A 52-week Study of Rilzabrutinib Efficacy and Safety Compared to Placebo in Adults Diagnosed With IgG4-related Disease

Official title

A Randomized, Phase 3, Double-blind, 52-week Study to Evaluate the Efficacy and Safety of Rilzabrutinib (SAR444671) Compared to Placebo in Adult Participants With Active IgG4-related Disease

Overview

This is a Phase 3, parallel group, 2-arm, randomized, double blind, placebo-controlled, 52-week treatment study to assess the efficacy and safety of rilzabrutinib as a treatment for adult patients with active IgG4-RD. The purpose of this study is to measure time to adjudicated IgG4-RD clinical disease flare, and other relevant efficacy endpoints including flare-free rate, control of IgG4-RD disease activity, use of GC rescue and safety parameters such as treatment-emergent adverse events, clinical laboratory values and electrocardiograms (ECG) in participants aged 18 years and above, diagnosed with IgG4-RD and treated with rilzabrutinib tablets over a 52-week placebo-controlled period. Study details include: The study duration will be up to 60 weeks, including a Screening period of 4 to 6 weeks, a 52-week double blind treatment period, and 2 weeks of follow up (plus an optional OLE of 108 weeks). The number of visits will be 16 (plus an optional 9 visits during the OLE).

Interventions

• Drug Rilzabrutinib
  Pharmaceutical form:Tablet-Route of administration:Oral
• Drug Placebo
  Pharmaceutical form:Tablet-Route of administration:Oral
• Drug Glucocorticoid
  Pharmaceutical form:Tablet, solution, suspension formulations according to local standard practices-Route of administration:Oral

Primary outcome measures

• Time to first adjudicated clinical disease flare treated by the investigator during the Blinded Treatment period [Time frame: Until Week 52]

Secondary outcome measures (12)

• Proportion of participants without IgG4-RD adjudicated clinical disease flare and off glucocorticoids and immunomodulators [Time frame: At Week 52]
• Proportion of participants without IgG4-RD adjudicated clinical disease flare and off glucocorticoids [Time frame: At Week 52]
• Annualized rate of clinical disease flares [Time frame: At Week 52]
• Change in IgG4-RD RI total activity scores from baseline to Week 52 [Time frame: From baseline to Week 52]
• Proportion of participants in complete remission at Week 52 [Time frame: At Week 52]
• Percent change in IgG4-RD RI total activity scores from baseline to Week 52 [Time frame: From baseline to Week 52]
• Change in IgG4-RD RI total activity scores from baseline to Week 12 [Time frame: From baseline to Week 12]
• Percent change in IgG4-RD RI total activity scores from baseline at Week 12 [Time frame: From baseline to Week 12]
• Proportion of participants with reduction of ≥2 points from the baseline IgG4-RD RI total activity score [Time frame: At Week 12, Week 24, and Week 52]
• Cumulative glucocorticoid dose for treatment of IgG4-RD [Time frame: At Week 52]
• Proportion of participants with potentially clinically significant abnormalities in laboratory tests, vital signs, and electrocardiograms in the Safety Population [Time frame: Until Week 160]
• Proportion of participants with TEAEs, AESIs, SAEs in the Safety Population [Time frame: Until Week 160]

Eligibility criteria

Inclusion criteria

• Participants must have a clinical diagnosis of IgG4-RD confirmed by the Adjudication Committee.
• Participants meeting Step 1 Entry criteria of 2019 ACR/EULAR classification criteria for IgG4-RD and Total inclusion points are ≥20
• Participants with active disease in at least 1 organ system, excluding lymph nodes, with active disease defined by an IgG4-RD Responder Index organ/site activity score ≥2 based on the manifestations of disease activity in the last 28 days.
• Participants with history or current involvement of at least 1 organ/site (excluding lymph nodes) affected with IgG4-RD.
• Participants with active IgG4-RD controlled for at least 2 weeks while on a stable dose of GC.
• Participants willing to taper off GC after starting IMP.
• Participants willing and able to participate in repeated study protocol mandated or clinically indicated imaging procedures to assess IgG4-RD such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or ultrasound.
• Participants who have an up-to-date vaccination status as per local guidelines. The last dose of live vaccines should be received at least 30 days before Day 1.
• Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.

Exclusion criteria

• Meet any Step 2 Exclusion criteria from the 2019 ACR/EULAR classification criteria for IgG4-RD.
• History of retroperitoneal fibrosis, sclerosing mesenteritis, fibrosing mediastinitis, or other overwhelmingly fibrotic expression of IgG4-RD that is the sole disease manifestation.
• Active malignancy or history of malignancy within 5 years before Day 1, except completely treated in situ carcinoma of the cervix, completely treated, and resolved nonmetastatic squamous or basal cell carcinoma of the skin.
• Known or suspected immunodeficiency, including history of invasive opportunistic infections (eg, histoplasmosis, listeriosis, coccidioidomycosis, pneumocystosis, and aspergillosis) despite infection resolution, or otherwise recurrent infections of abnormal frequency or prolonged duration suggesting an immune compromised status, as judged by the Investigator.
• History of serious infections with the potential for recurrence (as judged by the Investigator), with less than 4 weeks interval between resolution of serious infection and first dose of study drug, or currently active moderate to severe infection at Screening (Grade 2 or higher).
• Current or chronic history of liver disease unrelated to IgG4-RD.
• Refractory nausea and vomiting, malabsorption, external biliary shunt, bariatric surgery, or significant bowel resection that would preclude adequate rilzabrutinib/placebo absorption.
• History of solid organ transplant.
• Planned major surgical procedure during the participation in this study.
• History of drug abuse within the previous 12 months.
• Alcoholism or excessive alcohol use, defined as regular consumption of more than approximately 3 standard drinks per day.
• Prior participation in any rilzabrutinib studies or other BTK inhibitor studies.
• History of treatment with an investigational drug within 6 months or 5 half-lives of the investigational drug, whichever is longer.
• Laboratory abnormalities at the screening visit identified by the central laboratory The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Quadruple blind

