The purpose of this study is to assess safety and efficacy of the long-term treatment with RPH-104 at doses of 80 or 160 mg once every 2 weeks (q2w) in patients with familial Mediterranean fever (FMF) with colchicine resistance or intolerance (i.e. colchicine resistant, crFMF), who completed the core study, during which they received at least one dose of RPH-104 (i.e. study patient population).
This study is a long-term open-label extension (OLE) of the core double blind randomized placebo-controlled study CL04018065. This OLE study will have the following periods: 1. Screening period - 2 weeks (from signing an Informed Consent Form \[ICF\] at Visit 10 of the core study to Visit 1, Day 0 of this OLE study) - includes unblinding of the treatment groups determined in the core study (unless was unblinded previously) and determination of the eligibility criteria compliance for this study (all other screening procedures are performed after the completion of Visit 11 of the core study, which is also a Day 0 of this OLE study); All patients meeting the study inclusion/exclusion criteria according to the screening results will be transferred to the treatment period at the same day (Day 0) - the beginning of this period will be considered Visit 1 of this study 2. Treatment period - All patients will be receiving RPH-104 treatment for 198 weeks in the open-label regimen (both patient and the Investigator, along with all study team will know which treatment is used) at the doses determined for them in the core study. Thus, the possible RPH-104 dose will be: * 80 mg q2w subcutaneously (SC); * 160 mg q2w SC The first RPH-104 administration in this study will be performed at Visit 1. To maintain the q2w dosage regimen, the screening and the first open-label injection of RPH-104 (if the patient meets the study eligibility criteria) must be performed on the same day - Day 0 (which is also the day of Visit 11 of the core study) - i.e. the first administration in this study will be performed 2 weeks (±3 days) after the last administration in the core study. Further, RPH-104 will be administered to patients q2w both during each scheduled visit to the study site (with safety and efficacy assessments according to the visits schedule), and during Drug Administration Visits (DAVs) at the study site or at the patient's accommodation An injection of the study drug to patients is performed by qualified medical personnel every 2 weeks when the patient visits the study site; it is also possible for the patients to self-administer the drug at home (for which patients will be appropriately trained and provided with the necessary quantity of the drug, materials for the injection (including special containers for their disposal) and proper drug transportation). Safety and efficacy assessments are performed at Visit 1, Visit 2 (in 2 weeks), Visit 3 (in 4 weeks), Visit 4 (in 4 weeks), Visit 5 (in 8 weeks) and thereafter every 12 weeks (Visit 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 and 20) according to the visits schedule. In case of RPH-104 administration in patients' accommodation, telephone contacts with a patient will be conducted by the Investigator every 4 weeks in between the visits starting from the Visit 4.In case of FMF attack development, patients who receive 80 mg of the drug may be switched to the increased maximum drug dose160 mg based at the discretion of the investigator. The drug is administered only at scheduled visits. Dose reduction of RPH-104 is not allowed in this study. After patients receive the last dose of RPH-104 at Week 198 of the study, the treatment period will be considered completed and an 8-week safety follow-up will start 3. Safety follow-up period - 8 weeks. During this period the patients will have to visit the study site twice in 4 weeks (Visit 21) and 8 weeks (Visit 22) after the last RPH-104 dose for safety assessments. The last visit of the safety follow-up period (Visit 22) is the End of Study Visit; after completion of all procedures of this visit, patients will be considered to have completed the study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
60
solution for subcutaneous administration 40 mg/mL, 2 mL in the 4-mL glass vial
Center of Medical Genetics and Primary Health Care LLC
Yerevan, Armenia
RECRUITINGFSBEI HE First Moscow State Medical University named after I.M. Sechenov
Moscow, Russia
RECRUITINGMoscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin
Moscow, Russia
RECRUITINGMedical Technologies Ltd.
