Long-Term Extension Study of Ofatumumab in Subjects With Pemphigus Vulgaris

GlaxoSmithKline (GSK)

Status and phase: Terminated; Phase 3

Conditions: Pemphigus

Treatments: Drug: Antihistamine (cetirizine or equivalent); Drug: Acetaminophen/paracetamol; Drug: Prednisone/Prednisolone; Drug: Ofatumumab

Study type: Interventional

Funder types: Industry

Identifiers

NCT02613910

117059

Details and patient eligibility

About

This study is designed as a multi-country, multicenter, open label extension to Phase III trial OPV116910. The primary objective is to provide continued treatment with ofatumumab subcutaneous (SC) for eligible subjects who complete the OPV116910 trial in order to obtain further long term safety and tolerability information in subjects with pemphigus vulgaris receiving ofatumumab SC every 4 weeks (wk).

Enrollment: 1 patient

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult with clinically documented diagnosis of PV.
• Completed Study OPV116910 through Week 60 with one of the following outcomes:

Did not achieve remission by Week 60 of OPV116910. Achieved remission on a steroid dose >10 milligrams/day. Achieved remission on minimal steroid therapy, but is experiencing a disease flare/relapse while participating in the first year (yr)of the OPV116910 Individualized Follow up Period (It is recommended subjects are transitioned to the extension study before the steroid dose is increased).

• A woman is eligible to enter the study if she:

Is of non-childbearing potential: documented as surgically sterile (bilateral tubal ligation, bilateral oophorectomy, hysterectomy, or hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion) or is postmenopausal without menses for >2 years. Women who are <2 years postmenopausal are required to have menopausal status confirmed by follicle-stimulating hormone (FSH) and estradiol levels at the baseline evaluation. If FSH and estradiol levels do not provide confirmation of menopause, subject will be considered to be of childbearing potential.

Is of childbearing potential, with a negative pregnancy test at baseline, and agrees to the consistent and correct use of acceptable methods of contraception (Highly-Effective Methods for Avoiding Pregnancy) during heterosexual intercourse, beginning when the subject provides informed consent and lasting until 12 months after last dose of ofatumumab SC.

Exclusion criteria

• Past or current history of hypersensitivity to components of the investigational product or medically-significant adverse effects (including allergic reactions) from cetirizine (or antihistamine equivalent) or paracetamol/acetaminophen.
• Prior treatment with any of the following within the specified periods:

Medication and Other Treatment Restrictions Prior to OPV117059 Baseline Any time- Ofatumumab (Intravenous), total body irradiation, bone marrow transplantation, anti CD4; 6 weeks -Live vaccine 8 weeks- Immunosuppressive or immunomodulatory agents, including: azathioprine, cyclosporine, dapsone, mycophenolate, methotrexate, tacrolimus 6 months- Cyclophosphamide, cladribine, plasmapheresis, immunoabsorption, or immunoglobulin therapy, alemtuzumab, mitoxantrone 18 months -Rituximab or other anti CD20 treatments

• Confirmed PML or neurological findings potentially consistent with PML.
• Evidence or history of clinically significant infection or medical condition including:

Chronic or ongoing active infectious disease requiring long term systemic treatment, including, but not limited to, chronic renal infection, chronic chest infection with bronchiectasis, or active hepatitis C.

Positive test for hepatitis B surface antigen (HbsAg). For HbsAg negative, but hepatitis B core antibody positive (anti-HBc) (regardless of hepatitis B surface antibody [HbsAb] status), a hepatitis B virus deoxyribonucleic acid (HBV DNA) test will be performed and the subject will be excluded if results are positive. Consult with a physician experienced in the care and management of subjects with hepatitis B to manage/treat subjects who are anti HBc positive. Subjects who are anti-HBc positive and HBV DNA negative will continue to be monitored throughout the study.

History of positive serology for human immunodeficiency virus. Previous serious opportunistic or atypical infections. Prior history, or suspicion, of tuberculosis. A radiograph of the chest taken within 3 months before the first administration of investigational product suggests no evidence indicating current active tuberculosis or previous tuberculosis.

• Past or current malignancy, except for: Cervical carcinoma Stage 1B or less; Noninvasive basal cell and squamous cell skin carcinoma; Cancer diagnoses with a duration of complete response (remission) >5 years.
• Clinical chemistry and/or hematology laboratory values of clinical concern, in the investigator's opinion.

For subjects transitioning directly from the OPV116910 study, review central chemistry and hematology laboratory reports from the Week 48 through Week 56 visits of OPV116910.

For subjects transitioning from the Individualized Follow-up Period of OPV116910, review central chemistry and hematology laboratory reports from the most recent OPV116910 Individualized Follow-up visit. If the date of that laboratory report is more than 12 weeks from the extension study Screening visit, then the laboratory assessments need to be repeated.

For subjects with neutropenia (absolute neutrophil count <1 Giga units per liter, the neutropenia must resolve before the first dose of ofatumumab, which should occur within 4 weeks of the screening assessments.

• Electrocardiogram (ECG) showing a clinically significant abnormality or showing a Corrected QT Interval (QTc) interval >=450 millisecond (msec) (>=480 msec for subjects with bundle branch block) (ECG will be obtained during Week 60 visit of OPV116910; Repeat ECG if more than 12 weeks have elapsed).
• Significant concurrent, uncontrolled medical condition that could affect the subject's safety, impair the subject's reliable participation in the study, impair the evaluation of endpoints, or necessitate the use of medication not allowed by the protocol.
• In the Investigator's opinion, there is a reason why the subject would not be eligible for this study (eg, the subject is unable to comply with the visit schedule).

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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1 participants in 1 patient group

Ofatumumab

Experimental group

Description:

t the Baseline (Bln) and wk 4 visits, Subjects will receive 40mg ofatumumab sc (Oft) (as two 20mg sc inj) and as 1 Oft 20mg sc inj every 4 wks from wk 8 through wk 56. Subjects will return to clinic 4 wks after the last dose for a follow-up (f/u) visit (wk 60). Antihistamine 10 mg and Acetaminophen/paracetamol (A/P) 1 grams(g) will be given 1-2 hours(h) before and 4 h after each dose of Oft. A/P 1 g will be supplied for self administration if needed. Prednisone/Prednisolone dose will continue to be tapered during core study period (CSP) by 1 dose level every 2 wks to \<= 10 mg/day from Bln through wk 60. Upon completion of the CSP, subjects will enter Individualized f/u Period, where subjects will monitored every 12 wks for a minimum of 1 yr and for up to 2 yr, until CD19+ B-LC or IgG recover to lower limit of normal (LLN) or to the subject's Bln value from Study OPV116910 (if \<LLN) or if study withdrawal criteria are met or for a maximum of 2 yr after the last dose of Oft.

Treatment:

Drug: Ofatumumab

Drug: Antihistamine (cetirizine or equivalent)

Drug: Prednisone/Prednisolone

Drug: Acetaminophen/paracetamol