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Mevalonate Kinase DeficiencyPhase 2NCT01303380

Canakinumab in Patients With Active Hyper-IgD Syndrome

A Phase 2 study testing Canakinumab in people with Mevalonate Kinase Deficiency, run by Novartis Pharmaceuticals at 3 sites in Spain.

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 pilot study is designed to evaluate the efficacy, the safety, and the pharmacokinetics (PK) / pharmacodynamics (PD) of canakinumab treatment in patients with HIDS. Read more about this study

Who is it for?
Ages 24 months and older
Conditions the study is for
Mevalonate Kinase Deficiency
What is being tested?
Canakinumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
9 participants
Where
3 sitesSpain
Study dates
Mar 2011to Jul 2014
Phase
Phase 2
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 24 months and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patients with a diagnosis of HIDS proven by DNA analysis and/or enzymatic studies.
  • At time of start of drug treatment: active HIDS as evidenced by a physician global assessment of HIDS flare severity ≥ 2 and CRP values >10 mg/L (normal CRP < or = 10 mg/L).
  • Patients who have a history of > or = 3 febrile acute HIDS flares in a 6-month period when not receiving prophylaxis treatment (e.g. anakinra daily treatment) with a duration of each flare lasting > or = 4 days and limiting the normal daily activities.

Who cannot join

  • Pregnant or nursing (lactating) women.
  • History of being immunocompromised, including a positive HIV at screening (ELISA and Western blot) test result.
  • Positive Hepatitis B or Hepatitis C.
  • Live vaccinations within 3 months prior to the start of the trial
  • Positive tuberculosis screening test.
  • Other protocol-defined inclusion/exclusion criteria may apply

Trial locations and contacts

3 sites in 1 country.

Spain3 sites
  • Novartis Investigative Site

    Esplugues de Llobregat, Barcelona, 08950

  • Novartis Investigative Site

    Madrid, Madrid, 28046

  • Novartis Investigative Site

    Valencia, Valencia, 46026

Other trials in Spain

About this study

Official title: An Open-label, Multicenter, Efficacy and Safety Pilot Study of 6-month Canakinumab Treatment With up to 6-month Follow-up in Patients With Active Hyper-IgD Syndrome (HIDS)

This pilot study is designed to evaluate the efficacy, the safety, and the pharmacokinetics (PK) / pharmacodynamics (PD) of canakinumab treatment in patients with HIDS.

Being tested
Canakinumab
Keywords
Hyper IgD syndrome, canakinumab, HIDS, mevalonate kinase deficiency, MKD
Medical subject headings
Mevalonate Kinase Deficiency

What participants receive

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

  • CanakinumabDrug

Study groups in NCT01303380
Study groupRoleWhat they receive
CanakinumabExperimentalNot described
Receives: Drug: Canakinumab

What is being measured

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

  1. Number of Flares Per Participant During Historical Period and Treatment Period

    A flare was defined as Physician Global Assessment of HIDS flare severity score of ≥ 2 and a C-reactive protein (CRP) value > 10 mg/L. Flares during a historical period were defined as most recent 6-months in which the participant has not received treatment for their HIDS other than symptomatic treatment with NSAIDs and/or corticosteroids.

    Measured: Historical period, Month 6 (End of treatment period)

Secondary outcomes (22)
  1. Number of Flares Per Participant at During Treatment Period and 24 Month Extension Period

    A flare was defined as Physician Global Assessment of HIDS flare severity score of ≥ 2 and a CRP value > 10 mg/L.

    Measured: Month 6 (End of treatment period), Month 36 (End of Long term treatment Period 2)

  2. Number of Participants Who Flared at Month 6, Month 24 and Month 36

    A flare was defined as Physician Global Assessment of HIDS flare severity score of ≥ 2 and a CRP value > 10 mg/L.

    Measured: Baseline, Month 6 (End of treatment period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  3. Number of Participants With Flare Events Based on Physician Assessed HIDS Flare Severity Score

    Physician global assessment of severity of HIDS after each flare was based on HIDS flare severity score, a 5- point scale: 0 = Absent signs/symptoms; 1 = Minimal signs/symptoms; 2 = Mild; 3= Moderate; 4 = Severe.