Saint Petersburg, Russia
RECRUITINGTerafarm, Llc
Stavropol, Russia
RECRUITINGHacettepe University Faculty of Medicine
Ankara, Turkey (Türkiye)
RECRUITINGIstanbul University Istanbul Faculty of Medicine
Istanbul, Turkey (Türkiye)
RECRUITINGIstanbul University Cerrahpasa Faculty of Medicine
Istanbul, Turkey (Türkiye)
RECRUITINGIncidence of Treatment-Emergent Adverse Events (AEs), by System Organ Class and Preferred Term
Time frame: Up to 62 weeks
Incidence of Treatment-Emergent Serious Adverse Events (SAEs), by System Organ Class and Preferred Term
Time frame: Up to 62 weeks
Incidence of Treatment-Emergent Adverse Events of Special Interest (AESI), by System Organ Class and Preferred Term
Time frame: Up to 62 weeks
Incidence rate for serious adverse events (SAEs)
Incidence rate, expressed as the number of events per 100 patient-years of follow-up, for SAEs
Time frame: Up to 62 weeks
Incidence rate for adverse events of special Interest (AESI)
Incidence rate, expressed as the number of events per 100 patient-years of follow-up, for AESI
Time frame: Up to 62 weeks
Percentage of patients with physician global assessment of disease activity scale (PGA) <2
PGA of disease activity involves a 5-point system: from 0 = no clinical signs and symptoms associated with the disease to 4 = severe clinical signs and symptoms associated with the disease.
Time frame: Up to 62 weeks
Percentage of patients with serological remission
Serological remission is defined as C-reactive (CRP) level ≤10 mg/L.
Time frame: Up to 62 weeks
Percentage of patients whose Serum amyloid A (SAA) levels returned to normal values
SAA normal levels are defined as SAA \<10 mg/L
Time frame: Up to 62 weeks
Percentage of patients who have experienced ≥ 1 attacks per month (since Day 0)
Criteria for the diagnosis of an attack are defined as the simultaneous development of clinical and serological signs of an attack, including: * the score on the scale of global physician's assessment of disease activity (PGA) ≥ 2, suggesting "mild", "moderate" or "severe" activity of the disease (i.e., clinical signs), AND * CRP level ≥ 30 mg/L (i.e. serological signs)
Time frame: Up to 54 weeks
Percentage of patients who have not had a single attack
Criteria for the diagnosis of an attack are defined as the simultaneous development of clinical and serological signs of an attack, including: * the score on the scale of global physician's assessment of disease activity (PGA) ≥ 2, suggesting "mild", "moderate" or "severe" activity of the disease (i.e., clinical signs), AND * CRP level ≥ 30 mg/L (i.e. serological signs)
Time frame: Up to 54 weeks
Percentage of patients escalated to RPH-104 160 mg q2w dose
The dose may be increased if a new attack is confirmed
Time frame: Up to 54 weeks
Percentage of patients receiving additional symptomatic therapy with NSAIDs, paracetamol or glucocorticoids due to FMF
Symptomatic therapy was prescribed by the decision of the investigator upon confirmation of a new attack
Time frame: Up to 62 weeks
Change in the inflammatory markers CRP compared to baseline
CRP level mg/l at each visit
Time frame: Up to 62 weeks
Change in the inflammatory markers SAA compared to baseline
SAA level mg/l at each visit
Time frame: Up to 62 weeks
Changes in the PGA score over time
PGA of disease activity involves a 5-point system: from 0 = no clinical signs and symptoms associated with the disease to 4 = severe clinical signs and symptoms associated with the disease.
Time frame: Up to 54 weeks
Changes in the severity of chest pain based on the main disease symptoms scale.
An assessment of severity of the main symptoms of the disease will be based on a 5-point scale: 0 = no symptom, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe
Time frame: Up to 54 weeks
Changes in the severity of abdominal pain based on the main disease symptoms scale.
An assessment of severity of the main symptoms of the disease will be based on a 5-point scale: 0 = no symptom, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe
Time frame: Up to 54 weeks
Changes in the severity of arthralgia/arthritis based on the main disease symptoms scale.
An assessment of severity of the main symptoms of the disease will be based on a 5-point scale: 0 = no symptom, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe
Time frame: Up to 54 weeks
Changes in the severity of skin rash based on the main disease symptoms scale.
An assessment of severity of the main symptoms of the disease will be based on a 5-point scale: 0 = no symptom, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe
Time frame: Up to 54 weeks
Changes in the renal function in patients with impaired renal function at the screening
Impaired renal function is defined as creatinine clearance(ClCr) \<90 ml/min \[calculated using the Cockcroft-Gault formula\] at the screening
Time frame: Up to 62 weeks
Changes in proteinuria in patients with baseline proteinuria
Presence of protein in urine according to urinalysis results
Time frame: Up to 62 weeks
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