A Study Evaluating the Efficacy, Safety, Pharmacokinetics and Pharmacodynamics of Crovalimab in Pediatric Participants With Atypical Hemolytic Uremic Syndrome (aHUS)

NCT ID: NCT04958265

Last Updated: 2025-12-30

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: PHASE3
• Total Enrollment: 41 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-11-17
• Study Completion Date: 2029-05-19

Brief Summary

This study aims to evaluate the efficacy and safety of crovalimab in pediatric participants with aHUS.

Conditions

Atypical Hemolytic Uremic Syndrome

Study Design

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

Study Groups

Crovalimab

Participants will be enrolled in three cohorts: \[1\] Naive Cohort - participants who have not been previously treated with complement inhibitor therapy; \[2\] Switch Cohort - participants who switch to crovalimab from another C5 inhibitor and \[3\] Pretreated Cohort (includes C5 SNP (Single Nucleotide Polymorphism) participants) - participants who received treatment with another C5 inhibitor and subsequently discontinued it.

Group Type: EXPERIMENTAL

Crovalimab

Intervention Type: DRUG

Crovalimab will be administered at a dose of 1000 mg intravenously (IV) (for participants weighing =\> 40 to \<100 kg) or 1500 mg IV (for participants weighing \>=100 kg) on Week 1 Day 1. On Week 1 Day 2 and on Weeks 2, 3 and 4, crovalimab will be administered at a dose of 340 mg subcutaneously (SC). On Week 5 and Q4W thereafter, it will be administered at a dose of 680 mg SC (for participants weighing =\> 40 to \<100 kg) or 1020 mg SC (for participants weighing \>=100 kg). Enrollment of participants weighing \<40 kg will be staggered using two weight-based dose confirmation groups (Group 1 participants weighing \>=20 kg to \<40 kg, followed by Group 2 participants weighing \>=5 kg to \<20 kg). All participants will receive an initial IV loading dose, which will be followed by SC dosing at either Q2W or Q4W intervals (depending on body weight), until study completion.

Interventions

Crovalimab

Crovalimab will be administered at a dose of 1000 mg intravenously (IV) (for participants weighing =\> 40 to \<100 kg) or 1500 mg IV (for participants weighing \>=100 kg) on Week 1 Day 1. On Week 1 Day 2 and on Weeks 2, 3 and 4, crovalimab will be administered at a dose of 340 mg subcutaneously (SC). On Week 5 and Q4W thereafter, it will be administered at a dose of 680 mg SC (for participants weighing =\> 40 to \<100 kg) or 1020 mg SC (for participants weighing \>=100 kg). Enrollment of participants weighing \<40 kg will be staggered using two weight-based dose confirmation groups (Group 1 participants weighing \>=20 kg to \<40 kg, followed by Group 2 participants weighing \>=5 kg to \<20 kg). All participants will receive an initial IV loading dose, which will be followed by SC dosing at either Q2W or Q4W intervals (depending on body weight), until study completion.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Body weight >= 5 kg at screening.
• Vaccination against Neisseria meningitis serotypes A, C, W, and Y; vaccination against serotype B, according to national vaccination recommendations.
• Vaccination against Haemophilus influenzae type B and Streptococcus pneumoniae, according to national vaccination recommendations.
• For patients continuing to receive other therapies concomitantly with crovalimab (e.g., immunosuppressants, corticosteroids, mammalian target of rapamycin inhibitor (mTORi), or calcineurin inhibitors): stable dose for >=28 days prior to screening and up to the first crovalimab administration.
• For female participants of childbearing potential: an agreement to remain abstinent or use contraception.
• Participants with a prior kidney transplant are eligible if they have a known history of complement-mediated aHUS prior to the kidney transplant.
• Onset of initial TMA presentation within 28 days prior to the first dose of crovalimab (for Naive Cohort only).
• Documented treatment with either eculizumab or ravulizumab (for Switch Cohort only).
• Clinical evidence of response to a C5 inhibitor (for Switch Cohort only).
• Poorly controlled TMA following treatment with another C5 inhibitor (for C5 SNP participants in the Pretreated Cohort only).
• Known C5 polymorphism (for C5 SNP participants in the Pretreated Cohort only).

