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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04434092
Registration number
NCT04434092
Ethics application status
Date submitted
3/06/2020
Date registered
16/06/2020
Titles & IDs
Public title
A Phase III Study Evaluating the Efficacy and Safety of Crovalimab Versus Eculizumab in Participants With Paroxysmal Nocturnal Hemoglobinuria (PNH) Not Previously Treated With Complement Inhibitors.
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Scientific title
A Phase III, Randomized, Open-Label, Active-Controlled, Multicenter Study Evaluating the Efficacy and Safety of Crovalimab Versus Eculizumab in Patients With Paroxysmal Nocturnal Hemoglobinuria (PNH) Not Previously Treated With Complement Inhibitors.
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Secondary ID [1]
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2019-004931-21
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Secondary ID [2]
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BO42162
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Universal Trial Number (UTN)
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Trial acronym
COMMODORE 2
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Paroxysmal Nocturnal Hemoglobinuria
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Condition category
Condition code
Blood
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Haematological diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Crovalimab
Treatment: Drugs - Eculizumab
Experimental: Arm A (Crovalimab) - Crovalimab will be administered at an initial loading dose of 1000 milligrams (mg) (for participants with body weight between 40 and 100 kg) or 1500 mg (for participants with body weight \>=100kg), as intravenous (IV) injection on Day 1 of Week 1 followed by four weekly subcutaneous (SC) injections of 340 mg starting on Day 2 of Week 1 and then once weekly (QW) at Weeks 2,3 and 4. Thereafter crovalimab will be administered, as SC injection, at a maintenance dose of 680 mg (for participants with body weight between 40 and 100kg) or 1020 mg (for participants with body weight \>=100kg) once every 4 weeks (Q4W) from Week 5 for a total of 24 weeks of study treatment. Participants may continue to receive crovalimab after 24 weeks of treatment up to maximum of 5 years.
Active comparator: Arm B (Eculizumab) - Participants will receive loading dose of eculizumab 600 mg on Days 1, 8, 15, and 22, followed by maintenance dose of 900 mg on Day 29 and every 2 weeks (Q2W) thereafter until 24 weeks. Participants may switch to receive crovalimab after 24 weeks of eculizumab treatment.
Experimental: Arm C (Crovalimab) (Exploratory) - Paediatric participants will receive a loading series of Crovalimab comprised of an IV dose on Week 1 Day 1, followed by weekly crovalimab SC doses for 4 weeks on Week 1 (Day 2) then on Weeks 2, 3, and 4. Maintenance SC dosing will begin at Week 5 and will be administered Q4W thereafter. After 24 weeks of crovalimab treatment, participants who derive benefit from the drug may continue to receive crovalimab.
Treatment: Drugs: Crovalimab
Crovalimab will be administered as specified in the respective arms.
Treatment: Drugs: Eculizumab
Eculizumab will be administered as specified in the respective arm.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Percentage of Participants who achieve Transfusion Avoidance (TA)
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Assessment method [1]
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TA is defined as patients who are packed Red Blood Cell (pRBC) transfusion-free and do not require transfusion per protocol-specified guidelines.
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Timepoint [1]
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Baseline through Week 25
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Primary outcome [2]
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Percentage of Participants with hemolysis control
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Assessment method [2]
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Measured by LDH =\< 1.5 x ULN (as measured at the central laboratory).
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Timepoint [2]
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Week 5 through Week 25
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Secondary outcome [1]
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Percentage of Participants with Breakthrough Hemolysis (BTH)
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Assessment method [1]
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BTH is defined as at least one new or worsening symptom or sign of intravascular hemolysis (fatigue, hemoglobinuria, abdominal pain, shortness of breath \[dyspnea\], anemia \[hemoglobin \< 10 g/dL\], a major adverse vascular event \[MAVE; including thrombosis\], dysphagia, or erectile dysfunction) in the presence of elevated LDH \>= 2 x ULN after prior reduction of LDH to =\<1.5 x ULN on treatment.
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Timepoint [1]
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Baseline through Week 25
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Secondary outcome [2]
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Percentage of Participants with Stabilization of Hemoglobin
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Assessment method [2]
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Stabilized hemoglobin is defined as avoidance of a \>= 2 g/dL decrease in hemoglobin level from baseline, in the absence of transfusion.
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Timepoint [2]
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Baseline through Week 25
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Secondary outcome [3]
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Mean Change in Fatigue
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Assessment method [3]
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Assessed by the FACIT-Fatigue Questionnaire.
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Timepoint [3]
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Baseline up to Week 25
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Secondary outcome [4]
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Percentage of Participants with Adverse Events (AEs)
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Assessment method [4]
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Determined according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events, Version 5.
