A Study to Evaluate the Pharmacokinetics and Safety of Etavopivat in Pediatric Patients With Sickle Cell Disease

Официальное название

A Single Arm, Open Label, Phase 1/2 Study to Evaluate the Pharmacokinetics and Safety of Etavopivat in Pediatric Patients With Sickle Cell Disease

Обзор

This study is being done to learn about etavopivat, a once a day medicine taken by mouth in adolescents with sickle cell disease. The main goals are to study safety and how long etavopivat stays in the bloodstream, while also studying if there are benefits from taking etavopivat. Eligible participants who enter the study will start a 96-week treatment period. At the end of the 96 weeks, participants will have an end of study visit that occurs 4 weeks later. The participants will receive etavopivat every day throughout the treatment period.

Вмешательства

• Препарат Etavopivat
  Participants will receive oral tablets of etavopivat once daily.

Первичные конечные точки

• Single-dose: maximum plasma concentration (Cmax) [Срок оценки: During the 24-week primary treatment period]
• Single-dose: area under the plasma concentration time curve from dosing (time 0) to time t ((AUC)0-t) [Срок оценки: During the 24-week primary treatment period]
• Single-dose: area under the plasma concentration time curve from zero to time infinity (AUC0-inf) [Срок оценки: During the 24-week primary treatment period]
• Steady-state maximum plasma concentration (Cmax,ss) [Срок оценки: During the 24-week primary treatment period]
• Steady-state area under the concentration time curve over the dosing interval (AUCtau,ss) [Срок оценки: During the 24-week primary treatment period]
• Steady-state average plasma concentration (Cavg,ss) [Срок оценки: During the 24-week primary treatment period]
• Steady-state minimum plasma concentration (Cmin,ss) [Срок оценки: During the 24-week primary treatment period]
• Incidence of adverse events (AEs), serious adverse events (SAEs), and AEs related to etavopivat [Срок оценки: During the 24-week primary treatment period]
• Number of premature discontinuations [Срок оценки: During the 24-week primary treatment period]
• Number of dose interruptions [Срок оценки: During the 24-week primary treatment period]

Вторичные конечные точки (10)

• Incidence of AEs, SAEs, and AEs related to etavopivat [Срок оценки: During the 72-week treatment extension period]
• Number of premature discontinuations [Срок оценки: During the 72-week treatment extension period]
• Number of dose interruptions [Срок оценки: During the 72-week treatment extension period]
• Number of dose reductions [Срок оценки: During the 72-week treatment extension period]
• Hemoglobin (Hb) response rate [Срок оценки: Baseline, week 12 and 24]
• Change in Hb from baseline [Срок оценки: Baseline, week 12 and 24]
• Change from baseline in number of vaso-occlusive crises (VOCs) [Срок оценки: Baseline and week 24]
• Change from baseline in Annualized Rate of VOC [Срок оценки: Baseline and week 24]
• Change from baseline in Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Scale [Срок оценки: Baseline, week 12 and 24]
• Change from baseline in time-averaged mean of the maximum velocity (TAMMV) by transcranial Doppler ultrasonography (TCD) [Срок оценки: Baseline, week 24, 48, and 96]

Критерии участия

Критерии включения

• Type of Participant and Disease Characteristics

• Patient's parent, legal guardian, or legal representative has provided documented informed consent and patients have provided age-appropriate assent
• Age greater than or equal to (≥) 6 months and lesser than (<) 18 years of age at time of enrollment, according to the enrolling cohort:

• Cohort 1: age 12 to < 18 years (adolescents)
• Cohort 2: age 6 to < 12 years
• Cohort 3: age 2 to < 6 years
• Cohort 4: age 6 months to < 2 years
• Patient has confirmed diagnosis of SCD

• Documentation of SCD genotype (HbSS, HbSβ0-thalassemia or other sickle cell syndrome variants) based on prior history of laboratory testing. Molecular genotyping is not required. SCD genotype may be determined from the results of Hb electrophoresis, high-performance liquid chromatography (HPLC), or similar testing. Note that Hb electrophoresis is performed by the local laboratory at Screening.
• Hemoglobin ≥ 5.5 and lesser than or equal to (≤) 10.5 grams per deciliter (g/dL)
• Pediatric patients with severe SCD, as defined by at least 1 of the following:

