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A Phase 3 Study of Efficacy and Safety of Remibrutinib in the Treatment of CSU in Adults Inadequately Controlled by H1 Antihistamines

A Multicenter, Randomized, Double-blind, Placebo-controlled Phase 3 Study of Remibrutinib (LOU064) to Investigate the Efficacy, Safety and Tolerability for 52 Weeks in Adult Chronic Spontaneous Urticaria (CSU) Patients Inadequately Controlled by H1-antihistamines

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05030311
Acronym
REMIX-1
Enrollment
470
Registered
2021-09-01
Start date
2021-11-30
Completion date
2024-01-19
Last updated
2025-04-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chronic Spontaneous Urticaria

Keywords

BTK inhibitor, Chronic spontaneous urticaria, Urticaria activity score, Hives severity score, Itch severity score, CSU

Brief summary

The purpose of this study was to establish the efficacy, safety, and tolerability of remibrutinib (LOU064) in adult participants suffering from chronic spontaneous urticaria (CSU) inadequately controlled by H1-antihistamines in comparison to placebo.

Detailed description

This was a global Phase III multi-centered, randomized,double-blind, parallel-group, placebo-controlled study investigating the safety, tolerability, and efficacy of remibrutinib (25 mg b.i.d.) in adult patients with CSU inadequately controlled by second generation H1-antihistamines (H1-AHs). The study consisted of four periods, the total study duration was up to 60 weeks: Screening period of up to 4 weeks, Double-blind placebo-controlled treatment period of 24 weeks, Open-label treatment period with remibrutinib period of 28 weeks, and treatment-free follow-up period of 4 weeks. The planned sample size was approximately 450 patients randomized in 2:1 ratio to remibrutinib or placebo arm (300 in the remibrutinib arm and 150 in placebo arm).

Interventions

DRUGLOU064 25 mg (b.i.d)

LOU064 25 mg was administered by oral route twice a day (b.i.d) as a tablet.

DRUGPlacebo

Placebo

DRUGLOU064 25 mg (b.i.d) as a tablet.

LOU064 25 mg was administered by oral route twice a day (b.i.d) as a tablet in open label phase.

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Signed informed consent must be obtained prior to participation in the study. * Male and female adult participants ≥18 years of age. * CSU duration for ≥ 6 months prior to screening (defined as the onset of CSU determined by the investigator based on all available supporting documentation). * Diagnosis of CSU inadequately controlled by second generation H1 antihistamines at the time of randomization defined as: * The presence of itch and hives for ≥6 consecutive weeks prior to screening despite the use of second generation H1-antihistamines during this time period * UAS7 score (range 0-42) ≥16, ISS7 score (range 0-21) ≥ 6 and HSS7 score (range 0-21) ≥ 6 during the 7 days prior to randomization (Day 1) * Documentation of hives within three months before randomization (either at screening and/or at randomization; or documented in the participants medical history). * Willing and able to complete an Urticaria Patient Daily Diary (UPDD) for the duration of the study and adhere to the study protocol. * Participants must not have had more than one missing UPDD entry (either morning or evening) in the 7 days prior to randomization (Day 1).

Exclusion criteria

* Participants having a clearly defined predominant or sole trigger of their chronic urticaria (chronic inducible urticaria) including urticaria factitia (symptomatic dermographism), cold-, heat-, solar-, pressure-, delayed pressure-, aquagenic-, cholinergic-, or contact-urticaria * Other diseases with symptoms of urticaria or angioedema, including but not limited to urticaria vasculitis, urticaria pigmentosa, erythema multiforme, mastocytosis, hereditary urticaria, or drug-induced urticaria * Any other skin disease associated with chronic itching that might influence in the investigator's opinion the study evaluations and results, e.g. atopic dermatitis, bullous pemphigoid, dermatitis herpetiformis, senile pruritus or psoriasis * Evidence of clinically significant cardiovascular (such as but not limited to myocardial infarction, unstable ischemic heart disease, New York heart association (NYHA) Class III/IV left ventricular failure, arrhythmia and uncontrolled hypertension within 12 months prior to Visit 1), neurological, psychiatric, pulmonary, renal, hepatic, endocrine, metabolic, hematological disorders, gastrointestinal disease or immunodeficiency that, in the investigator's opinion, would compromise the safety of the participant, interfere with the interpretation of the study results or otherwise preclude participation or protocol adherence of the participant * Significant bleeding risk or coagulation disorders * History of gastrointestinal bleeding, e.g. in association with use of nonsteroidal anti-inflammatory drugs (NSAID), that was clinically relevant (e.g. requiring hospitalization or blood transfusion) * Requirement for anti-platelet medication, except for acetylsalicylic acid up to 100 mg/d or clopidogrel. The use of dual anti-platelet therapy (e.g. acetylsalicylic acid + clopidogrel) is prohibited. * Requirement for anticoagulant medication (for example, warfarin or Novel Oral Anti-Coagulants (NOAC)) * History or current hepatic disease including but not limited to acute or chronic hepatitis, cirrhosis or hepatic failure or Aspartate Aminotransferase (AST)/ Alanine Aminotransferase (ALT) levels of more than 1.5 x upper limit of normal (ULN) or International Normalized Ratio (INR) of more than 1.5 at screening

