AzTrials
AzTrials

Atypical Hemolytic Uremic SyndromePhase 3COMMUTE-pNCT04958265

A Study Evaluating the Efficacy, Safety, Pharmacokinetics and Pharmacodynamics of Crovalimab in Pediatric Participants With Atypical Hemolytic Uremic Syndrome (aHUS)

A Phase 3 study testing Crovalimab in people with Atypical Hemolytic Uremic Syndrome, run by Hoffmann-La Roche at 20 sites in 10 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record

Search all trials

Trial summary

This study aims to evaluate the efficacy and safety of crovalimab in pediatric participants with aHUS. Read more about this study

Who is it for?
Ages 28 days to 17 years
Conditions the study is for
Atypical Hemolytic Uremic Syndrome
What is being tested?
Crovalimab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
41 participants
Where
20 sitesin 10 countries
Study dates
17 Nov 2021to 19 May 2029
Phase
Phase 3

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 28 days to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Body weight >= 5 kg at screening.
  • Vaccination against Neisseria meningitis serotypes A, C, W, and Y; vaccination against serotype B, according to national vaccination recommendations.
  • Vaccination against Haemophilus influenzae type B and Streptococcus pneumoniae, according to national vaccination recommendations.
  • For patients continuing to receive other therapies concomitantly with crovalimab (e.g., immunosuppressants, corticosteroids, mammalian target of rapamycin inhibitor (mTORi), or calcineurin inhibitors): stable dose for >=28 days prior to screening and up to the first crovalimab administration.
  • For female participants of childbearing potential: an agreement to remain abstinent or use contraception.
  • Participants with a prior kidney transplant are eligible if they have a known history of complement-mediated aHUS prior to the kidney transplant.
Show all 11Show fewer
  • Onset of initial TMA presentation within 28 days prior to the first dose of crovalimab (for Naive Cohort only).
  • Documented treatment with either eculizumab or ravulizumab (for Switch Cohort only).
  • Clinical evidence of response to a C5 inhibitor (for Switch Cohort only).
  • Poorly controlled TMA following treatment with another C5 inhibitor (for C5 SNP participants in the Pretreated Cohort only).
  • Known C5 polymorphism (for C5 SNP participants in the Pretreated Cohort only).

Who cannot join

  • TMA associated with non-aHUS related renal disease.
  • Positive direct Coombs test.
  • Chronic dialysis within 90 days prior to first crovalimab administration , and /or end stage renal disease
  • Identified drug exposure-related TMA.
  • Presence or history of a condition that could trigger TMA, such as malignancy, bone marrow or organ transplant (other than kidney transplant) or autoimmune disease.
  • History of a kidney disease, other than aHUS.
Show all 24Show fewer
  • History of Neisseria meningitidis infection within 6 months of study enrollment.
  • Known or suspected immune deficiency (e.g., history of frequent recurrent infections).
  • Positive HIV test.
  • Active systemic bacterial, viral, or fungal infection within 14 days before first crovalimab administration.
  • Presence of fever (>= 38°C) before the first crovalimab administration (If fevers are solely due to the underlying aHUS pathology, and there is no evidence or suspicion of a systemic infection, participants may enroll).
  • Multi-system organ dysfunction or failure.
  • Recent intravenous immunoglobulin (IVIg) treatment.
  • Pregnant or breastfeeding or intending to become pregnant.
  • Participation in another interventional treatment study with an investigational agent or use of any experimental therapy within 28 days of screening or within five half lives of that investigational product, whichever is greater.
  • Recent use of tranexamic acid.
  • Current or previous treatment with a complement inhibitor (for Naive Cohort only).
  • First initiation of plasma exchange/plasma infusions (PE/PI) should not be more than 28 days prior to first crovalimab administration (for Naive Cohort only).
  • Last PE/PI completed less than 2 hours prior to first crovalimab administration (for Naive Cohort only).
  • Receiving PE/PI within 8 weeks of the first crovalimab administration (Switch Cohort only).
  • Normalization of serum creatinine values at baseline (<97.5th percentile for age), (for Naive Cohort only).
  • Positive for active Hepatitis B and/or C infections (HBV/HCV) (for Switch Cohort and switching C5 SNP Pretreated Cohort participants who recently received C5 inhibitor treatment).
  • Cryoglobulinemia at screening (for Switch Cohort and C5 SNP Cohort participants who recently received C5 inhibitor treatment).
  • Diagnosis of a condition leading to non-aHUS TMA: Thrombotic Thrombocytopenic Purpura (TTP), Shiga Toxin producing Escherichia Coli (STEC)-TMA, Pneumococcal HUS, TMA secondary to cobalamin C defect (as demonstrated by either increased total blood homocysteine levels or MMACHC gene mutation) and TMA related to Diacylglycerol kinase ε (DGKE) nephropathy.

