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Beta Thalassemia MajorPhase 2NCT01571635

Study to Determine the Safety and Tolerability of Sotatercept (ACE-011) in Adults With Beta( β)- Thalassemia.

A Phase 2 study testing SOTATERCEPT (ACE-011) in people with Beta Thalassemia Major and Beta Thalassemia Intermedia, run by Celgene at 18 sites in 4 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Dose finding study to determine the safety and tolerability of Sotatercept (ACE-011) in adults with Beta (β)-Thalassemia Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
SOTATERCEPT (ACE-011)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
46 participants
Where
18 sitesin 4 countries
Study dates
10 Oct 2012to 24 May 2022
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Men and women 18 years of age at the time of signing the informed consent document with a diagnosis of β-thalassemia major (including all subtypes) or β-thalassemia intermedia.
  • For transfusion dependent subjects: permanent transfusion dependency is defined as requiring packed red blood cells (pRBCs) and iron chelation therapy:
  • Average transfusion requirement of at least 2 units/30 days of pRBCs (Gale, 2011) confirmed for a minimum of 168 days (six months) immediately preceding enrollment (study Day 1, first Dose);
  • No transfusion-free period of more than 45 consecutive days during the 168 days immediately preceding enrollment (study Day 1, first Dose);
  • Prior transfusion hemoglobin levels ≤ 10.5 g/dL.
  • For non-transfusion dependent subjects: non-transfusion dependency is defined as a transfusion free for a minimum of 168 days immediately preceding enrollment (study Day 1, first Dose), with the exception of ≤ to one episode of transfusion in the period of a minimum of 168 days immediately preceding enrollment (study Day 1, first Dose) (One episode of transfusion is defined as ≤ 4 transfusion units administered, occurred within 42 days [first transfusion is counted as day 1] due to concurrent illness [e.g. infection], [Guidelines Clin Management of Thalassaemia, 2008]). (This inclusion criteria is not valid for France).
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  • Performance status: Eastern Cooperative Oncology Group (ECOG) score of 0 to 1
  • No concurrent severe hepatic disease:
  • Aspartate Aminotransferase (AST) or Alanine Transaminase (ALT) no greater than 3 x upper limit of normal (ULN);
  • Albumin ≥ 3 g/dL.
  • Serum creatinine ≤ 1.5 x ULN.
  • Females of childbearing potential participating in the study are to use highly effective methods of birth control during study participation and for 112 days (approximately five times the mean terminal half-life of sotatercept [23 days] based on multiple-dose PK data) following the last dose of sotatercept. FCBP must have a negative serum beta Human Chorionic Gonadotropin (β-HCG) pregnancy test within three days of Sotatercept dosing (Day 1). Subjects must be counseled concerning measures to be used to prevent pregnancy and potential toxicities prior to the first dose of sotatercept. A FCBP is a sexually mature woman who has not undergone a hysterectomy or bilateral oophorectomy or who has not been postmenopausal for at least 24 consecutive months (i.e., who has had menses at some time in the preceding 24 months).
  • Males must agree to use a latex condom during any sexual contact with FCBSs while participating in the study and for 112 days following the last dose of Sotatercept, even if he has undergone a successful vasectomy. Subjects must be counseled concerning measures to be used to prevent pregnancy and potential toxicities prior to the first dose of sotatercept.
  • Agreement to adhere to the study visit schedule, understand and comply with all protocol requirements.
  • Understand and provide written informed consent.

