Immune System DisorderPhase 1/2NCT04294459
Safety, Pharmacokinetics, and Preliminary Efficacy of Isatuximab in Patients Awaiting Kidney Transplantation
A Phase 1/2 study testing Isatuximab SAR650984, Acetaminophen (paracetamol) or equivalent and Ranitidine or equivalent in people with Immune System Disorder, run by Sanofi at 6 sites in 2 countries.
Trial summary
Primary Objectives: Phase 1: To characterize the safety and tolerability of isatuximab in kidney transplant candidates. Phase 2: To evaluate the efficacy of isatuximab in desensitization of participants awaiting kidney transplantation. Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Immune System Disorder
- What is being tested?
- Isatuximab SAR650984, Acetaminophen (paracetamol) or equivalent and Ranitidine or equivalent
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 23 participants
- Where
- 6 sitesin 2 countries
- Study dates
- 18 Jun 2020to 2 May 2022
- Phase
- Phase 1/2
- 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 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Diagnosis of chronic kidney disease (CKD) and active candidate on the kidney donor waitlist at the time of screening.
- Body mass index (BMI) </=40 kg/m^2.
- Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
- Capable of giving signed informed consent.
- For Participants in Cohort A: active candidates on the kidney waitlist with living donor.
- For Participants in Cohort B: active candidates on the kidney waitlist with no living donor cleared for donation.
Who cannot join
- Significant cardiac dysfunction.
- Known active, recurrent, or chronic infection.
- Active lupus or uncontrolled diabetes.
- Prior treatment with rituximab within 6 months from SAR650984 administration.
- Inadequate organ and bone marrow function at screening.
- Pregnant or breastfeeding women or women who intend to become pregnant during participation in the study.
Show all 9Show fewer
- Known intolerance or hypersensitivity to any component of SAR650984 or pre-medications.
- Participants who were not suitable for participation as judged by the Investigator.
- The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Trial locations and contacts
6 sites in 2 countries.
6 sites in 2 countries
United States4 sites
Investigational Site Number :8400004
Houston, Texas, 77030
Investigational Site Number :8400002
New York, New York, 10016
Investigational Site Number :8400001
Rochester, Minnesota, 55905
Investigational Site Number :8400003
San Francisco, California, 94143
Spain2 sites
Investigational Site Number :7240002
Barcelona, Barcelona [Barcelona], 08035
Investigational Site Number :7240001
L'Hospitalet de Llobregat, Catalunya [Cataluña], 08907
About this study
Official title: A Phase 1b/2 Study to Evaluate the Safety, Pharmacokinetics, and Preliminary Efficacy of Isatuximab (SAR650984) in Patients Awaiting Kidney Transplantation
Primary Objectives:
- Phase 1: To characterize the safety and tolerability of isatuximab in kidney transplant candidates.
- Phase 2: To evaluate the efficacy of isatuximab in desensitization of participants awaiting kidney transplantation.
Secondary Objectives:
- Phase 2: To characterize the safety profile of isatuximab in kidney transplant candidates.
- To characterize the pharmacokinetic (PK) profile of isatuximab in kidney transplant candidates.
- To evaluate the immunogenicity of isatuximab.
- To assess the overall efficacy of isatuximab in desensitization of participants awaiting kidney transplantation.
Read the detailed description
The study had a screening period of up to 28 days, a treatment period of up to 12 weeks, a site visit FUP of up to 26 weeks, and an extended follow-up (FUP) until study cut-off.
The study duration involved site visit per participant (i.e., screening, treatment, site visit FUP was approximately 42 weeks.
The study duration included extended FUP per participant was approximately 97.7 weeks (depending on when the participant was enrolled).