Trial locations and contacts

20 sites in 10 countries.

20 sites in 10 countries

United States3 sites
  • Children's Hospital Colorado

    Aurora, Colorado, 80045

  • Hackensack University Medical Center

    Hackensack, New Jersey, 07601

  • University of Nebraska

    Omaha, Nebraska, 68198

Other trials in United States

China3 sites
  • Peking University First Hospital

    Beijing, 100034

  • Beijing Children's Hospital, Capital Medical University

    Beijing, 100045

  • The children's hospital , Zhejiang university school of medicine

    Hangzhou, 310051

Other trials in China

India3 sites
  • Institute of Kidney Diseases and Research Centre

    Ahmedabad, Gujarat, 380016

  • Medanta-The Medicity

    Gurgaon, Haryana, 122001

  • All India Institute Of Medical Sciences (AIIMS)

    New Delhi, National Capital Territory of Delhi, 110029

Other trials in India

Belgium2 sites
  • UZ Gent

    Ghent, 9000

  • UZ Leuven Gasthuisberg

    Leuven, 3000

Other trials in Belgium

France2 sites
  • Hôpital Arnaud de Villeneuve

    Montpellier, 34295

  • Gh Necker Enfants Malades

    Paris, 75743

Other trials in France

Japan2 sites
  • Aichi Children?s Health and Medical Center

    Aichi, 474-8710

  • Chiba Children's Hospital

    Chibashi, Chibaken, 266-0007

Other trials in Japan

Poland2 sites
  • Uniwersyteckie Centrum Kliniczne

    Gdansk, 80-294

  • Instytut ?Centrum Zdrowia Matki Polki

    Lodz, 93-338

Other trials in Poland

Brazil1 site
  • Inst. Da Criança- Faculdade de Medicina Usp

    São Paulo, São Paulo, 05403-900

Other trials in Brazil

Canada1 site
  • CHU Sainte-Justine

    Montreal, Quebec, H3T 1C5

Other trials in Canada

Mexico1 site
  • Hospital de Especialidades Puerta de Hierro S.A de C.V.

    Zapopan, 45116

Other trials in Mexico

About this study

Official title: A Phase III, Multicenter, Single-Arm Study Evaluating the Efficacy, Safety, Pharmacokinetics, and Pharmacodynamics of Crovalimab in Pediatric Patients With Atypical Hemolytic Uremic Syndrome (aHUS)

This study aims to evaluate the efficacy and safety of crovalimab in pediatric participants with aHUS.

Being tested
Crovalimab
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.

  • CrovalimabDrug

    Crovalimab will be administered at a dose of 1000 mg intravenously (IV) (for participants weighing => 40 to <100 kg) or 1500 mg IV (for participants weighing >=100 kg) on Week 1 Day 1. On Week 1 Day 2 and on Weeks 2, 3 and 4, crovalimab will be administered at a dose of 340 mg subcutaneously (SC). On Week 5 and Q4W thereafter, it will be administered at a dose of 680 mg SC (for participants weighing => 40 to <100 kg) or 1020 mg SC (for participants weighing >=100 kg). Enrollment of participants weighing <40 kg will be staggered using two weight-based dose confirmation groups (Group 1 participants weighing >=20 kg to <40 kg, followed by Group 2 participants weighing >=5 kg to <20 kg). All participants will receive an initial IV loading dose, which will be followed by SC dosing at either Q2W or Q4W intervals (depending on body weight), until study completion.