Who cannot join

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing participating in the study.
  • Evidence of active Hepatitis C antibody (HCV), Hepatitis B surface antigen (HBsAg and HB core Ab), or Human Immunodeficiency Virus (HIV) antibody.
  • Known history of thromboembolic events ≥ Grade 3 according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0 (current active minor version).
  • Subjects with insulin dependent diabetes.
  • Subjects with major cardiac problems such as:
  • Major risk of heart failure, confirmed with myocardiac T2* ≤ 10 ms. Myocardiac T2* performed in the last one and a half years prior to subject enrollment (study Day 1, first Dose) will be considered valid.
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  • Cardiac arrhythmia which requires treatment (i.e. atrial fibrillation).
  • Treatment with another investigational drug or device < 28 days prior to study entry.
  • Use of an Erythropoiesis Stimulating Agent (ESA) within the 28 days prior to enrollment (study Day 1, first Dose).
  • Subjects on hydroxyurea treatment for which the dose was changed in the last one year prior to subject enrollment (study Day 1, first Dose).
  • Subjects on anticoagulant therapy, such as warfarin.
  • Subjects who started bisphosphonates within the last three months prior to subject enrollment (study Day 1, first Dose).
  • Pregnant or lactating females.
  • Uncontrolled hypertension. Controlled hypertension for this protocol is considered ≤ Grade 1 according to NCI CTCAE version 4.0 (current active minor version) (Appendix B).
  • A history of major organ damage including:
  • Liver disease with ALT > 3x ULN or histopathological evidence of liver cirrhosis on liver biopsy;
  • Heart disease with ejection fraction ≥ Grade 2 according to NCI CTCAE version 4.0 (current active minor version);
  • Kidney disease with a calculated creatinine clearance < 40 mL/min (Cockcroft-Gault formula);
  • Pulmonary fibrosis or pulmonary hypertension as confirmed by a specialist.
  • Adrenal insufficiency.
  • Heart failure as classified by the New York Heart Association (NYHA) classification of 3 or higher (Appendix C).
  • Major surgery within 30 days prior to study Day 1 (subjects must have completely recovered from any previous surgery prior to study Day 1).
  • History of severe allergic or anaphylactic reactions or hypersensitivity to recombinant proteins or excipients in the Investigational Product (see Investigator Brochure).

Trial locations and contacts

18 sites in 4 countries.

18 sites in 4 countries

Italy8 sites
  • Universita degli Studi di Cagliari - ASL8

    Cagliari, 09121

  • Universita Degli Studi Di Cagliari

    Cagliari, 09121

  • Local Institution - 200

    Genoa, 16128

  • Ospedale Galliera

    Genoa, 16128

  • Ente Ospedaliero Ospedali Galliera

    Genova, 16128

  • Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico

    Milan, 20122

  • Fondazione IRCCS Ospedale Maggiore

    Milan, 20122

  • Local Institution - 201

    Milan, 20122

Other trials in Italy

France5 sites
  • Hopital Henri Mondor

    Créteil, 94010

  • Groupe Hospitalier Henri Mondor

    Créteil

  • Hospital of Necker

    Paris, 75015

  • Local Institution - 001

    Paris, 75015

  • Hôpital Necker-Enfants Malades

    Paris

Other trials in France

United Kingdom3 sites
  • Local Institution - 100

    London, WC1E 6BT

  • UCL Cancer Institute

    London, WC1E 6BT

  • UCL Cancer Institue

    London, WC1E6BT

Other trials in United Kingdom

Greece2 sites
  • Local Institution - 300

    Ampelokipi - Athens, 115 26

  • Laiko General Hospital

    Ampelokipi - Athens, 11526

Other trials in Greece

About this study

Official title: A Phase 2A, Open-label Dose Finding Study to Determine the Safety and Tolerability of Sotatercept (ACE-011) in Adults With BETA(b)-THALASSEMIA.

Dose finding study to determine the safety and tolerability of Sotatercept (ACE-011) in adults with Beta (β)-Thalassemia

Being tested
SOTATERCEPT (ACE-011)
Keywords
Beta-Thalassaemia
Medical subject headings
beta-Thalassemia

What participants receive

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

  • SOTATERCEPT (ACE-011)Drug

    Also called (ACE-011)

    0.1 mg/kg to 1.5mg/kg Sotatercept will be administered as a subcutaneous injection once every 21 days during the treatment period.

