A Proof of Concept Study for a 12 Month Treatment in Patients With C3G or IC-MPGN Treated With ACH-0144471

NCT ID: NCT03459443

Last Updated: 2023-08-21

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: PHASE2
• Total Enrollment: 22 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-06-20
• Study Completion Date: 2021-03-29

Brief Summary

The primary purpose of this study was to evaluate the efficacy of 12 months of oral ACH-0144471 (also known as danicopan and ALXN2040) in participants with C3G or IC-MPGN based on histologic scoring and proteinuria.

Detailed Description

This was an open-label study to evaluate the efficacy of treatment with danicopan in participants 12 years of age or older with biopsy-confirmed C3G or IC-MPGN who had not undergone renal transplantation. All participants were to receive active treatment with danicopan for approximately 40 months. The starting dosage was to be 100 mg TID, and after 2 weeks, the dosage was to be increased to 200 mg TID for participants with body weight ≥ 60 kg or 150 mg TID for participants with body weight < 60 kg. Planned enrollment was approximately 20 participants.

Conditions

C3 Glomerulonephritis; C3 Glomerulopathy; Immune Complex Membranoproliferative Glomerulonephritis; IC-MPGN; Dense Deposit Disease

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Danicopan

Danicopan was to be administered to participants with C3G or IC-MPGN at a starting dose of 100 milligrams (mg) 3 times daily (TID) for the first 2 weeks, then the dosage was to be increased to 200 mg TID for the remainder of the study.

Group Type: EXPERIMENTAL

Danicopan

Intervention Type: DRUG

Danicopan was to be administered as an oral tablet.

Interventions

Danicopan

Danicopan was to be administered as an oral tablet.

Intervention Type: DRUG

Other Intervention Names

ACH-4471; ACH4471; 4471; ALXN2040

Eligibility Criteria

Inclusion Criteria

1. At least 12 years of age

2. Completion of the ACH471-201 clinical study OR diagnosed with biopsy-confirmed primary C3G or IC-MPGN

3. If a pre-treatment biopsy is obtained, or if a historical biopsy is available for review, it must have no more than 50% global fibrosis and no more than 50% of glomeruli with cellular crescents

4. Clinical evidence of ongoing disease based on significant proteinuria (defined as ≥500 mg/day of protein in a 24-hour urine) attributable to C3G disease or IC-MPGN in the opinion of the principal investigator (PI), and present prior to study entry and confirmed during Screening

5. If on corticosteroids, anti-hypertensive medications, anti-proteinuric medications (for example, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers), or mycophenolate mofetil, must be on a stable dose for at least 2 weeks prior to screening

6. Female participants must use an acceptable method birth control to prevent pregnancy during the clinical study and for 30 days after the last dose of study medication

7. Male participants must use highly effective birth control with a female partner to prevent pregnancy during the clinical study and for 90 days after the last dose of study medication

8. Must be up-to-date on routine vaccinations, or willing to be brought up-to-date, based on local guidelines

9. Must have access to emergency medical care

Exclusion Criteria

1. Have a history of a major organ transplant (for example, heart, lung, kidney, or liver) or hematopoietic stem cell/marrow transplant

2. Have a history or presence of any clinically relevant co-morbidities that would make the participant inappropriate for the study (for example, a comorbidity that is likely to result in deterioration of the participant's condition, affect the participant's safety during the study, or confound the results of the study), in the opinion of the PI

3. Have an eGFR <30 milliliter/minute/1.73 m^2 at the time of screening or at any time over the preceding 4 weeks

4. Is a renal transplant recipient or receiving renal replacement therapy

5. Have other renal diseases that would interfere with the interpretation of the study

6. Have evidence of monoclonal gammopathy of unclear significance, infections, malignancy, autoimmune diseases, or other conditions to which C3G or IC-MPGN is secondary

7. Have been diagnosed with or show evidence of hepatobiliary cholestasis

8. Females who are pregnant, nursing, or planning to become pregnant during the study or within 90 days of ACH-0144471 administration or participants with a female partner who is pregnant, nursing, or planning to become pregnant during the study or within 90 days of ACH-0144471 administration

9. Have a history of febrile illness, a body temperature >38°Celsius, or other evidence of a clinically significant active infection, within 14 days prior to danicopan administration

10. Have evidence of human immunodeficiency virus, hepatitis B infection, or active hepatitis C infection at Screening

11. Have a history of meningococcal infection within the prior year

12. Have a history of hypersensitivity reactions to commonly used antibacterial agents, including beta-lactams, penicillin, aminopenicillins, fluoroquinolones, cephalosporins, and carbapenems, which, in the opinion of the investigator and/or an appropriately qualified immunology or infectious disease expert, would make it difficult to properly provide either empiric antibiotic therapy or treat an active infection.

13. Have participated in a clinical study in which an investigational drug was given within 30 days, or within 5 half-lives of the investigational drug, whichever is longer, prior to the first dose of ACH-0144471

14. Have received eculizumab at any dose or interval within the past 50 days prior to the first dose of ACH-0144471

15. Have received tacrolimus or cyclosporine within 2 weeks of the first dose of ACH-0144471

16. Have a 12-lead electrocardiogram (ECG) with a QT interval Fridericia correction formula >450 millisecond (msec) for males or >470 msec for females, or have ECG findings which, in the opinion of the PI, could put the participant at undue risk

17. Have received any drug known to prolong the corrected QT interval within 2 weeks of the first dose of ACH-0144471 and which, in the opinion of the PI, could put the participant at undue risk

18. Have any of the following laboratory abnormalities at screening:

• Alanine transaminase > upper limit of normal (ULN)
• Aspartate aminotransferase > ULN
• Absolute neutrophil counts <1,000/microliter
• Total bilirubin >1.5* ULN
• Indirect bilirubin > ULN
• Any laboratory abnormality that, in the opinion of the PI, would make the participant inappropriate for the study

19. Unwilling or unable to comply with the study protocol for any reason

• Minimum Eligible Age: 12 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Alexion Pharmaceuticals, Inc.

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Clinical Study Site

Birmingham, Alabama, United States

Clinical Study Site

Stanford, California, United States

Clinical Study Site

New Haven, Connecticut, United States

Clinical Study Site

Cincinnati, Ohio, United States

Clinical Study Site

Columbus, Ohio, United States

Clinical Study Site

Philadelphia, Pennsylvania, United States

Clinical Study Site

Sydney, New South Wales, Australia

Clinical Study Site

Brisbane, Queensland, Australia

Clinical Study Site

Melbourne, Victoria, Australia

Clinical Study Site

Antwerp, , Belgium

Clinical Study Site

Ranica, , Italy

Clinical Study Site

Leiden, , Netherlands

Clinical Study Site

Nijmegen, , Netherlands

Countries

United States; Australia; Belgium; Italy; Netherlands

References

Nester C, Appel GB, Bomback AS, Bouman KP, Cook HT, Daina E, Dixon BP, Rice K, Najafian N, Hui J, Podos SD, Langman CB, Lightstone L, Parikh SV, Pickering MC, Sperati CJ, Trachtman H, Tumlin J, de Vries AP, Wetzels JFM, Remuzzi G. Clinical Outcomes of Patients with C3G or IC-MPGN Treated with the Factor D Inhibitor Danicopan: Final Results from Two Phase 2 Studies. Am J Nephrol. 2022;53(10):687-700. doi: 10.1159/000527167. Epub 2022 Nov 24.

Reference Type: DERIVED

PMID: 36423588 (View on PubMed)

Provided Documents

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

2017-002674-39

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

ACH471-205

Identifier Type: -

Identifier Source: org_study_id