Study groups in NCT04958265
Study groupRoleWhat they receive
CrovalimabExperimentalParticipants will be enrolled in three cohorts: [1] Naive Cohort - participants who have not been previously treated with complement inhibitor therapy; [2] Switch Cohort - participants who switch to crovalimab from another C5 inhibitor and [3] Pretreated Cohort (includes C5 SNP (Single Nucleotide Polymorphism) participants) - participants who received treatment with another C5 inhibitor and subsequently discontinued it.
Receives: Drug: Crovalimab

What is being measured

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

  1. Naïve Cohort: Percentage of Participants With Complete Thrombotic Microangiopathy Response (cTMAr) Anytime From Baseline to Week 25 (After 24 Weeks on Treatment)

    cTMAr was defined by meeting all of the following criteria at two separate assessments, obtained at least 4 weeks (a minimum of 26 days) apart, and any measurement in between: Platelet count ≥ lower limit of normal (LLN); Lactate dehydrogenase (LDH) ≤ upper limit of normal (ULN); and ≥ 25% decrease in serum creatinine from baseline. Participants with normalized creatinine (i.e., LLN ≤ creatinine ≤ ULN) at baseline were excluded from analysis. 95% confidence interval (CI) was calculated using Wilson's score method. Percentage has been rounded off.

    Measured: From baseline up to Week 25

Secondary outcomes (30)
  1. Naïve and Switch Cohorts: Percentage of Participants Requiring Dialysis at Baseline or Week 25 and Who Completed 24 Weeks of Treatment

    Participants were considered to be on dialysis at baseline or at Week 25 if dialysis occurred within 5 days prior to the first crovalimab administration or prior to the end date of the primary treatment period, respectively. The percentage of participants who required dialysis at baseline and Week 25 has been reported here. Percentages have been rounded off.

    Measured: Baseline and Week 25

  2. Naïve and Switch Cohorts: Percentage of Participants With Change From Baseline to Week 25 (After 24 Weeks on Treatment) on Dialysis Status (Yes/No)

    Participants were considered as being on dialysis at baseline or at Week 25 if dialysis occurred within 5 days prior to the first crovalimab administration or prior to the end date of the primary treatment period, respectively. Percentages have been rounded off.

    Measured: From baseline up to Week 25

  3. Naïve and Switch Cohorts: Observed Value of Estimated Glomerular Filtration Rate (eGFR), as Calculated From Central Serum Creatinine

    GFR is an index of kidney function that describes the flow rate of filtered fluid through the kidneys. It was categorized according to chronic kidney disease (CKD) staging criteria. eGFR was calculated using the creatinine-based bedside Schwartz equation. eGFR (milliliters per minute per 1.73 square meter [mL/min/1.73 m^2])=0.413*(height [ht]/serum creatinine [sCr]), if height is expressed in centimeters, or 41.3*(ht/sCr), if height is expressed in meters.

    Measured: Baseline, Weeks 2, 3, 4, 5, 7, 9, 11, 13, 17, 21, and 25

  4. Naïve and Switch Cohorts: Change From Baseline to Week 25 in eGFR, as Calculated From Central Serum Creatinine

    GFR is an index of kidney function that describes the flow rate of filtered fluid through the kidneys. It was categorized according to CKD staging criteria. eGFR was calculated using the creatinine-based bedside Schwartz equation. eGFR (mL/min/1.73 m^2])=0.413*(ht/sCr), if height is expressed in centimeters, or 41.3*(ht/sCr), if height is expressed in meters.

    Measured: Baseline, Weeks 2, 3, 4, 5, 7, 9, 11, 13, 17, 21, and 25

  5. Naïve and Switch Cohorts: Percentage of Participants With Change From Baseline to Week 25 (After 24 Weeks on Treatment) in CKD Stage, as Assessed Based on eGFR Calculated From Central Serum Creatinine

    CKD stage was assessed using eGFR, calculated from central serum creatinine using Creatinine-based bedside Schwartz equation \& classified according to National Kidney Foundation CKD staging criteria as follows: G1 (≥90 mL/min/1.73 m²; normal or high kidney function), G2 (60-89 mL/min/1.73 m²; mildly decreased kidney function), G3a (45-59 mL/min/1.73 m²; mildly to moderately decreased kidney function), G3b (30-44 mL/min/1.73 m²; moderately to severely decreased kidney function), G4 (15-29 mL/min/1.73 m²; severely decreased kidney function), \& G5 (<15 mL/min/1.73 m²; kidney failure). Change in CKD stage from baseline to Week 25 was categorized as improved (participants who improved in CKD stage from Baseline to Week 25 were based on the number of participants who completed 24 weeks and were not Stage 1 at baseline), stable (no change), or worsened (participants with CKD Stage 1 to 4 at baseline) among participants who completed 24 weeks of treatment. Percentages have been rounded off.

