A Study of Nipocalimab in Pregnancies at Risk for Severe Hemolytic Disease of the Fetus and Newborn (HDFN)
Purpose
The purpose of this study is to assess the effectiveness of nipocalimab when compared to placebo in decreasing the risk of fetal anemia (a condition in which a baby's red blood cell volume falls below normal levels while the baby is developing in the womb) with live neonates in pregnant participants at risk for severe hemolytic disease of the fetus and newborn.
Condition
- Hemolytic Disease of the Fetus and Newborn
Eligibility
- Eligible Ages
- Between 18 Years and 45 Years
- Eligible Sex
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Pregnant and an estimated gestational age (GA) (based on ultrasound dating) from Week 13^0/7 to Week 18^6/7 at randomization - History of severe Hemolytic Disease of the Fetus and Newborn (HDFN) in a prior pregnancy defined as documented: 1. fetal anemia as result of HDFN or fetal hydrops as result of HDFN or received greater than or equal to (>=)1 IUT as a result of HDFN or 2. fetal loss or neonatal death as a result of HDFN, with maternal alloantibody titers for Rhesus antigen D protein (RhD), Kell, Kell Rhesus antigen C protein (Rhc), Rhesus antigen E protein (RhE), or RhC antigen above the critical levels (anti-Kell >=4; other >=16) and evidence of an antigen-positive fetus - During the current pregnancy, presence of maternal alloantibody to RhD, Rhc, RhE, or RhC antigen with titers above the critical level (anti-Kell >= 4; other >=16) based on the designated central lab results at screening - Evidence of antigen-positivity corresponding to the current maternal alloantibody (RhD, Kell, Rhc, RhE, or RhC) confirmed by non-invasive antigen cell-free fetal DNA (cffDNA) performed at the central laboratory - Have screening lab test results within values within the study protocol-specified parameters: a) albumin >= lower limit of normal (LLN); b) alanine transaminase (AST) less than or equal to (<=) 2 × upper limit of normal (ULN); c) alanine transaminase (ALT) <=2 × ULN d) creatinine <=0.8 milligrams per deciliter (mg/dL), SI: <=70.7 micromole per liter (μmol/L), and Serum total immunoglobulins G (IgG) ≥ 600 mg/dL SI: >=6 g/L - Medically stable on the basis of physical examination, medical history, vital signs, 12-lead ECG, and clinical lab tests performed at screening
Exclusion Criteria
- Currently pregnant with a multiple gestation (twins or more) - Evidence of fetal anemia prior to randomization in the current pregnancy - History of severe preeclampsia prior to GA Week 34 or severe fetal growth restriction (estimated fetal weight <3rd percentile, based on local fetal growth normative standards) in a previous pregnancy - Current uncontrolled hypertension - History of myocardial infarction, unstable ischemic heart disease, or stroke - Has any confirmed or suspected clinical immunodeficiency syndrome or has a family history of congenital or hereditary immunodeficiency unless confirmed absent in the participant - Has inflammatory or autoimmune diseases requiring immunosuppressive therapies that may jeopardize the safety of the participant - Currently has a malignancy or has a history of malignancy within 3 years before screening (with the exception of localized basal cell carcinoma and/or squamous cell carcinoma skin cancer that has been adequately treated with no evidence of recurrence for at least 3 months before the first study intervention administration or cervical carcinoma in situ that has been treated with no evidence of recurrence for at least 3 months before the first study intervention) - Is currently receiving systemic corticosteroids or other immunosuppressants for disorders unrelated to the pregnancy - Has received or planning to receive plasmapheresis, immunoadsorption therapy, intravenous immunoglobulin (IV Ig), or any immunoglobulin (Ig)G fragment crystallizable (Fc)-related protein therapeutics during the current pregnancy - Has a severe infection including opportunistic infections - Presence of abnormal (protocol-specified) hematologic lab values during screening - History of an unprovoked pulmonary embolism or history of recurrent deep vein thrombosis (DVT) The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Study Design
- Phase
- Phase 3
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Intervention Model Description
- The participants will be randomized in a 2:1 to receive nipocalimab and placebo treatment.
- Primary Purpose
- Treatment
- Masking
- Triple (Participant, Investigator, Outcomes Assessor)
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Experimental Nipocalimab |
Participants will receive nipocalimab intravenously (IV) once weekly (qw) from randomization through gestational age (GA) Week 35. |
|
|
Placebo Comparator Placebo |
Participants will receive matching placebo IV qw from randomization through GA Week 35. |
|
Recruiting Locations
University of California at San Diego
La Jolla, California 92037
La Jolla, California 92037
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California 90027
Los Angeles, California 90027
UC Davis School of Medicine
Sacramento, California 95817
Sacramento, California 95817
Childrens Hospital Colorado
Aurora, Colorado 80045
Aurora, Colorado 80045
University of Miami
Miami, Florida 33136
Miami, Florida 33136
Advocate Children's Hospital
Park Ridge, Illinois 60068
Park Ridge, Illinois 60068
Riley Children s Hospital
Indianapolis, Indiana 46202
Indianapolis, Indiana 46202
University of Kentucky Medical Center
Lexington, Kentucky 40536
Lexington, Kentucky 40536
Johns Hopkins Hospital
Baltimore, Maryland 21287
Baltimore, Maryland 21287
Midwest Fetal Care Center
Minneapolis, Minnesota 55404
Minneapolis, Minnesota 55404
Columbia University Medical Center
New York, New York 10032
New York, New York 10032
University of North Carolina (UNC) - School of Medicine
Chapel Hill, North Carolina 27599-7516
Chapel Hill, North Carolina 27599-7516
University of Cincinnati
Cincinnati, Ohio 45267
Cincinnati, Ohio 45267
Oregon Health and Science University
Portland, Oregon 97239
Portland, Oregon 97239
Lehigh Valley Hospital
Allentown, Pennsylvania 18103-6218
Allentown, Pennsylvania 18103-6218
University of Texas Dell Medical School Department of Women's Health
Austin, Texas 78723
Austin, Texas 78723
University Of Texas Medical Branch At Galveston
Galveston, Texas 77555
Galveston, Texas 77555
Macon & Joan Brock Virginia Health Sciences at Old Dominion University
Norfolk, Virginia 23507
Norfolk, Virginia 23507
More Details
- Status
- Recruiting
- Sponsor
- Janssen Research & Development, LLC