    Measured: Any flare event [Baseline up to Month 36 (End of long term treatment period 2)]

  4. Number of Participants With Flare Events Based on Participant Assessed HIDS Flare Severity Score

    Participant's global assessment of severity of HIDS after each flare was based on HIDS flare severity score, a 5-point scale: 0 = Absent signs/symptoms; 1 = Minimal signs/symptoms; 2 = Mild; 3= Moderate; 4 = Severe. Same investigator assessed the same participant throughout the study to ensure consistency between assessments. Investigators reviewed every participant's diary at each visit after their own clinical assessment.

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  5. Percentage of Participants With Defined Grades of Participants Assessed Symptom Control

    Participants were assessed by participants/parent (participants aged 6-18 years) for control of signs and symptoms associated with HIDS based on 5-point scale: 0 = No control; 1 = Poor control; 2 = Somewhat control; 3 = Good control; and 4= Excellent control.

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  6. Percentage of Participants With Defined Grades of Physician Assessed Symptom Control

    Participants were assessed by physician for control of signs and symptoms associated with HIDS based on 5-point scale: 0 = No control; 1 = Poor control; 2 = Somewhat control; 3 = Good control; and 4= Excellent control.

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  7. Percentage of Participants Experiencing Fever as Assessed by Physician's Global Assessment

    Fever severity was assessed by physician after each flare using a 5-point scale: 0 =Absent signs/symptoms; 1 = Minimal signs/symptoms; 2 = Mild; 3 = Moderate; 4 = Severe.

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  8. Percentage of Participants Experiencing Apthus Ulcers as Assessed by Physician's Global Assessment

    Apthus ulcers were assessed by physician after each flare using a 5-point scale: 0 =Absent signs/symptoms; 1 = Minimal signs/symptoms; 2 = Mild; 3 = Moderate; 4 = Severe.

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  9. Percentage of Participants Experiencing Lymphadenopathy as Assessed by Physician's Global Assessment

    Lymphadenopathy severity was assessed by physician after each flare using a 5-point scale: 0 =Absent signs/symptoms; 1 = Minimal signs/symptoms; 2 = Mild; 3 = Moderate; 4 = Severe.

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  10. Percentage of Participants Experiencing Abdominal Pain as Assessed by Physician's Global Assessment

    Abdominal pain was assessed by physician after each flare using a 5-point scale: 0 =Absent signs/symptoms; 1 = Minimal signs/symptoms; 2 = Mild; 3 = Moderate; 4 = Severe.

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  11. Time to Resolution of the Initial Flare After First Canakinumab Treatment

    Time to resolution of the initial flare after first dose of canakinumab was determined.

    Measured: Day 1 (Baseline), Day 28

  12. Change From Baseline in Inflammation Markers Over Time up to Month 24

    The C-reactive Protein (CRP) and/or Serum amyloid A protein (SAA) were used as inflammatory markers. The normal range of CRP was 0-10 mg/L.

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  13. Health Assessment Questionnaire (HAQ) Global Score in Adults Over Time

    Participants were assessed for health-related quality of life (HRQoL) based on Health Assessment Questionnaire (HAQ). HAQ was an eight 8 categories questionnaire representing all activities related to physical function. Each category has various sub-categories, which were rated by the participants on a 4- point difficulty scale: 0 = any difficulty; 1 = some difficulty; 2 = much difficulty; 3 = unable to do. The total score was the mean of the 8 scores, and ranged from 0 (no disability) to 3 (completely disabled).

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  14. Childhood Health Assessment Questionnaire (CHAQ) Global Score in Children Over Time

    Participants or their parents (participants aged 6 to 17 years) were assessed for HRQoL based on Childhood Health Assessment Questionnaire (CHAQ). CHAQ was an eight domain questionnaire representing functional capacity and independence, evaluated for previous week. Each domain was rated on a 4-point difficulty scale: 0 = any difficulty; 1 = some difficulty; 2 = much difficulty; 3 = unable to do.The total score is the mean from the 8 scores, and ranges from 0 (no disability) to 3 (completely disabled).

