Phase 2
N=6
Pozelimab and Cemdisiran Combination Therapy in Adult Participants With Paroxysmal Nocturnal Hemoglobinuria Who Switch From Eculizumab Therapy
Paroxysmal Nocturnal Hemoglobinuria
Bottom Line
View on ClinicalTrials.gov: NCT04888507 ↗Enrolled (actual)
6
Serious AEs
18.2%
Results posted
Jun 2025
Primary outcome: Primary: OLTP: Number of Participants With Treatment-emergent Adverse Events (TEAEs) — 6 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Pozelimab (Drug); Cemdisiran (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Regeneron Pharmaceuticals
- Primary completion
- May 2022
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY OLTP: Number of Participants With Treatment-emergent Adverse Events (TEAEs) |
6 | — |
| SECONDARY OLTP: Percent Change in Lactate Dehydrogenase (LDH) From Pre-treatment to End-of-treatment Period |
-0.95 | — |
| SECONDARY OLTP: Percent Change in LDH From Pre-treatment Through Day 29 |
3.61 | — |
| SECONDARY OLTP: Percentage of Participants Who Were Transfusion-free From Baseline Through Week 32 |
100 | — |
| SECONDARY OLTP: Percentage of Participants Who Were Transfusion-free From Week 4 Through Week 32 |
100 | — |
| SECONDARY OLTP: Rate of Red Blood Cell (RBC) Transfusions From Baseline Through Week 32 |
— | — |
| SECONDARY OLTP: Rate of RBC Transfusions From Week 4 Through Week 32 |
— | — |
| SECONDARY OLTP: Number of RBC Units Transfused From Baseline Through Week 32 |
— | — |
| SECONDARY OLTP: Number of RBC Units Transfused From Week 4 Through Week 32 |
— | — |
| SECONDARY OLTP: Percentage of Participants With Breakthrough Hemolysis From Baseline Through Week 32 |
0.0 | — |
| SECONDARY OLTP: Percentage of Participants With Breakthrough Hemolysis From Week 4 Through Week 32 |
0.0 | — |
| SECONDARY OLTP: Percentage of Participants Who Maintained Adequate Control of Hemolysis From Day 1 Through Week 32 |
83.3 | — |
| SECONDARY OLTP: Percentage of Participants Who Maintained Adequate Control of Hemolysis From Week 8 Through Week 32 |
83.3 | — |
| SECONDARY OLTP: Number of Participants With Adequate Control of Hemolysis at Each Visit |
6; 5; 5; 6; 5; 5 | — |
| SECONDARY OLTP: Number of Participants With Normalization of Their LDH at Each Visit |
6; 5; 5; 6; 5; 4 | — |
| SECONDARY OLTP: Average LDH From Baseline Through Week 32 |
227.34 | — |
| SECONDARY OLTP: Average LDH From Week 8 Through Week 32 |
223.49 | — |
| SECONDARY OLTP: Percentage of Participants With Hemoglobin Stabilization From Baseline Through Week 32 |
100 | — |
| SECONDARY OLTP: Percentage of Participants With Hemoglobin Stabilization From Week 4 Through Week 32 |
100 | — |
| SECONDARY OLTP: Change From Baseline in Hemoglobin Levels |
0.54 | — |
| SECONDARY OLTP: Change From Baseline in Fatigue as Measured by Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score |
-1.0 | — |
| SECONDARY OLTP: Change From Baseline in Health Related Quality of Life (HRQoL) as Measured by the Global Health Status Subscale of the European Organization for Research and Treatment of Cancer (EORTC)- Quality of Life Cancer Patients Questionnaire (QLQ) - 30 Scale |
-8.333 | — |
| SECONDARY OLTP: Change From Baseline in Physical Function (PF) Scores on the EORTC QLQ-C30 |
6.667 | — |
| SECONDARY OLTP: Change From Baseline in Total Complement Hemolytic Activity Assay (CH50) |
0.0 | — |
| SECONDARY OLTP and OLEP: Concentration of Total Pozelimab in Serum |
0; 1280; 333; 189; 121; 102 | — |
| SECONDARY OLTP: Concentration of Total Eculizumab in Serum |
231; 225; 242; 101; 44.4; 22.5 | — |
| SECONDARY OLTP and OLEP: Concentration of Total Cemdisiran in Plasma |
0; 139; 0; 178; 0; 196 | — |
| SECONDARY OLTP and OLEP: Concentration of Total C5 in Plasma |
320; 191; 118; 54.5; 2.77; 2.90 | — |
| SECONDARY OLTP: Number of Participants With Pozelimab Anti-drug Antibodies (ADA) |
— | — |
| SECONDARY OLTP: Number of Participants With Cemdisiran ADA |
— | — |
| SECONDARY OLTP: Number of Participants Who Received Dose Intensification With TEAEs |
— | — |
| SECONDARY OLEP: Number of Participants With TEAEs |
5 | — |
| SECONDARY OLEP: Percent Change in LDH From Day 1 Through Week 24 of the OLEP |
-6.17 | — |
| SECONDARY OLEP: Percent Change in LDH From Day 1 Through Week 52 of the OLEP |
-3.46 | — |
| SECONDARY OLEP: Percentage of Participants Who Were Transfusion-free From Day 1 Through Week 24 of the OLEP |
100 | — |
| SECONDARY OLEP: Percentage of Participants Who Were Transfusion-free From Day 1 Through Week 52 of the OLEP |
80.0 | — |
| SECONDARY OLEP: Rate of RBC Transfusions From Day 1 Through Week 24 of the OLEP |
— | — |
| SECONDARY OLEP: Rate of RBC Transfusions From Day 1 Through Week 52 of the OLEP |
0.200 | — |
| SECONDARY OLEP: Number of RBC Units Transfused From Day 1 Through Week 24 of the OLEP |
— | — |
| SECONDARY OLEP: Number of RBC Units Transfused From Day 1 Through Week 52 of the OLEP |
0.4 | — |
| SECONDARY OLEP: Percentage of Participants With Breakthrough Hemolysis From Day 1 Through Week 24 of the OLEP |
0.0 | — |
| SECONDARY OLEP: Percentage of Participants With Breakthrough Hemolysis From Day 1 Through Week 52 of the OLEP |
0.0 | — |
