Study of Ravulizumab in Immunoglobulin A Nephropathy (IgAN)
The primary objective of this study to evaluate efficacy of ravulizumab compared with placebo on proteinuria reduction and change in eGFR in adult participants with IgAN who are at risk of disease progression.
Study details:
The I CAN study will enroll approximately 510 eligible participants with IgAN who are high risk of disease progression. Participants will be on stable concomitant IgAN treatment(s) consistent with standard of care for patients with IgAN for at least 3 months prior to Screening. Approximately 450 participants will be randomized in a 1:1 allocation ratio to receive a weight-based IV infusion of either ravulizumab or placebo.
An interim analysis may be conducted at Week 34 to evaluate change in proteinuria and the final analysis will be conducted at Week 106 to evaluate eGFR. In addition, approximately 60 participants with eGFR 20-29 mL/min/1. 73m2 will be enrolled in an Advanced Kidney Disease (AdKD) Cohort After Week 106, all participants have the option to enter an Open-label Ravulizumab Access Period.
Eligibility criteria
Researchers look for people who fit a certain description, called eligibility criteria. See if you qualify.
Inclusion criteria
- Documentation of IgAN diagnosis established on kidney biopsy obtained any time prior to or during the Screening Period for participants with eGFR ≥ 30 mL/min/1.73 m^2.
- For participants in the AdKD cohorts, eGFR 20 to 29 mL/min/1.73 m2 a kidney biopsy is required within 6 months prior to Screening or during the Screening Period.
- UPCR ≥ 0.75 g/g or UP ≥1 g/day calculated from the mean of two 24-hour urine during the Screening Period.
- Estimated GFR ≥ 30 mL/min/1.73 m2 at Screening.
- Stable and maximum allowed or tolerated RASI (ACEI and/or ARB) dose for ≥ 3 months prior to Screening with no planned change during Screening through Week 106.
- Participants who are receiving SGLT2I, DEARA, MRA or ERA must be on a stable and maximum allowed or tolerated dose for ≥ 3 months prior to Screening with no planned change in dose through Week 106.
Exclusion criteria
- Diagnosis of rapid progressive glomerulonephritis as measured by eGFR loss ≥ 50% over a period of 3 months prior to Screening.
- Secondary IgAN (eg, due to systemic lupus erythematosus (SLE), cirrhosis, or celiac disease; IgAV-N may be eligible).
- Concomitant clinically significant renal disease other than IgAN.
- Prior use of immunosuppressive treatment within 3 months of screening.
- Uncontrolled diabetes mellitus with glycosylated hemoglobin (HbA1c) > 8.5%.
- Henoch-Schonlein purpura (IgAV) requiring systemic immunosuppressive therapy within 12 months of Screening.
- History of kidney transplant or planned kidney transplant during the Treatment Period.
- Splenectomy or functional asplenia.
- History of Neisseria meningitidis infection.
- Active systemic bacterial, viral, or fungal infection within 14 days prior to randomization.
Eligibility
Age eligible for study : NA
Healthy volunteers accepted : No
Gender eligible for study: ALL
Things to know
Study dates
Study start:
Primary completion:
Study completion finish:
Study type
TREATMENT
Phase
- PHASE3
Study ID
NCT06291376
Intervention or treatment
DRUG: Ravulizumab
DRUG: Placebo
Conditions
- Immunoglobulin A Nephropathy
- IgAN
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Research sites nearby
Closest Location:
Research Site
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Research Site
Camperdown, Australia
Research Site
Canberra, Australia
Research Site
Clayton, Australia
Research Site
Concord, Australia
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Who is running the clinical trial?
Alexion Pharmaceuticals, Inc.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
| Participant Group/Arm | Intervention/Treatment |
|---|---|
EXPERIMENTAL: Ravulizumab IV q8w
| Drug: Ravulizumab |
PLACEBO_COMPARATOR: Placebo IV q8w
| Drug: Placebo |
What is the study measuring?
Primary Outcome
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline in Proteinuria Based on 24-hour Urine Protein Creatinine Ratio (UPCR) at Week 34 | Evaluated at interim analysis only | Baseline, Week 34 |
| Change from Baseline in Glomerular Filtration Rate (eGFR) at Week 106 | Evaluated at final analysis only | Baseline, Week 106 |
Secondary Outcome
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline in Proteinuria Based on 24-hour Urine Protein Creatinine Ratio (UPCR) at Weeks 10, 26, 34, 50, and 106 | Evaluated at interim and final analysis | Baseline, Weeks 10, 26, 34, 50, and 106 |
| Change From Baseline in eGFR at Weeks 34 and 50 | Evaluated at interim and final analysis | Baseline, Weeks 34 and 50 |
| Change From Baseline in Albuminuria at Each Scheduled Visit Up to Week 106 | Evaluated at interim and final analysis | Baseline, at Each Scheduled Visit Up to Week 106 |
| Reduction in 24-hour UPCR ≥ 50% From Baseline at Each Scheduled Visit Up to Week 106 | Evaluated at interim and final analysis | Baseline, at Each Scheduled Visit Up to Week 106 |
| Number of Participants With Partial Remission at Each Scheduled Visit Up to Week 106 | Evaluated at interim and final analysis | Baseline, at Each Scheduled Visit Up to Week 106 |
| Change from Baseline in Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue at Weeks 34, 50, and 106 | Evaluated at interim and final analysis | Baseline, Weeks 34, 50, and 106 |
| Annualized eGFR Slope Over 50 Weeks | Evaluated at interim analysis only | Baseline, Over 50 Weeks |
| Time to First Composite Kidney Event Up to Week 106 | Composite kidney event endpoint is defined as reaching at least 1 of the following: Sustained ≥ 30% decline in eGFR relative to baseline; or Sustained eGFR \< 15 milliliter (mL)/minute (min)/1.73 square meter (m\^2); or Maintenance dialysis; or Receipt of kidney transplant; or Death from kidney failure. Evaluated at final analysis only | Baseline Up to Week 106 |
| Time to Sustained ≥ 30% eGFR Decline Up to Week 106 | Evaluated at final analysis only | Baseline Up to Week 106 |
| Time to Sustained eGFR Decline ≥ 40% Up to Week 106 | Evaluated at final analysis only | Baseline Up to Week 106 |
| Use of Alternative IgAN Therapy Up to Week 106 | Evaluated at final analysis only | Baseline, Up to Week 106 |
References
Clinical Trials Gov: Study of Ravulizumab in Immunoglobulin A Nephropathy (IgAN)Other trials to consider
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