Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Ianalumab · 15 trials · 11 indications
Cohort 1: To estimate the time to renal flare, increase in immunosuppressive medication, or death following study treatment withdrawal in participants who completed the SIRIUS-LN core study on double-blind treatment and achieved CRR or PRR at Week 140 of the core study
Number of participants with AEs and SAEs, including changes in vital signs and clinical laboratory measurements qualifying and reported as AEs.
Assessment of long-term safety and tolerability of ianalumab
Assessment of safety and tolerability of ianalumab (VAY736) in patients with active Sjogrens syndrome
SRI-4 response is defined as: * Systemic Lupus Erythematosus Disease Activity Index - 2000 (SLEDAI-2K) reduction from baseline of ≥ 4 points * No British Isles Lupus Assessment Group-2004 (BILAG-2004) worsening, defined as ≥ 1 new A or ≥ 2 new B items compared to baseline * No worsening in Physician Global Assessment of Disease Activity (PhGA), defined as an increase of ≥ 0.3 from baseline on a 0 to 3 visual analog scale
SRI-4 response is defined as: * Systemic Lupus Erythematosus Disease Activity Index - 2000 (SLEDAI-2K) reduction from baseline of ≥ 4 points * No British Isles Lupus Assessment Group-2004 (BILAG-2004) worsening, defined as ≥ 1 new A or ≥ 2 new B items compared to baseline * No worsening in Physician Global Assessment of Disease Activity (PhGA), defined as an increase of ≥ 0.3 from baseline on a 0 to 3 visual analog scale
A participant will be considered in SROT-12 if at least 75% of the platelet counts collected between visits Week 53 Day 1 and Week 65 Day 1 (Study Days 352 and 463) qualify as Response. Response is any platelet counts of at least 50 G/L in the absence of rescue treatment or new immune thrombocytopenia (ITP) treatment).
Time from randomization until treatment failure is defined as the time from randomization date until the first of the following events indicative of treatment failure: * platelet count below 30 G/L * start of a new ITP treatment * need for a rescue treatment * ineligibility to taper or inability to discontinue eltrombopag * death
Durable response: hemoglobin level ≥10 g/dL and ≥2 g/dL increase from baseline, for a period of at least eight consecutive weeks between W9 and W25, in the absence of rescue medication or prohibited treatment
TTF is defined as the time from start of treatment until any of a list of specific events is met.
The proportion of participants who tolerate ianalumab (9 mg/kg) is defined as those who do not experience any of the following events during the combination treatment period (up to Week 16): * Discontinuation due to an adverse event (AE) unrelated to efficacy * Adverse events leading to dose reduction or dose rate reduction * Adverse events resulting in study drug interruption.
Treatment failure free (yes, no) by 12 months after start of second course of ianalumab at assigned dose.
Durable response (hemoglobin (Hb) ≥10 g/dL and ≥2 g/dL increase from baseline) for a period of at least 8 consecutive weeks, between W9 and W25 in the absence of rescue or prohibited treatment prior to that durable response achievement.
To demonstrate the superiority of ianalumab, compared to placebo, in achieving 3/5 Revised Composite Response Index in Systemic Sclerosis 25 (rCRISS25) response at Week 52
Confirmed response is defined as a platelet count of equal or above 50 G/L at two (or more) consecutive assessments at least 7 days apart, in the absence of: * Rescue treatment for ≥4 weeks prior to the assessment of the platelet count, and * New immune thrombocytopenia (ITP) treatment before reaching a confirmed response.
