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CDZ173

Phase 2

Common Variable Immunodeficiency (CVID), APDS / PASLI | Small molecule | Other |Novartis AG|Last Updated: Aug 10, 2022

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment37
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT02435173Study of Efficacy of CDZ173 in Patients With APDS/PASLIPHASE2 COMPLETED 37Aug 24, 2015Aug 16, 2021Aug 10, 202210 United States, Belarus +7
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Study Endpoints
Primary Endpoints
Part I: Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
From the start of treatment to 30 days after end of treatment, assessed up to maximum duration of 114 days

Number of participants with AEs and SAEs, including significant changes from baseline in physical findings, vital signs, electrocardiograms and laboratory values qualifying and reported as AEs. The number of participants in each category (AEs and SAEs) is reported per dose level: CDZ173 10 mg from Day 1 to Day 28, CDZ173 30 mg from day 29 to day 56 and CDZ173 70 mg from day 57 to day 84.

Part I: CDZ173 Dose Concentration
Days 1, 29 and 57 (0.25 and 3 h post morning dose) and Day 84

Venous whole blood samples were collected for the assessment of the dose-PD and the PK/PD relationship of CDZ173 in participants with APDS/PASLI for dose selection in Part II. CDZ173 was determined by a validated Liquid chromatography - Mass spectometry (LC-MS) method; anticipated Lower Limit of Quantification (LLOQ) was 3 ng/mL. Concentrations below the LLOQ were reported as "zero" and no methods for imputation of missing data were used.

Part I: Percentage of Inhibition of Unstimulated and Stimulated pAkt Levels in B Cells
Baseline, days 29 and 57 (3 and 12 h post-dose) and day 84

Phosphorylation of Akt in ex vivo stimulated and unstimulated B cells was quantified at baseline and at the end of the 4-week treatment period for each of the three dose levels. Determination of the percentage (%) of CD20B+ phospho-Akt positive cells after ex vivo stimulation of whole blood was performed by flow cytometry analysis. The percentage of inhibition of pAkt was defined as (-1) \* percent change from baseline pAkt value. Unstimulated cells served as controls at each time point. Baseline was defined as the mean of the day -1 value and the pre-dose value on Day 1 when both were available (if one was missing, then baseline was defined as the existing value). A higher percentage of inhibition of stimulated B cells indicates improvement. No methods for imputation of missing data were used.

Part II: Change From Baseline in the log10 Transformed Sum of Product of Diameters (SPD) in the Index Lesions
Baseline and Day 85

For the assessment of the impact of CDZ173 on lymphadenopathy, participants were scanned in a magnetic resonance imaging (MRI) or a computed tomography (CT) scanner as based on clinical practice and local regulation. MRI or CT imaging of the neck, chest, abdomen and pelvis was performed. Index lesions were selected from measurable nodal and extranodal lesions as per the Cheson methodology. A maximum of six of the largest dominant lesions were selected and documented at baseline and assessed again at the end of treatment. The change in lymph node size was measured using the log10 transformed sum of product of diameters (SPD), the sum of the longest lesion diameter (mm)" and "longest perpendicular diameter (mm)". A lower score indicates index lesions SPD reduction. A negative change from baseline indicates improvement.

Part II: Change From Baseline in Percentage of naïve B Cells Out of Total B Cells
Baseline and Day 85

APDS/PASLI patients suffer from dysregulation in B cell function and differentiation with low numbers of naive B cells. Change from baseline in percentage of naïve B cells out of total B cells at the end of treatment was assessed by flow cytometry to evaluate the pharmacodynamic effect of CDZ173 on B cell immunophenotyping. A higher percentage in naïve B out of total B cells is a positive outcome. A positive change from baseline indicates improvement.

Secondary Endpoints
Part I & II: Area Under the Plasma Concentration-time Curve From Time Zero to the Last Quantifiable Concentration (AUClast) for CDZ173
Part I: Days 1, 29 and 57 / Part II: Day 1
Part I & II: Maximum Observed Plasma Concentration (Cmax) for CDZ173
Part I: Days 1, 29 and 57 / Part II: Day 1
Part I & II: Mental Component Summary (MCS) and Physical Component Summary (PCS) From Short Form 36 (SF-36) Survey
Part I: Baseline and Days 29, 57 and 84 / Part II: Baseline and Days 29, 57 and 85
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Study Design & Arms
AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Part I: CDZ173EXPERIMENTALParticipants consecutively received CDZ173 10 mg twice a day (b.i.d.) from Day 1 to Day 28, CDZ173 30 mg b.i.d. from Day 29 to Day 56 and CDZ173 70 mg b.i.d. from Day 57 to Day 84.
Part II: CDZ173EXPERIMENTALParticipants received CDZ173 70 mg b.i.d. from Day 1 to Day 85.
Part II: PlaceboPLACEBO_COMPARATORParticipants received Placebo b.i.d. from Day 1 to Day 85.
Interventions
NameTypeDescription
CDZ173DRUGCDZ173 10 and 70 mg capsules for oral administration.
PlaceboOTHERPlacebo capsules for oral administration
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Eligibility Criteria
Age Range12 Years — 75 Years
SexALL
Healthy VolunteersNo
Study Sites10

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 w...

Countries:United StatesBelarusCzechiaGermanyIrelandItalyNetherlandsRussiaUnited Kingdom
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