Immunoglobulin G4 related disease
Conditions
Interventions
Drug: Rilzabrutinib (SAR444671)
Pharmaceutical form: Tablet, Route of administration: Oral
Drug: Placebo
Pharmaceutical form: Tablet, Route of administration: Oral
Drug: Glucocorticoids (GC)
Phar
Sponsors
Obara Kentaro
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Participants are eligible to be included in the study only if all the following inclusion criteria are fulfilled: - Participants must have an adjudicated clinical diagnosis of immunoglobulin G4-related disease (IgG4-RD). - Participants meeting Step 1 Entry criteria of 2019 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for IgG4-RD and Total inclusion points are >=20. - Participants with active disease at screening in at least one organ system, excluding lymph nodes, as an IgG4-RD Responder Index total activity score >=2. - Participants with history or current involvement of at least 1 organ/site (excluding lymph nodes) affected with IgG4-RD. - Participants with active IgG4-RD controlled for at least 2 weeks while on a stable dose of glucocorticoids (GC). - Participants willing to taper off GC after starting investigational medicinal product. - Participants willing and able to participate in repeated study protocol mandated or clinically indicated imaging procedures to assess IgG4-RD such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or ultrasound. - Participants who have an up-to-date vaccination status as per local guidelines. The last dose of live vaccines should be received at least 30 days before Day 1. - Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
Exclusion criteria
Exclusion criteria: Participants are excluded from the study if any of the following criteria apply: - Meet any Step 2 Exclusion criteria from the 2019 ACR/EULAR classification criteria for IgG4-RD. - History of retroperitoneal fibrosis, sclerosing mesenteritis, fibrosing mediastinitis, or other overwhelmingly fibrotic expression of IgG4-RD that is the sole disease manifestation. - Active malignancy or history of malignancy within 5 years before Day 1, except completely treated in situ carcinoma of the cervix, completely treated, and resolved non-metastatic squamous or basal cell carcinoma of the skin. - Known or suspected immunodeficiency, including history of invasive opportunistic infections (eg, histoplasmosis, listeriosis, coccidioidomycosis, pneumocystosis, and aspergillosis) despite infection resolution, or otherwise recurrent infections of abnormal frequency or prolonged duration suggesting an immune compromised status, as judged by the Investigator. - History of serious infections with the potential for recurrence (as judged by the Investigator), with less than 4 weeks interval between resolution of serious infection and first dose of study drug, or currently active moderate to severe infection at Screening (Grade 2 or higher). - Current or chronic history of liver disease unrelated to IgG4-RD. - Refractory nausea and vomiting, malabsorption, external biliary shunt, bariatric surgery, or significant bowel resection that would preclude adequate rilzabrutinib/placebo absorption. - History of solid organ transplant. - Planned major surgical procedure during the participation in this study. - History of drug abuse within the previous 12 months. - Alcoholism or excessive alcohol use, defined as regular consumption of more than approximately 3 standard drinks per day. - Prior participation in any rilzabrutinib studies or other Bruton's tyrosine kinase (BTK) inhibitor studies. - History of treatment with an investigational drug within 6 months or 5 half-lives of the investigational drug, whichever is longer. - Laboratory abnormalities at the screening visit identified by the central laboratory. The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Time to first adjudicated clinical disease flare treated by the investigator during the Blinded Treatment period [Time Frame: Until Week 52] The Adjudication Committee will include internationally recognized independent experts in diagnosis and management of patients with IgG4-RD, blinded to participant, investigator, and site identifiers. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Percentage of participants without IgG4-RD adjudicated clinical disease flare and off GC and immunomodulators [Time Frame: At Week 52] 2. Percentage of participants without IgG4-RD adjudicated clinical disease flare and off GC [Time Frame: At Week 52] 3. Annualized rate of clinical disease flares [Time Frame: At Week 52] 4. Percent change in IgG4-RD Responder Index (RI) total activity scores [Time Frame: From baseline to Week 52] 5. Change in IgG4-RD RI total activity scores [Time Frame: From baseline to Week 52] 6. Percent change in IgG4-RD RI total activity scores [Time Frame: From baseline to Week 12] 7. Proportion of participants with reduction of >=2 points from the baseline IgG4-RD RI total activity score [Time Frame: At Week 12, Week 24, and Week 52] 8. Proportion of participants in complete remission among participants without IgG4-RD adjudicated disease flare and off GC and immunomodulators [Time Frame: At Week 52] 9. Cumulative GC dose for treatment of IgG4-RD [Time Frame: At Week 52] 10. Proportion of participants with potentially clinically significant abnormalities in laboratory tests, vital signs, and electrocardiograms in the Safety Population [Time Frame: Until Week 160] 11. Proportion of participants with treatment-emergent adverse events (TEAEs), adverse events of special interest (AESIs), serious adverse events (SAEs) in the Safety Population [Time Frame: Until Week 160] | — |
Countries
Canada, Chile, Japan, United States
Contacts
Public ContactUnit Clinical
Sanofi K.K.
Outcome results
None listed