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Pemphigus VulgarisPhase 2NCT02704429

A Study of PRN1008 in Adult Patients With Pemphigus Vulgaris

A Phase 2 study testing PRN1008 in people with Pemphigus Vulgaris, run by Principia Biopharma, a Sanofi Company at 13 sites in 5 countries.

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

Open-label cohort study in adult patients with newly diagnosed or relapsing pemphigus vulgaris, with intra-patient dose-adjustment based on clinical response and BTK occupancy, and with conventional immunosuppressive "rescue treatment", if indicated. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Pemphigus Vulgaris
What is being tested?
PRN1008
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
13 sitesin 5 countries
Study dates
22 Jan 2016to 10 Jan 2020
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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female patients, aged 18 to 80 years old, with biopsy-proven, mild-moderate PV (PDAI 8 to 45) in Part A and mild to severe PV in Part B (PDAI 8 to 60) that are either:
  • newly diagnosed patients (i.e. naïve to an effective induction treatment regimen) for whom an initial period of PRN1008 monotherapy is judged clinically acceptable, or
  • relapsing patients, for whom an initial period of PRN1008 monotherapy, or combination therapy with any of low dose corticosteroid, ie.0.5 mg/kg of prednis(ol)one per day

Who cannot join

  • Pregnant or lactating women
  • A history of malignancy of any type, other than surgically excised non-melanoma skin cancers or in situ cervical cancer within 5 years before the day of dosing
  • Use of immunologic response modifiers with the following periods prior to Day 1: 1 week: cyclophosphamide; 4 weeks: intravenous immunoglobulin, Kinaret (anakinra) and Enbrel (etanercept); 12 weeks: Remicade (infliximab), Humira (adalimumab), Simponi (golimumab), Orencia (abatacept), Actemra (tocilizumab), Cimzia (certolizumab), Cosentyx (secukinumab), plasmapheresis; 6 months: Rituxan/MabThera (rituximab), ofatumumab, any other anti-CD20 antibody, other long acting biologics
  • More than 0.5 mg/kg of prednis(ol)one per day ("low dose corticosteroids") within the two weeks prior to Day 1
  • Use of proton pump inhibitor drugs such as omeprazole and esomeprazole
  • Has received any investigational drug (or is currently using an investigational device) within the 30 days before receiving the first dose of study medication, or at least 5 times the respective elimination half-life time (whichever is longer)
Show all 17Show fewer
  • History of drug abuse within the precious 12 months
  • Alcoholism or excessive alcohol use, defined as regular consumption of more than approximately 3 standard drinks per day
  • Refractory nausea and vomiting, malabsorption, external biliary shunt, significant bowel resection that would preclude adequate study drug absorption
  • History of anorexia nervosa or periods of three months or more of low body weight in the past 5 years
  • Donation of a unit or more of blood or blood products within 4 weeks prior to Day 1
  • History of solid organ transplant
  • History of epilepsy or other forms of seizures in the last 5 years
  • Positive for screening for human immunodeficiency virus, hepatitis B (surface and core antibodies unrelated to vaccination), or hepatitis C (anti-HCV antibody confirmed with Hep C RNA)
  • History of active or latent tuberculosis (TB) infection (must test negative using the QuantiFERON test to be eligible)
  • History of serious infections requiring intravenous (by catheter that delivers antibiotics into your blood) treatment
  • Live vaccine within 28 days prior to baseline or plan to receive one during the study

Trial locations and contacts

13 sites in 5 countries.

