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Atypical Hemolytic Uremic Syndrome (aHUS)Phase 3NCT02949128

Study of ALXN1210 in Complement Inhibitor Treatment-Naïve Adult and Adolescent Participants With Atypical Hemolytic Uremic Syndrome (aHUS)

A Phase 3 study testing Ravulizumab in people with Atypical Hemolytic Uremic Syndrome (aHUS), run by Alexion Pharmaceuticals, Inc. at 37 sites in 14 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the study is to assess the safety and efficacy of ravulizumab to control disease activity in adolescent and adult participants with aHUS who had not previously used a complement inhibitor. Read more about this study

Who is it for?
Any age
What is being tested?
Ravulizumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
58 participants
Where
37 sitesin 14 countries
Study dates
11 Jan 2017to 24 Jan 2023
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Male or female ≥ 12 years of age and weighing ≥ 40 kg at the time of consent.
  • Evidence of thrombotic microangiopathy, including low platelet count, hemolysis (breaking of red blood cells inside of blood vessels), and decreased kidney function.
  • Documented meningococcal vaccination not more than 3 years prior to, or at the time of, initiating study drug. Participants who received a meningococcal vaccine less than 2 weeks before initiating ravulizumab treatment must have received treatment with appropriate prophylactic antibiotics until 2 weeks after vaccination. Participants who had not been vaccinated prior to initiating ravulizumab treatment should have received prophylactic antibiotics prior to and for at least 2 weeks after meningococcal vaccination. Participants < 18 years of age must have been vaccinated against haemophilus influenzae type b and streptococcus pneumoniae according to national and local vaccination schedule guidelines.
  • Female participants of childbearing potential and male participants with female partners of childbearing potential had to use highly effective contraception starting at screening and continuing until at least 8 months after the last dose of ravulizumab.

Who cannot join

  • A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 deficiency (activity < 5%).
  • Shiga toxin-related hemolytic uremic syndrome.
  • Positive direct Coombs test.
  • Pregnancy or breastfeeding.
  • Identified drug exposure-related hemolytic uremic syndrome (HUS).
  • Bone marrow transplant/hematopoietic stem cell transplant within last 6 months prior to start of Screening.
Show all 9Show fewer
  • HUS related to known genetic defects of cobalamin C metabolism.
  • Systemic sclerosis (scleroderma), systemic lupus erythematosus, or antiphospholipid antibody positivity or syndrome.
  • Chronic dialysis (defined as dialysis on a regular basis as renal replacement therapy for end-stage kidney disease).

Trial locations and contacts

37 sites in 14 countries.

