Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Also known as QGE031
Ligelizumab · 10 trials · 5 indications
Participants with treatment emergent adverse events (AEs) and serious adverse events (SAEs) summary for entire study (64 weeks) An AE is any untoward medical occurrence, unfavorable, or unintended sign (including an abnormal laboratory finding), symptom, disease, or injury, temporally associated with the use of a marketed or investigational medicinal product, gene therapy, theragnostic product, or medical device, in patients, clinical-trial subjects, device users, or other persons, whether or not it is considered to be related to or due to the product.
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. 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). 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
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. 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). 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
UAS7 is a self-reported scoring system to evaluate urticaria signs and symptoms. UAS7 is the sum of daily urticaria activity scores (UAS) over a seven-day period. The possible range of UAS7 score is 0 to 42 (0 to 6 for daily UAS x 7 days). A higher urticaria activity score indicates more severe symptoms. A negative change score from baseline indicates improvement. Baseline was calculated using data from the 7 days prior to the first treatment date. To handle the missing data, if a participant had at least 4 non-missing daily scores within the 7 days prior to a study visit, the weekly score was calculated as the sum of the available scores in that week, divided by the number of days with daily scores available, multiplied by 7. However, if there were less than 4 non-missing daily scores within the prior 7 days, then the weekly score was missing for the week.
The primary objective of this study was to assess the long-term safety of one-year treatment of QGE031 in adult Chronic Spontaneous Urticaria (CSU) patients who completed the core study CQGE031C2201 using the following evaluations: number of participants with treatment emergent AEs of non-serious and serious nature including any events of special interest.
The primary objective was to establish the dose-response relationship of ligelizumab (24, 72 and 240 mg every 4 weeks) with respect to achievement of complete hives response (HSS7=0) at Week 12 and select an appropriate dose (or range of doses) which is likely to be superior to omalizumab at the highest approved dose (300 mg every 4 weeks). Hives Severity Score (HSS) is on a scale of 0 to 3. A weekly score (HSS7) is derived by adding up the average daily scores of the preceding 7 days, with a possible range of 0 - 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) To confirm an overall dose-response signal based on MCP-Mod, and to estimate the minimal ligelizumab dose that shows a relevant superior effect over omalizumab, based on the selected dose response model, the lowest ligelizumab dose that provides a response rate 15% higher than the response of omalizumab 300 mg.
The ACQ-7 measures asthma symptom control and consisted of 7 items: 5 on symptom assessment, 1 on rescue bronchodilator use and 1 on airway caliber (FEV1 % predicted). All 7 questions of the ACQ were equally weighted. Items 1-6 scored along a 7-point response scale, where 0 = good controlled and 6 = poor controlled. The 7th item on % predicted FEV1 (pre-bronchodilator) was scored by clinic staff on a 7-point scale (0 - \> 95%; 1 - 90-95%; 2 - 80-89%; 3 - 70-79%; 4 - 60-69%; 5 - 50-59%; 6 - \< 50%). The average score of the 7 questions was calculated as the sum of scores divided by the number of questions that were answered by the participants, as long as there were at least 6 questions answered and the missing items were neither question 1 nor question 7.
Efficacy response will be assessed using EASI.
Adverse events will be determined by evaluating clinical, laboratory evaluations, impact on vital signs and impacts on ECGs and other safety assessments.
