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Study to Evaluate Rilzabrutinib in Adults and Adolescents With Persistent or Chronic Immune Thrombocytopenia (ITP) (LUNA 3)

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ClinicalTrials.gov Identifier: NCT04562766
Recruitment Status : Recruiting
First Posted : September 24, 2020
Last Update Posted : April 11, 2024
Sponsor:
Information provided by (Responsible Party):
Sanofi ( Principia Biopharma, a Sanofi Company )

Study Description
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Brief Summary:

This is a randomized, double-blind study of rilzabrutinib in patients with persistent or chronic ITP, with an average platelet count of <30,000/μL (and no single platelet count >35,000/μL) on two counts at least 5 days apart in the 14 days before treatment begins. Patients will receive rilzabrutinib or placebo 400mg twice daily.

For each patient, the study will last up to 60 weeks from the start of the Screening Period to the End of Study (EOS) visit. This includes Screening (up to 4 weeks) through a 12 to 24-week Blinded Treatment Period followed by a 28-week Open-Label Period. Followed by a 4-week post dose follow-up.

For adult participants, the maximum duration of the long-term extension (LTE) period will be 12 months from the date of the last adult participant to enter the LTE.

For pediatric participants, the maximum duration of the LTE period will be 12 months from the date of the last pediatric participant to enter the LTE.


Condition or disease Intervention/treatment Phase
Immune Thrombocytopenia Drug: Rilzabrutinib Drug: Placebo Phase 3

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 194 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: Double-Blind
Primary Purpose: Treatment
Official Title: A Phase 3, Multicenter, Randomized, Double-Blind, Placebo Controlled, Parallel-Group Study With an Open-Label Extension to Evaluate the Efficacy and Safety of Oral Rilzabrutinib (PRN1008) in Adults and Adolescents With Persistent or Chronic Immune Thrombocytopenia (ITP)
Actual Study Start Date : December 14, 2020
Estimated Primary Completion Date : June 5, 2025
Estimated Study Completion Date : November 20, 2026

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: Rilzabrutinib
Patients receive rilzabrutinib 400mg orally twice daily for up to 24 weeks followed by 28 weeks of open label period
 Drug: Rilzabrutinib
400mg Caplet
Other Name: PRN1008
Placebo Comparator: Placebo
Patients receive matching placebo 400mg orally twice daily for up to 24 weeks
 Drug: Placebo
400mg Caplet
Other Name: PRN1008 Placebo


Outcome Measures
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Primary Outcome Measures :
  1. Durable platelet response during the last 6 weeks of the 24-week blinded treatment period (not for EU and UK) [ Time Frame: 24 weeks ]
    Durable platelet response is defined as a proportion of participants able to achieve platelet counts at or above 50,000/μL for ≥ two-thirds of at least 8 non-missing weekly scheduled platelet measurements during the last 12 weeks of the 24-week blinded treatment period in the absence of rescue therapy, provided that at least 2 non-missing weekly scheduled platelet measurements are at or above 50,000/μL.

  2. for EU and UK: Proportion of adult participants able to achieve platelet counts at or above 50,000/μL for at least 8 out of the last 12 weeks of the 24-week blinded treatment period in the absence of rescue therapy [ Time Frame: 24 weeks ]

Secondary Outcome Measures :
  1. Number of weeks with platelet count ≥50,000/μL OR between ≥30,000/μL and <50,000/μL and at least doubled from baseline over the 24-week blinded treatment period in the absence of rescue therapy [ Time Frame: 24 weeks ]
  2. Number of weeks with platelet counts ≥30,000/μL and at least doubled from baseline over the 24-week blinded treatment period in the absence of rescue therapy [ Time Frame: 24 weeks ]
  3. Time to first platelet count of ≥50,000/μL OR between ≥30,000/μL and <50,000/μL and doubled from baseline [ Time Frame: 24 weeks ]
  4. Proportion of patients requiring rescue therapy during the 24-week blinded treatment period [ Time Frame: 24 weeks ]
  5. Change from baseline on Item 10 of the ITP-Patient Assessment Questionnaire in adult patients (≥18 years) at Week 13 [ Time Frame: From baseline to Week 13 ]
  6. for EU and UK: Change from baseline in Idiopathic Thrombocytopenic Purpura Bleeding Scale (IBLS) assessment at Week 25 [ Time Frame: At Week 25 ]
  7. Proportion of participants who able to achieve stable platelet response, within a period of 24 weeks following initial achievement of the platelet response [ Time Frame: 24 weeks ]
    Stable platelet response is defined as no 2 scheduled visits, at least 4 weeks apart, with a platelet count less than 50,000/µL, without an intervening visit with a platelet count ≥50,000/µL. Initial platelet response defined as platelet count ≥50,000/μL within 12 weeks of initiation of treatment with rilzabrutinib during the study.