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Weekly Urticaria Score (UAS7) at Week 12 (Scenario 1 With UAS7 as Primary Efficacy Endpoint)Baseline, Week 12The Weekly Urticaria Activity Score (UAS7) is a simple scoring system to evaluate urticaria signs and symptoms. It is based on scoring wheals (hive severity score) and itch (itch severity score) separately on a scale of 0 (no signs/symptoms) to 3 (intense signs/symptoms) over 7 days. The final score is calculated by adding together the daily scores, which can range from 0 to 6, for 7 days. This results in a maximum total score of 42 (highest urticaria severity), and a minimum possible score of 0. This endpoint is a secondary endpoint for testing strategy Scenario 2 with Weekly Itch Severity Score (ISS7) and Weekly Hives Severity Score (HSS7) as co-primary efficacy endpoints).
Change From Baseline in Weekly Itch Severity Score (ISS7) at Week 12 (Scenario 2 With ISS7 and HSS7 as Co-primary Efficacy Endpoints)Baseline, Week 12The severity of the itch was recorded by the participant twice daily in their electronic Diary, on a scale of 0 (none) to 3 (severe). A weekly score (ISS7) was derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score was therefore 0 - 21 (highest itch severity). This endpoint is a secondary endpoint for testing strategy Scenario 1 with Weekly Urticaria Activity Score (UAS7) as the primary efficacy endpoint).
Change From Baseline in Weekly Hives Severity Score (HSS7) at Week 12 (Scenario 2 With ISS7 and HSS7 as Co-primary Efficacy Endpoints)Baseline, Week 12The hives (wheals) severity score, defined by number of hives, was recorded by the participant twice daily in their electronic Diary, on a scale of 0 (none) to 3 (\> 12 hives/12 hours). A weekly score (HSS7) was derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score was therefore 0 - 21 (highest hives activity). This endpoint is a secondary endpoint for testing strategy Scenario 1 with Weekly Urticaria Activity Score (UAS7) as the primary efficacy endpoint.

