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rhC1INH

Phase 3

Hereditary Angioedema | Small molecule | Immunology |Pharming Group N.V.|Trials Updated: Mar 29, 2024

rhC1INH development status

Highest phase Phase 3
Registered trials 13 across 3 sponsors since Sep 2005

rhC1INH target and mechanism

ModalitySmall molecule

Also known as Ruconest, Recombinant human C1 inhibitor, Conestat alfa, i.v. recombinant human C1 inhibitor

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials9
Total Enrollment407

FDA Designations

No designations recorded

rhC1INH clinical trials

rhC1INH · 9 trials · 4 indications

Phase 3 2Phase 2 7
NCT01188564Efficacy, Safety and Immunogenicity Study of Recombinant Human C1 Inhibitor for the Treatment of Acute HAE AttacksHereditary Angioedema
COMPLETED75 Analytics
NCT00262301Recombinant Human C1 Inhibitor for the Treatment of Acute Attacks in Patients With Hereditary AngioedemaHereditary Angioedema
COMPLETED75 Analytics
PHASE3COMPLETED
Efficacy, Safety and Immunogenicity Study of Recombinant Human C1 Inhibitor for the Treatment of Acute HAE Attacks
Hereditary AngioedemaUnlock trial analytics
PHASE3COMPLETED
Recombinant Human C1 Inhibitor for the Treatment of Acute Attacks in Patients With Hereditary Angioedema
Hereditary AngioedemaUnlock trial analytics

Study Endpoints

Primary Endpoints

Time to Beginning of Relief of Symptoms
Patients observed for 24 hours

Time to beginning of relief is the time lapsed from the beginning of the infusion of study medication to the beginning of a beneficial effect based on patient's responses to the Treatmetn Effect Questionnaire (TEQ) for the primary attack location. The beginning of relief is defined as the first timepoint at which * The patient reports any of the following answers for TEQ question 1: "A little better", "Better" or "Much better"; and; * The patient reports the following answer for TEQ question 2: "Yes"; and, * There is persistence in improvement at the next assessment time, i.e.either the same or a better response to Question 1 and "Yes" to Question 2.

Number of Participants With Each Score on WHO 7-point Outcome Scale at Day 7
Assessed on each day after enrollment (worst status) with the use of the WHO Ordinal Scale and the score on day 7 will be analyzed stratified by its baseline value

The disease severity on the 7-point WHO Ordinal Scale on Day 7 was the primary objective of this study. This endpoint had been suggested by the WHO for clinical trials in patients with Covid-19. The ordinal scale measures illness severity over time. The higher score, the worst outcome: meaning score 1, no limitation in activities and score 7, death.

Number of HAE Attacks
28 days

Average number of HAE attacks normalized to a 28 day period

Time to Beginning of Relief Based on Visual Analogue Scale (VAS) Was Defined as the Time, in Minutes, From Time of Infusion to the Beginning of Relief.
The assessment of the angioedema signs by the VAS and TEQ will be performed just before start of infusion, and at T30m, T1h, T2h, T4h, T8h and T24h after study medication infusion VAS score decrease of ≥ 20 mm from baseline.

Time to beginning of relief of symptoms that showed the response to treatment based on the overall VAS score decrease of ≥ 20 mm from baseline. Separate VAS forms will be given to express the current feelings considering the severity of angioedema symptoms for five possible anatomical locations. The form will be completed by placing vertical marks on each of the 100 mm horizontal lines. The Abdominal VAS measures the patient's perceptions relating to illness, pain, bloodedness, and nausea; the oro-pharyngeal-laryngeal (OPL) VAS measures illness, pain, swelling, breathing, speech, and swallowing; the facial VAS instrument measure illness, pain and swelling; the Peripheral VAS measures swelling, pain, and use of extremity; and the Urogenital VAS measures illness, pain, swelling, nausea, and urination. Time to beginning of relief will also be calculated based on the Investigator Score (IS) and Treatment Effect Questionnaire (TEQ).

HAE Attacks/Week
8 weeks

Prior to the treatment period, patients enrolled in the study, were asked about the amount of "HAE" attacks in the past 2 years, (calculated to attacks/week), this number is defined as "Historical". During the treatment period, patients received a dose of 50 IU/kg of "rhC1INH" administered by slow "IV" injection over 4 to 5 minutes, once a week during an eight week period. The amount of attacks during this period is defined as "Prophylaxis" (calculated to attacks/week).

