Active, not recruiting
Phase 3
A Study Evaluating the Efficacy and Safety of Mitapivat in Participants With Non-Transfusion-Dependent Alpha- or Beta-Thalassemia (α- or β-NTDT)
Condition(s) studied
Non-Transfusion-dependent Alpha-ThalassemiaNon-Transfusion-dependent Beta-Thalassemia
Investigational drug(s) / intervention(s)
Placebo Matching MitapivatMitapivat
Placebo Matching Mitapivat: Tablets
Mitapivat: Tablets
Study summary
The primary purpose of this study was to compare the effect of mitapivat versus placebo on hemolytic anemia in participants with alpha- or beta-non-transfusion dependent thalassemia (NTDT).
Eligibility
Inclusion Criteria:
* Documented diagnosis of thalassemia (β-thalassemia with or without α-globin gene mutations, hemoglobin E (HbE)/β-thalassemia, or α-thalassemia/hemoglobin H \[HbH\] disease) based on Hb electrophoresis, Hb high-performance liquid chromatography (HPLC)), and/or deoxyribonucleic acid (DNA) analysis;
* Hb concentration ≤10.0 grams per deciliter (g/dL) (100.0 grams per liter \[g/L\]), based on an average of at least 2 Hb concentration measurements (separated by ≥7 days) collected during the Screening Period;
* Non-transfusion-dependent, defined as ≤5 red blood cell (RBC) units during the 24-week period before randomization; and no RBC transfusions ≤8 weeks before providing informed consent and no RBC transfusions during the Screening Period;
* If taking hydroxyurea, the hydroxyurea dose must be stable for ≥16 weeks before randomization;
* Women of child-bearing potential (WOCBP) must be abstinent of sexual activities that may result in pregnancy as part of their usual lifestyle or agree to use 2 forms of contraception, one of which must be considered highly effective, from the time of providing informed consent, throughout the study, and for 28 days after the last dose of study drug. The second form of contraception can be an acceptable barrier method;
* Written informed consent before any study-related procedures are conducted and willing to comply with all study procedures for the duration of the study.
Exclusion Criteria:
* Pregnant, breastfeeding, or parturient
* Documented history of homozygous or heterozygous sickle hemoglobin (HbS) or hemoglobin C (HbC);
* Prior exposure to gene therapy or prior bone marrow or stem cell transplantation;
* Currently receiving treatment with luspatercept; the last dose must have been administered ≥18 weeks before randomization;
* Currently receiving treatment with hematopoietic stimulating agents; the last dose must have been administered ≥18 weeks before randomization;
* History of malignancy, (active or treated) ≤5 years before providing informed consent;
* History of active and/or uncontrolled cardiac or pulmonary disease ≤6 months before providing informed consent, except for nonmelanomatous skin cancer in situ, cervical carcinoma in situ, or breast carcinoma in situ;
* Hepatobiliary disorders;
* Estimated glomerular filtration rate \<45 milliliters per minute (mL/min)/1.73 m\^2 by Chronic Kidney Disease Epidemiology Collaboration creatinine equation;
* Nonfasting triglycerides \>440 milligrams per deciliter (mg/dL) (5 millimoles per liter \[mmol/L\]);
* Active infection requiring systemic antimicrobial therapy at the time of providing informed consent;
* Positive test for hepatitis C virus antibody (HCVAb) with evidence of active HCV infection, or positive test for hepatitis B surface antigen (HBsAg);
* Positive test for human immunodeficiency virus (HIV)-1 antibody (Ab) or HIV-2 Ab;
* History of major surgery (including splenectomy) ≤16 weeks before providing informed consent and/or a major surgical procedure planned during the study;
* Current enrollment or past participation (≤12 weeks before administration of the first dose of study drug or a timeframe equivalent to 5 half-lives of the investigational study drug, whichever is longer) in any other clinical study involving an investigational treatment or device;
* Receiving strong CYP3A4/5 inhibitors that have not been stopped for ≥5 days or a timeframe equivalent to 5 half-lives (whichever is longer); or strong CYP3A4 inducers that have not been stopped for ≥4 weeks or a timeframe equivalent to 5 half-lives (whichever is longer), before randomization;
* Receiving anabolic steroids that have not been stopped for at least 4 weeks before randomization. Testosterone replacement therapy to treat hypogonadism is allowed. The testosterone dose and preparation must be stable for ≥10 weeks before randomization;
* Known allergy to mitapivat or its excipients (microcrystalline cellulose, croscarmellose sodium, sodium stearyl fumarate, mannitol, and magnesium stearate, Opadry® II Blue \[hypromellose, titanium dioxide, lactose monohydrate, triacetin, and FD\&C Blue #2\]);
* Any medical, hematological, psychological, or behavioral condition(s) or prior or current therapy that, in the opinion of the Investigator, may confer an unacceptable risk to participating in the study and/or could confound the interpretation of the study data Also excluded are:
* Participants who are institutionalized by regulatory or court order
* Participants with any condition(s) that could create undue influence (including but not limited to incarceration, involuntary psychiatric confinement, and financial or familial affiliation with the Investigator or Sponsor)
Primary outcome measure(s)
- Double-Blind Period: Percentage of Participants Who Achieved Hemoglobin (Hb) Response From Week 12 Through Week 24 Compared With Baseline — Double-Blind Period: Baseline up to Week 12 through Week 24
Hb response is defined as ≥10 grams/ liter (g/L) (1.0 gram per deciliter) (g/dL) increase in average Hb concentration from Week 12 through Week 24 compared with baseline. Hb response was tested using the Mantel-Haenszel stratum weighted method adjusting for randomization stratification factors. Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.
