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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT03897205




Registration number
NCT03897205
Ethics application status
Date submitted
27/03/2019
Date registered
1/04/2019
Date last updated
28/02/2024

Titles & IDs
Public title
An Efficacy and Safety Study of Imlifidase in Treatment of Antibody-Mediated Rejection in Kidney Transplant Patients
Scientific title
A Randomized, Open-Label, Multi-Centre, Active Control, Efficacy and Safety Study of Imlifidase in Eliminating Donor Specific Anti-HLA Antibodies in the Treatment of Active Antibody-Mediated Rejection in Kidney Transplant Patients
Secondary ID [1] 0 0
2018-000022-66
Secondary ID [2] 0 0
16-HMedIdeS-12
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Kidney Transplant Rejection 0 0
Condition category
Condition code

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Imlifidase
Other interventions - Plasma Exchange

Experimental: Imlifidase - Subjects randomized to imlifidase treatment received one intravenous dose of imlifidase, 0.25 mg/kg, administered over 15 minutes.

Active Comparator: Plasma Exchange - Subjects randomized to plasma exchange (PE) treatment received 5-10 sessions of PE, as judged by the investigator. Immunoadsorption (IA) could replace PE, at the discretion of the investigator.


Treatment: Drugs: Imlifidase
Imlifidase is an immunoglobulin G (IgG) degrading enzyme of Streptococcus pyrogenes that cleaves all 4 human subclasses of IgG with strict specificity.

Other interventions: Plasma Exchange
The subject's plasma is removed and discarded and the subject receives replacement donor plasma, albumin, or a combination of albumin and saline. IA may be used instead of PE to the discretion of the investigator. IA is achieved by passing a subject's plasma over columns that bind immunoglobulins and then the plasma is passed back to the subject.
Intervention code [1] 0 0
Treatment: Drugs
Intervention code [2] 0 0
Other interventions
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Maximum Reduction in Donor Specific Antibodies (DSA) Level During the 5 Days Following the Start of Treatment
Timepoint [1] 0 0
Start of treatment until 5 days following start of treatment
Secondary outcome [1] 0 0
Reduction in DSA Levels After Treatment
Timepoint [1] 0 0
Screening until Day 180
Secondary outcome [2] 0 0
Estimated Glomerular Filtration Rate (eGFR) Levels
Timepoint [2] 0 0
Screening until Day 180
Secondary outcome [3] 0 0
Urine Albumine/Creatinine Ratio
Timepoint [3] 0 0
Pre-dose until Day 180
Secondary outcome [4] 0 0
Number of Patients With Graft Loss Within 180 Days of Treatment
Timepoint [4] 0 0
Screening until Day 180
Secondary outcome [5] 0 0
Number of Patients With Signs or no Signs of Transplant Glomerulopathy at Day 180
Timepoint [5] 0 0
Day 180
Secondary outcome [6] 0 0
Number of Patients With Different Types of Kidney Histopathology Throughout the Trial
Timepoint [6] 0 0
Screening, Day 29 and Day 180
Secondary outcome [7] 0 0
Number of Patients With Resolved AMR as Assessed by Messenger Ribonucleic Acid (mRNA) Levels
Timepoint [7] 0 0
Screening, Day 29, and Day 180
Secondary outcome [8] 0 0
Number of Administered Plasma Exchange (PE) and Immunoadsorption (IA) Sessions
Timepoint [8] 0 0
Day 1 to Day 180
Secondary outcome [9] 0 0
Total Serum Immunoglobulin G (IgG) Levels Until Administration of Intravenous Immunoglobulin (IVIg)
Timepoint [9] 0 0
Pre-dose until Day 6
Secondary outcome [10] 0 0
Number of Patients With Intact IgG, Single-cleaved IgG (scIgG), F(ab')2 Fragments Following Treatment Until Administration of IVIg
Timepoint [10] 0 0
Start of treatment (Day 1) up to administration of IVIg on Day 4 (imlifidase group) and until administration of IVIg within Day 15 (PE group)
Secondary outcome [11] 0 0
DSA Functionality Determined by C1q Analysis Pre- and Post-treatment
Timepoint [11] 0 0
Screening until Day 6
Secondary outcome [12] 0 0
Pharmacokinetic (PK) Profile of Imlifidase: Cmax
Timepoint [12] 0 0
Pre-dose, 30 min, 1 h, 2 h, 6 h, 24 h, 48 h, 72 h, 96 h, Day 6, Day 8, Day 1, and Day 15
Secondary outcome [13] 0 0
PK Profile of Imlifidase: Tmax
Timepoint [13] 0 0
Pre-dose, 30 min, 1 h, 2 h, 6 h, 24 h, 48 h, 72 h, 96 h, Day 6, Day 8, Day 1, and Day 15
Secondary outcome [14] 0 0
PK Profile of Imlifidase: t1/2
Timepoint [14] 0 0
Pre-dose, 30 min, 1 h, 2 h, 6 h, 24 h, 48 h, 72 h, 96 h, Day 6, Day 8, Day 1, and Day 15
Secondary outcome [15] 0 0
PK Profile of Imlifidase: AUC
Timepoint [15] 0 0
Pre-dose, 30 min, 1 h, 2 h, 6 h, 24 h, 48 h, 72 h, 96 h, Day 6, Day 8, Day 1, and Day 15
Secondary outcome [16] 0 0
PK Profile of Imlifidase: CL
Timepoint [16] 0 0
Pre-dose, 30 min, 1 h, 2 h, 6 h, 24 h, 48 h, 72 h, 96 h, Day 6, Day 8, Day 1, and Day 15
Secondary outcome [17] 0 0
PK Profile of Imlifidase: Volume of Distribution (V)
Timepoint [17] 0 0
Pre-dose, 30 min, 1 h, 2 h, 6 h, 24 h, 48 h, 72 h, 96 h, Day 6, Day 8, Day 1, and Day 15
Secondary outcome [18] 0 0
Concentration of Anti-drug Antibodies (ADAs)
Timepoint [18] 0 0
Screening until Day 180

