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C1 esterase inhibitor

Phase 3

Hereditary Angioedema | Small molecule | Immunology |Takeda Pharmaceutical Company Limited|Last Updated: Jun 11, 2021

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLEDDMC
Total Trials5
Total Enrollment395

FDA Designations

No designations recorded

Clinical trial landscape

C1 esterase inhibitor · 6 trials · 2 indications

Phase 3 4Phase 2 1Phase 1 1
NCT00438815Open-Label C1 Esterase Inhibitor (C1INH-nf) for the Treatment of Acute Hereditary Angioedema (HAE) AttacksHereditary Angioedema
COMPLETED113 Analytics
NCT00462709Open-Label C1 Esterase Inhibitor (C1INH-nf) for the Prevention of Acute Hereditary Angioedema (HAE) AttacksHereditary Angioedema
COMPLETED146 Analytics
NCT00289211C1 Esterase Inhibitor (C1INH-nf) for the Treatment of Acute Hereditary Angioedema (HAE) AttacksHereditary Angioedema
COMPLETED83 Analytics
NCT01005888C1 Esterase Inhibitor (C1INH-nf) for the Prevention of Acute Hereditary Angioedema (HAE) AttacksHereditary Angioedema
COMPLETED26 Analytics
PHASE3COMPLETED
Open-Label C1 Esterase Inhibitor (C1INH-nf) for the Treatment of Acute Hereditary Angioedema (HAE) Attacks
Hereditary AngioedemaUnlock trial analytics
PHASE3COMPLETED
Open-Label C1 Esterase Inhibitor (C1INH-nf) for the Prevention of Acute Hereditary Angioedema (HAE) Attacks
Hereditary AngioedemaUnlock trial analytics
PHASE3COMPLETED
C1 Esterase Inhibitor (C1INH-nf) for the Treatment of Acute Hereditary Angioedema (HAE) Attacks
Hereditary AngioedemaUnlock trial analytics
PHASE3COMPLETED
C1 Esterase Inhibitor (C1INH-nf) for the Prevention of Acute Hereditary Angioedema (HAE) Attacks
Hereditary AngioedemaUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Hereditary Angioedema (HAE) Attacks Treated With C1INH-nf
Duration of the study (2.5 years)
Percent of HAE Attacks With Substantial Relief of the Defining Symptom
Within 4 hours after initial treatment

Subjects were to assess their symptoms every 15 minutes up to 4 hours after the initial dose or until substantial relief of the defining symptom was achieved. The conservative analysis defined substantial relief as 3 consecutive assessments of improvement of the defining symptom; any attack that did not have 3 consecutive documented reports of improvement was considered a treatment failure. In the less conservative analysis, attacks also were considered to have responded if clinical improvement of the defining symptom occurred but data were incomplete due to cessation of symptom assessments.

Frequency of All HAE Attacks
Duration of the study

A hereditary angioedema (HAE) attack was defined as a discrete episode during which the subject progressed from no angioedema to symptoms of angioedema.

Time to Beginning of Substantial Relief of the Defining Symptom
Within 4 hours after initial treatment

Randomized subjects assessed their symptoms every 15 minutes up to 4 hours after the initial dose of blinded study drug or until substantial relief of the defining symptom was achieved. Substantial relief was defined as 3 consecutive assessments of improvement of the defining symptom. Beginning of substantial relief was considered the first of the 3 consecutive assessments.

Number of Hereditary Angioedema (HAE) Attacks During Each Prophylactic Therapy Period
12 weeks

An HAE attack was defined as the subject-reported indication of swelling at any location following a report of no swelling on the previous day. Analyses include observed attack counts and normalized attack counts (i.e., the number of attacks observed during each therapy period, normalized for the number of days the subject participated in that period).

Change From Baseline in Histopathology Endpoints
Within 72 hours prior to first dose of study drug, Day 20

The protocol-specified Day 20 (post-treatment) biopsy was compared to the qualifying biopsy to assess changes in histopathology for light and immunofluorescence microscopy. The Central Pathologist provided the following categorical information from the qualifying biopsy in an AMR Scorecard: C4d Score (0-100), Margination Score (0-100) Glomerulitis Score (0-100), Vasculitis Score (0-100), Glomerulosclerosis Score (0-100), Chronic Glomerulopathy Score (0-100), Interstitial Fibrosis Score (0-100), and the Chronic Vasculitis Score (0-100), with 0 being absence of abnormal histopathology. The "qualifying" renal allograft biopsy was performed as standard of care (SOC) within 12 months after transplant and prior to screening for this study. The first dose of study drug (Day 1) was administered within 72 hours after qualifying biopsy. A negative change from baseline indicates that histopathology has improved. Endpoint includes subjects with both Qualifying and Day 20 Biopsies.