13 sites in 5 countries

Greece4 sites
  • Hospital of Venereal and Skin Diseases A.Syggros

    Athens, 16121

  • University General Hospital of Ioannina

    Ioannina, Ioannina, 45500

  • University Hospital of Larissa

    Larissa, Thessaly, 41110

  • Papageorgiou General Hospital of Thessaloniki

    Thessaloniki, 56429

Other trials in Greece

Australia3 sites
  • Sinclair Dermatology

    East Melbourne, Victoria, 3002

  • Premier Specialists

    Kogarah, New South Wales, 2217

  • Royal Melbourne, Dermatology Office

    Melbourne, Victoria, 3050

Other trials in Australia

Croatia2 sites
  • Clinical Hospital Osijek

    Osijek, 31000

  • Klinichki Bolnicki Centar Zagreb

    Zagreb, 10 000

Other trials in Croatia

France2 sites
  • Hôpital Avicenne

    Bobigny, Siene-Saint Denis, 93009

  • Rouen University Hospital

    Rouen, 76038

Other trials in France

Israel2 sites
  • Chaim Sheba Medical Center

    Ramat Gan, 52621

  • Tel Aviv Sourasky Medical Center

    Tel Aviv, 64239

Other trials in Israel

About this study

Official title: An Open-Label, Phase 2, Pilot Study Investigating the Safety, Clinical Activity, Pharmacokinetics, and Pharmacodynamics of Oral Treatment With the BTK Inhibitor PRN1008 in Patients With Newly Diagnosed or Relapsing Pemphigus Vulgaris

Open-label cohort study in adult patients with newly diagnosed or relapsing pemphigus vulgaris, with intra-patient dose-adjustment based on clinical response and BTK occupancy, and with conventional immunosuppressive "rescue treatment", if indicated. The duration of therapy in Part A will be 12 weeks, followed by 12 weeks of follow up. The extension phase, Part B includes 24 weeks of therapy, followed by 4 weeks of follow-up.

Read the detailed description

Primary Objectives:

To evaluate the safety of PRN1008 in patients with pemphigus vulgaris (PV)

To evaluate the clinical activity of PRN1008 in patients with PV, per criteria in the European Academy of Dermatology and Venereology (EADV) 2014 Pemphigus S2 Guideline (Hertl et al. 2015)

Secondary Objectives

To evaluate the pharmacokinetics (PK) and the pharmacodynamics (PD) of multiple doses of PRN1008 in patients with PV

To evaluate the relationship of PK and PD to each other and to efficacy and safety in this patient population

Being tested
PRN1008
Medical subject headings
Pemphigus

What participants receive

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

  • PRN1008Drug

    Also called BTK inhibitor, Rilzabrutinib

    Part A dosing was initiated administering 400 mg BID. Intrapatient dose adjustments (reductions and increases) were permitted based upon tolerability and clinical response with the maximum dose allowed up to 600 mg BID for 12 weeks.

    Part B initial dosing was 400 mg QD for 2 weeks with dose escalation to 400 mg BID at the discretion of the Investigator for the purposes of investigating dose response and identifying the minimal efficacious dose of rilzabrutinib for 24 weeks.

Study groups in NCT02704429
Study groupRoleWhat they receive
PRN1008ExperimentalPart A: Open-label PRN1008, 12 weeks; 12 weeks follow-up; Part B: Open-label PRN1008, 24 weeks; 4 weeks follow-up
Receives: Drug: PRN1008

What is being measured

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

  1. Percentage of Participants With Treatment-emergent Adverse Events

    Treatment-emergent adverse events (TEAEs) including clinically significant changes in physical examination, laboratory tests, and vital signs. An AE was defined as any untoward medical occurrence in a participant who received study drug and did not necessarily had to have a causal relationship with the treatment. TEAEs were defined as AEs that developed or worsened or became serious during on-treatment phase that was defined as the time from the start of study drug up to study completion.

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  2. Percentage of Participants Who Are Able to Achieve Control of Disease Activity (CDA) Within 4 Weeks of Starting PRN1008 Treatment Without the Need for Doses of Prednisone or Prednisolone >0.5 mg/kg

    CDA was defined as the time at which new lesions cease to form and established lesions begin to heal.

    Measured: 4 weeks

Secondary outcomes (13)
  1. Percentage of Participants Able to Achieve Control of Disease Activity (CDA) Without Corticosteroids Within 4 Weeks

    CDA was defined as the time at which new lesions cease to form and established lesions begin to heal.

    Measured: 4 weeks

  2. Percentage of Participants Able to Achieve a Complete Response (CR) Without Corticosteroids

    CR was defined as complete healing of all lesions and the absence of new lesions.

    Measured: Part A: 12 weeks treatment and Part B: 24 weeks treatment

  3. Percentage of Participants Able to Achieve Complete Remission (CR) Without the Need for Doses of Prednisone or Prednisolone of Greater Than 0.5mg/kg

    CR was defined as complete healing of all lesions and the absence of new lesions.

