Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Also known as C1 esterase inhibitor [human] (C1INH-nf), C1 Esterase Inhibitor (Human), C1 Esterase Inhibitor Injection [Cinryze]
C1 esterase inhibitor · 7 trials · 3 indications
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.
A hereditary angioedema (HAE) attack was defined as a discrete episode during which the subject progressed from no angioedema to symptoms of angioedema.
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.
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).
Defined as either a new focal neurological impairment, or a decrease of at least 2 points on the Glasgow Coma Scale. This should last for at least 1 hour, is not apparent immediately after aneurysm occlusion, and cannot be attributed to other causes by means of clinical assessment, CT or MRI scanning of the brain, and appropriate laboratory studies.
Complication rate during hospitalization
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.
| Arm | Type | Description |
|---|---|---|
| Open-label C1INH-nf | EXPERIMENTAL | 1,000 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-nf | EXPERIMENTAL | 1,000 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. |
| Placebo | PLACEBO_COMPARATOR | Matching 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 Placebo | EXPERIMENTAL | 1,000 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-nf | EXPERIMENTAL | Matching 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 (Cinryze) | EXPERIMENTAL | One group receiving study medication (C1-esterase inhibitor Cinryze) |
| C1 Esterase Inhibitor (Human) | EXPERIMENTAL | Subjects 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 Saline | PLACEBO_COMPARATOR | placebo infused as above |
| Single Dose | EXPERIMENTAL | 1,000 Units (U) of C1INH-nf administered intravenously (IV). |
| First Dose Followed by Second Dose | EXPERIMENTAL | 1,000 U of C1INH-nf administered IV, followed by a second 1,000 U dose 60 minutes later. |
| Name | Type | Description |
|---|---|---|
| C1 esterase inhibitor [human] (C1INH-nf) | BIOLOGICAL | - |
| Placebo (saline) | DRUG | - |
| C1 Esterase Inhibitor Injection [Cinryze] | DRUG | C1 Esterase Inhibitor Injection \[Cinryze\] |
| Placebo | DRUG | Sodium Chloride /physiological saline (0.9%) in equal volume dosed intravenous |
| C1 Esterase Inhibitor (Human) | BIOLOGICAL | - |
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...
| Company | Ticker | Trials | Lead Phase | Drugs |
|---|---|---|---|---|
| Intellia Therapeutics, Inc. | NTLA | 3 | PHASE3 | NTLA-2002 |
| BioCryst Pharmaceuticals, Inc. | BCRX | 2 | PHASE3 | Berotralstat |
| Ionis Pharmaceuticals, Inc. | IONS | 1 | PHASE3 | Donidalorsen |
| Pharvaris N.V. | PHVS | 1 | PHASE2 | Deucrictibant |
| BioMarin Pharmaceutical Inc. | BMRN | 1 | PHASE1 | BMN 331 |
| Astria Therapeutics, Inc. | ATXS | 1 | PHASE2 | STAR-0215 |
C1 esterase inhibitor is being studied in hereditary angioedema, antibody-mediated graft rejection, and aneurysmal subarachnoid hemorrhage. It is an investigational therapy developed by Takeda Pharmaceutical Company Limited. Across its clinical program, trials have enrolled 395 participants in conditions spanning immunology and acute neurological injury.
C1 esterase inhibitor is developed by Takeda Pharmaceutical Company Limited, which trades under the ticker TAK. Takeda is the sponsor behind the clinical program evaluating the therapy across hereditary angioedema, graft rejection, and aneurysmal subarachnoid hemorrhage.
C1 esterase inhibitor is in Phase 2 development overall, though individual trials have been conducted at Phase 3. It is investigational and has not been approved by the FDA. Five trials have been completed and one Phase 2 study is currently recruiting.
The active trial is NCT06359782, a Phase 2 study of complement inhibition in aneurysmal subarachnoid hemorrhage, recruiting 128 patients in the Netherlands. Completed trials include NCT01147302 in graft rejection, plus NCT01005888 and NCT00462709 in hereditary angioedema prevention.
Yes. C1 esterase inhibitor is also known as C1 esterase inhibitor [human] (C1INH-nf), C1 Esterase Inhibitor (Human), and C1 Esterase Inhibitor Injection [Cinryze]. These names refer to the same therapy evaluated across the hereditary angioedema, graft rejection, and subarachnoid hemorrhage trials.
C1 esterase inhibitor trials have enrolled a total of 395 participants. The studies are randomized, double-blind, and placebo-controlled. Enrollment ranges from 18 patients in the graft rejection pilot to 146 in a hereditary angioedema prevention study.