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  15. Percentage of Participants Who Received Dose Up-titration During 6-month Treatment Period

    Participants who experienced a new HIDS flare between baseline and Week 4 and received an escalated dose of 450 mg of canakinumab every 6 weeks thereafter starting at Week 6 were determined.

    Measured: Day 1 up to Month 6 (End of follow up)

  16. Duration of Flares Experienced During the Study

    Flare was defined as Physician Global Assessment of HIDS flare severity score of ≥ 2 and a CRP value > 10 mg/L. The change in post canakinumab treatment flare duration during the study were assessed as compared to historical period.

    Measured: Baseline, Month 6 (End of treatment period), Month 12 (End of follow up period), Month 24 (End of Long term treatment period 1) and Month 36 (End of Long term treatment period 2)

  17. Time to Flare After the Last Dose of Canakinumab During the Follow-up Period

    The median time to flare by the participants after administration of the last dose of canakinumab during the follow-up period was analysed using Kaplan-Meier method.

    Measured: Last dose of canakinumab treatment in follow-up period to end of follow-up period (Day 337)

  18. Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Adverse events (AEs) were defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events (SAEs) were defined as any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalisation, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgement of investigators represent significant hazards.

    Measured: Day 1 (Start of study treatment) up to Month 36 (End of study)

  19. Participants Who Received Rescue Treatment

    Participants who experienced flares were treated with corticosteroids and NSAIDs as rescue medication.

    Measured: Baseline up to Month 36 (End of study)

  20. Serum Concentration-time Profile of Canakinumab

    Canakinumab concentrations in serum were assessed for evaluating pharmacokinetics (PK) of the drug.

    Measured: Day 1 (Pre-dose), Day 4, Day 15, Day 43, Day 85, Day 127, Day 169 (End of treatment period), Day 197, Day 225, Day 253, Day 281, Day 309, and Day 337 (End of follow-up period) (Post-dose)

  21. Serum Concentration of Total Interleukin-1β Antibody (IL-1β)

    Pharmacodynamics of canakinumab was assessed by total IL-1β (sum of free and bound canakinumab) concentration, determined in serum by means of sandwich ELISA assay with limit of detection at 0.1 picogram/millilitre.

    Measured: Day 1 (Pre-dose), Day 4, Day 15, Day 43, Day 85, Day 127, Day 169 (End of treatment period), Day 197, Day 225, Day 253, Day 281, Day 309, and Day 337 (End of follow-up period) (Post-dose)

  22. Number of Participants Exhibiting Anti-canakinumab Antibodies at Any Visit

    Immunogenicity assessment included determination of anti-canakinumab (ACZ885) antibodies in serum samples using bridging ECLIA assay.

    Measured: Baseline up to Month 36 (End of study)

Timeline

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

  1. First posted24 Feb 2011 (estimated)
  2. Study startMar 2011
  3. Primary completionJul 2014
  4. Study completionJul 2014

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 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
9 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01303380
Sponsor's protocol ID
CACZ885D2402
Other IDs
2010-020904-31
Status last verified
Oct 2015
First submitted
23 Feb 2011
Last updated
5 Nov 2015

Publications

  • Arostegui JI, Anton J, Calvo I, Robles A, Iglesias E, Lopez-Montesinos B, Banchereau R, Hong S, Joubert Y, Junge G, Pascual V, Yague J. Open-Label, Phase II Study to Assess the Efficacy and Safety of Canakinumab Treatment in Active Hyperimmunoglobulinemia D With Periodic Fever Syndrome. Arthritis Rheumatol. 2017 Aug;69(8):1679-1688. doi: 10.1002/art.40146. Epub 2017 Jul 5.

    PubMed 28482144

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Canakinumab in people with Mevalonate Kinase Deficiency, run by Novartis Pharmaceuticals at 3 sites in Spain.

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 3 inclusion and 6 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 5 Nov 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Spain. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 19 Aug 2015). 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?

Number of Flares Per Participant During Historical Period and Treatment Period (time frame: Historical period, Month 6 (End of treatment period)). 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 NCT01303380, which also lists 1 linked publication.

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 5 Nov 2015.

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