PK will be analyzed by means of incremental recovery, in vivo half-life, area under the curve, clearance, and mean residence time.
1 week
C1 inhibitor (functional and antigenic) and C4 antigen serum levels will be measured at a United States Clinical Laboratory Improvement Amendments-certified laboratory and the research division of Sanquin Blood Supply Foundation.
1 week

Secondary Endpoints

Time to Beginning of Substantial Relief of the Defining Symptom
Within 4 hours after initial treatment
Time to Beginning of Substantial Relief of the Defining Symptom for Subjects Who Received Multiple Treatments
Within 4 hours after initial treatment
Antigenic C1 Inhibitor (C1INH) Serum Levels
Pre-infusion to 1 hour post-infusion
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Open-label C1INH-nfEXPERIMENTAL1,000 Units (U) of C1INH-nf administered intravenously. If there was no response to treatment 60 minutes after the first dose, a second 1,000 U dose could be administered.
C1INH-nfEXPERIMENTAL1,000 Units (U) of C1INH-nf administered intravenously (IV). If there was no response to treatment 60 minutes after the first dose, a second 1,000 U dose could be administered.
PlaceboPLACEBO_COMPARATORMatching placebo (saline) administered IV. If there was no response to treatment 60 minutes after the first dose, a second placebo (saline) dose could be administered.
C1INH-nf First, then PlaceboEXPERIMENTAL1,000 Units (U) of C1INH-nf administered intravenously (IV) every 3 to 4 days (approximately twice weekly) for 12 weeks, followed by matching placebo (saline) administered IV every 3 to 4 days for 12 weeks.
Placebo First, then C1INH-nfEXPERIMENTALMatching placebo (saline) administered IV every 3 to 4 days (approximately twice weekly) for 12 weeks, followed by 1,000 U of C1INH-nf administered IV every 3 to 4 days for 12 weeks.
C1 Esterase Inhibitor (Human)EXPERIMENTALSubjects were to receive C1 esterase inhibitor intravenously at a rate of approximately 1 mL per minute as tolerated. Subjects were to receive a total of 7 doses over a 2-week period: an initial IV infusion of 5000 U (not to exceed 100 U/kg) on Day 1, followed by 2500 U (not to exceed 50 U/kg) IV on Days 3, 5, 7, 9, 11, and 13
Normal SalinePLACEBO_COMPARATORplacebo infused as above
Single DoseEXPERIMENTAL1,000 Units (U) of C1INH-nf administered intravenously (IV).
First Dose Followed by Second DoseEXPERIMENTAL1,000 U of C1INH-nf administered IV, followed by a second 1,000 U dose 60 minutes later.

Interventions

NameTypeDescription
C1 esterase inhibitor [human] (C1INH-nf)BIOLOGICAL -
Placebo (saline)DRUG -
PlaceboBIOLOGICAL -
C1 Esterase Inhibitor (Human)BIOLOGICAL -
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Eligibility Criteria

Age Range1 Year to N/A
SexALL
Healthy VolunteersNo
Study Sites30

Inclusion Criteria: This study was open to all subjects who: * Completed participation in LEVP2005-1/A (NCT00289211) and were not participating in LEVP2005-1/B (NCT01005888), any time after the 3-day telephone follow-up * Completed participation in LEVP2005-1/B any time after the final prophylacti...

Countries:United StatesGermany
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Frequently asked questions about C1 esterase inhibitor

What is C1 Esterase Inhibitor used for?

C1 Esterase Inhibitor is used for Hereditary Angioedema and Graft Rejection. It is being developed by Takeda Pharmaceutical Company Limited (TAK) and is currently in Phase 2 clinical development for these indications. The drug is a monoclonal antibody being studied in the immunology therapeutic area.

Who makes C1 Esterase Inhibitor?

C1 Esterase Inhibitor is being developed by Takeda Pharmaceutical Company Limited, which trades under the ticker TAK. The company is conducting clinical trials to evaluate the drug for Hereditary Angioedema and Graft Rejection. The drug is currently in Phase 2 development.

What phase is C1 Esterase Inhibitor in?

C1 Esterase Inhibitor is in Phase 2 clinical development. It is being studied for Hereditary Angioedema and Graft Rejection. The drug is investigational and has not been approved by regulatory authorities. Takeda Pharmaceutical Company Limited (TAK) is the developer.

What clinical trials is C1 Esterase Inhibitor in?

C1 Esterase Inhibitor has completed five clinical trials with a total enrollment of 395 participants. Key trials include NCT00432510, a Phase 1 pharmacokinetic study in Hereditary Angioedema, and NCT00438815, NCT00462709, and NCT01005888, which are Phase 3 studies for treating or preventing acute Hereditary Angioedema attacks. All trials were conducted in the United States.

Is C1 Esterase Inhibitor FDA approved?

C1 Esterase Inhibitor is not FDA approved. It is an investigational drug currently in Phase 2 clinical development for Hereditary Angioedema and Graft Rejection. The developer, Takeda Pharmaceutical Company Limited (TAK), has completed five clinical trials but the drug remains under investigation.

What is the mechanism of C1 Esterase Inhibitor?

C1 Esterase Inhibitor is a monoclonal antibody that targets the C1 esterase enzyme. By inhibiting this enzyme, the drug aims to regulate the complement system and reduce inflammation. It is being studied for its potential to treat Hereditary Angioedema and Graft Rejection.