), and thereby increase ATP and impact RBC function. This study is a randomized, placebo-controlled, double-blind, multicenter Phase 2/3 study of patients age 12 to 65 years (inclusive), with sickle cell disease. There is one planned interim analyses in this study design. Initially, patients will be randomized at 1:1:1 to one of two dose levels of etavopivat or placebo. At the first interim analysis, one of the two etavopivat dose levels will be selected for the Phase 3 portion of the study, in which patients will be randomized at 1:1 to the selected etavopivat dose or placebo. Efficacy on hemoglobin will be evaluated at conclusion of the double-blind treatment period. Following completion of 52 weeks of double-blind treatment, patients may enter a 112-week etavopivat open-label extension period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
450
Hemoglobin response rate
Hemoglobin response rate at Week 24 (increase of \> 1 g/dL \[\> 10 g/L\] from baseline) during the blinded treatment period
Time frame: 24 Weeks
Annualized vaso-occlusive crisis
Annualized vaso-occlusive crisis rate during the 52-week blinded treatment period based on adjudicated vaso-occlusive crisis review
Time frame: 52 Weeks
Hemoglobin
Change from baseline in hemoglobin at Week 52 during the blinded treatment period
Time frame: 52 Weeks
Absolute reticulocyte count
Change in absolute reticulocyte count from baseline at Week 24 during the blinded treatment period
Time frame: 24 Weeks
Indirect bilirubin
Change in unconjugated bilirubin from baseline at Week 24 during the blinded treatment period
Time frame: 24 Weeks
Lactate dehydrogenase
Change in lactate dehydrogenase from baseline at Week 24 during the blinded treatment period
Time frame: 24 Weeks
Vaso-occlusive crisis
Time to first vaso-occlusive crisis during the blinded treatment period
Time frame: 52 Weeks
Fatigue
Change in Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue Scale from baseline in adult patients at Week 52 during the blinded treatment period
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Selected dose once daily
Univ of Alabama Birmingham
Birmingham, Alabama, United States
Phoenix Children's Hsptl
Phoenix, Arizona, United States
[Legal] Woodland International Research Group, LLC
Little Rock, Arkansas, United States
[Legal] Collaborative Neuroscience Network, LLC
Long Beach, California, United States
Pacific Research Partners
Oakland, California, United States
UCSF Oakland Benioff ChildHosp
Oakland, California, United States
University Of California Irvine
Orange, California, United States
UC Davis Medical Center
Sacramento, California, United States
University of Connecticut
Farmington, Connecticut, United States
Yale University
New Haven, Connecticut, United States
...and 132 more locations
Time frame: 52 Weeks