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Belumosudil

Phase 3

Chronic Graft Versus Host Disease | Small molecule | Immunology |Sanofi|Last Updated: Jul 24, 2026

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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials3
Total Enrollment355
FDA Designations
No designations recorded
Clinical trial landscape

Belumosudil · 12 trials · 11 indications

Phase 3 2Phase 2 5Phase 1 5
NCT06143891A Study to Test an Oral Medicine, Belumosudil, in Combination With Corticosteroids in Participants at Least 12 Years of Age With Newly Diagnosed Chronic Graft Versus Host Disease.Chronic Graft Versus Host Disease
ACTIVE NOT_RECRUITING260 Analytics
NCT06082037A Study to Test How Effective Belumosudil Tablets Are for Treating Adult Participants With Chronic Lung Allograft DysfunctionLung Transplant Rejection
RECRUITING180 Analytics
PHASE3ACTIVE NOT_RECRUITING
A Study to Test an Oral Medicine, Belumosudil, in Combination With Corticosteroids in Participants at Least 12 Years of Age With Newly Diagnosed Chronic Graft Versus Host Disease.
Chronic Graft Versus Host DiseaseUnlock trial analytics
PHASE3RECRUITING
A Study to Test How Effective Belumosudil Tablets Are for Treating Adult Participants With Chronic Lung Allograft Dysfunction
Lung Transplant RejectionUnlock trial analytics
Study Endpoints
Primary Endpoints
Event-Free Survival (EFS)
Until the end of the study (up to 2.5 years since first patient in).

From the date of randomization to the date of any predefined event, whichever occurs first

Percent change from baseline to Week 26 in forced expiratory volume in 1 second (FEV1)
Baseline to Week 26
Efficacy will be assessed using overall response rate (ORR) as per the NIH cGvHD Consensus Response Criteria at 24 weeks of combination treatment. Tolerability and safety will be assessed by the incidence and severity of adverse events (AEs)
Enrollment to 24 and 48 weeks after combination therapy.

The proportion of responders and its 95% confidence interval (using exact binomial methods) will be calculated.

Phase 1: AUC
Cycle 1 Day 15 after the last participant dosed in the phase 1 part.

PK parameter (AUC at steady state)

Proportion of participants who achieve an overall response (partial response [PR] or complete response [CR]) by Week 25 or Cycle 7 Day 1 whichever is first
Last participant completing 24 weeks (Week 25 visit or Cycle 7 Day 1 visit, whichever comes first) in the study

Proportion of participants who achieve an overall response (partial response \[PR\] or complete response \[CR\]) with up to 24 weeks of therapy (i.e. by the Week 25 or Cycle 7 Day 1 visit whichever is first), as defined by the National Institute of Health (NIH) Consensus response criteria

24-week Overall Response Rate (ORR) [Cohort A]
up to 24 weeks.

24-week ORR defined as the proportion of participants achieving BOS complete response (CR) or partial response (PR) based on change in FEV1 measurement per criteria of the 2014 NIH Consensus Conference.

24-week Overall Response Rate (ORR) [Cohort B]
up to 24 weeks.

24-week ORR defined as the proportion of participants achieving BOS complete response (CR) or partial response (PR) based on change in FEV1 measurement per criteria of the 2014 NIH Consensus Conference.

24-week Progression Rate [Cohort B]
up to 24 weeks.

24-week progression rate is defined as the proportion of participants experiencing BOS progression based on change in FEV1 measurement per criteria of the 2014 NIH Consensus Conference.

Duration of Response (DOR)
At Baseline (Day 1), Month 3 and every 3 months thereafter (+/-14 days), up to 23 months

DOR is defined as time from first documentation of response to time of first documentation of deterioration from best response (e.g., complete response \[CR\] to partial response \[PR\], or PR to Lack of response \[LR\]). As per the 2014 National Institutes of Health (NIH) Consensus Development Project for clinical trials in cGVHD criteria: CR was defined as resolution of all manifestations of cGVHD in each organ or site.PR was defined as the improvement in at least 1 organ or site without progression in any other organ or site.LR included response status of mixed, unchanged, or progression.Mixed LR was defined as complete or partial response in at least 1 organ accompanied by progression in another organ. Unchanged LR was defined as outcomes that did not meet criteria for CR, PR, progression or mixed response. Progression LR was defined as progression in at least 1 organ or site without a response in any other organ or site. Confidence interval (CI) is calculated using Kaplan-Meier method.

