Approval Probability
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Also known as LOU064 25mg, LOU064 (blinded)
LOU064 · 10 trials · 4 indications
The Urticaria Activity Score (UAS) is sum of the Hive Severity Score (HSS) and the Itch Severity Score (ISS). UAS7 is sum of the HSS7 and the ISS7 scores. Possible range of weekly UAS7 score is 0 to 42. Complete UAS7 response is UAS7 = 0. Negative change from baseline indicates improvement.
Itch Severity Score (ISS) scale is 0 to 3. Score (ISS7) is derived by adding up average daily scores of 7 days preceding visit. Possible range of weekly score is therefore 0 to 21. Itch Severity Score scale: 0 - None 1 - Mild (minimal awareness, easily tolerated) 2 - Moderate (definite awareness, bothersome but tolerable) 3 - Severe (difficult to tolerate). Negative change from baseline indicates improvement.
Hives Severity Score (HSS) scale is 0 to 3. A weekly score (HSS7) is derived by adding up the average daily scores of the 7 days preceding the visit. Possible range of the weekly score is therefore 0 to 21. Hives Severity Score scale: 0 - None 1 - Mild (1-6 hives/12 hours) 2 - Moderate (7-12 hives/12 hours) 3 - Severe (\>12 hives/12 hours). Negative change from baseline indicates improvement.
A linear regression with SBP as a covariate was employed. The change in SBP from baseline to Week 4 was predicted at the median baseline level. The change from baseline in the 24-hour weighted average SBP was calculated using the time weighted average of the area under the curve (AUC) of SBP obtained over a 24-hour period as measured by ABPM. That is, the time weighted average of AUC of 24-hour SBP obtained at baseline was subtracted from corresponding time weighted average of AUC of SBP at Week 4. In the analysis, if participants took prohibited antihypertensive treatment before Week 4, their subsequent measurements were excluded. In such cases, the excluded measurements were imputed by increasing the 24-hour SBP by 3 mmHg from the baseline value at Week 4. Moreover, participants who discontinued of study treatment due to any reason prior to the Week 4 were excluded from the analysis. The Mixed Models for Repeated Measures (MMRM) approach was used.
The efficacy of remibrutinib in CSU participants with a UAS7\<16 at Week 52 in the prior core study with respect to time to first of the three events: relapse or study treatment discontinuation due to lack of efficacy or intake of strongly confounding prohibited medication up to Week 24 compared to placebo. (Epoch 1) Time to first composite event (i.e., relapse (UAS7≥16), study treatment discontinuation due to lack of efficacy or intake of strongly confounding prohibited medication) during the randomized withdrawal period (Epoch 1) Urticaria Activity Score (UAS7) describes the number of hives with 0 being No Hives and 3 is most severe. The final score is calculated by adding together daily scores which can range from 0-6 for 7 days. The resulting maximum score is then 42.
An adverse event (AE) is any untoward medical occurrence (e.g., any unfavorable and unintended sign \[including abnormal laboratory findings\], symptom or disease) in a clinical investigation participant after providing written informed consent for participation in the study. Therefore, an AE may or may not be temporally or causally associated with the use of a medicinal (investigational) product. Treatment emergent Adverse Event (TEAEs) in this study are events that started after the first dose of study treatment and until 30 days after the last study treatment, or events present prior to the first dose of treatment which increased in severity based on preferred term within 30 days after the last study treatment.
The Weekly Urticaria Activity Score (UAS7) is a simple scoring system to evaluate urticaria signs and symptoms. It is based on scoring wheals (hive severity score) and itch (itch severity score) separately on a scale of 0 (no signs/symptoms) to 3 (intense signs/symptoms) over 7 days. The final score is calculated by adding together the daily scores, which can range from 0 to 6, for 7 days. This results in a maximum total score of 42 (highest urticaria severity), and a minimum possible score of 0. This endpoint is a secondary endpoint for testing strategy Scenario 2 with Weekly Itch Severity Score (ISS7) and Weekly Hives Severity Score (HSS7) as co-primary efficacy endpoints).