Trial sites (68)
| Facility | City | Region | Status |
| San Diego Hospital, UC San Diego Health |
La Jolla |
California |
|
| Stanford Medicine |
Palo Alto |
California |
|
| Massachusetts General Hospital |
Boston |
Massachusetts |
|
| Weill Cornell Medical Center |
New York |
New York |
|
| Duke University Medical Center |
Durham |
North Carolina |
|
| Penn Medicine - University of Pennsylvania Health System |
Philadelphia |
Pennsylvania |
|
| Universidade de Caxias do Sul |
Caxias do Sul |
Brazil |
|
| Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP |
Ribeirão Preto |
Brazil |
|
| HEMORIO Instituto Nacional de Hematologia |
Rio de Janeiro |
Brazil |
|
| Praxis Pesquisa Medica |
Santo André |
Brazil |
|
| GSH Banco de Sangue de São Paulo |
São Paulo |
Brazil |
|
| Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidad de São Paulo |
São Paulo |
Brazil |
|
| MHAT "Dr. Nikola Vasiliev" AD |
Kyustendil |
Bulgaria |
|
| SHATHD Sofia |
Sofia |
Bulgaria |
|
| Toronto General Hospital, University Health Network |
Toronto |
Canada |
|
| Rigshospitalet |
Copenhagen |
Denmark |
|
| CHU Hôpital Henri Mondor |
Créteil |
France |
|
| Hopital Edouard Herriot, CHU de Lyon |
Lyon |
France |
|
| Laiko General Hospital |
Athens |
Greece |
|
| Children's Hospital Agia Sophia, National and Kapodistrian University of Athens Medical School |
Athens |
Greece |
|
| University General Hospital of Patras |
Rio |
Greece |
|
| Ippokrateio General Hospital |
Thessaloniki |
Greece |
|
| Ospedale "A. Perrino" - Brindisi |
Brindisi |
Italy |
|
| Ospedale Pediatrico Microcitemico |
Cagliari |
Italy |
|
| Ospedale Sant'Anna |
Ferrara |
Italy |
|
| Ente Ospedaliero Ospedali Galliera |
Genova |
Italy |
|
| Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico |
Milan |
Italy |
|
| A.O.U Di Modena |
Modena |
Italy |
|
| A.O.R.N. "A. Cardarelli" |
Naples |
Italy |
|
| AOU L. Vanvitelli Universita degli Studi della Campania Luigi Vanvitelli |
Naples |
Italy |
|
| A.O.U. San Luigi Gonzaga |
Orbassano |
Italy |
|
| Chronic Care Center |
Beirut |
Lebanon |
|
| Hospital Sultanah Bahiyah |
Alor Star |
Malaysia |
|
| Hospital Ampang |
Ampang |
Malaysia |
|
| Hospital Sultanah Aminah Johor Bahru |
Johor Bahru |
Malaysia |
|
| Hospital Queen Elizabeth, Kota Kinabalu |
Kota Kinabalu |
Malaysia |
|
| Hospital Tunku Azizah |
Kuala Lumpur |
Malaysia |
|
| Hospital Tengku Ampuan Afzan |
Kuantan |
Malaysia |
|
| Hospital Umum Sarawak |
Kuching |
Malaysia |
|
| Hospital Pulau Pinang |
Pulau Pinang |
Malaysia |
|
+ 28 more sites — see the full list on the official registry below.
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