Change from baseline in logarithm of salivary gland B/B+T cell ratio at Week 25 (EOT)
The number of patients with adverse events after repeated subcutaneous (s.c) injections of a fixed dose of ianalumab
The area under the serum ianalumab concentration-time curve from time zero to the end of the dosing interval (AUCtau)
Observed maximum serum concentration of ianalumab following drug administration (Cmax)
| Arm | Type | Description |
|---|---|---|
| Study Treatment Withdrawal (cohort 1) | NO_INTERVENTION | (Cohort 1): Study Treatment-Withdrawal group. Participants who received blinded study treatment in the core study and achieve CRR or PRR at Week 140 in the core study will enter the extension study and discontinue study treatment while maintaining standard of care (SoC) medication, as required. If renal flare criteria are met, participants will be eligible to receive open-label ianalumab. |
| Open-Label Ianalumab (cohort 2) | EXPERIMENTAL | (Cohort 2): Open-Label Ianalumab group: Participants who received blinded study treatment throughout the core study and did not achieve CRR or PRR at Week 140 of the core study, or who had switched to open-label ianalumab during the core study, will be eligible or will continue to receive open-label ianalumab in the extension study. |
| Ianalumab monthly | EXPERIMENTAL | Ianalumab s.c. monthly |
| Ianalumab quarterly | EXPERIMENTAL | Ianalumab s.c. quarterly |
| Placebo monthly | PLACEBO_COMPARATOR | Placebo s.c. monthly |
| Ianalumab 3 Monthly | EXPERIMENTAL | Ianalumab 300 mg s.c. every three months and placebo once monthly between doses during initial double-blind treatment period. Open-label treatment and receive ianalumab 300 mg monthly. |
| ianalumab s.c. monthly | EXPERIMENTAL | ianalumab s.c. monthly |
| placebo s.c. monthly | PLACEBO_COMPARATOR | placebo s.c. monthly |
| Ianalumab s.c. quarterly | EXPERIMENTAL | Ianalumab s.c. quarterly |
| Ianalumab Lower dose | EXPERIMENTAL | Lower dose of ianalumab administered intravenously with corticosteroids oral or parental (if clinically justified) |
| Ianalumab Higher dose | EXPERIMENTAL | Higher dose of ianalumab administered intravenously with corticosteroids oral or parental (if clinically justified) |
| Placebo | PLACEBO_COMPARATOR | Placebo administered intravenously with corticosteroids oral or parental (if clinically justified) |
| Treatment arm 1 - Lower dose | EXPERIMENTAL | Participants will receive eltrombopag and ianalumab lower dose |
| Treatment arm 2 - Higher dose | EXPERIMENTAL | Participants will receive eltrombopag and ianalumab higher dose |
| Treatment arm 3 - Placebo | PLACEBO_COMPARATOR | Participants will receive eltrombopag and placebo |
| Ianalumab low dose | EXPERIMENTAL | Participants will receive low dose ianalumab intravenously |
| Ianalumab high dose | EXPERIMENTAL | Participants will receive high dose ianalumab intravenously |
| Ianalumab + eltrombopag | EXPERIMENTAL | Participants will receive ianalumab in addition to eltrombopag. |
| Main cohort: Primary immune thrombocytopenia (ITP) | EXPERIMENTAL | All participants will be assigned to ianalumab 9 mg/kg plus investigator's choice thrombopoietin receptor agonist (IC TPO-RA). |
| Exploratory cohort: Primary Evans syndrome (ES) | EXPERIMENTAL | All participants will be assigned to ianalumab 9 mg/kg plus investigator's choice thrombopoietin receptor agonist (IC TPO-RA). |
| Treatment arm 1 | EXPERIMENTAL | Participants will receive ianalumab lower dose |
| Treatment arm 2 | EXPERIMENTAL | Participants will receive ianalumab higher dose |
| VAY736 (Ianalumab) | EXPERIMENTAL | Treatment Period 1: Ianalumab subcutaneous (s.c.) injection as defined in the protocol Treatment Period 2: Open-label (OL) Ianalumab subcutaneous (s.c.) injection as defined in the protocol |
| Single-arm | EXPERIMENTAL | All eligible participants will receive ianalumab at the same dose. |
| Treatment Arm | EXPERIMENTAL | Ianalumab 300 mg subcutaneous monthly |
| Reference VAY736 Drug Product | ACTIVE_COMPARATOR | Powder for solution for injection / infusion |
| Test VAY736 Drug Product | EXPERIMENTAL | Solution for injection |
| Name | Type | Description |
|---|---|---|
| Ianalumab | DRUG | Ianalumab (VAY736) is a human monoclonal antibody (mAb) of the IgG1/κ-class, directed against B cells and binding to BAFF receptor (BAFF-R). |
| Placebo | DRUG | Placebo s.c. monthly |
| Ianalumab (VAY736) | DRUG | Ianalumab 300 mg / 2 mL, PFS or AI, monthly or every 3 months, solution for injection for subcutaneous use |
| Corticosteroids | DRUG | Oral or parental (if clinically justified) |
| Eltrombopag | DRUG | Film-coated tablet for oral use |
| thrombopoietin receptor agonist (TPO-RA) | DRUG | IC TPO-RAs will be administered according to the respective United States Prescribing Information (USPIs) |
Inclusion Criteria: 1. Signed informed consent prior to participation in the extension study. 2. Participants must have participated in the SIRIUS-LN core study and must have completed the entire treatment up to Week 144 on double-blind or open label study treatment. Exclusion Criteria: 1. Use of...