The severity of the itch was recorded by the participant twice daily in their electronic Diary, on a scale of 0 (none) to 3 (severe). A weekly score (ISS7) was derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score was therefore 0 - 21 (highest itch severity). This endpoint is a secondary endpoint for testing strategy Scenario 1 with Weekly Urticaria Activity Score (UAS7) as the primary efficacy endpoint).
The hives (wheals) severity score, defined by number of hives, was recorded by the participant twice daily in their electronic Diary, on a scale of 0 (none) to 3 (\> 12 hives/12 hours). A weekly score (HSS7) was derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score was therefore 0 - 21 (highest hives activity). This endpoint is a secondary endpoint for testing strategy Scenario 1 with Weekly Urticaria Activity Score (UAS7) as the primary efficacy endpoint).
The Weekly Urticaria Activity Score (UAS7) is a simple scoring system to evaluate urticaria signs and symptoms. It is based on scoring wheals (hive severity score) and itch (itch severity score) separately on a scale of 0 (no signs/symptoms) to 3 (intense signs/symptoms) over 7 days. The final score is calculated by adding together the daily scores, which can range from 0 to 6, for 7 days. This results in a maximum total score of 42 (highest urticaria severity), and a minimum possible score of 0. This endpoint is a secondary endpoint for testing strategy Scenario 2 with Weekly Itch Severity Score (ISS7) and Weekly Hives Severity Score (HSS7) as co-primary efficacy endpoints).
The severity of the itch was recorded by the participant twice daily in their electronic Diary, on a scale of 0 (none) to 3 (severe). A weekly score (ISS7) was derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score was therefore 0 - 21 (highest itch severity). This endpoint is a secondary endpoint for testing strategy Scenario 1 with Weekly Urticaria Activity Score (UAS7) as the primary efficacy endpoint).
The hives (wheals) severity score, defined by number of hives, was recorded by the participant twice daily in their electronic Diary, on a scale of 0 (none) to 3 (\> 12 hives/12 hours). A weekly score (HSS7) was derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score was therefore 0 - 21 (highest hives activity). This endpoint is a secondary endpoint for testing strategy Scenario 1 with Weekly Urticaria Activity Score (UAS7) as the primary efficacy endpoint.
The facial inflammatory lesion count is defined as the sum of papules, pustules, and nodules present on the face. Lesions are visually counted across the full facial area (forehead, cheeks, nose, chin). A negative value indicates a reduction in lesions (clinical improvement), as lower counts reflect less inflammatory activity.
Responder rate was defined as the percentage of participants tolerating a single dose of \>= 600 mg (1044 mg cumulative tolerated dose) of peanut protein without dose-limiting symptoms during the double blind placebo controlled food challenge (DBPCFC). The cumulative tolerated dose is the sum of the tolerated doses, not including the reactive dose. Dose-limiting symptoms indicate a true allergic reaction occurring during administration of a single dose of peanut protein at the DBPCFC that should preclude the administration of any further doses in the view of the investigator. Symptoms that require administration of any rescue medication were considered dose-limiting symptoms.
An AE refers to any undesirable medical occurrence, such as an unintended sign (including abnormal laboratory findings), symptom, or disease, experienced by a participant. Serious AEs (SAEs) is defined as any AE that results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, results in a congenital anomaly/birth defect, or any other medically significant condition. Treatment-emergent AEs were defined as AEs that either begin on the same day or after the first dose of study medication during the treatment period in the extension study or worsen on the same day or after the first dose of study medication in the extension study and within the minimum of either 28 days post last dose or the end of the study visit. The number of participants with treatment-emergent AEs was summarized.