Secondary

MeasureTime frameDescription
Cumulative Number of Weeks With Disease Activity Control (UAS7 <= 6) up to Week 12up to Week 12Maintaining disease activity control was assessed as cumulative number of weeks with an UAS7 =\< 6 response between baseline and Week 12. The UAS7 is the sum of the Weekly Hives Severity Score (HSS7) and the Weekly Itch Severity Score (ISS7). The possible range of the UAS7 score is 0 - 42 (highest hives and itch severity).
Number of Patients Who Achieved DLQI = 0 - 1Week 12The Dermatology Life Quality Index (DLQI) is a 10-item (grouped in 6 domains) dermatology-specific quality of life (QoL) measure. Participants are rating their dermatology symptoms as well as the impact of their skin condition on various aspects of their lives thinking about the previous 7 days. An overall score is calculated and ranges from 0 to 30 (higher score meaning worse disease-related QoL). Domain scores are calculated for: Symptoms and Feelings (0-6), Daily Activities (0-6), Leisure (0-6), Work and School (0-3), Personal Relationships (0-6), Treatment (0-3). The overall DLQI score range was split into score bands and validated in terms of their meaning/relevance to patients overall. DLQI = 0-1 means no effect on patient's life.
Number of Patients Who Achieved Disease Activity Control (UAS7 ≤6)Week 12The percentage of patients achieving disease activity control (UAS7 =\< 6) at Week 12 was assessed to evaluate the efficacy of Remibrutinib in Chronic Spontaneous Urticaria (CSU) patients. The UAS7 is the sum of the Weekly Hives Severity Score (HSS7) and the Weekly Itch Severity Score (ISS7). The possible range of the UAS7 score is 0 - 42 (highest hives and itch severity).
Number of Participants With Adverse EventsOn-treatment adverse events are reported from first dose of study medication up to 28 days after last dose of study medication, for a timeframe up to approximately 56 weeksAn adverse event (AE) is any untoward medical occurrence (e.g., any unfavorable and unintended sign \[including abnormal laboratory findings\], symptom or disease) in a clinical investigation participant after providing written informed consent for participation in the study. Therefore, an AE may or may not be temporally or causally associated with the use of a medicinal (investigational) product.
Cumulative Number of Weeks Without Angioedema (AAS7 = 0)Up to Week 12Angioedema occurrence was recorded once daily in the evening in the electronic Diary by the participant. Reporting the occurrence of angioedema was used as opening question for the assessment of the Angioedema Activity Score (AAS). The AAS consists of 5 questions with 4 answer options (scored 0-3) for each item, with a minimum score of 0 and a maximum score of 15 per day. The AAS score over 7 days (AAS7) ranges from 0 (no angioedema episodes) to 105 (highest angioedema severity).
Number of Patients Who Achieved Complete Absence of Hives and Itch (UAS7 = 0)Week 12The number of patients achieving complete absence of hives and itch (UAS7 = 0) at Week 12 was assessed to evaluate the efficacy of Remibrutinib in Chronic Spontaneous Urticaria (CSU) patients. The UAS7 is the sum of the Weekly Hives Severity Score (HSS7) and the Weekly Itch Severity Score (ISS7). The possible range of the UAS7 score is 0 - 42 (highest hives and itch severity).
Number of Patients With Early Onset of Disease Control (UAS7 ≤ 6 at Week 2)Week 2The percentage of patients achieving disease activity control (UAS7 =\< 6) at Week 2 was assessed to evaluate the efficacy of Remibrutinib in Chronic Spontaneous Urticaria (CSU) patients. The UAS7 is the sum of the Weekly Hives Severity Score (HSS7) and the Weekly Itch Severity Score (ISS7). The possible range of the UAS7 score is 0 - 42 (highest hives and itch severity).

Countries

Argentina, Australia, Bulgaria, Colombia, Czechia, France, Hungary, India, Italy, Japan, Mexico, Puerto Rico, Russia, Singapore, South Korea, Spain, Taiwan, Turkey (Türkiye), United States

Participant flow

Pre-assignment details

The study was conducted globally across 18 countries. Participants underwent a screening period of up to 4 weeks.

Participants by arm

ArmCount
LOU064 25mg b.i.d.
Patients initially randomized to Remibrutinib during the Double-blind treatment period and continued Remibrutinib during the Open-label treatment period (Up to Week 52)
313
Placebo
Patients initially randomized to Placebo (Up to Week 24)
157
Total470

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event135
Overall StudyLost to Follow-up51
Overall StudyPhysician Decision52
Overall StudyProtocol Violation44
Overall StudyTechnical problems01
Overall StudyUnsatisfactory therapeutic effect43
Overall StudyWithdrawal by Subject3117

Baseline characteristics

CharacteristicLOU064 25mg b.i.d.PlaceboTotal
Age, Continuous44.6 Years
STANDARD_DEVIATION 14.27
45.9 Years
STANDARD_DEVIATION 13.44
45 Years
STANDARD_DEVIATION 13.99
Age, Customized
>= 18 - < 65 years
282 Participants143 Participants425 Participants
Age, Customized
>= 65 - < 85 years
31 Participants14 Participants45 Participants
Age, Customized
>= 85 years
0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
76 Participants44 Participants120 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
237 Participants113 Participants350 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
12 Participants14 Participants26 Participants
Race (NIH/OMB)
Asian
94 Participants46 Participants140 Participants
Race (NIH/OMB)
Black or African American
12 Participants3 Participants15 Participants
Race (NIH/OMB)
More than one race
6 Participants2 Participants8 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants1 Participants1 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants2 Participants3 Participants
Race (NIH/OMB)
White
188 Participants89 Participants277 Participants
Sex: Female, Male
Female
212 Participants109 Participants321 Participants
Sex: Female, Male
Male
101 Participants48 Participants149 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 3090 / 1530 / 133
other
Total, other adverse events
139 / 30953 / 15326 / 133
serious
Total, serious adverse events
13 / 3091 / 1531 / 133

Outcome results

Primary

Change From Baseline in Weekly Hives Severity Score (HSS7) at Week 12 (Scenario 2 With ISS7 and HSS7 as Co-primary Efficacy Endpoints)

The hives (wheals) severity score, defined by number of hives, was recorded by the participant twice daily in their electronic Diary, on a scale of 0 (none) to 3 (\> 12 hives/12 hours). A weekly score (HSS7) was derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score was therefore 0 - 21 (highest hives activity). This endpoint is a secondary endpoint for testing strategy Scenario 1 with Weekly Urticaria Activity Score (UAS7) as the primary efficacy endpoint.