• 2-15 episodes of documented VOC within the 12 months prior to screening. Documentation must exist in the patient's medical record prior to screening. Events based solely on patient recall without supporting documentation should not be counted towards eligibility.
• Hospitalization for any SCD-related complication in the last 12 months prior to starting study treatment
• Proteinuria, defined as an albumin:creatinine ratio (ACR) > 100 mg/g on 2 measures (separated by ≥ 1 month) as an indicator of early renal disease
• History of a conditional TCD in the last 12 months prior to starting study treatment, but not currently being treated with chronic transfusion therapy (applicable to participants > 2 years of age). Conditional TCD is defined as a TAMMV of 170-199 cm/s by TCD or 155-184 cm/s by imaging TCD (TCDi).
• For participants taking hydroxyurea (HU), the dose of HU (mg/kg) must be stable (no more than a 20% change in dosing) for at least 90 days prior to start of study treatment with no anticipated need for dose adjustments during the study, in the opinion of the Investigator
• Patients on crizanlizumab or L-glutamine treatment at the time of consent may be eligible if they:

• Have been on a stable dose for ≥ 12 months at the time of consent (ie, no changes to the dose except for changes to weight or for safety reasons)
• For patients on crizanlizumab, have been ≥ 80% compliant with the planned regimen during the 12 months prior to the time of consent
• Female patients of childbearing potential who are using acceptable methods of contraception and agree not to donate ova from study start to 90 days after the last dose of study drug, and male patients who are willing to use acceptable methods of contraception and agree not to donate sperm, from study start to 90 days after the last dose of study drug.

Критерии исключения

• Medical Conditions

• Female who is breastfeeding or pregnant
• More than 15 VOCs within the 12 months prior to starting study treatment that required a hospital, emergency room (ER), or clinic visit
• Hospitalized for sickle cell crisis or other vaso-occlusive event occurring in the 14 days prior to starting study treatment
• Abnormal TCD in the 12 months prior to starting study treatment

Prior/Concomitant Therapy

• Patients receiving regularly scheduled blood (RBC) transfusion therapy (also termed chronic, prophylactic, or preventive transfusion)
• Received any blood products within 30 days of starting study treatment
• Receiving or use of concomitant medications that are strong inducers of cytochrome P450 (CYP) 3A4/5 within 2 weeks of starting study treatment
• Use of voxelotor within 28 days prior to starting study treatment or anticipated need for this agent during the study
• Receipt of erythropoietin or other hematopoietic growth factor treatment within 28 days of starting study treatment or anticipated need for such agents during the study
• Receipt of prior cellular based therapy (eg, hematopoietic cell transplant, gene modification therapy)

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Не применимо

Модель

Одна группа

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Kenya · 4 центра

• KEMRI-Walter-Reed Kericho — Kericho
• Kombewa Clinical Research Centre — Kisumu
• Ahero Clinical Trials Unit — Kisumu
• Kenya Medical Research Institute-Centre for Respiratory Disease Research, Siaya Clinical R — Siaya

Франция · 3 центра

• APHP - Centre de Référence des Syndromes — Paris
• Hospices Civils de Lyon-Hopital Lyon Sud — Pierre-Bénite
• Centre Hospitalier Universitaire de Rouen-Hopital Charles Nicolle — Roeun

Nigeria · 3 центра

• University of Nigeria Teaching Hospital (UNTH) — Ituku-Ozalla
• Lagos University Teaching Hospital, Lagos — Lagos
• Aminu Kano Teaching Hospital (AKTH) — Tarauni

Великобритания · 3 центра

• Guys and St Thomas NHS Foundation Trust / Evelina Childrens Hospital — London
• King's College Hospital - Alex Mowat Research Hub — London
• Manchester Royal Infirmary_1 — Manchester

Ливан · 2 центра

• American University of Beirut Medical center — Beirut
• Hospital Nini — Tripoli

Turkey (Türkiye) · 2 центра

• Hacettepe University pediatric hematology — Ankara
• Acıbadem Adana Hastanesi — Seyhan

Канада · 1 центр

• The Hospital for Sick Children — Toronto

Идентификаторы

NCT: NCT06198712 · 4202-HEM-202 · 2022-001689-36

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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