Clinically significant changes in physical examination and anamnesis, vital signs, ECG, safety laboratory will be reported under (S)AEs.
| Arm | Type | Description |
|---|---|---|
| Arm 1: LOU064 (blinded) | EXPERIMENTAL | LOU064 (blinded) taken orally b.i.d. for 24 weeks, followed by LOU064 (open-label) taken orally b.i.d. for up to 6 cycles of 24 weeks. |
| Arm 2: LOU064 placebo (blinded) | PLACEBO_COMPARATOR | LOU064 placebo (blinded) taken orally b.i.d. for 24 weeks (randomized in a 2:1 ratio arm 1: arm 2) |
| LOU064 (remibrutinib) | EXPERIMENTAL | All participants were assigned to remibrutinib 25 mg b.i.d. for 12 weeks. |
| Arm 3: LOU064 (Open Label) | EXPERIMENTAL | LOU064 (open-label) taken orally for 24 weeks per treatment cycle (Arm 3) |
| LOU064 25 mg b.i.d. | EXPERIMENTAL | Patients were treated with remibrutinib 25 mg bis in die/twice a day (b.i.d.). LOU064 open-label treatment taken orally for 52 weeks. |
| LOU064 25mg b.i.d. | EXPERIMENTAL | LOU064A (blinded) taken orally b.i.d. for 24 weeks, followed by LOU064 (open- label) taken orally b.i.d. for 28 weeks. Randomised in 2:1 ratio (active vs placebo) |
| Placebo | PLACEBO_COMPARATOR | LOU064A placebo (blinded) taken orally for 24 weeks, followed by LOU064 (open-label) taken orally b.i.d. for 28 weeks. Randomised in 2:1 ratio (active vs placebo) |
| LOU064 | EXPERIMENTAL | LOU064 administered by oral route |
| LOU064 10 mg | EXPERIMENTAL | LOU064 10 mg was administered orally twice per day, on Days 1 through 28. |
| LOU064 25 mg | EXPERIMENTAL | LOU064 25 mg was administered orally twice per day, on Days 1 through 28. |
| LOU064 100 mg | EXPERIMENTAL | LOU064 100 mg was administered orally twice per day, on Days 1 through 28. |
| Placebo + LOU064 25 mg | EXPERIMENTAL | Placebo was administered orally twice per day, on Days 1 through 21 followed by LOU064 25 mg twice per day, on Days 22 through 28. |
| All participants | EXPERIMENTAL | Participants with UAS7\<16 at Week 16 of CLOU064A2201 were followed up to 12 weeks without receiving treatment (observational period). If participants relapsed (UAS7≥16 at least once), they were transitioned to the treatment period. Otherwise, they were discontinued from the study. Participants with a UAS7≥16 at Week 12 or Week 16 in the CLOU064A2201, as well as participants who experienced a relapse during the 12-week observational period, were administered 100 mg of LOU064 b.i.d. open-label for up to 52 weeks. |
| Part 1 Dose A | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Dose B | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Dose C | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Dose D | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Dose E | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Dose F | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Dose G | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Dose H | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Dose I | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Dose J | EXPERIMENTAL | (Single Ascending Dose) Healthy volunteers will receive a single dose of LOU064. |
| Part 1 Placebo | PLACEBO_COMPARATOR | (Single Ascending Dose) Healthy volunteers will receive a single dose of placebo. |
| Part 2 Dose K | EXPERIMENTAL | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take LOU064 once daily for 12 days |
| Part 2 Dose L | EXPERIMENTAL | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take LOU064 once daily for 12 days |
| Part 2 Dose M | EXPERIMENTAL | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take LOU064 once daily for 12 days |
| Part 2 Dose N | EXPERIMENTAL | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take LOU064 once daily for 12 days |
| Part 2 Dose O | EXPERIMENTAL | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take LOU064 once daily for 12 days |
| Part 2 Dose P | EXPERIMENTAL | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take LOU064 once daily for 12 days |
| Part 2 Placebo | PLACEBO_COMPARATOR | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take placebo once daily for 12 days |