Number of Participants With a >=7 Point Reduction (7PtR) From Baseline and >=7 Point Reduction From Baseline on 2 Consecutive Post-Baseline Assessments as Assessed by Lee Symptom Scale (LSS)
Baseline (Day 1) up to 23 months

The questionnaire asked participants to indicate the degree of bother that they experienced due to symptoms in 7 domains potentially affected by cGVHD. It consists of 30 items of 7 domains: skin, eyes and mouth, breathing, eating and digestion, muscles and joints, energy, and mental and emotional. Each question was rated/scored as 0-not at all, 1-slightly, 2-moderately, 3-quite a bit, 4-extremely with lower values representing better outcome. A domain score was calculated for each domain by taking the mean of all items completed if more than 50% were answered and normalizing to a 0 to 100 scale. A total score was calculated as average of all non-missing domain scores if more than 50% of them were non-missing, ranged from 0-100. A higher score indicated more bothersome symptoms. A 7-point difference on the total score of cGVHD symptom scale was found to be clinically meaningful.

Duration of >=7 Point Reduction as Assessed by Lee Symptom Scale
Baseline (Day 1) up to 23 months

The questionnaire asked participants to indicate the degree of bother that they experienced due to symptoms in 7 domains potentially affected by cGVHD. It consisted of 30 items of 7 domains: skin, eyes and mouth, breathing, eating and digestion, muscles and joints, energy, and mental and emotional. Each question was rated/scored as 0-not at all, 1-slightly, 2-moderately, 3-quite a bit, 4-extremely with lower values representing better outcome. A domain score was calculated for each domain by taking the mean of all items completed if more than 50% were answered and normalizing to a 0 to 100 scale. A total score was calculated as average of all non-missing domain scores if more than 50% of them were non-missing, ranged from 0-100. A higher score indicated more bothersome symptoms. A 7-point difference on the total score of cGVHD symptom scale was found to be clinically meaningful. Mean of duration of \>=7PtR is presented.

Time to Next Treatment (TTNT)
At Baseline (Day 1), Month 3 and every 3 months thereafter (+/-14 days), up to 23 months

The TTNT was measured as the time from first treatment to the time of new systemic cGVHD treatment, censored by last response assessment or long term follow up assessment, whichever was the latest and available. TTNT was analyzed by the Kaplan-Meier survival method.

Failure-Free Survival (FFS)
At Baseline (Day 1), Month 3 and every 3 months thereafter (+/-14 days), up to 23 months

FFS was defined as the absence of new cGVHD systemic therapy, non-relapse mortality and recurrent malignancy (i.e. underlying disease) and was censored by last response assessment or long term follow up assessment, whichever was the latest and available. Kaplan-Meier method was used for the analysis.

Overall Survival (OS)
From first dose of study drug (Day 1) to the date of death due to any cause, up to approximately 24 months

OS was defined as time from first dose of belumosudil to the date of death due to any cause. CI was calculated using Kaplan-Meier method.

Percentage of Participants With Complete Response (CR) and Partial Response (PR)
At Baseline (Day 1), Month 3 and every 3 months thereafter (+/-14 days), up to 23 months

As per the 2014 NIH Consensus Development Project for clinical trials in cGVHD criteria: CR was defined as resolution of all manifestations of cGVHD in each organ or site. PR was defined as the improvement in at least 1 organ or site without progression in any other organ or site.

Number of Participants With Best Response by Organ System
At Baseline (Day 1), Month 3 and every 3 months thereafter (+/-14 days), up to 23 months

The best response (CR, PR) for individual organs (skin, eyes, mouth, esophagus, upper gastrointestinal \[GI\], lower GI, liver, lungs, joints and fascia) was summarized. As per the 2014 NIH Consensus Development Project for clinical trials in cGVHD criteria, CR was defined as resolution of all manifestations of cGVHD in each organ or site. PR was defined as the improvement in at least 1 organ or site without progression in any other organ or site.