| Arm | Type | Description |
|---|---|---|
| Ligelizumab 120 mg per 1 mL qw4 | EXPERIMENTAL | Subjects received one subcutaneous injection every 4 weeks at 13 visits during the treatment period |
| Ligelizumab 120 mg | EXPERIMENTAL | Ligelizumab 120 mg arm: 1 injection of 1.0 mL ligelizumab + 1 injection of 1.0 mL ligelizumab placebo q4w |
| Ligelizumab 72 mg | EXPERIMENTAL | Ligelizumab 72 mg arm: 1 injection of 0.6 mL ligelizumab + 1 injection of 1.0 mL ligelizumab placebo q4w |
| Omalizumab 300 mg | ACTIVE_COMPARATOR | Omalizumab 300 mg arm: 2 injections of 1.2 mL omalizumab q4w |
| Placebo | PLACEBO_COMPARATOR | Placebo-ligelizumab arm: 2 injections of 1.0mL of ligelizumab placebo from Week 0 through Week 20; 1 injection of 1.0mL of ligelizumab 120 mg + 1 injection of 1.0 mL ligelizumab placebo from Week 24 through Week 48 |
| Ligelizumab 24 mg | EXPERIMENTAL | Participants received a dose of ligelizumab 24 mg (low dose) which consisted of one injection of 0.2 ml of ligelizumab 120 mg/ 1 ml vial every 4 weeks from Day 1 to Week 20 (inclusive). |
| Placebo + Ligelizumab 120 mg | PLACEBO_COMPARATOR | Participants received Placebo which consisted of one injection of 1 ml placebo every 4 weeks from Day 1 to Week 8 (inclusive). From week 12 to week 20 (inclusive), participants received a dose of ligelizumab 120 mg (high dose) which consisted of one injection of 1 ml of ligelizumab 120 mg/ 1 ml vial. |
| Ligelizumab | EXPERIMENTAL | QGE031 240 mg s.c. q4w x 13 treatments |
| QGE031 24 mg s.c. q4w | EXPERIMENTAL | ligelizumab 24 mg injection subcutaneous every 4 weeks |
| QGE031 72 mg s.c. q4w | EXPERIMENTAL | ligelizumab 72 mg injection subcutaneous every 4 weeks |
| QGE031 240 mg s.c. q4w | EXPERIMENTAL | ligelizumab 240 mg injection subcutaneous every 4 weeks |
| Omalizumab 300 mg s.c. q4w | ACTIVE_COMPARATOR | omalizumab 300 mg injection subcutaneous every 4 weeks |
| Placebo s.c. q4w | PLACEBO_COMPARATOR | placebo injection subcutaneous every 4 weeks |
| QGE031 120 mg s.c. s.d. | EXPERIMENTAL | ligelizumab 120 mg injection subcutaneous single dose |
| QGE031 240 mg every 2 weeks (q2w) | EXPERIMENTAL | Participants received QGE031 240 mg subcutaneously (s.c.) q2w for 16 weeks. |
| QGE031 240 mg q4w | EXPERIMENTAL | Participants received QGE031 240 mg s.c. q4w for 16 weeks. |
| QGE031 180 mg q2w | EXPERIMENTAL | Participants received QGE031 180 mg s.c. q2w for 16 weeks. |
| QGE031 120 mg q2w | EXPERIMENTAL | Participants received QGE031 120 mg s.c. q2w for 16 weeks. |
| QGE031 36 mg q2w | EXPERIMENTAL | Participants received QGE031 36 mg s.c. q2w for 16 weeks. |
| QGE031 12 mg q2w | EXPERIMENTAL | Participants received QGE031 12 mg s.c. q2w for 16 weeks. |
| Omalizumab (as per locally approved dosing table) | ACTIVE_COMPARATOR | Participants received omalizumab as per locally approved dosing table s.c. q2w or q4w for 16 weeks. |
| Placebo to QGE031 240 mg q2w | PLACEBO_COMPARATOR | Participants received matching placebo to QGE031 240 mg s.c. q2w for 16 weeks. |
| Placebo to QGE031 240 mg q4w | PLACEBO_COMPARATOR | Participants received placebo to QGE031 240 mg s.c. q2w for 16 weeks. |
| Placebo to QGE031 180 mg q2w | PLACEBO_COMPARATOR | Participants received QGE031 180 mg s.c. q2w for 16 weeks. |
| Placebo to QGE031 120 mg q2w | PLACEBO_COMPARATOR | Participants received QGE031 120 mg s.c. q2w for 16 weeks. |
| Placebo to QGE031 36 mg q2w | PLACEBO_COMPARATOR | Participants received QGE031 36 mg s.c. q2w for 16 weeks. |
| Placebo to QGE031 12 mg q2w | PLACEBO_COMPARATOR | Participants received QGE031 12 mg s.c. q2w for 16 weeks. |
| Placebo to omalizumab | PLACEBO_COMPARATOR | Participants received placebo to omalizumab s.c. q2w or q4w for 16 weeks. |
