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Phase 3 N=37 Randomized Triple-blind Treatment

Study of Efficacy of CDZ173 in Patients With APDS/PASLI

Common Variable Immunodeficiency (CVID), APDS / PASLI

Enrolled (actual)
37
Serious AEs
9.1%
Results posted
Mar 2022
Primary outcome: Primary: Part I: Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) — 2; 0; 2; 0 Participants

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
CDZ173 (Drug); Placebo (Other)
Age
Pediatric, Adult, Older Adult · 12+ yrs
Sex
All
Sponsor
Novartis Pharmaceuticals
Primary completion
Aug 2021

Outcome Measures

OutcomeResultp-value
PRIMARY
Part I: Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
2; 0; 2; 0; 4; 0
PRIMARY
Part I: CDZ173 Dose Concentration
10.10; 321.00; 249.00; 916.00; 150.00; 1710.00
PRIMARY
Part I: Percentage of Inhibition of Unstimulated and Stimulated pAkt Levels in B Cells
82.07; 78.00; 50.58; 47.14; 86.61; 60.98
PRIMARY
Part II: Change From Baseline in the log10 Transformed Sum of Product of Diameters (SPD) in the Index Lesions
-0.30; -0.06 0.0012 sig
PRIMARY
Part II: Change From Baseline in Percentage of naïve B Cells Out of Total B Cells
34.76; -5.37 <0.0001 sig
SECONDARY
Part I & II: Area Under the Plasma Concentration-time Curve From Time Zero to the Last Quantifiable Concentration (AUClast) for CDZ173
1760.0; 10400.0; 4760.0; 10800.0
SECONDARY
Part I & II: Maximum Observed Plasma Concentration (Cmax) for CDZ173
393.0; 2150.0; 1060.0; 2540.0
SECONDARY
Part I & II: Mental Component Summary (MCS) and Physical Component Summary (PCS) From Short Form 36 (SF-36) Survey
47.94; 47.36; 45.94; 47.54; 44.49; 44.06
SECONDARY
Part I & II: Overall Work Impairment Due to Health Score From Work Productivity Activity Impairment and Classroom Impairment Questionnaire (WPAI-CIQ)
25.00; 51.25; 5.00; 44.00; 35.31; 5.00
SECONDARY
Part I & II: Overall Classroom Impairment Due to Health Score From the Work Productivity Activity Impairment and Classroom Impairment Questionnaire (WPAI-CIQ)
65.68; 47.33; 23.75; 57.30; 0.00; 22.65
SECONDARY
Part I & II: Physician's Global Assessment (PGA)
34.7; 47.10; 41.38; 21.8; 38.81; 29.75
SECONDARY
Part I & II: Patient's Global Assessment (PtGA)
62.0; 54.53; 62.50; 65.0; 68.37; 57.75
SECONDARY
Part I & II: High Sensivity C Reactive Protein (hsCRP) as Biomarker for Systemic Inflammation
2.49; 10.58; 5.70; 2.43; 8.95; 7.85
SECONDARY
Part I & II: Lactate Dehydrogenase (LDH) as Biomarker for Systemic Inflammation
130.42; 172.92; 169.38; 132.17; 170.88; 175.71
SECONDARY
Part II: Beta2 Microglobulin as Biomarker for Systemic Inflammation
2.46; 2.32; 2.43; 2.31; 2.10; 2.31
SECONDARY
Part II: Ferritin as Biomarker for Systemic Inflammation
139.16; 62.05; 142.67; 61.34; 146.99; 24.61
SECONDARY
Part II: Fibrinogen as Biomarker for Systemic Inflammation
2.66; 2.68; 2.61; 2.65; 2.65; 2.67
SECONDARY
Part II: Erythrocyte Sedimentation Rate (ESR) as Biomarker for Systemic Inflammation
28.09; 25.44; 26.88; 25.13; 19.50; 16.00
SECONDARY
Part II: 3D Volume of Index Lesions
20142.12; 37123.69; 7858.08; 40169.28
SECONDARY
Part II: 3D Volume of the Spleen
586448.74; 448456.15; 411130.98; 480333.09

Summary

This study was designed to explore CDZ173, a selective PI3Kδ inhibitor, in patients with genetically activated PI3Kδ, i.e., patients with Activated phosphoinositide 3-kinase delta syndrome/ p110δ-activating mutation causing senescent T cells, lymphadenopathy and immunodeficiency (APDS/PASLI). The study consisted of two parts: Part I was the open label part designed to establish the safety and pharmacokinetics of CDZ173 in the target population, as well as to select the optimal dose to be tested in Part II. Part II was designed to assess efficacy and safety of CDZ173 in the target population.

Eligibility Criteria

Key Inclusion Criteria

  • Male and female patients 12 to 75 years of age (inclusive), who had a documented APDS/PASLI-associated genetic PI3K delta mutation.
  • In Part I and Part II, patients must had nodal and/or extranodal lymphoproliferation, and clinical findings and manifestations compatible with APDS/PASLI such as a history of repeated oto-sino-pulmonary infections and/or organ dysfunction (e.g., lung, liver). Additionally, in part II, patients must had at least one measurable nodal lesion on a CT or MRI scan.
  • At screening, vital signs (systolic and diastolic blood pressure and pulse rate) were assessed in the sitting position after the patient rested for at least three minutes.

Key Exclusion Criteria

  • Previous or concurrent use of immunosuppressive medication.
  • Current use of medication known to be strong inhibitor or moderate or strong inducers of isoenzyme CYP3A, if treatment cannot be discontinued or switched to a different medication prior to starting study treatment.
  • Current use of medications that are metabolized by isoenzyme CYP1A2 and have a narrow therapeutic index (drugs whose exposureresponse indicates that increases in their exposure levels by the concomitant use of potent inhibitors may lead to serious safety concerns (e.g., Torsades de Pointes)).
  • Administration of live vaccines (this includes any attenuated live vaccines) starting from 6 weeks before study entry, during the study and up to 7 days after the last dose of CDZ173.
  • Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test.
  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception during dosing of study medication and for 2 days after stopping study treatment.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02435173). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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