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GBT440

Phase 4FDA approved 2019

Sickle Cell Disease | Small molecule | Hematology |Pfizer, Inc.|Trials Updated: Nov 22, 2024

GBT440 development status

FDA approval Nov 25, 2019 as Oxbryta
Approval holderGlobal Blood Theraps
ApplicationNDA213137
Highest phase Phase 4 (NCT04400487)
Phase scored for PFEPhase 3
Registered trials 20 across 2 sponsors since Aug 2016

Label indication OXBRYTA is indicated for the treatment of sickle cell disease (SCD) in adults and pediatric patients 4 years of age and older. This indication is approved under accelerated approval based on increase in hemoglobin (Hb) [see Clinical Studies (14) ] . Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trial(s). FDA label

GBT440 target and mechanism

ModalitySmall molecule

Also known as Voxelotor, Oxbryta

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLEDDMC
Total Trials10
Total Enrollment772

FDA Designations

No designations recorded

GBT440 clinical trials

GBT440 · 10 trials · 7 indications

Phase 3 1Phase 2 2Phase 1 7
NCT03036813Study to Evaluate the Effect of Voxelotor Administered Orally to Patients With Sickle Cell Disease (GBT_HOPE)Sickle Cell Disease
COMPLETED449 Analytics
PHASE3COMPLETED
Study to Evaluate the Effect of Voxelotor Administered Orally to Patients With Sickle Cell Disease (GBT_HOPE)
Sickle Cell DiseaseUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Increase in Hb >1 g/dL From Baseline to Week 24
Baseline to Week 24

Number of participants with increase in Hb \>1 g/dL from Baseline to Week 24

Part A: Maximum Observed Plasma Concentration (Cmax) for Bupropion
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48, and 72 hours post-dose on Period 1 Day 1, Period 2 Day 2 and Period 2 Day 12 for Treatment A, D and G, respectively
Part A: Cmax for Repaglinide
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours post-dose on Period 1 Day 4 and Period 2 Day 6 for Treatment B and F, respectively
Part A: Cmax for Flurbiprofen
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and E, respectively
Part A: Cmax for Omeprazole
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and E, respectively
Part A: Cmax for Midazolam
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and E, respectively
Part A: Area Under the Plasma Concentration-Time Curve From Time Zero (0) to the Time of the Last Quantifiable Concentration (AUCt) for Bupropion
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48, and 72 hours post-dose on Period 1 Day 1, Period 2 Day 2 and Period 2 Day 12 for Treatment A, D and G, respectively

AUCt was calculated using the linear/log trapezoidal rule.

Part A: AUCt for Repaglinide
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours post-dose on Period 1 Day 4 and Period 2 Day 6 for Treatment B and F, respectively

AUCt was calculated using the linear/log trapezoid rule.

Part A: AUCt for Flurbiprofen
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and E, respectively

AUCt was calculated using the linear/log trapezoid rule.

Part A: AUCt for Omeprazole
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and E, respectively

AUCt was calculated using the linear/log trapezoid rule.

Part A: AUCt for Midazolam
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and E, respectively

AUCt was calculated using the linear/log trapezoid rule.

Part A: Area Under the Plasma Concentration-Time Curve From Time 0 Extrapolated to Infinity (AUCinf) for Bupropion
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48, and 72 hours post-dose on Period 1 Day 1, Period 2 Day 2 and Period 2 Day 12 for Treatment A, D and G, respectively

AUCinf was calculated as AUClast + Clast/lamda z, where AUClast: area under the plasma concentration-time curve from time 0 to time of the last quantifiable concentration. Clast is the last measurable concentration and lamda z: apparent terminal elimination rate constant.

Part A: AUCinf for Repaglinide
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours post-dose on Period 1 Day 4 and Period 2 Day 6 for Treatment B and F, respectively

AUCinf was calculated as AUClast + Clast/lamda z, where AUClast: area under the plasma concentration-time curve from time 0 to time of the last quantifiable concentration. Clast is the last measurable concentration and lamda z: apparent terminal elimination rate constant.