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Timepoint [4]
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Up to 7 years
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Secondary outcome [5]
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Percentage of Participants with Injection-Site Reactions, Infusion-Related Reactions, Hypersensitivity and Infections (including meningococcal meningitis)
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Assessment method [5]
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Timepoint [5]
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Up to 7 years
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Secondary outcome [6]
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Percentage of Participants with Adverse Events (AEs) leading to Study Drug Discontinuation
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Assessment method [6]
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Timepoint [6]
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Up to 7 years
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Secondary outcome [7]
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Percentage of Participants with clinical manifestations of Drug-Target-Drug Complex (DTDC) formation amongst those participants who switched to crovalimab treatment from eculizumab treatment
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Assessment method [7]
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Timepoint [7]
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Up to 6.5 years
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Secondary outcome [8]
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Serum concentrations of crovalimab and eculizumab over time
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Assessment method [8]
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Timepoint [8]
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Up to 6.5 years
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Secondary outcome [9]
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Percentage of Participants with Anti-Crovalimab Antibodies
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Assessment method [9]
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Timepoint [9]
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Up to 6.5 years
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Secondary outcome [10]
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Change in PD biomarkers including complement activity (CH50) over time
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Assessment method [10]
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Assessed by a Liposome Immunoassay (LIA) and total C5 concentration
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Timepoint [10]
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Up to 6.5 years
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Secondary outcome [11]
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Change over time in free C5 concentration in crovalimab-treated participants
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Assessment method [11]
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Timepoint [11]
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Up to 6.5 years
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Secondary outcome [12]
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Observed Value in Reticulocyte Count (count/mL)
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Assessment method [12]
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Timepoint [12]
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Up to 6.5 years
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Secondary outcome [13]
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Observed Value in Free Hemoglobin and Haptoglobin (mg/dL)
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Assessment method [13]
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Timepoint [13]
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Up to 6.5 years
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Secondary outcome [14]
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Change in Reticulocyte Count (count/mL)
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Assessment method [14]
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Timepoint [14]
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Baseline up to Week 25
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Secondary outcome [15]
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Change in Free Hemoglobin and Haptoglobin (mg/dL)
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Assessment method [15]
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Timepoint [15]
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Baseline up to Week 25
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Eligibility
Key inclusion criteria
* Body weight >= 40 kg at screening.
* Willingness and ability to comply with all study visits and procedures.
* Documented diagnosis of PNH, confirmed by high sensitivity flow cytometry.
* LDH level >= 2x ULN at screening (as per local assessment).
* Vaccination against Neisseria meningitidis serotypes A, C, W, and Y< 3 years prior to initiation of study treatment; or, if not previously done, vaccination administered no later than one week after the first drug administration.
* Women of childbearing potential: agreement to remain abstinent or use contraception during the treatment period and for 10.5 months after the final dose of crovalimab or for 3 months after the final dose of eculizumab (or longer if required by the local product label).
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Current or previous treatment with a complement inhibitor.
* History of allogeneic bone marrow transplantation.
* History of Neisseria meningitidis infection within 6 months prior to screening and up to first study drug administration.
* History of myelodysplastic syndrome with Revised International Prognostic Scoring System (IPSS-R) prognostic risk categories of intermediate, high and very high.
* Pregnant or breastfeeding, or intending to become pregnant during the study, within 10.5 months after the final dose of crovalimab, or 3 months after the final dose of eculizumab (or longer if required by the local product label).
* Participation in another interventional treatment study with an investigational agent or use of any experimental therapy within 28 days of screening or within 5 half-lives of that investigational product, whichever is greater.
* Concurrent disease, treatment, procedure or surgery, or abnormality in clinical laboratory tests that could interfere with the conduct of the study, may pose any additional risk for the participant, or would, in the opinion of the Investigator, preclude the participant's safe participation in and completion of the study.
* Splenectomy < 6 months before screening.
* Positive for Active Hepatitis B and C infection (HBV/HCV).
* History of or ongoing cryoglobulinemia at screening.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
8/10/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
30/06/2028
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Actual
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Sample size
Target
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Accrual to date
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Final
204
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Liverpool Hospital - Liverpool
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Recruitment postcode(s) [1]
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2170 - Liverpool
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Recruitment outside Australia
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Argentina
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Ciudad Autonoma Buenos Aires
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Brazil
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PR
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Brazil
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RS
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Brazil
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SP
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China
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Beijing City
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China
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Guangzhou
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China
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China
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Nanjing
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China
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China
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China
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Lille
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France
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Pierre Benite
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Germany
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Essen
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Germany
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Ulm
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Shatin
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Uppsala
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Kaohisung
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Samsun
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KIEV Governorate
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United Kingdom
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Leeds
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United Kingdom
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London
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Hoffmann-La Roche
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Address
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Other collaborator category [1]
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Commercial sector/industry
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Chugai Pharmaceutical
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Ethics approval
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Summary
Brief summary
A study designed to evaluate the non-inferiority of crovalimab compared with eculizumab in participants with PNH who have not been previously treated with complement inhibitor therapy.
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Trial website
https://clinicaltrials.gov/study/NCT04434092
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
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Clinical Trials
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Hoffmann-La Roche
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.vivli.org). Further details on Roche's criteria for eligible studies are available here (https://vivli.org/ourmember/roche/). For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04434092