Time frame: Baseline, Week 12

Population: Full Analysis Set (FAS)

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
LOU064 25mg b.i.d.Change From Baseline in Weekly Hives Severity Score (HSS7) at Week 12 (Scenario 2 With ISS7 and HSS7 as Co-primary Efficacy Endpoints)-10.47 Scores on a scaleStandard Error 0.401
PlaceboChange From Baseline in Weekly Hives Severity Score (HSS7) at Week 12 (Scenario 2 With ISS7 and HSS7 as Co-primary Efficacy Endpoints)-6.86 Scores on a scaleStandard Error 0.548
Comparison: HSS7 at Week 12 (Scenario 2 with ISS7 and HSS7 as co-primary efficacy endpoints)p-value: <0.00195% CI: [-4.85, -2.36]Mixed Models Analysis
Primary

Change From Baseline in Weekly Itch Severity Score (ISS7) at Week 12 (Scenario 2 With ISS7 and HSS7 as Co-primary Efficacy Endpoints)

The severity of the itch was recorded by the participant twice daily in their electronic Diary, on a scale of 0 (none) to 3 (severe). A weekly score (ISS7) was derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score was therefore 0 - 21 (highest itch severity). This endpoint is a secondary endpoint for testing strategy Scenario 1 with Weekly Urticaria Activity Score (UAS7) as the primary efficacy endpoint).

Time frame: Baseline, Week 12

Population: Full Analysis Set (FAS)

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
LOU064 25mg b.i.d.Change From Baseline in Weekly Itch Severity Score (ISS7) at Week 12 (Scenario 2 With ISS7 and HSS7 as Co-primary Efficacy Endpoints)-9.52 Scores on a scaleStandard Error 0.343
PlaceboChange From Baseline in Weekly Itch Severity Score (ISS7) at Week 12 (Scenario 2 With ISS7 and HSS7 as Co-primary Efficacy Endpoints)-6.89 Scores on a scaleStandard Error 0.47
Comparison: ISS7 at Week 12 (Scenario 2 with ISS7 and HSS7 as co-primary efficacy endpoints)p-value: <0.00195% CI: [-3.7, -1.56]Mixed Models Analysis
Primary

Change From Baseline in Weekly Urticaria Score (UAS7) at Week 12 (Scenario 1 With UAS7 as Primary Efficacy Endpoint)

The Weekly Urticaria Activity Score (UAS7) is a simple scoring system to evaluate urticaria signs and symptoms. It is based on scoring wheals (hive severity score) and itch (itch severity score) separately on a scale of 0 (no signs/symptoms) to 3 (intense signs/symptoms) over 7 days. The final score is calculated by adding together the daily scores, which can range from 0 to 6, for 7 days. This results in a maximum total score of 42 (highest urticaria severity), and a minimum possible score of 0. This endpoint is a secondary endpoint for testing strategy Scenario 2 with Weekly Itch Severity Score (ISS7) and Weekly Hives Severity Score (HSS7) as co-primary efficacy endpoints).

Time frame: Baseline, Week 12

Population: Full Analysis Set (FAS)

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
LOU064 25mg b.i.d.Change From Baseline in Weekly Urticaria Score (UAS7) at Week 12 (Scenario 1 With UAS7 as Primary Efficacy Endpoint)-20.02 Scores on a scaleStandard Error 0.716
PlaceboChange From Baseline in Weekly Urticaria Score (UAS7) at Week 12 (Scenario 1 With UAS7 as Primary Efficacy Endpoint)-13.79 Scores on a scaleStandard Error 0.98
p-value: <0.00195% CI: [-8.45, -4]Mixed Models Analysis
Secondary

Cumulative Number of Weeks With Disease Activity Control (UAS7 <= 6) up to Week 12

Maintaining disease activity control was assessed as cumulative number of weeks with an UAS7 =\< 6 response between baseline and Week 12. The UAS7 is the sum of the Weekly Hives Severity Score (HSS7) and the Weekly Itch Severity Score (ISS7). The possible range of the UAS7 score is 0 - 42 (highest hives and itch severity).

