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Hereditary AngioedemaPhase 3NCT04656418

CSL312 (Garadacimab) in the Prevention of Hereditary Angioedema Attacks

A Phase 3 study testing CSL312 in people with Hereditary Angioedema, run by CSL Behring at 28 sites in 7 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

This is a multicenter, double-blind, randomized, placebo-controlled, parallel-arm study to investigate the efficacy and safety of subcutaneous administration of CSL312 (garadacimab) in the prophylactic treatment of hereditary angioedema. Read more about this study

Who is it for?
Ages 12 years and older
Conditions the study is for
Hereditary Angioedema
What is being tested?
CSL312
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
64 participants
Where
28 sitesin 7 countries
Study dates
27 Jan 2021to 7 Jun 2022
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 12 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Male or female ≥ 12 years of age; diagnosed with clinically confirmed C1-INH hereditary angioedema; experience ≥ 3 attacks during the 3 months before screening.
  • Note: For subjects taking any prophylactic HAE therapy during the 3 months before Screening, ≥ 3 HAE attacks may be documented over 3 consecutive months before commencing the prophylactic therapy.

Who cannot join

  • Concomitant diagnosis of another form of angioedema such as idiopathic or acquired angioedema, recurrent angioedema associated with urticarial or hereditary angioedema type 3

Trial locations and contacts

28 sites in 7 countries.

28 sites in 7 countries

United States8 sites
  • Clinical Research Center of Alabama

    Birmingham, Alabama, 35209

  • Institute of Asthma and Allergy

    Chevy Chase, Maryland, 20815

  • Bernstein Clinical Research Center LLC

    Cincinnati, Ohio, 45231

  • AARA Research Center

    Dallas, Texas, 75231

  • Pennsylvania State University

    Hershey, Pennsylvania, 17033

  • Raffi Tachdjian MD, Inc.

    Santa Monica, California, 90404

  • Medical Research of Arizona

    Scottsdale, Arizona, 85251

  • Allergy and Asthma Clinical Research

    Walnut Creek, California, 94598

Other trials in United States

Japan8 sites
  • Juntendo University Hospital

    Bunkyo, Tokyo, 113-8431

  • Hiroshima University Hospital

    Hiroshima, Hiroshima, 734-8551

  • St.Marianna University School of Medicine Hospital

    Kawasaki-shi, Kanagawa, 216-8511

  • Kobe University Hospital

    Kobe, Hyōgo, '650-0017

  • Saga University Hospital

    Saga, Saga-shi, '849-8501

  • Saitama Medical Center

    Saitama, Kawagoe-shi, 350-8550

  • Saiyu Soka Hospital

    Saitama, 340-0041

  • Koga Community Hospital

    Yaizu-shi, Shizuoka, 425-0088

Other trials in Japan

Germany5 sites
  • Charité Universitätsmedizin Berlin

    Berlin, 10117

  • Universitätsklinikum Frankfurt Goethe-Universität

    Frankfurt am Main, Hesse, 60590

  • Universitätsklinikum Leipzig

    Leipzig, 04103

  • CRC Clinical Research / Hautklinik und Poliklinik der Universitätsklinik Mainz

    Mainz, 55131

  • HZRM Hämophilie Zentrum Rhein Main GmbH

    Mörfelden-Walldorf, 64546

Other trials in Germany

Canada4 sites
  • University of Alberta - Research Transition Facility

    Edmonton, Alberta, T6G 2B7

  • Ottawa Allergy Research Corp

    Ottawa, Ontario, K1H 1E4

  • Clinique specialisee en allergie de la Capitale

    Québec, G1V 4W2

  • Gordon Sussman Clinical Research Inc.

    Toronto, Ontario, M3B 3S6

Other trials in Canada

Hungary1 site
  • Semmelweis University

    Budapest, 1088

Other trials in Hungary

Israel1 site
  • Barzilai University Medical Center

    Ashkelon, 7830604

Other trials in Israel

Netherlands1 site
  • Amsterdam UMC, Location AMC

    Amsterdam, 1105 AZ

Other trials in Netherlands

About this study

Official title: A Multicenter, Double-blind, Randomized, Placebo-controlled, Parallel-arm Study to Investigate the Efficacy and Safety of Subcutaneous Administration of CSL312 (Garadacimab) in the Prophylactic Treatment of Hereditary Angioedema

This is a multicenter, double-blind, randomized, placebo-controlled, parallel-arm study to investigate the efficacy and safety of subcutaneous administration of CSL312 (garadacimab) in the prophylactic treatment of hereditary angioedema.