Exclusion Criteria

• TMA associated with non-aHUS related renal disease.
• Positive direct Coombs test.
• Chronic dialysis within 90 days prior to first crovalimab administration , and /or end stage renal disease
• Identified drug exposure-related TMA.
• Presence or history of a condition that could trigger TMA, such as malignancy, bone marrow or organ transplant (other than kidney transplant) or autoimmune disease.
• History of a kidney disease, other than aHUS.
• History of Neisseria meningitidis infection within 6 months of study enrollment.
• Known or suspected immune deficiency (e.g., history of frequent recurrent infections).
• Positive HIV test.
• Active systemic bacterial, viral, or fungal infection within 14 days before first crovalimab administration.
• Presence of fever (>= 38°C) before the first crovalimab administration (If fevers are solely due to the underlying aHUS pathology, and there is no evidence or suspicion of a systemic infection, participants may enroll).
• Multi-system organ dysfunction or failure.
• Recent intravenous immunoglobulin (IVIg) treatment.
• Pregnant or breastfeeding or intending to become pregnant.
• Participation in another interventional treatment study with an investigational agent or use of any experimental therapy within 28 days of screening or within five half lives of that investigational product, whichever is greater.
• Recent use of tranexamic acid.
• Current or previous treatment with a complement inhibitor (for Naive Cohort only).
• First initiation of plasma exchange/plasma infusions (PE/PI) should not be more than 28 days prior to first crovalimab administration (for Naive Cohort only).
• Last PE/PI completed less than 2 hours prior to first crovalimab administration (for Naive Cohort only).
• Receiving PE/PI within 8 weeks of the first crovalimab administration (Switch Cohort only).
• Normalization of serum creatinine values at baseline (<97.5th percentile for age), (for Naive Cohort only).
• Positive for active Hepatitis B and/or C infections (HBV/HCV) (for Switch Cohort and switching C5 SNP Pretreated Cohort participants who recently received C5 inhibitor treatment).
• Cryoglobulinemia at screening (for Switch Cohort and C5 SNP Cohort participants who recently received C5 inhibitor treatment).
• Diagnosis of a condition leading to non-aHUS TMA: Thrombotic Thrombocytopenic Purpura (TTP), Shiga Toxin producing Escherichia Coli (STEC)-TMA, Pneumococcal HUS, TMA secondary to cobalamin C defect (as demonstrated by either increased total blood homocysteine levels or MMACHC gene mutation) and TMA related to Diacylglycerol kinase ε (DGKE) nephropathy.

• Minimum Eligible Age: 28 Days
• Maximum Eligible Age: 17 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Chugai Pharmaceutical

INDUSTRY

Sponsor Role: collaborator

Hoffmann-La Roche

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Clinical Trials

Role: STUDY_DIRECTOR

Hoffmann-La Roche

Locations

Children's Hospital Colorado

Aurora, Colorado, United States

University of Nebraska

Omaha, Nebraska, United States

Hackensack University Medical Center

Hackensack, New Jersey, United States

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

UT Health Science Center

San Antonio, Texas, United States

UZ Gent

Ghent, , Belgium

UZ Leuven Gasthuisberg

Leuven, , Belgium

Inst. Da Criança- Faculdade de Medicina Usp

São Paulo, São Paulo, Brazil

CHU Sainte-Justine

Montreal, Quebec, Canada

Peking University First Hospital

Beijing, , China

Beijing Children's Hospital, Capital Medical University

Beijing, , China

The children's hospital , Zhejiang university school of medicine

Hangzhou, , China

Hôpital Arnaud de Villeneuve

Montpellier, , France

Gh Necker Enfants Malades

Paris, , France

Institute of Kidney Diseases and Research Centre

Ahmedabad, Gujarat, India

Medanta-The Medicity

Gurgaon, Haryana, India

All India Institute Of Medical Sciences (AIIMS)

New Delhi, National Capital Territory of Delhi, India

Aichi Children?s Health and Medical Center

Aichi, , Japan

Chiba Children's Hospital

Chibashi, Chibaken, , Japan

Hospital de Especialidades Puerta de Hierro S.A de C.V.

Zapopan, , Mexico

Uniwersyteckie Centrum Kliniczne

Gdansk, , Poland

Instytut Centrum Zdrowia Matki Polki

Lodz, , Poland

Countries

Hungary; Israel; Italy; South Africa; Spain; United States; Belgium; Brazil; Canada; China; France; India; Japan; Mexico; Poland

Other Identifiers

2020-002437-15

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

2023-505638-82-00

Identifier Type: CTIS

Identifier Source: secondary_id

BO42354

Identifier Type: -

Identifier Source: org_study_id