Percent Change From Baseline in Corticosteroid Dose to Greatest Reduction
Baseline (Day 1) and Month 23

Change in corticosteroid doses was analyzed by using prednisone dose equivalents. If participants were not using prednisone as the systemic corticosteroid, then the prednisone dose equivalent would be determined according to following conversion ratios: 1 mg prednisone is equivalent to: 4.0 mg Hydrocortisone; 0.8 mg Methylprednisolone; 0.15 mg Dexamethasone; 1.0 mg Prednisolone and 0.8 mg Triamcinolone. Baseline was defined as the valid and last non-missing value obtained within 28 days prior to participant receiving the first study drug in parent study (KD025-208 \[NCT02841995\] or KD025-213 \[NCT03640481\]).

Number of Participants With Maximal Improvement From Baseline in Global Severity Rating (GSR) Based on Clinician-Reported Chronic Graft-Versus-Host-Disease Assessment
From Baseline (Day 1) up to 23 months

The GSR assessment was performed by asking the participants to rate their disease severity of cGVHD symptoms on a 0 to 10-point numeric rating scale, where score 0 indicated 'not at all severe cGVHD symptoms' and score 10 indicated 'most severe cGVHD symptoms possible'. The response was defined using scores from 9 organs: skin, eyes, mouth, esophagus, upper GI track, lower GI tract, liver, lungs, and joints and fascia plus GSR. Baseline was defined as the valid and last non-missing value obtained within 28 days prior to participant receiving the first study drug in parent study (KD025-208 \[NCT02841995\] or KD025-213 \[NCT03640481\]). Maximal improvement from Baseline was calculated as lowest GSR score on scheduled visits minus GSR score at Baseline with possible ranges from -10 to 10. The lower the number means the better improvement in cGVHD symptoms.

Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Treatment-Emergent Serious Adverse Events (TESAEs), Grade >=3 Treatment-Emergent Adverse Events and Deaths
From the first dose of study drug (Day 1) up to 28 days after the last dose of study drug, approximately 24 months

An adverse event (AE) was defined as any untoward medical occurrence in a clinical trial participant associated with the use of a study drug, whether or not considered drug-related. Serious adverse event (SAE) was any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, was a congenital anomaly/birth defect or was an important medical event. The severity of each AE was graded using the Common Terminology Criteria for Adverse Events version 4.03 scale. TEAEs were defined as AEs that developed, worsened or became serious during the TE period.

Percentage of Participants With Overall Response (OR)
From the date of randomization to the date of first documentation of progression or death due to any cause or data cut-off, whichever occurred first (maximum duration: up to 64.2 months)

OR was defined as the percentage of participants with complete response (CR) or partial response (PR). The OR determination of chronic graft versus host disease (cGVHD) was based on cGVHD response assessment performed by clinicians as per the 2014 National Institutes of Health (NIH) Consensus Development Project for Clinical Trials in cGVHD criteria. CR was defined as the resolution of all manifestations in each organ or site. PR was defined as the improvement in at least 1 organ or site without progression in any other organ or site; and cGVHD progression was defined as the clinically meaningful worsening in 1 or more organs regardless of improvement in other organs.

Number of Participants With Treatment-emergent Adverse Events (TEAEs), and Treatment-emergent Serious Adverse Events (TESAEs)
From first dose of study drug up to 28 days after the last dose of study drug (maximum duration: up to 64.2 months)

An adverse event (AE) was defined as any untoward medical occurrence in a participant who received study drug and did not necessarily have to have a causal relationship with the treatment. Serious adverse events (SAEs) was any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as AEs that developed, worsened or became serious during the TEAE period (defined as the time from the first dose of study drug up to 28 days after the last dose of study drug). TEAEs included both SAEs and non-SAEs.