Being tested
CSL312, Placebo
Medical subject headings
Angioedemas, Hereditary

What participants receive

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

  • CSL312Biological

    Also called Factor XIIa inhibitor monoclonal antibody, garadacimab

    Fully human immunoglobulin G subclass 4/lambda recombinant monoclonal antibody

  • PlaceboDrug

    Buffer without active ingredient

Study groups in NCT04656418
Study groupRoleWhat they receive
CSL312ExperimentalParticipants received a CSL312 loading dose of 400 mg as two 200 mg SC injections in Month 1 along with CSL312 of 200 mg subcutaneous (SC) injections, once monthly from Months 2 to 6.
Receives: Biological: CSL312
PlaceboPlacebo comparatorParticipants received a CSL312 matched loading dose of placebo as two SC injections in Month 1 along with CSL312 matched placebo SC injections, once monthly from Months 2 to 6.
Receives: Drug: Placebo

What is being measured

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

  1. Time-Normalized Number of Hereditary Angioedema (HAE) Attacks Per Month During Treatment Period

    Time-normalized number of HAE attacks per month during treatment was calculated per participant as: [number of HAE attacks / length of participant treatment in days] * 30.4375.

    Measured: First injection up to 6 months

Secondary outcomes (12)
  1. Percentage Change in the Time-normalized Number of HAE Attacks Per Month During the Treatment Period Compared to the Run-in Period

    Percentage change in the time-normalized number of HAE attacks was calculated within a participant as:

    100 * [1 - (time-normalized number of HAE attacks per month during treatment period / time-normalized number of HAE attacks per month during run-in period)]. Time-normalized number of HAE attacks per month during treatment period was calculated per participant as: [number of HAE attacks / length of participant treatment in days] * 30.4375.

    Measured: 6 months, first 3-months and second 3-months of treatment period

  2. Time-Normalized Number of HAE Attacks Per Month Requiring On-Demand Treatment

    Time-normalized number of HAE attacks per month requiring on-demand treatment was calculated per participant as: [number of HAE attacks requiring on-demand treatment / length of participant in days] * 30.4375.

    Measured: 6 months, first 3-months and second 3-months of treatment period

  3. Time-Normalized Number of Moderate or Severe HAE Attacks Per Month

    Time-normalized number of moderate or severe HAE attacks per month during treatment period was calculated per participant as: [number of moderate or severe HAE attacks / length of participant treatment in days] * 30.4375.

    Measured: 6 months, first 3-months and second 3-months of treatment period

  4. Time-normalized Number of HAE Attacks Per Month in the First 3-months and Second 3-months of Treatment Period

    Time-normalized number of HAE attacks per month during treatment was calculated per participant as: [number of HAE attacks / length of participant treatment in days] * 30.4375.

    Measured: First 3-months and second 3-months of treatment period

  5. Relative Difference in Means in the Time-Normalized Number of HAE Attacks Per Month Between CSL312 to Placebo

    Relative difference in means in the time-normalized number of HAE attacks per month CSL312 to Placebo was calculated as: 100 * [(mean time-normalized number of HAE attacks for CSL312 - mean time-normalized number of HAE attacks for placebo) / mean time-normalized number of HAE attacks for placebo]. Time-normalized number of HAE attacks per month during treatment was calculated per participant as: [number of HAE attacks / length of participant treatment in days] * 30.4375.

    Measured: 6 months, first 3-months and second 3-months of treatment period

  6. Percentage of Participants With a Response to Subject's Global Assessment of Response to Therapy (SGART)

    SGART is a self-assessment by the participant and measures the subject's overall treatment response to the investigational product using the following ratings: 0 (none: worse or no response at all, not acceptable), 1 (poor: very little response, not acceptable), 2 (fair: some response, acceptable but could be better), 3 (good: good response, acceptable), and 4 (excellent: excellent response, as good as can be imagined).

    Measured: Up to 6 months

  7. Number of Participants With at Least One Adverse Event (AE), Serious Adverse Event (SAE), and AEs of Special Interest (AESI)

    AE is any untoward medical occurrence in a participant administered with an investigational product which does not necessarily have a causal relationship with treatment, can be any unfavorable and unintended sign, symptom, or disease temporally associated with use of an investigational product, whether or not considered related to product. SAE is any untoward medical occurrence that results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, is a congenital anomaly or birth defect, or is a medically significant event. An AESI is an AE of scientific and medical concern specific to sponsor's product or program, for which ongoing monitoring and rapid communication by investigator to sponsor is appropriate.

    Measured: From first dose of study drug up to 3 months after the last injection (approximately 8 months)

  8. Number of Participants With CSL312-induced Anti-CSL312 Antibodies

    Measured: Up to 8 months

  9. Number of Participants With Clinically Significant Abnormalities in Laboratory Assessments Reported as Treatment Emergent Adverse Events (TEAEs)

    Laboratory assessments included: Hematology, biochemistry, urinalysis, and coagulation parameters.