- Conditions
- Immune System Disorder
- Being tested
- Isatuximab SAR650984, Acetaminophen (paracetamol) or equivalent, Ranitidine or equivalent, Diphenhydramine or equivalent, Methylprednisolone or equivalent
- Keywords
- Anti-CD38 monoclonal antibody
- Medical subject headings
- Immune System Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Isatuximab SAR650984Drug
Also called Sarclisa
Pharmaceutical form: Solution for infusion
Route of administration: Intravenous
Acetaminophen (paracetamol) or equivalentDrug
Pharmaceutical form: Tablets
Route of administration: Oral
Ranitidine or equivalentDrug
Pharmaceutical form: Solution
Route of administration: Intravenous
Diphenhydramine or equivalentDrug
Pharmaceutical form: Solution
Route of administration: Intravenous
Methylprednisolone or equivalentDrug
Pharmaceutical form: Solution
Route of administration: Intravenous
Montelukast or equivalentDrug
Pharmaceutical form: Tablets
Route of administration: Oral
| Study group | Role | What they receive |
|---|---|---|
| Cohort A: Participants with cPRA >=99.90% | Experimental | Participants with calculated panel reactive antibodies (cPRA) >=99.90% (indicating active candidates on kidney transplant waitlist) received isatuximab 10 milligrams per kilogram (mg/kg), intravenous (IV) infusion, once weekly (QW) for 4 weeks (i.e., on Day 1, Day 8, Day 15 and Day 22 of Cycle 1) and then every 2 weeks (Q2W) for subsequent treatment cycles (each cycle of 28 days) until unacceptable adverse events (AEs) or participant's decision to stop the treatment (maximum treatment duration: 13 weeks). Receives: Drug: Isatuximab SAR650984; Drug: Acetaminophen (paracetamol) or equivalent; Drug: Ranitidine or equivalent; Drug: Diphenhydramine or equivalent; Drug: Methylprednisolone or equivalent; Drug: Montelukast or equivalent |
| Cohort B: Participants with cPRA 80.00% to 99.89% | Experimental | Participants with cPRA between 80.00% to 99.89% (indicating active candidates on kidney transplant waitlist with no living donor cleared for donation) received isatuximab 10 mg/kg, IV infusion, QW for 4 weeks (i.e., on Day 1, Day 8, Day 15 and Day 22 of Cycle 1) and then Q2W for subsequent treatment cycles (each cycle of 28 days) until unacceptable AEs or participant's decision to stop the treatment (maximum treatment duration: 13 weeks). Receives: Drug: Isatuximab SAR650984; Drug: Acetaminophen (paracetamol) or equivalent; Drug: Ranitidine or equivalent; Drug: Diphenhydramine or equivalent; Drug: Methylprednisolone or equivalent; Drug: Montelukast or equivalent |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Treatment-Emergent Adverse Events (TEAEs), and Treatment-Emergent Serious Adverse Events (TESAEs)
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. Serious adverse events (SAEs) were any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as AEs that developed, worsened or became serious during the TEAE period (defined as the time from the first dose of study drug until study cut-off date).
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Participants With Hematological Abnormalities
Abnormal hematological parameters assessed were anemia, platelet count decreased, neutrophil count decreased, lymphocyte count decreased and monocytes. The hematological abnormality grades were based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs. Monocytes were assessed as per potentially clinically significant abnormality (PCSA) criteria defined as: greater than (>) 0.7*10^9/L.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Participants With Renal Function Abnormalities
Abnormal renal parameters assessed were creatinine increased and estimated Glomerular Filtration Rate (eGFR). The renal function abnormality grades were based on NCI-CTCAE, Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs. eGFR was assessed as per PCSA criteria: 60 (less than equal to) <= to less than (<) 90 milliliter/minute/1.73 meter square (mL/min/1.73m^2) (Mild), 30<= to <60 mL/min/1.73m^2 (Moderate), 15<=to <30 mL/min/1.73m^2 (Severe), <15 mL/min/1.73m^2 (End Stage Renal Disease).
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Participants With Abnormal Electrolytes Parameters
Abnormal electrolyte parameters assessed were hypernatremia, hyponatremia, hyperkalemia, hypokalemia, hypercalcemia, hypocalcemia, blood bicarbonate decreased, hypermagnesemia, hypomagnesemia and chloride. The abnormal grades were based on NCI-CTCAE, Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs. Chloride was estimated as per PCSA criteria: <80 millimoles per liter (mmol/L) and >115 mmol/L.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Participants With Abnormal Metabolism Parameters
Abnormal metabolism parameters assessed were hypoglycemia, hypoalbuminemia and glycated Hemoglobin (HbA1c). The abnormal grades were based on NCI-CTCAE, Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs. HbA1c was estimated as per PCSA criteria: >8%.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Participants With Liver Function Abnormalities
Abnormal liver function parameters assessed were Alanine aminotransferase (ALT) increased, Aspartate aminotransferase (AST) increased, Alkaline phosphatase (ALP) increased, and Total bilirubin (TB) increased. The abnormal grades were based on NCI-CTCAE, Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Percentage of Participants With Response
Response was defined as the percentage of participants meeting at least one of the predefined desensitization efficacy criteria as measured by single antigen bead (SAB) assay as follows: reduction in cPRA resulting in at least 100% increase of likelihood of finding a compatible donor; reduction in antibody titer (>=75% reduction from Baseline) to achieve target cPRA; elimination of >=1 human leukocyte antigen (HLA) antibody (i.e., mean fluorescence intensity [MFI] reduced to <2000) as measured by a SAB assay, for antibodies with Baseline MFI >=3000.