AUClast
Baseline (H0) to Day 3 (H48) for each of the 2 periods

Area under the plasma concentration versus time curve until the time of last quantifiable concentration

Cmax
Baseline (H0) to Day 3 (H48) for each of the 2 periods

Maximum plasma concentration observed

AUC(0-last)- Parts 1,2, and 3 (victim drugs)
Multiple timepoints up to approximately 15 days

Area under the curve from time 0 to the time of last measurable concentration

AUC(0-inf)- Parts 1,2, and 3 (victim drugs
Multiple timepoints up to approximately 15 days

Area under the curve from time 0 extrapolated to infinity

Number of participants with adverse events and serious adverse events
Up to approximately 58 days
Secondary Endpoints
Modified Lee Symptom Scale (mLSS)
Until the end of the study (up to 2.5 years since first patient in).
Durable overall response rate
Until the end of the study (up to 2.5 years since first patient in).
Rate of corticosteroid withdrawal
Until the end of the study (up to 2.5 years since first patient in).
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
BelumosudilEXPERIMENTALParticipants will receive belumosudil 200 mg tablets per os(PO) once daily (QD) per 28-day cycles starting on Day 1 until discontinuation criteria are met or until end of study Note: 200mg two times a day (BID) is used in some cases, when the subject is taking a proton pump inhibitor or a strong CYP3A4 inducer)
PlaceboPLACEBO_COMPARATORParticipants will receive matching placebo tablets PO QD per 28-day cycles starting on Day 1 until discontinuation criteria are met or until end of study
Belumosudil + AzithromycinEXPERIMENTALParticipants will receive 200 mg belumosudil orally once daily
Placebo + AzithromycinPLACEBO_COMPARATORParticipants will receive placebo orally once daily
Combination therapy with two oral agents (belumosudil, ruxolitinib)EXPERIMENTALRuxolitinib monotherapy (4 weeks), then combination therapy with belumosudil (48 weeks), 52 weeks total, unless cGvHD progresses or side effects become intolerable.
Cohort A: Belumosudil + Standard of Care MedicationsEXPERIMENTAL30 participants with bronchiolitis obliterans syndrome (BOS) will complete study procedures as follows: * Drug diary * CT scans at Cycles 3 and 7 and at End of Treatment. * Cycle 1 * Day 1 - 28 of 28-day cycle: Predetermined dose of Belumosudil 1x daily. * Predetermined doses of Fluticasone, Montelukast, and Prednisone 1x daily. * Predetermined dose of azithromycin 3 days per treatment week. * Cycle 2 - 3 * Day 1 - 28 of 28-day cycle: Predetermined dose of Belumosudil 1x daily. * Predetermined doses of Fluticasone Montelukast 1x daily. Predetermined doses of Prednisone 1x daily at treating physician's discretion. * Predetermined dose of azithromycin 3 days per treatment week. * Cycle 4 - 12 * Day 1 - 28 of 28-day cycle: Predetermined dose of Belumosudil 1x daily. * Predetermined doses of Fluticasone and Montelukast 1x daily. * Predetermined dose of azithromycin 3 days per treatment week.
Cohort B: BelumosudilEXPERIMENTAL15 participants with signs concerning developing BOS will complete study procedure as follows: * Drug diary * CT scans at Cycles 3 and 7 and at End of Treatment. * Cycle 1 - 12 - Day 1 - 28 of 28-day cycle: Predetermined dose of Belumosudil 1x daily.
Arm A: belumosudil 200 mg QDEXPERIMENTALThe assigned arm is per the previous study KD025-213 or study KD025-208
Arm B: belumosudil 200 mg BIDEXPERIMENTALThe assigned arm is per the previous study KD025-213 or study KD025-208
Arm C: belumosudil 400 mg QDEXPERIMENTALThe assigned arm is per the previous study KD025-213 or study KD025-208
Cohort 1: Belumosudil 200 mg QDEXPERIMENTALParticipants received belumosudil 200 mg orally QD in each 28-day treatment cycle until disease progression, unacceptable toxicity, or death whichever occurred first (maximum duration: 64.2 months).
Cohort 2: Belumosudil 200 mg BIDEXPERIMENTALParticipants received belumosudil 200 mg orally BID in each 28-day treatment cycle until disease progression, unacceptable toxicity, or death whichever occurred first (maximum duration: 45.9 months).