    Measured: From baseline up to Week 25

  6. Naïve and Switch Cohorts: Observed Value of Platelet Count

    Measured: Baseline and Week 25

  7. Naïve and Switch Cohorts: Observed Value of LDH

    Measured: Baseline and Week 25

  8. Naïve and Switch Cohorts: Observed Value of Hemoglobin (Hb)

    Measured: Baseline and Week 25

  9. Naïve and Switch Cohorts: Change From Baseline to Week 25 (After 24 Weeks on Treatment) in Platelet Count

    Measured: Baseline and Week 25

  10. Naïve and Switch Cohorts: Change From Baseline to Week 25 (After 24 Weeks on Treatment) in LDH

    Measured: Baseline and Week 25

  11. Naïve and Switch Cohorts: Change From Baseline to Week 25 (After 24 Weeks on Treatment) in Hb

    Measured: Baseline and Week 25

  12. Naïve Cohort: Percentage of Participants With Platelet Count ≥ LLN at Two Separate Assessments, Obtained at Least 4 Weeks Apart (Minimum of 26 Days), by Week 25 (After 24 Weeks on Treatment)

    This event was confirmed at two separate assessments obtained at least 4 weeks (a minimum of 26 days) apart and any measurement in between.

    Measured: From baseline up to Week 25

  13. Naïve Cohort: Percentage of Participants With LDH Normalization (i.e., ≤ ULN) at Two Separate Assessments, Obtained at Least 4 Weeks Apart (Minimum of 26 Days), by Week 25 (After 24 Weeks on Treatment)

    Percentage has been rounded off.

    Measured: From baseline up to Week 25

  14. Naïve Cohort: Percentage of Participants With ≥ 25% Decrease in Serum Creatinine From Baseline, Confirmed at Two Separate Assessments, Obtained at Least 4 Weeks Apart (Minimum of 26 Days), by Week 25 (After 24 Weeks on Treatment)

    Percentage has been rounded off.

    Measured: From baseline up to Week 25

  15. Naïve Cohort: Time to cTMAr

    cTMAr was defined by meeting all of the following criteria at two separate assessments, obtained at least 4 weeks (a minimum of 26 days) apart, and any measurement in between: Platelet count ≥ LLN; LDH ≤ ULN; and ≥ 25% decrease in serum creatinine from baseline. Kalpan-Meier (K-M) method was used to estimate median time to cTMAr. Data for participants who did not reach cTMAr during PTP were censored at the date of their last visit when cTMAr was assessed during the primary treatment period or prior to the treatment discontinuation, whichever was earlier. Data for participants who received a prohibited therapy during the PTP were censored at the date of the first received prohibited therapy during the primary treatment period or prior to the treatment discontinuation, whichever was earlier.

    Measured: From baseline up to Week 25

  16. Naïve Cohort: Duration of cTMAr, Among Participants Who Achieved cTMAr

    cTMAr=meeting following criteria at 2 separate assessments, obtained at least 4 weeks (minimum of 26 days) apart \& any measurement in between: Platelet count ≥LLN; LDH ≤ULN; \& ≥25% decrease in serum creatinine from baseline. Duration of cTMAr was calculated as time from start of cTMAr to end of cTMAr. End of cTMAr=when all of following criteria were met during same visit \& confirmed at assessment that took place at least 4 weeks (minimum of 26 days) later: Platelet count <LLN; LDH >ULN; \& ≥25% increase in serum creatinine from baseline \& ULN. K-M method was used to estimate the median duration of cTMAr. Data for participants with no observed end of cTMAr at CCOD were censored at the date of their last visit when cTMAr was assessed before CCOD or before treatment discontinuation, whichever was earlier. Data for participants who received prohibited therapy before CCOD were censored at date of first receiving prohibited therapy or before treatment discontinuation, whichever was earlier.