Measured: From first dose of study drug until end of follow-up period (maximum duration: up to 39.1 weeks)
Secondary outcomes (18)
Pharmacokinetics (PK) Parameters: Concentration Observed at the End of First Intravenous Infusion (Ceoi) of Isatuximab
Ceoi is the plasma concentration observed at the end of intravenous infusion of isatuximab.
Measured: At End of infusion on Cycle 1 Day 1
PK Parameters: Maximum Concentration Observed (Cmax) After the First Infusion of Isatuximab
Cmax was defined as the maximum concentration observed after the first administration calculated using the noncompartmental analysis after the intravenous infusion of isatuximab.
Measured: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
PK Parameters: Time Taken to Reach Cmax (Tmax) After the First Infusion of Isatuximab
Tmax was defined as the time to reach Cmax, calculated using the non-compartmental analysis after the intravenous infusion of isatuximab.
Measured: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
PK Parameters: Last Concentration Observed Above the Lower Limit of Quantification (Clast) After the First Infusion of Isatuximab
Clast was defined as the last concentration of isatuximab observed above the lower limit of quantification calculated using non-compartmental analysis after the first infusion of isatuximab.
Measured: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
PK Parameters: Time of Clast (Tlast) After First Infusion of Isatuximab
Tlast was defined as the time of last concentration observed above the lower limit of quantification, calculated using the non-compartmental analysis after the intravenous infusion of isatuximab.
Measured: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
PK Parameters: Trough Plasma Concentrations (Ctrough) of Isatuximab
Ctrough was the plasma concentration of isatuximab observed just before (pre-dose) treatment administration.
Measured: Cycle 2 Day 1
PK Parameters: Area Under the Plasma Concentration Versus Time Curve From Time 0 to 168 Hours Over the Dosing Interval (AUC0-168 Hours) After First Infusion of Isatuximab
AUC0-168 hours was defined as the area under the plasma concentration versus time curve from time 0 to 168 hours post dose calculated using trapezoidal method after first infusion of isatuximab.
Measured: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
Number of Participants With Anti-drug Antibodies (ADA) Against Isatuximab
ADA responses were categorized as treatment boosted ADA and treatment-induced ADA. Treatment boosted ADA was defined as pre-existing ADAs with a significant increase in the ADA titer during the study compared to the Baseline titer. Treatment-induced ADA was defined as ADA that developed at any time during the ADA on-study observation period in participants without pre-existing ADA.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Duration of Response (DOR)
Duration of response (DOR) was defined as time (in weeks) from laboratory sample collection date used in determining a participant to be a responder (defined as participants meeting at least one of the predefined desensitization efficacy criteria: reduction in cPRA resulting in at least 100% increase of likelihood of finding a compatible donor; reduction in antibody titer [>=75% reduction from Baseline] to achieve target cPRA; elimination of >=1 anti-HLA antibody i.e. MFI reduced to <2000 as measured by a SAB assay, for antibodies with Baseline MFI >=3000) up to the laboratory sample collection date when participant was confirmed as no longer meeting any response criterion (i.e., non-responder) or the date of death due to any cause, whichever occurs first. DOR was analyzed using Kaplan-Meier method.
Measured: From first dose of study drug until end of follow-up period (maximum duration: up to 39.1 weeks)
Number of Participants Achieving Target cPRA
Target calculated panel reactive antibodies (cPRA) was defined as the reduction of cPRA required to achieve at least 100% increase of likelihood of compatible donor (LCD). Number of participants who achieved target cPRA was assessed using the Organ Procurement and Transplantation Network (OPTN) calculator during the specified timepoint were reported in this outcome measure. Participants who retained their target cPRA values were censored at the date of the last available laboratory assessment achieving their target cPRA.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Duration for Achieving Target cPRA
Duration of achieving target cPRA was defined as the time (in weeks) from laboratory sample collection date of achieving target cPRA (defined as the reduction of cPRA required to achieve at least 100% increase of LCD) the first time up to the laboratory sample collection date when no longer achieving target cPRA calculated using OPTN calculator or the date of death due to any cause, whichever occurs first. The duration of achieving target cPRA was assessed using the Kaplan-Meier method.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Participants With Anti-Human Leukocyte Antigen (HLA)-Antibody Reduction
Number of participants with anti-HLA-antibody (Baseline MFI >=3000) reduced to <2000 as measured using a SAB assay per central laboratory assessment was reported in this outcome measure. Participants were categorized in various categories of number of antibodies which were reduced as: none, 1-5, >5-10, >10-15, and >15. If multiple visits had the same number of total anti-HLA antibody reduction, the last visit data was summarized.
