This is a multicenter, randomized, double-masked phase II study evaluating the efficacy and safety of IBI311 in subjects with inactive or active thyroid eye disease. Approximately 36 subjects meeting the study eligibility criteria will be randomly assigned to the 3-10 mg group, 3-20 mg group, 10 mg group, or 20 mg group on day 1 in a 1:1:2:2 ratio. Dose conversion of the 3-10 mg or 3-20 mg group was performed at week 12. Active and inactive TED was a stratification factor in this study. Active and inactive TED subjects were enrolled in a 1:1 ratio.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
38
Arm 4: 10 mg/kg IBI311 on Day 1, followed by 20 mg/kg IBI311 from week 3 to week 21, Q3W.
Arm 2: 3 mg/kg IBI311 from day 1 to week 9, Q3W, followed by 20 mg/kg IBI311 from week 12 to week 21, Q3W.
Arm 3: 10 mg/kg IBI311 from day 1 to week 21, Q3W.
Innovent Biologics (Suzhou) Co. Ltd
Suzhou, Suzhou, China
Mean change from Baseline in proptosis in the study eye.
Proptosis assessment: protrusion of the eye from the orbital rim as measured by Hertel exophthalmometer.
Time frame: Week 12
Safety and Tolerability
Incidence, severity, and association with the study drug of ocular and systemic adverse events (AE), treatment-emergent adverse events (TEAE), and serious adverse events (SAE).
Time frame: After receiving IBI311 treatment for 48 weeks
The proptosis responder rate in the study eye
Defined as percentage of subjects with a ≥ 2 mm reduction from baseline in proptosis in the study eye, without deterioration \[≥ 2 mm increase\] of proptosis in the non-study eye.
Time frame: Week 12, 24 and 48
Mean change from Baseline in proptosis in the study eye.
Proptosis assessment: protrusion of the eye from the orbital rim as measured by Hertel exophthalmometer.
Time frame: Week 24 and 48
The overall responder rate in the study eye.
Defined as participants with a reduction in clinical activity score (CAS) of ≥ 2 points, and a reduction in proptosis of ≥ 2 mm in the study eye, and no deterioration (increase in CAS of ≥ 2 points or increase in proptosis of ≥ 2 mm) in the non-study eye.
Time frame: Week 12, 24 and 48
Percentage of subjects with a CAS of 0 or 1 in the study eye.
According to the 7-item European Group on Graves' Ophthalmopathy (EUGOGO) amendment, CAS was used to evaluate clinical activity. For each of the following items, one point is given: spontaneous orbital pain, gaze evoked orbital pain, eyelid swelling that is considered to be due to active (inflammatory phase) Graves' ophthalmopathy (GO), eyelid erythema, conjunctival redness that is considered to be due to active (inflammatory phase) GO, chemosis, and inflammation of caruncle or plica. The sum of these points is the total score, with 0 indicating no clinical activity and 7 indicating the most severe clinical activity.
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Arm 1: 3 mg/kg IBI311 from day 1 to week 9, Q3W, followed by 10 mg/kg IBI311 from week 12 to week 21, Q3W.
Time frame: Week 12, 24 and 48
Mean change from Baseline in CAS in the study eye.
Time frame: Week 12, 24 and 48
Positive responder rate to IBI311 treatment in the study eye.
Defined as: 1. ≥2 mm reduction of lid aperture; 2. ≥1 point reduction in five-item CAS (excluding subjective, patient-reported spontaneous or gaze-evoked pain), 3. ≥2 mm reduction in exophthalmos, 4. ≥8° increase of eye muscle duction; Improvement in ≥2 features in the study eye without deterioration in the non-study eye
Time frame: Week 12, 24 and 48
The impact of IBI311 on the quality of life.
Changes in Graves' Ophthalmopathy Quality of Life (GO-QoL) questionnaire score
Time frame: Week 12, 24 and 48
The diplopia responder rate
Defined as subjects with a ≥ 1-point improvement in Gorman diplopia score.
Time frame: Week 12, 24 and 48
The relapse rate after IBI311 treatment
Defined as proptosis increased by ≥2 mm from baseline and/or CAS increased by ≥2 points from baseline with total CAS score ≥3 in either eye.
Time frame: Week 28, 36 and 48
Systemic Pharmacokinetics profile of IBI311
Descriptive statistics will be performed for concentration data, and the corresponding Pharmacokinetics parameters will be estimated if sufficient data are available.
Time frame: From Day 1 to week 24
Change from Baseline in MRI in the study eye.
Changes in exophthalmia from baseline on MRI at week 12, 24, and 48; Changes in the volume and maximum thickness of extraocular muscle, orbital fat and lacrimal gland on MRI from baseline at week 12, 24 and 48; Changes in MRI signal of intraorbital tissue from baseline at week 12, 24 and 48.
Time frame: Week 12, 24 and 48