    Measured: From baseline up to primary CCOD (up to 190 weeks)

  17. Naïve Cohort: Percentage of Participants With cTMAr Ongoing at Week 25

    cTMAr at Week 25 was defined by meeting all of the three cTMAr criteria at Week 25: Platelet count ≥ LLN; LDH ≤ ULN; and ≥ 25% decrease in serum creatinine from baseline. Percentage has been rounded off.

    Measured: At Week 25

  18. Switch Cohort: Percentage of Participants With Maintained Thrombotic Microangiopathy Response Control (mTMAc) From Baseline Through Week 25 (After 24 Weeks on Treatment)

    mTMAc was considered not maintained if all of the following criteria were met during one of the visits between baseline and Week 25, and were confirmed at an assessment that took place at least 4 weeks (a minimum of 26 days) later: Platelet count < LLN; LDH > ULN; and 25% increase in serum creatinine from baseline.

    Measured: From baseline up to Week 25

  19. All Cohorts: Number of Participants With Adverse Events (AEs)

    An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product, regardless of causal attribution. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.

    Measured: Up to approximately 8 years

  20. All Cohorts: Number of Participants With Injection-site Reactions, Infusion-related Reactions, Hypersensitivity, Malignant Hypertension (Including Malignant Renal Hypertension), and Infections (Including Meningococcal Meningitis)

    An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product, regardless of causal attribution. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.

    Measured: Up to approximately 8 years

  21. All Cohorts: Number of Participants With AEs Leading to Study Drug Discontinuation

    An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product, regardless of causal attribution. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.

    Measured: Up to approximately 8 years

  22. Switch Cohort: Number of Participants With Clinical Manifestations of Drug-target-drug Complexes (DTDCs)

    Crovalimab and eculizumab bind distinct epitopes on complement component C5, and formation of DTDCs comprising crovalimab, eculizumab, and C5 are formed when participants switch treatment. DTDCs will be characterized using size exclusion chromatography (SEC) coupled with enzyme-linked immunosorbent assay (ELISA).

    Measured: Up to approximately 8 years

  23. All Cohorts: Serum Concentrations of Crovalimab Over Time

    Measured: Up to approximately 8 years

  24. All Cohorts: Number of Participants With Anti-drug Antibodies (ADAs) to Crovalimab

    Participants will be considered to be ADA positive if they were ADA negative at baseline but developed an ADA response following stuy drug exposure (treatment-induced ADA response), or if they were ADA positive at baseline and the titer of one or more post-baseline samples is at least 4-fold greater than the titer of the baseline sample (treatment-enhanced ADA response).

    Measured: Up to approximately 8 years

  25. All Cohorts: Observed Value of Total Complement Activity 50 (CH50), as Measured by Liposome Immunoassay (LIA)

    Measured: Up to approximately 8 years

  26. All Cohorts: Change From Baseline in CH50 Over Time, as Measured by LIA

    Measured: Up to approximately 8 years

  27. All Cohorts: Observed Value of Free Complement Component 5 (C5) Concentrations in Crovalimab-treated Participants

    Measured: Up to approximately 8 years

  28. All Cohorts: Change From Baseline in Free C5 Concentrations Over Time in Crovalimab-treated Participants

    Measured: Up to approximately 8 years

  29. All Cohorts: Observed Value of Total C5 Concentrations in Crovalimab-treated Participants

    Measured: Up to approximately 8 years

  30. All Cohorts: Change From Baseline in Total C5 Concentrations Over Time in Crovalimab-treated Participants

    Measured: Up to approximately 8 years

Timeline

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

  1. First posted12 Jul 2021
  2. Study start17 Nov 2021
  3. Primary completion4 Jul 2025
  4. Study completion19 May 2029 (estimated)

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
41 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04958265
Sponsor's protocol ID
BO42354
Other IDs
2020-002437-15, 2023-505638-82-00, 2023
Acronym
COMMUTE-p
Status last verified
Sep 2026
First submitted
6 Jul 2021
Last updated
1 Oct 2026
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: For eligible studies, qualified researchers may request access to individual patient level clinical data. See Roche's commitment to transparency of clinical study information here: https://go.roche.com/data\_sharing

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in