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Phase 3 N=439 Randomized Double-blind Treatment

GRAVITAS-301: A Study of Itacitinib or Placebo in Combination With Corticosteroids for Treatment of Acute Graft-Versus-Host Disease

Graft-versus-host Disease (GVHD)

Enrolled (actual)
439
Serious AEs
61.3%
Results posted
May 2020
Primary outcome: Primary: Overall Response Rate Based on Center for International Blood and Marrow Transplant Research (CIBMTR) Response Index — 74.0; 66.4 Percentage of Participants — p=0.0782

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Itacitinib (Drug); Placebo (Drug); Prednisone (Drug); Methylprednisolone (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Incyte Corporation
Primary completion
May 2019

Outcome Measures

OutcomeResultp-value
PRIMARY
Overall Response Rate Based on Center for International Blood and Marrow Transplant Research (CIBMTR) Response Index
74.0; 66.4 0.0782
SECONDARY
Nonrelapse Mortality
36; 37; 46; 45; 51; 52
SECONDARY
Duration of Response
587; NA
SECONDARY
Cmax of Itacitinib When Administered in Combination With Corticosteroids
796
SECONDARY
Cmin of Itacitinib When Administered in Combination With Corticosteroids
72.5
SECONDARY
Tmax of Itacitinib When Administered in Combination With Corticosteroids
2.1
SECONDARY
AUC of Itacitinib When Administered in Combination With Corticosteroids
6720
SECONDARY
CL/F of Itacitinib When Administered in Combination With Corticosteroids
104
SECONDARY
Time to Response
9.9; 10.1
SECONDARY
Relapse Rate of Malignant and Nonmalignant Hematologic Disease
12.4; 11.4
SECONDARY
Malignancy Relapse-related Mortality Rate
6.4; 7.7
SECONDARY
Failure-free Survival
44.29; 40.00
SECONDARY
Overall Survival (OS)
365; 348.5
SECONDARY
Number of Treatment-emergent Adverse Events With INCB39110
208; 214
SECONDARY
Incidence Rate of Secondary Graft Failure
2; 0
SECONDARY
Proportion of Subjects Who Discontinue Corticosteroids
3; 3; 16; 11; 39; 45
SECONDARY
Proportion of Subjects Who Discontinue Immunosuppressive Medications
12; 10; 11; 8
SECONDARY
Incidence Rate of aGVHD Flares
42; 48
SECONDARY
Incidence Rate of cGVHD
25; 36; 43; 58
SECONDARY
Objective Response Rate
170; 160; 138; 124; 92; 96

Summary

The purpose of this study is to evaluate itacitinib or placebo in combination with corticosteroids as first-line treatment of participants with Grade II to IV acute graft-versus-host disease (aGVHD).

Eligibility Criteria

Inclusion Criteria

  • Has undergone 1 allo-HSCT from any donor (related or unrelated with any degree of HLA matching) and any donor source (bone marrow, peripheral blood stem cells, or cord blood) for a hematologic malignancy or disorder. Recipients of myeloablative and reduced-intensity conditioning regimens are eligible.
  • Clinically suspected Grade II to IV aGVHD as per MAGIC criteria, occurring after allo-HSCT and any GVHD prophylaxis regimen.
  • Evidence of myeloid engraftment. Use of growth factor supplementation is allowed.
  • Serum creatinine ≤ 2.0 mg/dL or creatinine clearance ≥ 40 mL/min measured or calculated by Cockroft Gault equation.
  • Willing to avoid pregnancy or fathering children.
  • Able to give written informed consent and comply with all study visits and procedures.
  • Able to swallow and retain oral medication.

Exclusion Criteria

  • Has received more than 1 allo-HSCT.
  • Has received more than 2 days of systemic corticosteroids for aGVHD.
  • Presence of GVHD overlap syndrome.
  • Presence of an active uncontrolled infection.
  • Known human immunodeficiency virus infection.
  • Active hepatitis B virus (HBV) or hepatitis C virus infection that requires treatment or at risk for HBV reactivation.
  • Participants with evidence of relapsed primary disease, or participants who have been treated for relapse after the allo-HSCT was performed.
  • Any corticosteroid therapy for indications other than GVHD at doses > 1 mg/kg per day methylprednisolone (or prednisone equivalent) within 7 days of randomization.
  • Severe organ dysfunction unrelated to underlying GVHD, including:
  • Cholestatic disorders or unresolved veno-occlusive disease of the liver.
  • Clinically significant or uncontrolled cardiac disease.
  • Clinically significant respiratory disease that requires mechanical ventilation support or 50% oxygen.
  • Currently breast feeding.
  • Received JAK inhibitor therapy after allo-HSCT for any indication. Treatment with a JAK inhibitor before allo-HSCT is permitted.
  • Treatment with any other investigational agent, device, or procedure within 21 days (or 5 half-lives, whichever is greater) of enrollment.
  • Any medical complications or conditions that would, in the investigator's judgment, interfere with full participation in the study, including administration of study drug and attending required study visits; pose a significant risk to the participant; or interfere with interpretation of study data.
  • Known allergies, hypersensitivity, or intolerance to any of the study medications, excipients, or similar compounds.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03139604). 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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