Measured: From first dose of study drug until end of follow-up period (maximum duration: up to 39.1 weeks)
Time to First Transplant Offer
Time to first transplant offer was defined as time (in days) from date of first study treatment dose up to date of first kidney transplant offer. Data on transplant status were collected and followed up until study cut-off date.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Time to Transplant
Time to transplant was defined as time (in days) from date of first study treatment dose up to date of kidney transplant. Data on transplant status were collected and followed up until study cut-off date.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Kidney Transplant Offers
Number of kidney transplants offers received for each participant was reported in the outcome measure. Data on transplant offers were collected and followed up until study cut-off date.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Time to First Antibody Mediated Rejection (AMR) Episode
Time to first AMR was defined as time from date of first study treatment dose up to date of biopsy with first AMR (defined as the graft rejection due to generation of antibodies against the graft). Transplanted participants without any AMR were censored at the participant's last assessment or contact date collected in the study or at the analysis cut-off date, whichever was earlier.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Percentage of Participants Who Experienced Any Antibody Mediated Rejection (AMR)
Antibody mediated rejection was defined as the graft rejection due to generation of antibodies against the graft. The number of participants with AMR field checked as 'yes' based on the graft rejection biopsy in the electronic case report form was considered.
Measured: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Participants With Graft Survival at 6 Months Post-Transplant
Number of participants with graft survival status as functioning at 6-months post-transplant was reported in this outcome measure.
Measured: At 6 Months post-transplant
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Mar 2020
- Study start18 Jun 2020
- Primary completion2 May 2022
- Study completion2 May 2022
Why it stopped: Terminated due to non-safety reasons
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Immune System DisorderStudies of the same condition, open and under way.
- More trials run by SanofiThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1/2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 23 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sanofi
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Sciences & Operations, Study director, Sanofi
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04294459
- Sponsor's protocol ID
- TED16414
- Other IDs
- 2019-004154-28, U1111-1238-9716, 2019
- Status last verified
- Sep 2025
- First submitted
- 19 Feb 2020
- Last updated
- 17 Sep 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- 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
Publications
Torija A, Matignon M, Vincenti F, Casanova-Ferrer F, Pilon C, Tambur AR, Donadeu L, Crespo E, Kervella D, Meneghini M, Torres IB, Hafkamp F, Martinez-Lacalle A, Carrera C, Zuniga J, Brar A, Cruzado J, Gaber AO, Lee H, Montgomery RA, Stegall M, Carmagnat M, Usureau C, Moreso F, Grimbert P, Bestard O. Anti-HLA serologic response to CD38-targeting desensitization therapy is challenged by peripheral memory B cells in highly sensitized kidney transplant candidates. Am J Transplant. 2025 Jan;25(1):88-101. doi: 10.1016/j.ajt.2024.08.004. Epub 2024 Aug 10.
PubMed 39134120Mannon RB, Vincenti FG. Poised for Innovation: Considerations for End Points for New Drug Development in Kidney Transplantation. J Am Soc Nephrol. 2024 Nov 1;35(11):1603-1606. doi: 10.1681/ASN.0000000000000475. Epub 2024 Aug 5. No abstract available.
PubMed 39102302Vincenti F, Bestard O, Brar A, Cruzado JM, Seron D, Gaber AO, Ali N, Tambur AR, Lee H, Abbadessa G, Paul JA, Dudek M, Siegel RJ, Torija A, Semiond D, Lepine L, Ternes N, Montgomery RA, Stegall M. Isatuximab Monotherapy for Desensitization in Highly Sensitized Patients Awaiting Kidney Transplant. J Am Soc Nephrol. 2024 Mar 1;35(3):347-360. doi: 10.1681/ASN.0000000000000287. Epub 2023 Dec 26.