| SECONDARY OLEP: Percentage of Participants Who Maintained Adequate Control of Hemolysis From Day 1 Through Week 24 of the OLEP |
100 | — |
| SECONDARY OLEP: Percentage of Participants Who Maintained Adequate Control of Hemolysis From Day 1 Through Week 52 of the OLEP |
100 | — |
| SECONDARY OLEP: Number of Participants Who Maintained Adequate Control of Hemolysis at Each Visit in OLEP |
5; 5; 5; 5; 5; 5 | — |
| SECONDARY OLEP: Number of Participants With Normalization of Their LDH at Each Visit in OLEP |
5; 5; 5; 5; 5; 5 | — |
| SECONDARY OLEP: Average LDH From Day 1 Through Week 24 of the OLEP |
210.55 | — |
| SECONDARY OLEP: Average LDH From Day 1 Through Week 52 of the OLEP |
210.13 | — |
| SECONDARY OLEP: Percentage of Participants With Hemoglobin Stabilization From Day 1 Through Week 24 of the OLEP |
100 | — |
| SECONDARY OLEP: Percentage of Participants With Hemoglobin Stabilization From Day 1 Through Week 52 of the OLEP |
80.0 | — |
| SECONDARY OLEP: Change From Baseline in Hemoglobin Levels |
0.16 | — |
| SECONDARY OLEP: Change From Baseline in Hemoglobin Levels |
0.16 | — |
| SECONDARY OLEP: Change From Baseline in FACIT-Fatigue Score |
-2.4 | — |
| SECONDARY OLEP: Change From Baseline in HRQoL as Measured by the Global Health Status Subscale of the EORTC-QLQ-30 Scale |
-10.000 | — |
| SECONDARY OLEP: Change From Baseline in PF Scores on the EORTC QLQ-C30 |
0.000 | — |
| SECONDARY OLEP: Change From Baseline in CH50 |
0.0; 0.6; 1.2 | — |
| SECONDARY OLEP: Number of Participants With Pozelimab ADA |
— | — |
| SECONDARY OLEP: Number of Participants With Cemdisiran ADA |
— | — |
Summary
The primary objective of the study is to evaluate the safety and tolerability of pozelimab and cemdisiran combination therapy in participants with PNH who switch from eculizumab therapy
The secondary objectives of the study are:
* To evaluate the effect of the combination treatment on the following parameters of intravascular hemolysis: lactate dehydrogenase (LDH) control, breakthrough hemolysis, and inhibition of CH50
* To evaluate the effect of the combination treatment on the stability of LDH during the transition period from eculizumab monotherapy to combination with pozelimab and cemdisiran
* To evaluate the effect of the combination treatment on red blood cell (RBC) transfusion requirements
* To evaluate the effect of the combination treatment on hemoglobin levels
* To evaluate the effect of the combination treatment on clinical outcome assessments (COAs) measuring fatigue and health related quality of life (HRQoL)
* To assess the concentrations of total pozelimab and eculizumab in serum; and total cemdisiran and C5 protein in plasma
* To assess the immunogenicity of pozelimab and cemdisiran
* To assess safety after dose intensification
* To evaluate the long-term safety and efficacy of the combination treatment in an optional open-label extension period (OLEP)
Eligibility Criteria
Key Inclusion Criteria
- Diagnosis of paroxysmal nocturnal hemoglobinuria confirmed by a history of high-sensitivity flow cytometry from prior testing
- Treated with stable (ie, no change in dose or frequency) eculizumab therapy at the labeled dosing regimen or a higher dose and/or more frequently administered than labeled for at least 12 weeks prior to screening visit
Key Exclusion Criteria
- History of bone marrow transplantation or receipt of an organ transplant
- Body weight <40 kg at screening
- Current plans for modification of the following background concomitant medications, as applicable, during screening and treatment period: erythropoietin, immunosuppressive drugs, corticosteroids, anti-thrombotic agents, anticoagulants, iron supplements, and folic acid as described in the protocol
- Any use of complement inhibitor therapy other than eculizumab in the 12 weeks prior to the screening visit or planned use during the study
- Known hypocellular bone marrow based on a history of reduced age-adjusted bone marrow cellularity and/or bone marrow cellularity ≤25%
- No documented meningococcal vaccination within 5 years prior to screening visit unless it is documented that vaccination has been administered during the screening period and prior to initiation of study treatment
- Unable to take antibiotics for meningococcal prophylaxis, if required by local standard of care
- Any active, ongoing infection or a recent infection requiring ongoing systemic treatment with antibiotics, antivirals, or antifungals within 2 weeks of screening or during the screening period
- Documented positive polymerase chain reaction (PCR) or equivalent test based on regional recommendations for COVID-19 or suspected SARS-CoV-2 infection as described in the protocol
- Documented history of active, uncontrolled, ongoing systemic autoimmune diseases
- Recent, unstable medical conditions, excluding PNH and PNH-related complications, within the past 3 months prior to screening visit as described in the protocol
- Anticipated need for major surgery during the study
NOTE: Other protocol-defined Inclusion/ Exclusion Criteria apply.
Data sourced from ClinicalTrials.gov (NCT04888507). 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.