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A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Ravulizumab in Adult Participants With Immunoglobulin A Nephropathy (IgAN)


Description

The primary objective of this study to evaluate the efficacy of ravulizumab compared with placebo to reduce proteinuria and slow the rate of eGFR decline in adult participants with IgAN who are at risk of disease progression.The I CAN study will enroll approximately 450 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, 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 20 participants with eGFR 20-29 mL/min/1.73m2 will be enrolled in an Exploratory Cohort and will receive open label weight-based IV infusion of ravulizumab. After Week 106, all participa

Trial Eligibility

Inclusion Criteria: * Documentation of IgAN diagnosis established on kidney biopsy obtained any time prior to or during the Screening Period. * UPCR ≥ 0.75 g/g or UP ≥1 g/day from the mean of two 24-hour urine collections during Screening. * Estimated GFR ≥ 30 mL/min/1.73 m2 at Screening. * Exploratory Cohort: eGFR 20-29 mL/min/1.73 m2 at Screening. A kidney biopsy is required within 6 months prior to Screening or during the Screening Period. * Presence of hematuria as defined by a positive result on urine dipstick for blood or ≥ 5 red blood cells (RBCs)/high power field microscopy on urine sediment during or within 3 months of 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 on an SGLT2I, ERA, or MRA must be on a stable and maximum allowed or tolerated dose for ≥ 3 months prior to Screening with no planned change 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). * Concomitant clinically significant renal disease other than IgAN. * Prior use of immunosuppressive treatment for IgAN within 6 months of screening. * Uncontrolled diabetes mellitus with glycosylated hemoglobin (HbA1c) \> 8.5%. * Clinically active Henoch-Schonlein purpura (IgA vasculitis) requiring ongoing systemic immunosuppressive therapy at 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.

Study Info

Organization

Alexion Pharmaceuticals, Inc.


Primary Outcome

Change from Baseline in Proteinuria Based on 24-hour Urine Protein Creatinine Ratio (UPCR) at Week 34


Outcome Timeframe Baseline, Week 34

NCTID NCT06291376

Phases PHASE3

Primary Purpose TREATMENT

Start Date 2024-03-29

Completion Date 2026-02-23

Enrollment Target 470

Interventions

DRUG Ravulizumab

DRUG Placebo

Locations Recruiting

Research Site

United States, Alabama, Alabaster


Research Site

United States, Arizona, Phoenix


Research Site

United States, California, Loma Linda


Research Site

United States, California, Los Angeles


Research Site

United States, California, Los Angeles


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