37 sites in 14 countries

France6 sites
  • Clinical Trial Site

    Bordeaux

  • Clinical Trial Site

    Clermont-Ferrand

  • Clinical Trial Site

    Lille

  • Clinical Trial Site

    Montpellier

  • Clinical Trial Site

    Nice

  • Clinical Trial Site

    Paris

Other trials in France

United States5 sites
  • Clinical Trial Site

    Columbus, Ohio, 43210

  • Clinical Trial Site

    Durham, North Carolina, 27705

  • Clinical Trial Site

    Fort Wayne, Indiana, 46804

  • Clinical Trial Site

    Fort Wayne, Indiana, 46845

  • Clinical Trial Site

    Winston-Salem, North Carolina, 27103

Other trials in United States

Germany5 sites
  • Clinical Trial Site

    Aachen

  • Clinical Trial Site

    Essen

  • Clinical Trial Site

    Hanover

  • Clinical Trial Site

    München

  • Clinical Trial Site

    Tübingen

Other trials in Germany

Australia3 sites
  • Clinical Trial Site

    Clayton

  • Clinical Trial Site

    Geelong

  • Clinical Trial Site

    Parkville

Other trials in Australia

Spain3 sites
  • Clinical Trial Site

    Barcelona

  • Clinical Trial Site

    Madrid

  • Clinical Trial Site

    Valencia

Other trials in Spain

Italy2 sites
  • Clinical Trial Site

    Bologna

  • Clinical Trial Site

    Florence

Other trials in Italy

Japan2 sites
  • Clinical Trial Site

    Saitama

  • Clinical Trial Site

    Tokyo

Other trials in Japan

Russia2 sites
  • Clinical Trial Site

    Moscow

  • Clinical Trial Site

    Saint Petersburg

Other trials in Russia

South Korea2 sites
  • Clinical Trial Site

    Gyeonggi-do

  • Clinical Trial Site

    Seoul

Other trials in South Korea

Taiwan2 sites
  • Clinical Trial Site

    Taichung

  • Clinical Trial Site

    Taipei

Other trials in Taiwan

United Kingdom2 sites
  • Clinical Trial Site

    Cardiff

  • Clinical Trial Site

    London

Other trials in United Kingdom

Austria1 site
  • Clinical Trial Site

    Vienna

Other trials in Austria

Belgium1 site
  • Clinical Trial Site

    Brussels

Other trials in Belgium

Canada1 site
  • Clinical Trial Site

    London

Other trials in Canada

About this study

Official title: Single Arm Study of ALXN1210 in Complement Inhibitor Treatment-naïve Adult and Adolescent Patients With Atypical Hemolytic Uremic Syndrome (aHUS)

The purpose of the study is to assess the safety and efficacy of ravulizumab to control disease activity in adolescent and adult participants with aHUS who had not previously used a complement inhibitor.

Being tested
Ravulizumab
Medical subject headings
Atypical Hemolytic Uremic Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RavulizumabBiological

    Also called ALXN1210, Ultomiris

    Single loading dose on Day 1, followed by regular maintenance dosing beginning on Day 15, based on weight: ≥ 40 to < 60 kilograms (kg), 2400 milligrams (mg) loading, then 3000 mg every 8 weeks; ≥ 60 to < 100 kg, 2700 mg loading, then 3300 mg every 8 weeks; ≥ 100 kg, 3000 mg loading, then 3600 mg every 8 weeks.

Study groups in NCT02949128
Study groupRoleWhat they receive
RavulizumabExperimentalParticipants were administered weight-based doses of ravulizumab every 8 weeks for 26 weeks in the Initial Evaluation Period. After the Initial Evaluation Period, participants could enter an Extension Period and receive ravulizumab until the product registration or approval (in accordance with country-specific regulations) or for up to 4.5 years, whichever occurs first.
Receives: Biological: Ravulizumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage Of Participants With Complete Thrombotic Microangiopathy (TMA) Response at Week 26

    Complete TMA response during the 26-week Initial Evaluation Period is a composite outcome measure that required normalization of hematological parameters (platelet count and lactate dehydrogenase [LDH]) and improvement in kidney function (≥25% reduction in serum creatinine from baseline); for participants on dialysis, baseline was established at least 6 days after the end of dialysis. Participants had to meet these criteria for 2 separate assessments obtained at least 4 weeks (28 days) apart, and any measurement in between. To be considered a responder during the 26-week Initial Evaluation Period, the latest time point a participant could first meet the response criteria was 28 days before the Week 26 (Day 183) assessment. Formal statistical comparison analyses were not planned for this study. The percentage was based on the responders among treated participants. The 95% confidence interval (CI) was based on the asymptotic Gaussian approximation method with a continuity correction.

    Measured: Week 26

Secondary outcomes (11)
  1. Time To Complete TMA Response

    Participants that did not have a response were censored at the date of last visit or study discontinuation at the time when the analysis was performed. The time to complete TMA Response is reported in days. The time of the event of a confirmed complete TMA response was considered the first time point at which all the criteria for complete TMA response were met.

    Measured: Baseline through Week 114

  2. Participants Who Do Not Require Dialysis at Weeks 26 and 52

    For participants requiring dialysis within 5 days prior to ALXN1210 treatment initiation, the number of participants no longer requiring dialysis is reported

    Measured: Week 26 and Week 52

  3. Proportion Of Participants With Complete TMA Response At Week 52

    The proportion of participants considered responders, along with a 2-sided 95% CI for the Week 52 time point, is reported. To be considered a responder during the 26-week Initial Evaluation Period, the latest time point a participant could first meet the response criteria was 28 days before the Week 26 (Day 183) assessment (components of the response maintained for at least 28 days).