Primary outcomes: Relief of angioedema symptoms
24 hours

Secondary Endpoints

Time to Minimal Symptoms
24 hours
Time to Clinical Improvement
Daily until day 14
Invasive (Mechanical) or Non-invasive Ventilation
Daily until day 14.
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
rhC1INHEXPERIMENTAL -
Placebo (Saline)PLACEBO_COMPARATOR -
100 IU/kg "rhC1INH"EXPERIMENTAL100 IU/kg recombinant human C1 inhibitor
SalinePLACEBO_COMPARATORSaline solution
RuconestEXPERIMENTALPatients receive (150 U/ml) of Ruconest at a 50 U/kg dose (max dose of 4200 U) as a slow intravenous injection via a peripheral every 12 hours; for 4 days. A total of 8 doses will be administered.
Standard of CareOTHERSOC
rhC1INH twice weeklyEXPERIMENTALrhC1INH administered twice weekly
rhC1INH once weeklyEXPERIMENTALrhC1INH administered once weekly
Placebo (Saline) twice weeklyPLACEBO_COMPARATORPlacebo (Saline) administered twice weekly
Recombinant Human C1 InhibitorEXPERIMENTALPatients presented to the clinic within 5 hours of onset received rhC1INH 50 U/kg body weight up to a maximum of 4200 U.
100 IU/kg rhC1INHEXPERIMENTAL100 IU/kg Recombinant human C1 inhibitor
50 IU/kg rhC1INHEXPERIMENTAL50 IU/kg Recombinant human C1 inhibitor
Recombinant Human C1INHEXPERIMENTAL -
1OTHEROpen-label i.v. administration of 100 U/kg rhC1INH

Interventions

NameTypeDescription
rhC1INHDRUGOne i.v. injection of rhC1INH at the dose of 50 U/kg, for patients up to 84 kg; one i.v. injection of rhC1INH at the dose of 4200U (2 vials) for patients of 84 kg body weight or greater.
Placebo (Saline)DRUGOne i.v. injection of saline (NaCl 0.9% w/v), equivalent in volume to the active treatment
recombinant human C1 inhibitorDRUGIV
PlaceboDRUGIV
RuconestDRUGPatients will be randomized to Ruconest or Standard of Care
i.v. recombinant human C1 inhibitorDRUG -
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Eligibility Criteria

Age Range13 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites27

Inclusion Criteria: * Aged at least 13 years * Signed written informed consent * Clear clinical and laboratory diagnosis of HAE with baseline plasma level of functional C1INH of less than 50% of normal * Willingness and ability to comply with all protocol procedures * Clinical symptoms of an eligib...

Countries:United StatesBulgariaCanadaHungaryIsraelItalyNorth MacedoniaPolandRomaniaSerbiaSouth AfricaNetherlandsCzechiaGermanySlovakia
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Frequently asked questions about rhC1INH

What is rhC1INH used for in Hereditary Angioedema?

rhC1INH is an investigational recombinant human C1 inhibitor being developed for the treatment of acute attacks of Hereditary Angioedema (HAE). It is administered to patients experiencing HAE attacks, with clinical trials evaluating its efficacy, safety, and immunogenicity in this setting.

Who makes rhC1INH?

rhC1INH is being developed by Pharming Group N.V., a biopharmaceutical company listed on the stock exchange under the ticker PHAR. The company is conducting clinical trials to evaluate the drug's safety and efficacy for treating Hereditary Angioedema.

What phase is rhC1INH in?

rhC1INH is in Phase 3 clinical development for Hereditary Angioedema. A Phase 3 trial has been completed, along with a Phase 2 trial in younger patients. The drug is investigational and has not been approved by regulatory authorities.

What clinical trials is rhC1INH in?

rhC1INH has completed two clinical trials. NCT01188564 was a Phase 3 study in 75 patients aged 13 years and older with acute HAE attacks. NCT01359969 was a Phase 2 study in 57 patients aged 2 to 13 years. Both trials were completed and evaluated safety and efficacy.

Is rhC1INH the same as Ruconest?

Yes, rhC1INH is the same as Ruconest. The Phase 2 trial in pediatric patients is titled 'Safety of Ruconest in 2-13 Year Old Hereditary Angioedema (HAE) Patients,' confirming that Ruconest is the brand name for rhC1INH.

What does rhC1INH target?

rhC1INH is a recombinant human C1 inhibitor that targets the complement system. It works by inhibiting C1 esterase, thereby regulating complement activation and preventing the excessive production of bradykinin that leads to swelling in Hereditary Angioedema attacks.