Eligibility
Key inclusion criteria
1. Signed Informed Consent obtained before any study-related procedures

2. Willingness and ability to comply with the protocol

3. Male and/or female donor kidney recipients age =18 years at the time of screening

4. Presence of DSA(s)

5. Meet the Banff 2017 criteria for active or chronic active AMR

6. At least 25% rise in serum creatinine compared to last individual value taken prior to
the AMR. Patients with delayed graft function and AMR within 10 days after transplant
(confirmed by kidney biopsy) can be included regardless of serum creatinine level

7. Women of child-bearing potential willing or able to use at least one highly effective
contraceptive method throughout the study. In the context of this study, an effective
method is defined as those which result in low failure rate (i.e. less than 1% per
year) when used consistently and correctly

8. Men willing to use double-barrier contraception from the first day of treatment until
at least 2 months after the dose of imlifidase, if not abstinent
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Previous treatment with imlifidase

2. Previous high dose IVIg treatment (2 g/kg) within 28 days prior to inclusion

3. Lactating or pregnant females

4. Significantly abnormal general serum screening lab results judged inappropriate for
inclusion in the study by the investigator

5. Intake of other investigational drugs within 5 half-lives (or similar) of the product
prior to inclusion

6. Clinically relevant active infection(s) as judged by the investigator

7. Any condition that in the opinion of the investigator could increase the subject's
risk by participating in the study such as severe immune deficiency and severe cardiac
insufficiency [New York Heart Association (NYHA) Class IV] or severe uncontrolled
heart disease

8. Known allergy/sensitivity to imlifidase, IVIg and/or rituximab and the respective
excipients

9. Patient unable to tolerate treatment with plasmapheresis or immunoadsorption, as
judged by the investigator

10. Unsuitable to participate in the study for any other reason as judged by the
investigator

11. Positive polymerase chain reaction (PCR) test for severe acute respiratory syndrome
corona virus 2 (SARS-CoV-2) infection

12. Current diagnosis or history of thrombotic thrombocytopenic purpura (TTP), or known
familial history of TTP

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Phase 2
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
30/04/2019
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
16/11/2022
Sample size
Target
Accrual to date
Final
30
Recruitment in Australia
Recruitment state(s)
VIC
Recruitment hospital [1] 0 0
The Royal Melbourne Hospital - Melbourne
Recruitment hospital [2] 0 0
Royal Adelaide Hospital - Adelaide
Recruitment hospital [3] 0 0
Royal Prince Alfred Hospital - Sydney
Recruitment postcode(s) [1] 0 0
3050 - Melbourne
Recruitment postcode(s) [2] 0 0
5000 - Adelaide
Recruitment postcode(s) [3] 0 0
- Sydney
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
California
Country [2] 0 0
United States of America
State/province [2] 0 0
Massachusetts
Country [3] 0 0
United States of America
State/province [3] 0 0
Minnesota
Country [4] 0 0
United States of America
State/province [4] 0 0
New York
Country [5] 0 0
Austria
State/province [5] 0 0
Vienna
Country [6] 0 0
France
State/province [6] 0 0
Bordeaux
Country [7] 0 0
France
State/province [7] 0 0
Grenoble
Country [8] 0 0
France
State/province [8] 0 0
Paris
Country [9] 0 0
Germany
State/province [9] 0 0
Berlin
Country [10] 0 0
Germany
State/province [10] 0 0
Hannover

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Hansa Biopharma AB
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The purpose of this study was to investigate how efficiently the study medication imlifidase
reduces the amount of donor specific antibodies (DSA) in comparison with plasma exchange (PE)
therapy, in patients who have had an active or chronic active antibody mediated rejection
(AMR) after being kidney transplanted. The purpose was also to investigate and compare safety
for these two treatments.
Trial website
https://clinicaltrials.gov/ct2/show/NCT03897205
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Clinical Operations
Address 0 0
Hansa Biopharma AB
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT03897205