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Phase 3 N=42 Randomized Double-blind Treatment

A Study to Assess the Efficacy and Safety of BIVV009 (Sutimlimab) in Participants With Primary Cold Agglutinin Disease Without A Recent History of Blood Transfusion

Cold Agglutinin Disease

Enrolled (actual)
42
Serious AEs
12.4%
Results posted
Dec 2022
Primary outcome: Primary: Part A: Percentage of Participants With Response to Treatment — 72.7; 15.0 percentage of participants — p=<0.001

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
sutimlimab (BIVV009) (Drug); placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Bioverativ, a Sanofi company
Primary completion
Dec 2021

Outcome Measures

OutcomeResultp-value
PRIMARY
Part A: Percentage of Participants With Response to Treatment
72.7; 15.0 <0.001 sig
PRIMARY
Part B: Number of Participants With Treatment-emergent Adverse Events (AEs) and Serious AEs (SAEs)
29; 7; 6; 1
SECONDARY
Part A: Mean Change From Baseline in Hemoglobin (Hgb) Level at the Treatment Assessment Timepoint
2.66; 0.09 <0.001 sig
SECONDARY
Part A: Mean Change From Baseline in Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale Score at the Treatment Assessment Timepoint
10.83; 1.91 <0.001 sig
SECONDARY
Part A: Mean Change From Baseline in Total Bilirubin Levels at the Treatment Assessment Timepoint
-22.881; -1.388
SECONDARY
Part A: Mean Change From Baseline in Lactate Dehydrogenase (LDH) at the Treatment Assessment Timepoint
-150.833; 7.600
SECONDARY
Part A: Percentage of Participants With Solicited Symptomatic Anemia at Week 26
31.6; 68.4; 5.3; 31.6; 5.3; 36.8
SECONDARY
Part B: Change From Baseline in Hemoglobin (Hgb) Level at Each Specified Time Points
2.647; 1.125; 2.507; 1.947; 2.490; 2.358
SECONDARY
Part B: Change From Baseline in Total Bilirubin Levels at Each Specified Time Points
-22.965; -18.761; -20.119; -19.889; -21.675; -22.153
SECONDARY
Part B: Change From Baseline in Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale Score (Quality of Life) at Each Specified Time Points
11.048; 7.958; 10.080; 6.354; 10.672; 8.499
SECONDARY
Part B: Change From Baseline in 12-Item Short-Form Survey (SF-12) Physical Component Summary (PCS) and Mental Component Summary (MCS) Scores at Each Specified Time Points
4.814; 6.745; 8.543; 1.151; 5.320; 5.654
SECONDARY
Part B: Change From Baseline in 5-level European Quality of Life 5- Dimensions 5-Level Questionnaire (EQ-5D-5L) Health State Utility Index and VAS Scores at Each Specified Time Points
0.020; 0.054; 0.075; -0.008; 0.060; 0.015
SECONDARY
Part B: Number of Participants With Response to Participant's Global Impression of (Fatigue) Severity (PGIS) Questionnaire at Each Specified Time Points
7; 5; 8; 7; 1; 5
SECONDARY
Part B: Number of Participants With Response to Participant's Global Impression of Change (PGIC) Questionnaire at Each Specified Time Points
4; 3; 8; 6; 2; 6
SECONDARY
Part B: Mean Change From Baseline in Lactate Dehydrogenase (LDH) Level at Each Specified Time Points
-151.000; 0.650; -115.944; 11.000; -85.111; 38.882
SECONDARY
Part B: Number of Blood Transfusions Per Participant
0.4; 0.3
SECONDARY
Part B: Mean Change From Baseline in Haptoglobin Values at Each Specified Time Points
0.219; 0.082; 0.240; 0.182; 0.183; 0.256
SECONDARY
Part B: Number of Healthcare Visits by Type
13; 12; 3; 1; 1; 3

Summary

The purpose of Part A was to determine whether sutimlimab administration resulted in a greater than or equal to (>=)1.5 grams per deciliter (g/dL) increase in hemoglobin (Hgb) level and avoidance of transfusion in participants with primary cold agglutinin disease (CAD) without a recent history of blood transfusion. The purpose of Part B was to evaluate the long-term safety and tolerability of sutimlimab in participants with primary CAD.

Eligibility Criteria

Inclusion criteria

  • Body weight of >=39 kg at screening.
  • Confirmed diagnosis of primary CAD based on the following criteria: a) Chronic hemolysis, b) Polyspecific direct antiglobulin test (DAT) positive, c) Monospecific DAT strongly positive for C3d, d) Cold agglutinin titer >= 64 at 4 degree Celsius, and e) Immunoglobulin G DAT less than or equal to (<=) 1+, and, f) No overt malignant disease.
  • Hemoglobin level <= 10.0 g/dL.
  • Bilirubin level above the normal reference range, including participants with Gilbert's Syndrome.

Exclusion criteria

  • Cold agglutinin syndrome secondary to infection, rheumatologic disease, or active hematologic malignancy.
  • History of blood transfusion within 6 months of screening, or history of more than one blood transfusion within 12 months of screening.
  • Clinically relevant infection of any kind within the month preceding enrollment (example, active hepatitis C, pneumonia).
  • Clinical diagnosis of systemic lupus erythematosus; or other autoimmune disorders with anti-nuclear antibodies at screening. Anti-nuclear antibodies of long-standing duration without associated clinical symptoms would be adjudicated on a case-by-case basis during the confirmatory review of participant eligibility.
  • Positive hepatitis panel (including hepatitis B surface antigen and/or hepatitis C virus antibody) prior to or at screening.
  • Positive human immunodeficiency virus antibody at screening.
  • Treatment with rituximab monotherapy within 3 months or rituximab combination therapies (example, with bendamustine, fludarabine, ibrutinib, or cytotoxic drugs) within 6 months prior to enrollment.

The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03347422). 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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