A Phase 3, Double-blind, Placebo-controlled Study Evaluating Efficacy and Safety of Riliprubart in Participants With Refractory Chronic Inflammatory Demyelinating Polyneuropathy
The purpose of the study is to evaluate efficacy of riliprubart compared to placebo in adult participants with CIDP whose disease is refractory to standard of care. The study duration will be for a maximum of 111 weeks including screening, treatment phases, and follow-up.
‣ Participants are eligible to be included in the study only if all of the following criteria apply:
• Participant must have CIDP or possible CIDP criteria, based on European Academy of Neurology (EAN)/ Peripheral Nerve Society (PNS) Task Force CIDP guidelines, second revision (2021).
⁃ Participant must have either typical CIDP, or one of the following two CIDP variants: motor CIDP (including motor predominant), multifocal CIDP (also known as Lewis Sumner Syndrome). Diagnosis must be confirmed by the adjudication committee.
⁃ Participant must be refractory to either immunoglobulin therapy or corticosteroid therapy, as defined below.
∙ Immunoglobulinrefractory subgroup: Historic evidence of failure or inadequate response to immunoglobulin therapy prior to screening, defined as no clinically meaningful improvement or persistent INCAT score ≥2 after a minimum of:
⁃ One dose of IVIg of 2 g/kg, followed by a second dose of 2 g/kg or two doses of 1 g/kg, with a separation of approximately 3 weeks between doses (each dose can be divided over 2 to 5 days), as indicated in the EAN/PNS 2021 guidelines OR
• SCIg maintenance therapy with at least 0.2 g/kg weekly for 5 weeks
‣ Corticosteroidrefractory subgroup:
‣ Historic evidence of failure or inadequate response to corticosteroid therapy prior to screening, defined as no clinically meaningful improvement or persistent INCAT score ≥2 after a minimum of 12 weeks of corticosteroid therapy. Corticosteroid regimen can be daily oral prednisone/prednisolone, at least 60 mg, equivalent to methylprednisolone 48 mg, tapered over 6 to 8 months, or alternative regimens, e.g. pulsed high-dose corticosteroid treatment (40 mg/day oral dexamethasone or 500 mg/day IV methylprednisolone, each daily for 4 days per month for 6 months), as indicated in the EAN/PNS 2021 guidelines A clinically meaningful improvement is defined as one or more of the following:
⁃ A ≥1 point decrease in adjusted INCAT disability score
⁃ An increase in IRODS centile score ≥4 points
⁃ An increase in MRC Sum score ≥3 points
⁃ An improvement in hand grip strength of ≥8 kilopascals or
⁃ Equivalent improvement based on information from medical records and per the Investigator's judgment
∙ Participant has an adjusted INCAT score of 2 to 9
• -(a score of 2 should be exclusively from the leg disability component of INCAT).
‣ Any allowed immunosuppressant drugs (azathioprine, cyclosporine, or mycophenolate mofetil) have been taken for ≥6 months at a stable dose for ≥3 months prior to Screening
‣ Participant may be receiving low-dose oral corticosteroids (≤20 mg/day of prednisone \[or equivalent dose for other oral corticosteroids\]), but only if taken at a stable dose for ≥3 months prior to Screening
‣ Participant must have active disease, defined by a CIDP disease activity score (CDAS) of ≥ 2 points at Screening
‣ Participant must have documented vaccinations against encapsulated bacterial pathogens given within 5 years prior to Day 1 or initiated a minimum of 14 days prior to first dose of study intervention
‣ All participants must agree to use contraception methods during and after the study as required.
‣ Contraceptive use by men and women participating in the study should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
⁃ Male participants are eligible to participate if they agree to the following during the study intervention period and for at least 55 weeks after the last dose of study medication:
⁃ Refrain from donating or cryopreserving sperm PLUS
⁃ Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent OR
⁃ Must agree to use contraception/barrier as detailed below:
⁃ \---- A male condom and an additional highly effective contraceptive method as described in the protocol.
⁃ \-- A female participant is eligible to participate if she is not pregnant or breastfeeding, and one of the following conditions applies:
⁃ Is a woman of nonchildbearing potential (WONCBP) as defined by the protocol OR
⁃ Is a woman of childbearing potential (WOCBP) and agrees to use a contraceptive method that is highly effective (with a failure rate of \<1% per year), as described in Appendix 10.4 Contraception and barrier guidance during the study intervention period (to be effective before starting the intervention) and for at least 55 weeks after the last administration of study intervention and agrees not to donate or cryopreserve eggs (ova, oocytes) for the purpose of reproduction during this period.
∙ Body weight at Screening of 35 kg to 154 kg (77 to 340 lbs), inclusive