Study groups in NCT01571635
Study groupRoleWhat they receive
Sotatercept dose level 0.1mg/kgExperimentalExperimental 0.1 mg/kg -Sotatercept will be administered as a subcutaneous injection once every 21 days during the treatment period
Receives: Drug: SOTATERCEPT (ACE-011)
Sotatercept dose level 0.3mg/ kgExperimentalExperimental 0.3 mg/kg - Sotatercept will be administered as a subcutaneous injection once every 21 days during the treatment period
Receives: Drug: SOTATERCEPT (ACE-011)
Sotatercept dose level 0.5mg/kgExperimentalExperimental 0.5 mg/kg -Sotatercept will be administered as a subcutaneous injection once every 21 days during the treatment period
Receives: Drug: SOTATERCEPT (ACE-011)
Sotatercept dose level 0.75mg/kgExperimentalExperimental 0.75 mg/kg - Sotatercept will be administered as a subcutaneous injection once every 21 days during the treatment period
Receives: Drug: SOTATERCEPT (ACE-011)
Sotatercept dose level 1.0mg/kgExperimentalExperimental 1.0 mg/kg -Sotatercept will be administered as a subcutaneous injection once every 21 days during the treatment period
Receives: Drug: SOTATERCEPT (ACE-011)
Sotatercept dose level 1.5mg/kgExperimentalExperimental 1.5 mg/kg -Sotatercept will be administered as a subcutaneous injection once every 21 days during the treatment period
Receives: Drug: SOTATERCEPT (ACE-011)

What is being measured

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

  1. Potential Recommended Dose as Determined by Number of Participants Experiencing Dose-Limiting Toxicities and Recommended Dose

    Number of participants with dose-limiting toxicities (DLT) are used to determine the potential recommended dose (PRD). PRD is defined as the highest dose with up to 1 out of 6 patients experiencing a DLT. DLT is defined as any side effects of the study treatment serious enough to prevent an increase in dose or level of treatment, including at least one of the following: Hypertension ≥ Grade 3 per National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0; Hgb > 14 g/dL sustained for four weeks; any NCI CTCAE toxicity ≥ Grade 3. Grade 3 is defined as severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care activities of daily life.

    PRD was identified as 1 mg/kg. Due to study termination, no patients were enrolled after 1 mg/kg cohort or in the Expansion Cohort. Thus, primary analyses to determine recommended dose (RD) were not conducted.

    Measured: From first dose up to 28 days post the first dose

Secondary outcomes (6)
  1. Number of Participants With Red Blood Cell Transfusion Burden Reduction From Baseline During Treatment

    Transfusion burden at baseline is defined as the total number of units of RBC transfusions that participants received within 168 days (24 weeks) prior to the first dose of study therapy. Transfusion burden during treatment is defined as the total number of RBC transfusion units that each participant received during the treatment divided by the treatment duration and multiplied by 168 days. The result is a 168-day transfusion burden average. Baseline measurement includes RBC transfusion history for transfusion dependent and non-transfusion dependent participants, starting at 168 days prior to enrollment.

    Measured: From baseline to the last dose of study treatment (up to approximately 112 months)

  2. Number of Participants With Hemoglobin Level Increase From Baseline in Non-Transfusion Dependent B-Thalassemia Intermedia Participants

    The Number of participants with a change in Hemoglobin levels will be listed for non-RBC transfusion dependent participants. Baseline assessments are the average of the last two measurements prior to the start of therapy.

    Measured: Measurements were taken in 9 and 12-week intervals, from baseline up to approximately 112 months

  3. Number of Participants Experiencing Adverse Events (AEs)

    An Adverse Event (AE) is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in a clinical investigation participant administered study treatment and that does not necessarily have a causal relationship with this treatment. Adverse events are graded on a scale from 1 to 5, with Grade 1 being mild and asymptomatic; Grade 2 is moderate requiring minimal, local or noninvasive intervention; Grade 3 is severe or medically significant but not immediately life-threatening; Grade 4 events are usually severe enough to require hospitalization; Grade 5 events are fatal. Treatment emergent adverse events (TEAE) are defined as an AE that began after the start of trial medication treatment; or if the event was continuous from baseline and was serious, trial medication-related, or resulted in death, discontinuation, or interruption or reduction of trial therapy.

    Measured: From first dose up to 112 days after the last dose of study treatment (up to 115 months)

  4. Concentrations of Sotatercept in Serum

    Sotatercept was administered as a subcutaneous injection every 21 days during the Treatment Period. Pharmacokinetic (PK) samples were collected at the pre-specified timepoints.