Time frame: up to Week 12

Population: Full Analysis Set (FAS)

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
LOU064 25mg b.i.d.Cumulative Number of Weeks With Disease Activity Control (UAS7 <= 6) up to Week 125.17 weeksStandard Error 0.414
PlaceboCumulative Number of Weeks With Disease Activity Control (UAS7 <= 6) up to Week 121.92 weeksStandard Error 0.241
p-value: <0.00195% CI: [2.01, 3.61]Negative binomial regression model
Secondary

Cumulative Number of Weeks Without Angioedema (AAS7 = 0)

Angioedema occurrence was recorded once daily in the evening in the electronic Diary by the participant. Reporting the occurrence of angioedema was used as opening question for the assessment of the Angioedema Activity Score (AAS). The AAS consists of 5 questions with 4 answer options (scored 0-3) for each item, with a minimum score of 0 and a maximum score of 15 per day. The AAS score over 7 days (AAS7) ranges from 0 (no angioedema episodes) to 105 (highest angioedema severity).

Time frame: Up to Week 12

Population: Full Analysis Set (FAS)

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
LOU064 25mg b.i.d.Cumulative Number of Weeks Without Angioedema (AAS7 = 0)8.43 WeeksStandard Error 0.274
PlaceboCumulative Number of Weeks Without Angioedema (AAS7 = 0)6.72 WeeksStandard Error 0.33
Comparison: Angioedema occurrence-free weeks (AAS7 = 0 response) up to Week 12p-value: <0.00195% CI: [1.12, 1.41]Regression, Linear
Secondary

Number of Participants With Adverse Events

An adverse event (AE) is any untoward medical occurrence (e.g., any unfavorable and unintended sign \[including abnormal laboratory findings\], symptom or disease) in a clinical investigation participant after providing written informed consent for participation in the study. Therefore, an AE may or may not be temporally or causally associated with the use of a medicinal (investigational) product.

Time frame: On-treatment adverse events are reported from first dose of study medication up to 28 days after last dose of study medication, for a timeframe up to approximately 56 weeks

Population: Safety Set (SAF)

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with at least one AE188 Participants
LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Treatment interruption due to AEs17 Participants
LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Discontinued study treatment due to any SAEs2 Participants
LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Death0 Participants
LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Treatment interruption due to SAEs5 Participants
LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - SAEs10 Participants
LOU064 25mg b.i.d.Number of Participants With Adverse EventsDiscontinued study treatment due to any AEs11 Participants
PlaceboNumber of Participants With Adverse EventsPatients with serious or other significant events - Treatment interruption due to AEs9 Participants
PlaceboNumber of Participants With Adverse EventsDiscontinued study treatment due to any AEs3 Participants
PlaceboNumber of Participants With Adverse EventsPatients with serious or other significant events - SAEs1 Participants
PlaceboNumber of Participants With Adverse EventsPatients with serious or other significant events - Discontinued study treatment due to any SAEs0 Participants
PlaceboNumber of Participants With Adverse EventsPatients with serious or other significant events - Treatment interruption due to SAEs1 Participants
PlaceboNumber of Participants With Adverse EventsPatients with serious or other significant events - Death0 Participants
PlaceboNumber of Participants With Adverse EventsPatients with at least one AE86 Participants
Entire Study Period: LOU064 25mg b.i.d.Number of Participants With Adverse EventsDiscontinued study treatment due to any AEs15 Participants
Entire Study Period: LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with at least one AE218 Participants
Entire Study Period: LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Death0 Participants
Entire Study Period: LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - SAEs13 Participants
Entire Study Period: LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Discontinued study treatment due to any SAEs3 Participants
Entire Study Period: LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Treatment interruption due to AEs18 Participants
Entire Study Period: LOU064 25mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Treatment interruption due to SAEs5 Participants
Open-label Period: Transitioned to LOU064 25 mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - SAEs1 Participants
Open-label Period: Transitioned to LOU064 25 mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Treatment interruption due to SAEs0 Participants
Open-label Period: Transitioned to LOU064 25 mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Treatment interruption due to AEs3 Participants
Open-label Period: Transitioned to LOU064 25 mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Death0 Participants
Open-label Period: Transitioned to LOU064 25 mg b.i.d.Number of Participants With Adverse EventsPatients with at least one AE62 Participants
Open-label Period: Transitioned to LOU064 25 mg b.i.d.Number of Participants With Adverse EventsPatients with serious or other significant events - Discontinued study treatment due to any SAEs1 Participants
Open-label Period: Transitioned to LOU064 25 mg b.i.d.Number of Participants With Adverse EventsDiscontinued study treatment due to any AEs2 Participants
Secondary

