This was a Phase 2a, multi-center, placebo-controlled study in which patients with autoimmune hepatitis received zetomipzomib or placebo in addition to standard-of-care for 24 weeks; an optional open-label extension period allowed participants to receive zetomipzomib (KZR-616) for an additional 24 weeks of treatment.
This was a Phase 2a, multi-center, randomized, double-blind, placebo-controlled study with an open-label extension to evaluate safety, tolerability, and efficacy of zetomipzomib in patients with autoimmune hepatitis (AIH) who have not benefited from standard-of-care treatment, had an incomplete response to ≥3 months of standard-of-care treatment, or had a disease flare after standard of care. Zetomipzomib or placebo were administered weekly for a 24-week treatment period in addition to standard-of-care (glucocorticoids), followed by a 4-week off-treatment safety follow-up period. Zetomipzomib and placebo was administered subcutaneously (SC) once weekly. At the end of the 24-week treatment period, eligible participants from both the zetomipzomib- and placebo-treated arms who completed the double-blind treatment period could enroll in the open-label extension period to receive up to an additional 24 weeks of treatment with zetomipzomib.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
24
Subcutaneous injection of zetomipzomib with a target dose of 60 mg weekly
Subcutaneous injection of placebo
Subcutaneous injection of zetomipzomib with a target dose of 60 mg weekly
Mayo Clinic Arizona
Phoenix, Arizona, United States
Patients Who Achieved Complete Biochemical Response
The number of patients who achieve complete biochemical response (CR), defined as normal ALT, AST, and IgG values (if IgG level is elevated at Baseline) with glucocorticoid dose not higher than starting dose (at Baseline), by Week 24 of the Double-Blind Treatment Period. Analyses were also conducted at Week 12, Week 16, and Week 20.
Time frame: Week 12, Week 16, Week 20, and Week 24
The Safety and Tolerability of Zetomipzomib
Proportion of participants who experience AEs (adverse events) and SAEs (serious adverse events) during the double-blind treatment period (DBTP) and the open-label extension (OLE).
Time frame: Baseline through end of study visit (DBTP, Week 28 and OLE, Up to Week 24)
Proportion of Participants Experiencing a Disease Flare Among the Participants Who Achieved a CR During the Double-blind Treatment Period
Proportion of participants experiencing a disease flare among the participants who achieved a complete biochemical response (CR) during the double-blind treatment period.
Time frame: Start of open-label extension (OLE) period through End of Study (EOS) up to OLE Week 25
Alanine Aminotransferase (ALT)
Changes from baseline in alanine aminotransferase (ALT) during the double-blind treatment period.
Time frame: Weeks 12, 16, 20, and 24
Partial Response
Proportion of participants who achieved a partial response (PR) during the double-blind treatment period of the study.
Time frame: Weeks 12, 16, 20, and 24
Time to Complete Response
Time to complete response (CR), defined as the duration from first dose of study drug (zetomipzomib or placebo) to first CR, during the double-blind treatment period was measured using the Kaplan-Meier method. Due to the small sample size, not enough events of participants achieving CR were observed to provide Kaplan-Meier estimates for the 25th percentile, median, and 75th percentile time to CR.
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Keck School of Medicine of USC
Los Angeles, California, United States
University of California, Los Angeles
Los Angeles, California, United States
Stanford Medicine
Redwood City, California, United States
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San Francisco, California, United States
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San Francisco, California, United States
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Aurora, Colorado, United States
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New Haven, Connecticut, United States
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Jacksonville, Florida, United States
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Miami, Florida, United States
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Time frame: Baseline through Week 24
Disease Flare After CR
Proportion of participants who experienced a disease flare after complete response (CR) during the double-blind treatment period.
Time frame: Week 24
Treatment Failures
Proportion of participants who were considered treatment failures, defined as ALT or AST level worsened ≥2 times that of the Baseline value that is sustained for ≥1 week as verified via repeat laboratory assessments, despite compliance with standard of care (ie, with regard to inclusion criteria) or protocol-defined therapy or a glucocorticoid dose is increased above the Baseline dose, it may be considered a treatment failure unless attributed to an adverse event not relating to AIH, during the double-blind treatment period.
Time frame: Week 24
Complete Response With Glucocorticoid Taper to ≤10 mg
Percentage of participants who achieved complete response with successful glucocorticoid taper to ≤10 mg by Week 24 of the double-blind treatment period.
Time frame: Weeks 12, 16, 20, and 24
Complete Response With Glucocorticoid Taper to ≤5 mg
Percentage of participants who achieved complete response and glucocorticoid taper to ≤5 mg by Week 24 of the double-blind treatment period.
Time frame: Weeks 12, 16, 20, and 24
Complete Response With Glucocorticoid Taper to 0 mg
Percentage of participants who achieved complete response with glucocorticoid taper to 0 mg by Week 24 of the double-blind treatment period.
Time frame: Weeks 12, 16, 20, and 24
Partial Response With Glucocorticoid Taper to ≤10 mg
Percentage of participants who achieved partial response with successful glucocorticoid taper to ≤10 mg by Week 24 of the double-blind treatment period.
Time frame: Week 24
Partial Response With Glucocorticoid Taper to ≤5 mg
Percentage of participants who achieved partial response and glucocorticoid taper to ≤5 mg by Week 24 of the double-blind treatment period.
Time frame: Week 24
Partial Response With Glucocorticoid Taper to 0 mg
Percentage of participants who achieved partial response with glucocorticoid taper to 0 mg by Week 24 of the double-blind treatment period.
Time frame: Week 24