Part A: AUCinf for Flurbiprofen
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and E, respectively

AUCinf was calculated as AUClast + Clast/lamda z, where AUClast: area under the plasma concentration-time curve from time 0 to time of the last quantifiable concentration. Clast is the last measurable concentration and lamda z: apparent terminal elimination rate constant.

Part A: AUCinf for Omeprazole
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and E, respectively

AUCinf was calculated as AUClast + Clast/lamda z, where AUClast: area under the plasma concentration-time curve from time 0 to time of the last quantifiable concentration. Clast is the last measurable concentration and lamda z: apparent terminal elimination rate constant.

Part A: AUCinf for Midazolam
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and E, respectively

AUCinf was calculated as AUClast + Clast/lamda z, where AUClast: area under the plasma concentration-time curve from time 0 to time of the last quantifiable concentration. Clast is the last measurable concentration and lamda z: apparent terminal elimination rate constant.

Part B: Cmax for Metformin
Predose, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and Treatment C, respectively
Part B: Cmax for Furosemide
Predose, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and Treatment C, respectively
Part B: Cmax for Rosuvastatin
Predose, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and Treatment C, respectively
Part B: AUCt for Metformin
Predose, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and Treatment C, respectively

AUCt was calculated using the linear/log trapezoid rule.

Part B: AUCt for Furosemide
Predose, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and Treatment C, respectively

AUCt was calculated using the linear/log trapezoid rule.

Part B: AUCt for Rosuvastatin
Predose, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 24, and 48 hours post-dose on Day 1 and Day 4 for Treatment A and Treatment C, respectively

AUCt was calculated using the linear/log trapezoid rule.

Part B: AUCinf for Metformin
Predose, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and Treatment C, respectively

AUCinf was calculated as AUClast + Clast/lamda z, where AUClast: area under the plasma concentration-time curve from time 0 to time of the last quantifiable concentration. Clast is the last measurable concentration and lamda z: apparent terminal elimination rate constant.

Part B: AUCinf for Furosemide
Predose, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and Treatment C, respectively

AUCinf was calculated as AUClast + Clast/lamda z, where AUClast: area under the plasma concentration-time curve from time 0 to time of the last quantifiable concentration. Clast is the last measurable concentration and lamda z: apparent terminal elimination rate constant.

Part B: AUCinf for Rosuvastatin
Predose, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 24, and 48 hours post-dose on Period 1 Day 1 and Period 2 Day 4 for Treatment A and Treatment C, respectively

AUCinf was calculated as AUClast + Clast/lamda z, where AUClast: area under the plasma concentration-time curve from time 0 to time of the last quantifiable concentration. Clast is the last measurable concentration and lamda z: apparent terminal elimination rate constant.

To assess the Cmax of GBT440 in patients with mild, moderate, or severe hepatic impairment
28 days max

Maximum observed plasma concentration

To assess the Tmax of GBT440 in patients with mild, moderate, or severe hepatic impairment
28 days max

Time at which maximum concentration was observed

To assess the AUC of GBT440 in patients with mild, moderate, or severe hepatic impairment
28 days max

Area under the concentration-time curve

To assess the T1/2 of GBT440 in patients with mild, moderate, or severe hepatic impairment
28 days max