Number of Patients Who Achieved Complete Absence of Hives and Itch (UAS7 = 0)

The number of patients achieving complete absence of hives and itch (UAS7 = 0) at Week 12 was assessed to evaluate the efficacy of Remibrutinib in Chronic Spontaneous Urticaria (CSU) patients. The UAS7 is the sum of the Weekly Hives Severity Score (HSS7) and the Weekly Itch Severity Score (ISS7). The possible range of the UAS7 score is 0 - 42 (highest hives and itch severity).

Time frame: Week 12

Population: Full Analysis Set (FAS)

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
LOU064 25mg b.i.d.Number of Patients Who Achieved Complete Absence of Hives and Itch (UAS7 = 0)96 Participants
PlaceboNumber of Patients Who Achieved Complete Absence of Hives and Itch (UAS7 = 0)16 Participants
Comparison: Complete absence of hives and itch (UAS7 = 0) at Week 12p-value: <0.00195% CI: [2.16, 6.82]Regression, Logistic
Secondary

Number of Patients Who Achieved Disease Activity Control (UAS7 ≤6)

The percentage of patients achieving disease activity control (UAS7 =\< 6) at Week 12 was assessed to evaluate the efficacy of Remibrutinib in Chronic Spontaneous Urticaria (CSU) patients. The UAS7 is the sum of the Weekly Hives Severity Score (HSS7) and the Weekly Itch Severity Score (ISS7). The possible range of the UAS7 score is 0 - 42 (highest hives and itch severity).

Time frame: Week 12

Population: Full Analysis Set (FAS)

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
LOU064 25mg b.i.d.Number of Patients Who Achieved Disease Activity Control (UAS7 ≤6)154 Participants
PlaceboNumber of Patients Who Achieved Disease Activity Control (UAS7 ≤6)38 Participants
Comparison: Disease activity control (UAS7 =\< 6) at Week 12p-value: <0.00195% CI: [2, 4.84]Regression, Logistic
Secondary

Number of Patients Who Achieved DLQI = 0 - 1

The Dermatology Life Quality Index (DLQI) is a 10-item (grouped in 6 domains) dermatology-specific quality of life (QoL) measure. Participants are rating their dermatology symptoms as well as the impact of their skin condition on various aspects of their lives thinking about the previous 7 days. An overall score is calculated and ranges from 0 to 30 (higher score meaning worse disease-related QoL). Domain scores are calculated for: Symptoms and Feelings (0-6), Daily Activities (0-6), Leisure (0-6), Work and School (0-3), Personal Relationships (0-6), Treatment (0-3). The overall DLQI score range was split into score bands and validated in terms of their meaning/relevance to patients overall. DLQI = 0-1 means no effect on patient's life.

Time frame: Week 12

Population: Full Analysis Set (FAS) - for patients with a valid measurement without a protocol deviation with impact.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
LOU064 25mg b.i.d.Number of Patients Who Achieved DLQI = 0 - 1120 Participants
PlaceboNumber of Patients Who Achieved DLQI = 0 - 134 Participants
p-value: <0.00195% CI: [1.53, 3.9]Regression, Logistic
Secondary

Number of Patients With Early Onset of Disease Control (UAS7 ≤ 6 at Week 2)

The percentage of patients achieving disease activity control (UAS7 =\< 6) at Week 2 was assessed to evaluate the efficacy of Remibrutinib in Chronic Spontaneous Urticaria (CSU) patients. The UAS7 is the sum of the Weekly Hives Severity Score (HSS7) and the Weekly Itch Severity Score (ISS7). The possible range of the UAS7 score is 0 - 42 (highest hives and itch severity).

Time frame: Week 2

Population: Full Analysis Set (FAS)

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
LOU064 25mg b.i.d.Number of Patients With Early Onset of Disease Control (UAS7 ≤ 6 at Week 2)104 Participants
PlaceboNumber of Patients With Early Onset of Disease Control (UAS7 ≤ 6 at Week 2)5 Participants
p-value: <0.00195% CI: [6.18, 39.77]Regression, Logistic

Source: ClinicalTrials.gov · Data processed: Jun 17, 2026