| Part 3 Dose Fasted | EXPERIMENTAL | Healthy volunteers will receive a single dose of LOU064 given under fasting conditions followed by a single dose of LOU064 given after a high fat meal (cross-over design). |
| Part 3 Dose Fed | EXPERIMENTAL | Healthy volunteers will receive a single dose of LOU064 given after a high fat meal followed by a single dose of LOU064 given under fasting conditions (cross-over design). |
| Part 4 Dose R | EXPERIMENTAL | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take LOU064 twice daily for 12 days |
| Part 4 Dose S | EXPERIMENTAL | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take LOU064 twice daily for 12 days |
| Part 4 Placebo | PLACEBO_COMPARATOR | (Multiple Ascending Dose) Healthy Volunteers with asymptomatic atopic diathesis will take placebo twice daily for 12 days |
| Part 5 Formulation A | EXPERIMENTAL | Healthy Volunteers will receive a single dose of LOU064 formulation A followed by a single dose of LOU064 formulation B (cross-over design). |
| Part 5 Formulation B | EXPERIMENTAL | Healthy Volunteers will receive a single dose of LOU064 formulation B followed by a single dose of LOU064 formulation A (cross-over design). |
| Part 6 Dose T | EXPERIMENTAL | Subjects with atopic dermatitis will receive a twice daily dose of LOU064 for 4 weeks |
| Part 6 Placebo | PLACEBO_COMPARATOR | Subjects with atopic dermatitis will receive a twice daily dose of placebo for 4 weeks |
| Name | Type | Description |
|---|---|---|
| LOU064 (blinded) | DRUG | LOU064 (blinded) active treatment |
| placebo | DRUG | matching active drug |
| LOU064 | DRUG | One film-coated tablet (25 mg) was to be taken in the morning and evening, respectively, with a 12-hour interval at approximately the same time everyday. |
| LOU064 (open label) | DRUG | LOU064 (open-label) active treatment |
| LOU064 (open-label) | DRUG | LOU064 (open-label) active treatment |
| LOU064 25 mg (b.i.d) | DRUG | LOU064 25 mg was administered by oral route twice a day (b.i.d) as a tablet. |
| LOU064 25 mg (b.i.d) as a tablet. | DRUG | LOU064 25 mg was administered by oral route twice a day (b.i.d) as a tablet in open label phase. |
Key Inclusion Criteria: * Male and female adolescent participants aged \>= 12 to \< 18 years of age at the time of signing the informed consent * CSU duration for \>= 6 months prior to screening (defined as the onset of CSU determined by the investigator based on all available supporting documentat...
LOU064, also known as remibrutinib, is an investigational small molecule being studied for several immunology-related conditions. These include chronic spontaneous urticaria, papulopustular rosacea, peanut allergy, and atopic dermatitis. It is also being evaluated in healthy volunteers for safety and tolerability studies.
LOU064 targets Bruton's tyrosine kinase (BTK), a protein involved in B-cell and mast cell signaling. By inhibiting BTK, LOU064 aims to modulate immune responses implicated in allergic and inflammatory conditions. This mechanism is being explored across multiple indications, including chronic spontaneous urticaria and peanut allergy.
LOU064 is being developed by Novartis AG, a global pharmaceutical company listed on the New York Stock Exchange under the ticker NVS. Novartis is conducting clinical trials to evaluate the drug's safety and efficacy across several immune-mediated conditions.
LOU064 is in Phase 2 clinical development for papulopustular rosacea and has completed a Phase 2 trial for peanut allergy. It is also being studied in a Phase 3 extension trial for chronic spontaneous urticaria. The drug remains investigational and is not yet approved by regulatory authorities.
LOU064 is being evaluated in several clinical trials. NCT03918980 is a completed Phase 1 study in healthy volunteers and atopic dermatitis. NCT05432388 is a completed Phase 2 peanut allergy trial. NCT05513001 is an active Phase 3 extension study in chronic spontaneous urticaria. NCT07681271 is a recruiting Phase 2 trial for papulopustular rosacea.
Yes, LOU064 is also known as remibrutinib. Clinical trials use both names interchangeably, with recent studies referring to the drug as remibrutinib (LOU064). This naming applies across indications, including chronic spontaneous urticaria and papulopustular rosacea.