Cohort 3: Belumosudil 400 mg QDEXPERIMENTALParticipants received belumosudil 400 mg orally QD in each 28-day treatment cycle until disease progression, unacceptable toxicity, or death whichever occurred first (maximum duration: 49.2 months).
belumosudil tablet,then belumosudil oral suspensionEXPERIMENTALbelumosudil tablet in period 1, then belumosudil oral suspension in period 2.
belumosudil oral suspension, then belumosudil tabletEXPERIMENTALbelumosudil oral suspension in period 1, then belumosudil tablet in period 2.
Part 1EXPERIMENTALBelumosudil + UGT1A1 victim drug administered in the fed state
Part 2EXPERIMENTALBelumosudil + P-gp victim drug administered in the fed state
Part 3EXPERIMENTALBelumosudil + OATP1B1/BCRP victim drug administered in the fed state
KD025EXPERIMENTAL500 mg KD025 administered orally twice daily (BID) for 28 days
Cohort 1EXPERIMENTAL500 mg KD025 or placebo once daily (QD) for 7 days
Cohort 2EXPERIMENTAL800 mg KD025 or placebo QD for 7 days
Cohort 3EXPERIMENTAL500 mg KD025 or placebo twice daily (BID) for 7 days
Cohort 4EXPERIMENTAL1000 mg KD025 or placebo QD for 7 days
Dose level 1EXPERIMENTALSingle Oral Doses of 20 mg SLx-2119 or placebo on Day 1
Dose level 2EXPERIMENTALSingle Oral Doses of 40 mg SLx-2119 or placebo on Day 1
Dose level 3EXPERIMENTALSingle Oral Doses of 80 mg SLx-2119 or placebo on Day 1
Dose level 4EXPERIMENTALSingle Oral Doses of 160 mg SLx-2119 or placebo on Day 1
Dose level 5EXPERIMENTALSingle Oral Doses of 320 mg SLx-2119 or placebo on Day 1
Dose level 6EXPERIMENTALSingle Oral Doses of 640 mg SLx-2119 or placebo on Day 1
Interventions
NameTypeDescription
BelumosudilDRUGPharmaceutical form:Tablet-Route of administration:oral
PlaceboDRUGPharmaceutical form:Table-Route of administration:oral
PrednisoneDRUGPharmaceutical form:Tablet-Route of administration:oral
PrednisoloneDRUGPharmaceutical form:Tablet-Route of administration:oral
AzithromycinDRUGDepends on pharmaceutical presentation, Oral
RuxolitinibDRUGPatients receive ruxolitinib (10 mg twice daily) alone for one 28-day cycle, then add belumosudil (200 mg once or twice daily if on a PPI) from cycles 2-12 (48 weeks total), unless cGvHD progresses or side effects become intolerable.
FluticasoneDRUGVia inhalation by metered-dose inhaler.
MontelukastDRUGLeukotriene Receptor Antagonist, taken orally
Belumosudil 200 mg QDDRUGBelumosudil is an orally available Rho-associated protein kinase-2 (ROCK2) selective inhibitor.
Belumosudil 200 mg BIDDRUGBelumosudil is an orally available Rho-associated protein kinase-2 (ROCK2) selective inhibitor.
Belumosudil 400 mg QDDRUGBelumosudil is an orally available Rho-associated protein kinase-2 (ROCK2) selective inhibitor.
Belumosudil (KD025)DRUGPharmaceutical form: Capsules or Tablets Route of administration: Oral
UGT1A1 victim drugDRUGPharmaceutical form: Tablet; Route of administration: Oral
P-gp victim drugDRUGPharmaceutical form: Capsule; Route of administration: Oral
OATP1B1/BCRP victim drugDRUGPharmaceutical form: Tablet; Route of administration: Oral
Belumosudil mesylateDRUGPharmaceutical form: capsule; Route of administration: oral
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Eligibility Criteria
Age Range12 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites151

Inclusion Criteria: * Patients must be at least 12 years of age inclusive, at the time of signing the informed consent * Participants who have undergone allogenic HCT with newly diagnosed moderate to severe cGVHD according to NIH consensus diagnosis and staging criteria (2014) * Participants who re...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilCanadaChinaCzechiaDenmarkFranceGermanyGreeceHong KongIsraelItalyNetherlandsPolandPortugalSouth KoreaSpainSwedenTurkey (Türkiye)United KingdomFinlandHungaryJapan
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Recent Changes (Last 90 Days)
LOWJul 24, 2026NCT07726914NEW_TRIAL: changed
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