  8. Frequency and severity of Treatment Emergent Adverse Events [ Time Frame: 52 weeks of treatment, 12 months of long term extension and 4 weeks of follow up post last dose ]
    Including physical examination, ECG, clinical laboratory test results, vital signs and laboratory tests (serum chemistry, hematology, except for platelet counts included in the primary efficacy endpoint)

  9. Frequency and severity of bleeding TEAEs [ Time Frame: 52 weeks of treatment, 12 months of long term extension and 4 weeks of follow up post last dose ]
  10. Plasma concentrations of rilzabrutinib [ Time Frame: Until 52 weeks ]
  11. Change from baseline on the Symptoms, Bother and Activity domains of the ITP Patient Assessment Questionnaire (ITP-PAQ) in adult patients (≥18 years) [ Time Frame: 52 weeks of treatment, 12 months of long term extension and 4 weeks of follow up post last dose ]
    The ITP Patient Assessment Questionnaire™ (ITP-PAQ™) is a disease-specific instrument that was designed to measure the Quality of Life (QoL) of adult patients with immune thrombocytopenia. The items employ a 4-week recall with responses recorded on 4-, 5- or 7-point Likert scales. All item scores are transformed to a 0 to 100 continuum where higher scores represent better QoL and are weighted equally to derive the scale scores.

  12. Change from baseline in disease-specific QoL as measured by the Kids' ITP Tools (ITP-KIT) score in pediatric participants [ Time Frame: 52 weeks of treatment, 12 months of long term extension and 4 weeks of follow up post last dose ]
    The ITP-KIT include a battery of three disease-specific instruments, a child self-report form designed to be completed by children ≥7 years, a parent proxy report form for children <7 and a parent impact form. Respondents record their disease experience based on a 1-week recall. The instrument yields a total score which is the summation of the items converted to a 0 to 100 score with higher scores indicating better disease-specific QoL.


Eligibility Criteria
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Ages Eligible for Study:   10 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Patients will be male and female with primary ITP with duration of >6 months in pediatric participants aged 12 to <18 years (pediatric participants aged 10 to <12 years will be enrolled in the EU [EEA countries] only) and duration of >3 months in ages 18 years and above
  2. Patients who had a response (achievement of platelet count ≥50,000/µL) to IVIg/anti-D or CSs that was not sustained and who have documented intolerance, insufficient response or any contra-indication to any appropriate courses of standard of care ITP therapy

  3. An average of 2 platelet counts at least 5 days apart of <30,000/µL during the Screening period and no single platelet count >35,000/µL, within 14 days prior to the first dose of study drug.

    - Pediatric patients must additionally be determined to need treatment for ITP as per clinical assessment by the Investigator.

  4. Adequate hematologic, hepatic, and renal function (absolute neutrophil count ≥1.5 X 10^9/L, AST/ALT ≤1.5 x upper limit of normal [ULN], albumin ≥3 g/dL, total bilirubin ≤1.5 x ULN [unless the patient has documented Gilbert syndrome], glomerular filtration rate >50 [Cockcroft and Gault method])
  5. Hemoglobin >9 g/dL within 1 week prior to Study Day 1
  6. All contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies
  7. Patients must be able to provide written informed consent or informed assent with corresponding informed consent obtained from the patient's guardian and agree to the schedule of assessments

Exclusion Criteria:

  1. Patients with secondary ITP
  2. Pregnant or lactating women
  3. History (within 5 years of Study Day 1) or current, active malignancy requiring or likely to require chemotherapeutic or surgical treatment during the study, with the exception of non melanoma skin cancer
  4. Transfusion with blood, blood products, plasmapheresis, or use of any other rescue medications with intent to increase platelet count within 14 days before Study Day 1
  5. Change in CS and/or TPO-RA dose within 14 days prior to Study Day 1 (more than 10% variation from current doses)
  6. Immunosuppressant drugs other than CSs within 5 times the elimination half-life of the drug or 14 days of Study Day 1, whichever is longer

  7. Treatment with rituximab or splenectomy within the 3 months prior to Study Day 1

    - Patients treated with rituximab will have normal B-cell counts prior to enrollment

  8. Has received any investigational drug within the 30 days before receiving the first dose of study medication, or at least 5 times elimination half-life of the drug (whichever is longer); patient should not be using an investigational device at the time of dosing

    • Patients who previously received treatment with Bruton's Tyrosine Kinase (BTK) inhibitors (except rilzabrutinib) within 30 days before the first dose of study drug are not eligible
    • Patients who previously received rilzabrutinib at any time are not eligible
  9. History of solid organ transplant
  10. Myelodysplastic syndrome
  11. Live vaccine within 28 days prior to Study Day 1 or plan to receive one during the study
  12. Planned surgery in the time frame of the dosing period
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04562766


Contacts
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Contact: Trial Transparency email recommended (Toll free number for US & Canada) 800-633-1610 ext option 6 contact-us@sanofi.com

Locations
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Sponsors and Collaborators
Principia Biopharma, a Sanofi Company
More Information
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Responsible Party: Principia Biopharma, a Sanofi Company
ClinicalTrials.gov Identifier: NCT04562766    
Other Study ID Numbers: EFC17093
PRN1008-018 ( Other Identifier: Principia Biopharma )
2023-509401-71 ( Registry Identifier: CTIS )
First Posted: September 24, 2020    Key Record Dates
Last Update Posted: April 11, 2024
Last Verified: April 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Thrombocytopenia
Purpura, Thrombocytopenic, Idiopathic
Blood Platelet Disorders
Hematologic Diseases
Cytopenia
Purpura, Thrombocytopenic
Purpura
Blood Coagulation Disorders
 Thrombotic Microangiopathies
Hemorrhagic Disorders
Autoimmune Diseases
Immune System Diseases
Hemorrhage
Pathologic Processes
Skin Manifestations