    Measured: Week 52

  4. Change From Baseline In Estimated Glomerular Filtration Rate (eGFR) At Weeks 26 and 52

    Kidney function evaluated by eGFR was summarized at baseline and the Week 26 and Week 52 time points using descriptive statistics for continuous variables for the observed value, as well as the change from baseline. The baseline value was defined as the average of the values from the assessments performed prior to the first study drug infusion (these could include results from Screening and the Day 1 visit). A value of 10 milliliters (mL)/minute (min)/1.73 meters squared (m^2) for eGFR was imputed for participants requiring dialysis for acute kidney injury. The observed value and change from baseline are reported in mL/min/1.73 m^2. An increase indicated improvement in kidney function.

    Measured: Baseline, Week 26 and Week 52

  5. Participants With Change From Baseline In CKD Stage At Weeks 26 and 52

    The CKD stage is presented as the change from baseline in the participants that Improved (excluding those with Stage 1 [normal renal function] at baseline as they cannot improve), Worsened (excluding those with Stage 5 at baseline as they cannot worsen), and Stayed the Same, compared to the CKD stage at baseline. Baseline was derived based on the last available eGFR before starting treatment. Stage 5 was considered the worst category, while Stage 1 was considered the best category. A 2-sided 95% CI for the proportion, based on exact confidence limits using the Clopper-Pearson method, was provided for each category. The CKD stage was classified based on the National Kidney Foundation Chronic Kidney Disease Stage.

    Measured: Baseline, Week 26, and Week 52

  6. Change From Baseline In Platelet Count At Weeks 26 and 52

    The hematologic TMA parameter of platelet count was summarized at baseline and at Week 26 and Week 52 using descriptive statistics for continuous variables for the change from baseline. Results are reported in platelets*10^9/liter (L) blood.

    Measured: Baseline, Week 26 and Week 52

  7. Change From Baseline In LDH At Weeks 26 and 52

    The hematologic TMA parameter of serum LDH was summarized at baseline and at Week 26 and Week 52 using descriptive statistics for continuous variables for the change from baseline. Results are reported in units (U)/L.

    Measured: Baseline, Week 26 and Week 52

  8. Change From Baseline In Hemoglobin At Weeks 26 and 52

    The hematologic TMA parameter of hemoglobin level was summarized at baseline and at Week 26 and Week 52 using descriptive statistics for continuous variables for the change from baseline. Results are reported in grams (g)/L.

    Measured: Baseline, Week 26 and Week 52

  9. Percentage Of Complement Inhibitor Treatment-naïve Participants With An Increase From Baseline In Hemoglobin ≥20 g/L Through Week 26 and Week 52

    The percentage of participants with an increase from baseline in hemoglobin ≥20 g/L, observed at 2 separate assessments obtained at least 4 weeks (28 days) apart, and any measurement in between, was assessed through Week 26 and Week 52 and is presented as the percentage of responders, along with a 2-sided 95% CI. The 95% CIs are based on exact confidence limits using the Clopper-Pearson method. To be considered a responder during the 26-week and 52-week Extension Periods, the latest time point a participant could first meet the response criteria was 28 days before the respective Week 26 and Week 52 assessments (components of the response maintained for at least 28 days).

    Measured: Baseline through Week 26 and through Week 52

  10. Change From Baseline In Quality Of Life As Measured By The EuroQol 5-Dimension 3-Level (EQ-5D-3L) At Weeks 26 and 52

    The EQ-5D-3L is a participant-answered questionnaire that scores 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression (scored as a 1, 2, or 3, with 3 being the worst health state), as well as health state on a visual analogue scale (0 to 100, with 100 representing the best health state). From these scores, a summary index score is derived using the time trade-off valuation set for the United States and ranges from -1 to 1, where a score above 0.94 indicates full health. An increase in score from baseline indicates improvement in quality of life.