Terminal elimination half-life

Secondary Endpoints

Annualized Vaso-Occlusive Crisis (VOC) Incidence Rate
Baseline to Week 72
Percentage Change From Baseline in Hemolysis Measures
Baseline to Week 24
Part A: Cmax for 6-Hydroxybupropion
Predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48, and 72 hours post-dose on Period 1 Day 1, Period 2 Day 2 and Period 2 Day 12 for Treatment A, D and G, respectively
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Dose 1ACTIVE_COMPARATORvoxelotor
Dose 2ACTIVE_COMPARATORvoxelotor
PlaceboPLACEBO_COMPARATORPlacebo
Part AEXPERIMENTALTo evaluate the effect of multiple doses of voxelotor on the plasma pharmacokinetics (PK) of a single dose of bupropion, repaglinide, flurbiprofen, omeprazole, and midazolam
Part BEXPERIMENTALTo evaluate the effect of multiple doses of voxelotor on the plasma PK of a single dose of metformin, furosemide, and rosuvastatin
GBT440 Dose 1:Mild hepatic impairmentEXPERIMENTALChild Pugh A
GBT440 Dose 1:Moderate hep. impairmentEXPERIMENTALChild Pugh B
GBT440 Dose 1:Severe hepatic impairmentEXPERIMENTALChild Pugh C
GBT440 Dose 1:Normal hepatic functionEXPERIMENTALHealthy subjects

Interventions

NameTypeDescription
voxelotorDRUG -
PlaceboOTHER -
GBT440DRUGCapsules which contain GBT440 drug substance in Swedish orange
BupropionDRUGDrug drug interaction
RepaglinideDRUGDrug drug interaction
FlurbiprofenDRUGDrug drug interaction
OmeprazoleDRUGDrug drug interaction
MidazolamDRUGDrug drug interaction
MetforminDRUGDrug drug interaction
FurosemideDRUGDrug drug interaction
RosuvastatinDRUGDrug drug interaction
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Eligibility Criteria

Age Range12 Years to 65 Years
SexALL
Healthy VolunteersNo
Study Sites62

Inclusion Criteria: 1. Male or female study participants with sickle cell disease 2. Participants have had at least 1 episode of vaso-occlusive crisis (VOC) in the past 12 months. 3. Age 12 to 65 years 4. Hemoglobin (Hb) ≥5.5 and ≤10.5 g/dL during screening 5. For participants taking hydroxyurea (H...

Countries:United StatesCanadaEgyptFranceItalyJamaicaKenyaLebanonNetherlandsOmanTurkey (Türkiye)United Kingdom
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Frequently asked questions about GBT440

What is GBT440?

GBT440 is an investigational small molecule developed by Pfizer, Inc. (ticker PFE) for hematology conditions. It has been studied in sickle cell disease, anemia, hepatic impairment, renal impairment, and idiopathic pulmonary fibrosis. GBT440 is also known as voxelotor. It is not approved and remains in clinical development.

What is GBT440 used for in sickle cell disease?

GBT440 has been studied in sickle cell disease, including a Phase 2 extension study for patients who previously participated in the GBT440-001 study. Research has also covered anemia, hepatic impairment, renal impairment, and idiopathic pulmonary fibrosis. GBT440 is investigational and has not been approved for any indication.

Who makes GBT440?

Pfizer, Inc. develops GBT440. The company trades under the ticker PFE. Pfizer is the sponsor behind the clinical program for GBT440, which is also known as voxelotor.

What phase is GBT440 in?

GBT440 is in Phase 1 development overall, with six completed trials. One completed trial, the extension study in sickle cell disease, was Phase 2. GBT440 is investigational and has not been approved by the FDA for any indication.

What clinical trials is GBT440 in?

GBT440 has been studied in six completed trials. These include NCT05981365, a Phase 1 drug interaction study in sickle cell disease; NCT03161015, a Phase 1 single-dose pharmacokinetic study in renal impairment; NCT03114540, a Phase 1 pharmacokinetic and safety study in hepatic impairment; and NCT03041909, a Phase 2 extension study in sickle cell disease.

Is GBT440 the same as voxelotor?

Yes, GBT440 is the same as voxelotor. Voxelotor is the alternative name for GBT440, the investigational small molecule developed by Pfizer, Inc. (ticker PFE) for sickle cell disease and related hematology conditions. Searches for either name refer to the same drug candidate.