    Measured: From first dose of study drug up to 3 months after the last injection (approximately 8 months)

  10. Percentage of Participants With at Least One AE, SAE, and AESI

    AE is any untoward medical occurrence in a participant administered with an investigational product which does not necessarily have a causal relationship with treatment, can be any unfavorable and unintended sign, symptom, or disease temporally associated with use of an investigational product, whether or not considered related to product. SAE is any untoward medical occurrence that results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, is a congenital anomaly or birth defect, or is a medically significant event. An AESI is an AE of scientific and medical concern specific to sponsor's product or program, for which ongoing monitoring and rapid communication by investigator to sponsor is appropriate.

    Measured: From first dose of study drug up to 3 months after the last injection (approximately 8 months)

  11. Percentage of Participants With CSL312-induced Anti-CSL312 Antibodies

    Measured: Up to 6 months

  12. Percentage of Participants With Clinically Significant Abnormalities in Laboratory Assessments Reported as TEAEs

    Laboratory assessments included: Hematology, biochemistry, urinalysis, and coagulation parameters.

    Measured: From first dose of study drug up to 3 months after the last injection (approximately 8 months)

Timeline

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

  1. First posted7 Dec 2020
  2. Study start27 Jan 2021
  3. Primary completion7 Jun 2022
  4. Study completion7 Jun 2022

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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
64 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04656418
Sponsor's protocol ID
CSL312_3001
Other IDs
2020-000570-25
Status last verified
Jun 2023
First submitted
1 Dec 2020
Last updated
29 Jun 2023
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: CSL will consider requests to share Individual Patient Data (IPD) from systematic review groups or bona-fide researchers. For information on the process and requirements for submitting a voluntary data sharing request for IPD, please contact CSL at clinicaltrials@cslbehring.com. Applicable country specific privacy and other laws and regulations will be considered and may prevent sharing of IPD. If the request is approved and the researcher has executed an appropriate data sharing agreement, IPD that has been appropriately anonymized will be available.

Publications

  • Craig TJ, Guilarte M, Li HH, Anderson J, Martinez Saguer I, Jacobs JS, Tachdjian R, Farkas H, Yang WH, Ohsawa I, Hakl R, Pollen M, Pragst I, Lawo JP, Shetty H, Nenci C, Magerl M. Long-Term Integrated Safety and Efficacy of Garadacimab for Hereditary Angioedema Prophylaxis. Adv Ther. 2026 Jun 10. doi: 10.1007/s12325-026-03628-x. Online ahead of print.

    PubMed 42268494
  • Staubach P, Craig TJ, Fukuda T, Aygoren-Pursun E, Hakl R, Braverman J, Lawo JP, Pollen M, Nenci C, Li PH, Farkas H. Becoming attack-free further improves health-related quality of life in patients with hereditary angioedema receiving garadacimab. Allergy Asthma Proc. 2025 May 1;46(3):200-208. doi: 10.2500/aap.2025.46.250026.

    PubMed 40380356
  • Craig TJ, Reshef A, Li HH, Jacobs JS, Bernstein JA, Farkas H, Yang WH, Stroes ESG, Ohsawa I, Tachdjian R, Manning ME, Lumry WR, Saguer IM, Aygoren-Pursun E, Ritchie B, Sussman GL, Anderson J, Kawahata K, Suzuki Y, Staubach P, Treudler R, Feuersenger H, Glassman F, Jacobs I, Magerl M. Efficacy and safety of garadacimab, a factor XIIa inhibitor for hereditary angioedema prevention (VANGUARD): a global, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2023 Apr 1;401(10382):1079-1090. doi: 10.1016/S0140-6736(23)00350-1. Epub 2023 Feb 28.

    PubMed 36868261
  • Beard N, Frese M, Smertina E, Mere P, Katelaris C, Mills K. Interventions for the long-term prevention of hereditary angioedema attacks. Cochrane Database Syst Rev. 2022 Nov 3;11(11):CD013403. doi: 10.1002/14651858.CD013403.pub2.

    PubMed 36326435

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing CSL312 in people with Hereditary Angioedema, run by CSL Behring at 28 sites in 7 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 2 inclusion and 1 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 29 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 28 sites in United States, Japan, Germany, Canada, Hungary and 2 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. Some participants in this study may receive a placebo. 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 29 Jun 2023). 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?

Time-Normalized Number of Hereditary Angioedema (HAE) Attacks Per Month During Treatment Period (time frame: First injection up to 6 months). 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 NCT04656418, which also lists 4 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 29 Jun 2023.

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