| Group 1 QGE031 | EXPERIMENTAL | QGE031 will be administered as a subcutaneous dose q2 weeks |
| Group 2 Placebo | PLACEBO_COMPARATOR | A QGE031 matched placebo will be administered as a subcutaneous dose q2 weeks |
| Group 3 Cyclosporine A | EXPERIMENTAL | Cyclosporine A will be administered (as per label) for atopic dermatitis. |
| QGE031 | EXPERIMENTAL | During the 10-week treatment period, participants will receive a dose of study drug subcutaneously once every two weeks (total of six doses). Three dose levels of QGE031 will be offered during the study: low, medium, and high. Participants will be randomized to receive one of these dose levels for all dosing visits. |
| omalizumab | ACTIVE_COMPARATOR | During the 10-week treatment period, participants will receive a dose of study drug subcutaneously once every two weeks (total of six doses) or once every four weeks (total of three doses). The dose that a participant receives will depend upon the participant's body weight and IgE level; dosage will be determined based upon local omalizumab dosing charts. |
| QGE031 Dose 1 | EXPERIMENTAL | QGE031 Dose 1: subcutaneous injection, single dose |
| QGE031 Dose 2 | EXPERIMENTAL | QGE031 Dose 2: subcutaneous injection, single dose |
| QGE031 Dose 3 | EXPERIMENTAL | QGE031 Dose 3: subcutaneous injection, single dose |
| Name | Type | Description |
|---|---|---|
| Ligelizumab | BIOLOGICAL | Liquid in vial |
| Omalizumab | BIOLOGICAL | Lyophilized powder for solution in vial |
| Placebo | OTHER | Liquid in vial |
| QGE031 | BIOLOGICAL | - |
| Cyclosporine A | DRUG | - |
Key Inclusion Criteria: * Signed informed consent must be obtained prior to participation in the study * Male and female subjects ≥ 18 years of age at the time of screening * CSU diagnosis for ≥ 6 months * Diagnosis of CSU refractory to H1-AH at approved doses at the time of Baseline (Visit 110, Da...
Ligelizumab is an investigational monoclonal antibody developed by Novartis AG for chronic spontaneous urticaria, a form of chronic hives. It is designed as an IGHE inhibitor and has been studied in Phase 3 clinical trials in patients whose symptoms are not adequately controlled with H1-antihistamines.
Ligelizumab is being developed for chronic spontaneous urticaria in adolescents and adults who remain inadequately controlled with H1-antihistamines. It is an investigational therapy and has been evaluated in Phase 3 trials in this indication, including studies in Japanese patients and in adolescent and adult populations.
Ligelizumab targets IGHE, the immunoglobulin E molecule, and acts as an inhibitor of this target. By binding immunoglobulin E, the monoclonal antibody is designed to reduce the allergic signaling pathway that drives chronic spontaneous urticaria symptoms in patients not controlled by antihistamines.
Ligelizumab is developed by Novartis AG, which trades under the ticker NVS. Novartis has sponsored the clinical development program for ligelizumab in chronic spontaneous urticaria, including the Phase 2 and Phase 3 trials conducted across multiple countries.
Ligelizumab is in Phase 3 development for chronic spontaneous urticaria. It is an investigational monoclonal antibody and is not described as approved. Five trials have been completed, including Phase 3 studies, with no active trials currently listed.
Ligelizumab has been studied in completed trials including NCT03580369 and NCT03580356, two Phase 3 studies in adolescents and adults with chronic spontaneous urticaria, and NCT03907878, a Phase 3 study in Japanese patients. A Phase 2 trial, NCT03437278, enrolled adolescent patients with the condition.