    Measured: Part A: 12 weeks treatment and Part B: 24 weeks treatment

  4. Time to Control of Disease Activity (CDA)

    CDA was defined as the time at which new lesions cease to form and established lesions begin to heal. Kaplan-Meier estimate median time is reported.

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  5. Time to End of Consolidation Phase (ECP)

    ECP was defined as the time at which no new lesions have developed for minimum of 2 weeks, and approximately 80% of existing lesions have healed. The median time to ECP was based on Kaplan-Meier estimate which considered censoring at end of follow-up for patients who didn't have an event. A +/-3 days window for visits at Week 3 and 5, and +/-7 days window for visits at Week 9, 13, 17, 21, 25.

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  6. Time to Complete Remission (CR)

    CR was defined as complete healing of all lesions and the absence of new lesions.

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  7. Time to Relapse After PRN1008 Treatment Discontinuation

    Relapse was defined as appearance of ≥3 new lesions/month that do not heal spontaneously within 1 week, or by extension of established lesions, in a patient who has achieved disease control. The median time to relapse was based on Kaplan-Meier estimate which considered censoring at end of follow-up for patients who didn't have an event. A +/-3 days window for visits at Week 3 and 5, and +/-7 days window for visits at Week 9, 13, 17, 21, 25.

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  8. Cumulative Corticosteroid Usage

    Cumulative corticosteroid usage

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  9. Percentage Change From Baseline in Pemphigus Disease Area Index (PDAI) Total Activity Scores

    The PDAI questionnaire has 2 components including activity and damage. The activity component consists of skin, scalp and mucosa parts, and the damage component consists of skin and scalp parts. The total activity score was used for the summary of PDAI scores. PDAI total activity score = Total skin activity + Total scalp activity + Total mucosa activity. PDAI Total Activity Score ranged from 0 to 250 points representing disease activity (higher scores mean a worse outcome). Negative change in total activity score from baseline indicates improvement in pemphigus activity.

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  10. Change From Baseline in Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) Total Activity Score

    ABSIS Total Activity Score ranged from 0 to 206 points representing disease activity (higher scores mean a worse outcome). Negative change in total activity score from baseline indicates improvement in pemphigus activity.

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  11. Change From Baseline in Autoimmune Bullous Diseases Quality of Life (ABQOL)

    ABQOL score ranged from 0 to 68 points representing disease activity (higher scores mean a worse outcome).

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  12. Change From Baseline in Treatment of Autoimmune Bullous Diseases Quality of Life (TABQOL) Scores

    TABQOL score ranged from 0 to 68 points representing disease activity (higher scores mean a worse outcome).

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

  13. Change From Baseline in Appetite (SNAQ Score)

    Simplified Nutritional Appetite Questionnaire (SNAQ) score ranged from 0 to 20 points representing disease activity (higher scores mean a better outcome).

    Measured: Part A: until 24 weeks and Part B: until 28 weeks

Timeline

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

  1. First posted10 Mar 2016 (estimated)
  2. Study start22 Jan 2016
  3. Primary completion18 Dec 2019
  4. Study completion10 Jan 2020

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
Not applicable
Intervention model
Single group
Model description
Part A with 12 weeks treatment and 12 weeks follow-up. Part B with 24 weeks treatment and 4 weeks follow-up.
Masking
None (open label)
Enrolment
42 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02704429
Sponsor's protocol ID
PRN1008-005
Other IDs
2015-003564-37, 2015
Status last verified
Dec 2022
First submitted
24 Feb 2016
Last updated
13 Feb 2023
Data monitoring committee
Yes
FDA-regulated drug
Yes
Individual data sharing
Yes: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing PRN1008 in people with Pemphigus Vulgaris, run by Principia Biopharma, a Sanofi Company at 13 sites in 5 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 3 inclusion and 17 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 13 Feb 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in Greece, Australia, Croatia, France, Israel. 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 13 Feb 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?

Percentage of Participants With Treatment-emergent Adverse Events (time frame: Part A: until 24 weeks and Part B: until 28 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 13 Feb 2023.

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