    Measured: Dose 1, Day 8; Dose 1, Day 15; Dose 2, Day 1; Dose 2, Day 8; Dose 3, Day 1; Dose 3, Day 8; Dose 4, Day 1; Dose 5, Day 1; Dose 6, Day 1

  5. Number of Participants With Anti-Drug Antibody (ADA)

    The number of participants with Anti-Sotatercept Antibody is a summary of antidrug antibody (ADA) status for ADA-evaluated participants. A participant is counted as 'positive' if there is any positive result captured during the study, a participant is counted as 'negative' if there is no positive result captured during the study. ADA data was collected Day 1 in dose schedules 1 through 6. Starting from Dose 7, ADA was measured at Day 1 every 3 Doses, then finally at the post-treatment follow-up visit at Month 2 and Month 4.

    Measured: From first dose up to 4 months after last dose (up to approximately 116 months)

  6. Number of Participants Experiencing Quality of Life (QOL) Change From Baseline

    The number of participants in the expansion cohort experiencing changes from baseline in Quality of Life. QOL was planned to be assessed at Day 168 (6 months) and Day 336 (12 months), after Dose 1 Day 1, independent of Dose Delay for participants enrolled in the Expansion Cohort only. QOL was planned to be calculated using the SF-36 and the FACT Anemia. The SF-36 is a Medical Outcomes Study (MOS) consisting of 36 questions developed to determine health status. The SF-36 measures eight scales: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. The FACT Anemia measures fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) Measurement System.

    Due to early study termination, no participants were enrolled in the expansion cohort and QOL was not assessed.

    Measured: From pre-dose up to Dose 8 (168 days/6months) and Dose 16 (336 days/12months) only

Timeline

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

  1. First posted5 Apr 2012 (estimated)
  2. Study start10 Oct 2012
  3. Primary completion2 Jul 2015
  4. Study completion24 May 2022

Why it stopped: Business objectives have changed

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
Parallel groups
Masking
None (open label)
Enrolment
46 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01571635
Sponsor's protocol ID
ACE-011-B-THAL-001
Other IDs
2011-005659-15
Status last verified
May 2023
First submitted
3 Apr 2012
Last updated
18 Jun 2023
Data monitoring committee
No

Publications

  • Cappellini MD, Porter J, Origa R, Forni GL, Voskaridou E, Galacteros F, Taher AT, Arlet JB, Ribeil JA, Garbowski M, Graziadei G, Brouzes C, Semeraro M, Laadem A, Miteva D, Zou J, Sung V, Zinger T, Attie KM, Hermine O. Sotatercept, a novel transforming growth factor beta ligand trap, improves anemia in beta-thalassemia: a phase II, open-label, dose-finding study. Haematologica. 2019 Mar;104(3):477-484. doi: 10.3324/haematol.2018.198887. Epub 2018 Oct 18.

    PubMed 30337358
  • Cappellini M, et al. A Phase 2a, Open-Label, Dose-Finding Study to Determine the Safety and Tolerability of Sotatercept (ACE-011) in Adults With Beta ( )-Thalassemia: Interim Results. Presented at the 55th Annual Meeting of the American Society of Hematology (ASH), December 7-10, 2013, New Orleans, LA. Abstract No. 3448

  • "Porter J, et al. Interim Results From a Phase 2A, Open-Label, Dose-Finding Study To Determine The Safety, Efficacy, And Tolerability of Sotatercept (ACE-001) In Adults with Beta-Thalassemia. Presented at the 19thCongress of the European Hematology Association, June 12-15, 2015, Milan, Italy. Abstract No. S622 "

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing SOTATERCEPT (ACE-011) in people with Beta Thalassemia Major and Beta Thalassemia Intermedia, run by Celgene at 18 sites in 4 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 15 inclusion and 23 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: stopped early, as of the sponsor's last update on 18 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 18 sites in Italy, France, United Kingdom, Greece. 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 18 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?

Potential Recommended Dose as Determined by Number of Participants Experiencing Dose-Limiting Toxicities and Recommended Dose (time frame: From first dose up to 28 days post the first dose). 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 NCT01571635, which also lists 3 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 18 Jun 2023.

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