Primary purpose

Treatment

Study locations

United States · 17 centers

• Kaiser Permanente - Fontana Medical Center- Site Number : 8400015 — Fontana
• San Jose Clinical Trials- Site Number : 8400016 — San Jose
• Solace Clinical Research - Tustin- Site Number : 8400020 — Tustin
• Life Clinical Trials - Margate - Colonial Drive- Site Number : 8400002 — Margate
• Schiff Center for Liver Diseases- Site Number : 8400010 — Miami
• Vitalia Medical Research - Margate- Site Number : 8400025 — Palm Beach Gardens
• Emory University School of Medicine - Atlanta- Site Number : 8400013 — Atlanta
• Primeway Clinical Research- Site Number : 8400019 — Fayetteville
• … and 9 more centers

Japan · 11 centers

• Investigational Site Number : 3920004 — Kitakyushu
• Hiroshima University Hospital-Site Number : 3920007 — Hiroshima
• Investigational Site Number : 3920011 — Sapporo
• Kobe University Hospital-Site Number : 3920010 — Kobe
• Kanazawa Medical University Hospital-Site Number : 3920002 — Kahoku, Uchinada
• Investigational Site Number : 3920001 — Kanazawa
• Investigational Site Number : 3920005 — Nagaoka
• Investigational Site Number : 3920003 — Hirakata
• … and 3 more centers

China · 10 centers

• Investigational Site Number : 1560008 — Beijing
• Investigational Site Number : 1560004 — Beijing
• Investigational Site Number : 1560001 — Beijing
• Investigational Site Number : 1560012 — Chengdu
• Investigational Site Number : 1560010 — Hangzhou
• Investigational Site Number : 1560003 — Jiazhuang
• Investigational Site Number : 1560013 — Taiyuan
• Investigational Site Number : 1560005 — Taiyuan
• … and 2 more centers

Chile · 5 centers

• Investigational Site Number : 1520005 — Concepción
• Centro de estudios G y C-Site Number : 1520003 — Santiago
• Investigational Site Number : 1520006 — Santiago
• Investigational Site Number : 1520001 — Santiago
• Investigational Site Number : 1520002 — Santiago

Argentina · 4 centers

• Investigational Site Number : 0320005 — Berazategui
• Investigational Site Number : 0320003 — San Isidro
• Investigational Site Number : 0320002 — Resistencia
• Investigational Site Number : 0320004 — Buenos Aires

Germany · 4 centers

• Investigational Site Number : 2760001 — Berlin
• Investigational Site Number : 2760003 — Erlangen
• Investigational Site Number : 2760004 — Minden
• Investigational Site Number : 2760006 — Ulm

France · 3 centers

• AP-HP - Hôpital Beaujon-Site Number : 2500002 — Clichy
• Investigational Site Number : 2500001 — Marseille
• CHU Bordeaux - Hôpital Haut Leveque-Site Number : 2500003 — Pessac

Italy · 3 centers

• AOU Meyer IRCCS-Site Number : 3800003 — Florence
• IRCCS Ospedale San Raffaele-Site Number : 3800001 — Milan
• Centro Ricerche Cliniche di Verona s.r.l. c/o Policlinico G.B.Rossi-Site Number : 3800002 — Verona

Poland · 3 centers

• Malopolskie Badania Kliniczne sp. z. o.o.-Site Number : 6160001 — Krakow
• Investigational Site Number : 6160002 — Wroclaw
• Uniwersyteckie Centrum Kliniczne, Centrum Wsparcia Badan Klinicznych UCK Osrodek Badan Wcz — Gdansk

Spain · 3 centers

• Investigational Site Number : 7240001 — Barcelona
• Investigational Site Number : 7240002 — Barcelona
• Investigational Site Number : 7240004 — Madrid

Taiwan · 3 centers

• Investigational Site Number : 1580004 — Kaohsiung City
• Investigational Site Number : 1580001 — Taipei
• Investigational Site Number : 1580002 — Taoyuan City

Israel · 2 centers

• Rabin MC, Outpatient Clinics Building-Site Number : 3760001 — Petah Tikva
• Sourasky Rheumatology Dept, Rishonim Building-Site Number : 3760005 — Tel Aviv

Netherlands · 2 centers

• Erasmus Medisch Centrum-Site Number : 5280001 — Rotterdam
• UMCG-Site Number : 5280002 — Groningen

Saudi Arabia · 2 centers

• Investigational Site Number : 6820002 — Riyadh
• Investigational Site Number : 6820001 — Riyadh

South Korea · 2 centers

• Investigational Site Number : 4100002 — Suwon
• Investigational Site Number : 4100001 — Seoul

Sweden · 2 centers

• Investigational Site Number : 7520001 — Huddinge
• Investigational Site Number : 7520002 — Uppsala

Belgium · 1 center

• Investigational Site Number : 0560001 — Leuven

Canada · 1 center

• Investigational Site Number : 1240001 — Sherbrooke

United Kingdom · 1 center

• Investigational Site Number : 8260004 — Norwich

Identifiers

NCT: NCT07190196 · EFC17359 · U1111-1316-0266 · 2025-521398-15

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