PubMed 38147137
Study at a glance
From the registry record, last updated by the sponsor on 17 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1b/2 Study to Evaluate the Safety, Pharmacokinetics, and Preliminary Efficacy of Isatuximab (SAR650984) in Patients Awaiting Kidney Transplantation
- ClinicalTrials.gov ID
- NCT04294459
- Acronym / sponsor ID
- TED16414
- Conditions
- Immune System Disorder
- Keywords
- Anti-CD38 monoclonal antibody
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Terminated due to non-safety reasons
- Enrolment
- 23 participants (actual)
- Lead sponsor
- SanofiIndustry (pharma, biotech, devices)
- Study start
- 18 Jun 2020 (actual)
- Primary completion
- 2 May 2022 (actual)
- Study completion
- 2 May 2022 (actual)
- First posted
- 4 Mar 2020 (actual)
- Results
- Posted 30 May 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Primary Objectives:
- Phase 1: To characterize the safety and tolerability of isatuximab in kidney transplant candidates.
- Phase 2: To evaluate the efficacy of isatuximab in desensitization of participants awaiting kidney transplantation.
Secondary Objectives:
- Phase 2: To characterize the safety profile of isatuximab in kidney transplant candidates.
- To characterize the pharmacokinetic (PK) profile of isatuximab in kidney transplant candidates.
- To evaluate the immunogenicity of isatuximab.
- To assess the overall efficacy of isatuximab in desensitization of participants awaiting kidney transplantation.
Detailed description
The study had a screening period of up to 28 days, a treatment period of up to 12 weeks, a site visit FUP of up to 26 weeks, and an extended follow-up (FUP) until study cut-off.
The study duration involved site visit per participant (i.e., screening, treatment, site visit FUP was approximately 42 weeks.
The study duration included extended FUP per participant was approximately 97.7 weeks (depending on when the participant was enrolled).
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Cohort A: Participants with cPRA >=99.90% | Experimental | Drug: Isatuximab SAR650984, Drug: Acetaminophen (paracetamol) or equivalent, Drug: Ranitidine or equivalent, Drug: Diphenhydramine or equivalent, Drug: Methylprednisolone or equivalent, Drug: Montelukast or equivalentParticipants with calculated panel reactive antibodies (cPRA) >=99.90% (indicating active candidates on kidney transplant waitlist) received isatuximab 10 milligrams per kilogram (mg/kg), intravenous (IV) infusion, once weekly (QW) for 4 weeks (i.e., on Day 1, Day 8, Day 15 and Day 22 of Cycle 1) and then every 2 weeks (Q2W) for subsequent treatment cycles (each cycle of 28 days) until unacceptable adverse events (AEs) or participant's decision to stop the treatment (maximum treatment duration: 13 weeks). |
| Cohort B: Participants with cPRA 80.00% to 99.89% | Experimental | Drug: Isatuximab SAR650984, Drug: Acetaminophen (paracetamol) or equivalent, Drug: Ranitidine or equivalent, Drug: Diphenhydramine or equivalent, Drug: Methylprednisolone or equivalent, Drug: Montelukast or equivalentParticipants with cPRA between 80.00% to 99.89% (indicating active candidates on kidney transplant waitlist with no living donor cleared for donation) received isatuximab 10 mg/kg, IV infusion, QW for 4 weeks (i.e., on Day 1, Day 8, Day 15 and Day 22 of Cycle 1) and then Q2W for subsequent treatment cycles (each cycle of 28 days) until unacceptable AEs or participant's decision to stop the treatment (maximum treatment duration: 13 weeks). |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Diagnosis of chronic kidney disease (CKD) and active candidate on the kidney donor waitlist at the time of screening.
- Body mass index (BMI) </=40 kg/m^2.
- Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
- Capable of giving signed informed consent.
- For Participants in Cohort A: active candidates on the kidney waitlist with living donor.
Key exclusion criteria (9 listed)
- Significant cardiac dysfunction.
- Known active, recurrent, or chronic infection.
- Active lupus or uncontrolled diabetes.
- Prior treatment with rituximab within 6 months from SAR650984 administration.