    Measured: Baseline, Week 26 and Week 52

  11. Change From Baseline In Quality Of Life As Measured By The Functional Assessment Of Chronic Illness Therapy (FACIT)-Fatigue Version 4 Questionnaire At Weeks 26 and 52

    Quality of life was evaluated in part using FACIT Fatigue Version 4. The data were summarized at baseline and at the Week 26 and Week 52 time point using descriptive statistics for continuous variables. The FACIT Fatigue Version 4 questionnaire at baseline and the Week 52 timepoint was scored using standard scoring algorithms. The score ranges from 0-52, with a higher score indicating less Fatigue. An increase in score indicated an improvement in quality of life.

    Measured: Baseline, Week 26 and Week 52

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Oct 2016 (estimated)
  2. Study start11 Jan 2017
  3. Primary completion24 Jan 2023
  4. Study completion24 Jan 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
58 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02949128
Sponsor's protocol ID
ALXN1210-aHUS-311
Other IDs
2016-002027-29, 2016
Status last verified
Jan 2024
First submitted
25 Oct 2016
Last updated
20 Feb 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Barbour T, Scully M, Ariceta G, Cataland S, Garlo K, Heyne N, Luque Y, Menne J, Miyakawa Y, Yoon SS, Kavanagh D; 311 Study Group Members. Long-Term Efficacy and Safety of the Long-Acting Complement C5 Inhibitor Ravulizumab for the Treatment of Atypical Hemolytic Uremic Syndrome in Adults. Kidney Int Rep. 2021 Mar 24;6(6):1603-1613. doi: 10.1016/j.ekir.2021.03.884. eCollection 2021 Jun.

    PubMed 34169200
  • Matsumoto M, Shimono A, Yokosawa J, Hirose K, Wang E, Maruyama S. Correlation between a 2-week change in platelet count and clinical outcomes after the initiation of ravulizumab treatment in adult patients with atypical hemolytic uremic syndrome: post-hoc analysis of the phase III trial. Thromb J. 2024 Oct 28;22(1):93. doi: 10.1186/s12959-024-00652-1.

    PubMed 39468592
  • Cammett TJ, Garlo K, Millman EE, Rice K, Toste CM, Faas SJ. Exploratory Prognostic Biomarkers of Complement-Mediated Thrombotic Microangiopathy (CM-TMA) in Adults with Atypical Hemolytic Uremic Syndrome (aHUS): Analysis of a Phase III Study of Ravulizumab. Mol Diagn Ther. 2023 Jan;27(1):61-74. doi: 10.1007/s40291-022-00620-3. Epub 2022 Nov 4.

    PubMed 36329366
  • Pugh D, O'Sullivan ED, Duthie FA, Masson P, Kavanagh D. Interventions for atypical haemolytic uraemic syndrome. Cochrane Database Syst Rev. 2021 Mar 23;3(3):CD012862. doi: 10.1002/14651858.CD012862.pub2.

    PubMed 33783815
  • Gackler A, Schonermarck U, Dobronravov V, La Manna G, Denker A, Liu P, Vinogradova M, Yoon SS, Praga M. Efficacy and safety of the long-acting C5 inhibitor ravulizumab in patients with atypical hemolytic uremic syndrome triggered by pregnancy: a subgroup analysis. BMC Nephrol. 2021 Jan 6;22(1):5. doi: 10.1186/s12882-020-02190-0.

    PubMed 33407224

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Ravulizumab in people with Atypical Hemolytic Uremic Syndrome (aHUS), run by Alexion Pharmaceuticals, Inc. at 37 sites in 14 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 37 sites in France, United States, Germany, Australia, Spain and 9 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 10 Feb 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage Of Participants With Complete Thrombotic Microangiopathy (TMA) Response at Week 26 (time frame: Week 26). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02949128, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Feb 2024.

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