518 Participants Needed

LNP023 for IgA Nephropathy

(APPLAUSE-IgAN Trial)

Recruiting at 213 trial locations
NP
Overseen ByNovartis Pharmaceuticals
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: Novartis Pharmaceuticals
Must be taking: ACEi, ARB
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

The study is designed as a multicenter, randomized, double-blind, placebo controlled study to demonstrate the superiority of iptacopan (LNP023) at a dose of 200 mg b.i.d. compared to placebo on top of maximally tolerated ACEi or ARB on reduction of proteinuria and slowing renal disease progression in primary IgA Nephropathy patients.

Will I have to stop taking my current medications?

The trial requires that you stay on a stable dose of ACE inhibitors or ARBs for about 90 days before starting the study drug. If you're taking other medications for IgA nephropathy, those doses should also be stable for about 90 days before the trial begins.

How is the drug LNP023 different from other treatments for IgA nephropathy?

LNP023 (Iptacopan) is unique because it is an oral drug that specifically targets and inhibits the alternative complement pathway, which plays a key role in the development of IgA nephropathy. This mechanism of action is different from other treatments, such as steroids or tonsillectomy, and has shown promising results in reducing protein levels in urine, indicating improved kidney function.12345

What data supports the effectiveness of the drug LNP023 (Iptacopan) for treating IgA Nephropathy?

In a Phase 2 study, Iptacopan (LNP023) showed a significant reduction in protein levels in urine, which is a sign of kidney damage, in patients with IgA Nephropathy. The drug was well-tolerated and led to a strong inhibition of the alternative complement pathway, suggesting its potential effectiveness for this condition.13456

Who Is on the Research Team?

NP

Novartis Pharmaceuticals

Principal Investigator

Novartis Pharmaceuticals

Are You a Good Fit for This Trial?

Adults with biopsy-confirmed IgA nephropathy, a kidney disease, and certain levels of protein in their urine can join. They must have been on stable doses of specific blood pressure medicines for about 90 days. Vaccinations against certain infections are required before starting the trial.

Inclusion Criteria

I am 18 or older with IgA nephropathy confirmed by biopsy and kidney function test.
My kidney function is low, but a biopsy showed less than 50% damage.
I have IgA nephropathy with high protein levels in my urine.
See 11 more

Exclusion Criteria

I have IgA nephropathy linked to another health condition.
You have a history of frequent serious infections caused by certain types of bacteria like meningococcus and pneumococcus.
I have not had any serious infections like COVID-19 in the last 14 days.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive iptacopan (LNP023) or placebo to evaluate efficacy and safety in reducing proteinuria and slowing renal disease progression

9 months
Regular visits for monitoring and assessments

Follow-up

Participants are monitored for safety and effectiveness after treatment, focusing on long-term efficacy based on eGFR decline

15 months

What Are the Treatments Tested in This Trial?

Interventions

  • LNP023
Trial Overview The trial is testing if LNP023 (iptacopan) is better than a placebo at reducing proteinuria and slowing down kidney disease when taken alongside standard treatments. Participants will be randomly assigned to either the drug or placebo group without knowing which one they're getting.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Placebo Group
Group I: LNP023 200mg b.i.dExperimental Treatment1 Intervention
Group II: Placebo to LNP023 200mg b.i.dPlacebo Group1 Intervention

LNP023 is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as FABHALTA for:
  • Paroxysmal nocturnal hemoglobinuria (PNH)
🇪🇺
Approved in European Union as FABHALTA for:
  • Paroxysmal nocturnal hemoglobinuria (PNH)

Find a Clinic Near You

Who Is Running the Clinical Trial?

Novartis Pharmaceuticals

Lead Sponsor

Trials
2,963
Recruited
4,275,000+
Founded
1996
Headquarters
Basel, Switzerland
Known For
Precision medicine
Top Products
Gleevec, Cosentyx, Entresto, Kisqali
Dr. Vas Narasimhan profile image

Dr. Vas Narasimhan

Novartis Pharmaceuticals

Chief Executive Officer since 2018

MD from Harvard Medical School

Dr. Shreeram Aradhye profile image

Dr. Shreeram Aradhye

Novartis Pharmaceuticals

Chief Medical Officer since 2021

MD

Published Research Related to This Trial

Iptacopan, an oral complement inhibitor, showed a significant dose-response effect in reducing proteinuria in patients with immunoglobulin A nephropathy (IgAN), with a 23% reduction in urine protein-to-creatinine ratio at the highest dose after three months.
The treatment was well-tolerated with no serious adverse events reported, indicating a favorable safety profile, and it demonstrated sustained reductions in complement biomarkers, supporting its potential for further evaluation in larger trials.
Results of a randomized double-blind placebo-controlled Phase 2 study propose iptacopan as an alternative complement pathway inhibitor for IgA nephropathy.Zhang, H., Rizk, DV., Perkovic, V., et al.[2023]
Iptacopan, a complement inhibitor, is being evaluated in a Phase 3 study (APPLAUSE-IgAN) involving approximately 450 adults with immunoglobulin A nephropathy (IgAN) to determine its efficacy in reducing proteinuria and slowing kidney function decline over 24 months.
The primary goal of the study is to show that iptacopan is superior to placebo in reducing the urine protein-to-creatinine ratio and in slowing the decline of estimated glomerular filtration rate, with safety and tolerability also being assessed as secondary outcomes.
Targeting the Alternative Complement Pathway With Iptacopan to Treat IgA Nephropathy: Design and Rationale of the APPLAUSE-IgAN Study.Rizk, DV., Rovin, BH., Zhang, H., et al.[2023]
In a study of 66 IgA nephropathy patients, those treated with tonsillectomy plus steroid pulse (TSP) therapy showed significantly higher clinical remission rates compared to those treated with oral prednisolone (oPSL) at 12, 36, and 72 months.
TSP therapy not only resulted in better preservation of renal function but also had fewer adverse events (11.5% vs. 34.6%) compared to oPSL, indicating it may be a safer and more effective treatment option for IgAN.
Comparison of oral steroids with tonsillectomy plus steroid pulse therapy in patients with IgA nephropathy.Hoshino, Y., Moriyama, T., Uchida, K., et al.[2018]

Citations

Results of a randomized double-blind placebo-controlled Phase 2 study propose iptacopan as an alternative complement pathway inhibitor for IgA nephropathy. [2023]
Targeting the Alternative Complement Pathway With Iptacopan to Treat IgA Nephropathy: Design and Rationale of the APPLAUSE-IgAN Study. [2023]
Comparison of oral steroids with tonsillectomy plus steroid pulse therapy in patients with IgA nephropathy. [2018]
Iptacopan monotherapy in patients with paroxysmal nocturnal hemoglobinuria: a 2-cohort open-label proof-of-concept study. [2022]
Randomized Phase II JANUS Study of Atacicept in Patients With IgA Nephropathy and Persistent Proteinuria. [2022]
Complement factor B inhibitor LNP023 improves lupus nephritis in MRL/lpr mice. [2022]
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