- Inadequate organ and bone marrow function at screening.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Isatuximab SAR650984Also: SarclisaPharmaceutical form: Solution for infusion Route of administration: Intravenous | Drug | Cohort A: Participants with cPRA >=99.90%, Cohort B: Participants with cPRA 80.00% to 99.89% |
| Acetaminophen (paracetamol) or equivalentPharmaceutical form: Tablets Route of administration: Oral | Drug | Cohort A: Participants with cPRA >=99.90%, Cohort B: Participants with cPRA 80.00% to 99.89% |
| Ranitidine or equivalentPharmaceutical form: Solution Route of administration: Intravenous | Drug | Cohort A: Participants with cPRA >=99.90%, Cohort B: Participants with cPRA 80.00% to 99.89% |
| Diphenhydramine or equivalentPharmaceutical form: Solution Route of administration: Intravenous | Drug | Cohort A: Participants with cPRA >=99.90%, Cohort B: Participants with cPRA 80.00% to 99.89% |
| Methylprednisolone or equivalentPharmaceutical form: Solution Route of administration: Intravenous | Drug | Cohort A: Participants with cPRA >=99.90%, Cohort B: Participants with cPRA 80.00% to 99.89% |
| Montelukast or equivalentPharmaceutical form: Tablets Route of administration: Oral | Drug | Cohort A: Participants with cPRA >=99.90%, Cohort B: Participants with cPRA 80.00% to 99.89% |
Primary outcome
Number of Participants With Treatment-Emergent Adverse Events (TEAEs), and Treatment-Emergent Serious Adverse Events (TESAEs)
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
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. Serious adverse events (SAEs) were any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as AEs that developed, worsened or became serious during the TEAE period (defined as the time from the first dose of study drug until study cut-off date).
Number of Participants With Hematological Abnormalities
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Abnormal hematological parameters assessed were anemia, platelet count decreased, neutrophil count decreased, lymphocyte count decreased and monocytes. The hematological abnormality grades were based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs. Monocytes were assessed as per potentially clinically significant abnormality (PCSA) criteria defined as: greater than (>) 0.7*10^9/L.
Number of Participants With Renal Function Abnormalities
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Abnormal renal parameters assessed were creatinine increased and estimated Glomerular Filtration Rate (eGFR). The renal function abnormality grades were based on NCI-CTCAE, Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs. eGFR was assessed as per PCSA criteria: 60 (less than equal to) <= to less than (<) 90 milliliter/minute/1.73 meter square (mL/min/1.73m^2) (Mild), 30<= to <60 mL/min/1.73m^2 (Moderate), 15<=to <30 mL/min/1.73m^2 (Severe), <15 mL/min/1.73m^2 (End Stage Renal Disease).
Number of Participants With Abnormal Electrolytes Parameters
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Abnormal electrolyte parameters assessed were hypernatremia, hyponatremia, hyperkalemia, hypokalemia, hypercalcemia, hypocalcemia, blood bicarbonate decreased, hypermagnesemia, hypomagnesemia and chloride. The abnormal grades were based on NCI-CTCAE, Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs. Chloride was estimated as per PCSA criteria: <80 millimoles per liter (mmol/L) and >115 mmol/L.
Number of Participants With Abnormal Metabolism Parameters
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Abnormal metabolism parameters assessed were hypoglycemia, hypoalbuminemia and glycated Hemoglobin (HbA1c). The abnormal grades were based on NCI-CTCAE, Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs. HbA1c was estimated as per PCSA criteria: >8%.
Number of Participants With Liver Function Abnormalities
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Abnormal liver function parameters assessed were Alanine aminotransferase (ALT) increased, Aspartate aminotransferase (AST) increased, Alkaline phosphatase (ALP) increased, and Total bilirubin (TB) increased. The abnormal grades were based on NCI-CTCAE, Version 5.0, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially Life Threatening. Grade refers to the severity of the AEs.
Percentage of Participants With Response
Time frame: From first dose of study drug until end of follow-up period (maximum duration: up to 39.1 weeks)
Response was defined as the percentage of participants meeting at least one of the predefined desensitization efficacy criteria as measured by single antigen bead (SAB) assay as follows: reduction in cPRA resulting in at least 100% increase of likelihood of finding a compatible donor; reduction in antibody titer (>=75% reduction from Baseline) to achieve target cPRA; elimination of >=1 human leukocyte antigen (HLA) antibody (i.e., mean fluorescence intensity [MFI] reduced to <2000) as measured by a SAB assay, for antibodies with Baseline MFI >=3000.
18 secondary outcomes
Pharmacokinetics (PK) Parameters: Concentration Observed at the End of First Intravenous Infusion (Ceoi) of Isatuximab
Time frame: At End of infusion on Cycle 1 Day 1
PK Parameters: Maximum Concentration Observed (Cmax) After the First Infusion of Isatuximab
Time frame: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
PK Parameters: Time Taken to Reach Cmax (Tmax) After the First Infusion of Isatuximab
Time frame: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
PK Parameters: Last Concentration Observed Above the Lower Limit of Quantification (Clast) After the First Infusion of Isatuximab
Time frame: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
PK Parameters: Time of Clast (Tlast) After First Infusion of Isatuximab
Time frame: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
PK Parameters: Trough Plasma Concentrations (Ctrough) of Isatuximab
Time frame: Cycle 2 Day 1
PK Parameters: Area Under the Plasma Concentration Versus Time Curve From Time 0 to 168 Hours Over the Dosing Interval (AUC0-168 Hours) After First Infusion of Isatuximab
Time frame: At Start of infusion (SOI), End of infusion (EOI), EOI+4H (initial protocol) EOI+1H (amended protocol), 72H and 168H on Day 1 of Cycle 1
Number of Participants With Anti-drug Antibodies (ADA) Against Isatuximab
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Duration of Response (DOR)
Time frame: From first dose of study drug until end of follow-up period (maximum duration: up to 39.1 weeks)
Number of Participants Achieving Target cPRA
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Duration for Achieving Target cPRA
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Participants With Anti-Human Leukocyte Antigen (HLA)-Antibody Reduction
Time frame: From first dose of study drug until end of follow-up period (maximum duration: up to 39.1 weeks)
Time to First Transplant Offer
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Time to Transplant
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Kidney Transplant Offers
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Time to First Antibody Mediated Rejection (AMR) Episode
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Percentage of Participants Who Experienced Any Antibody Mediated Rejection (AMR)
Time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)
Number of Participants With Graft Survival at 6 Months Post-Transplant
Time frame: At 6 Months post-transplant
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Sep 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 39134120Torija A, Matignon M, Vincenti F, Casanova-Ferrer F, Pilon C, Tambur AR, Donadeu L, Crespo E, Kervella D, Meneghini M, Torres IB, Hafkamp F, Martinez-Lacalle A, Carrera C, Zuniga J, Brar A, Cruzado J, Gaber AO, Lee H, Montgomery RA, Stegall M, Carmagnat M, Usureau C, Moreso F, Grimbert P, Bestard O. Anti-HLA serologic response to CD38-targeting desensitization therapy is challenged by peripheral memory B cells in highly sensitized kidney transplant candidates. Am J Transplant. 2025 Jan;25(1):88-101. doi: 10.1016/j.ajt.2024.08.004. Epub 2024 Aug 10.
- Derived from this study: PubMed 39102302Mannon RB, Vincenti FG. Poised for Innovation: Considerations for End Points for New Drug Development in Kidney Transplantation. J Am Soc Nephrol. 2024 Nov 1;35(11):1603-1606. doi: 10.1681/ASN.0000000000000475. Epub 2024 Aug 5. No abstract available.
- Derived from this study: PubMed 38147137Vincenti F, Bestard O, Brar A, Cruzado JM, Seron D, Gaber AO, Ali N, Tambur AR, Lee H, Abbadessa G, Paul JA, Dudek M, Siegel RJ, Torija A, Semiond D, Lepine L, Ternes N, Montgomery RA, Stegall M. Isatuximab Monotherapy for Desensitization in Highly Sensitized Patients Awaiting Kidney Transplant. J Am Soc Nephrol. 2024 Mar 1;35(3):347-360. doi: 10.1681/ASN.0000000000000287. Epub 2023 Dec 26.
- TED16414 Plain Language Results SummaryLink provided by the sponsor.
- Individual participant dataSharing planned: 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
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Sciences & Operations study director
Sanofi
6 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Isatuximab SAR650984, Acetaminophen (paracetamol) or equivalent and Ranitidine or equivalent in people with Immune System Disorder, run by Sanofi at 6 sites in 2 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 6 inclusion and 9 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 17 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 6 sites in United States, 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 combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
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 30 May 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?
Number of Participants With Treatment-Emergent Adverse Events (TEAEs), and Treatment-Emergent Serious Adverse Events (TESAEs) (time frame: From first dose of study drug until study cut-off date (maximum duration: up to 97.7 weeks)). The study lists 7 primary outcomes in all. 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 NCT04294459, 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 17 Sep 2025.