Safety and Efficacy Study of Sotatercept in Adults With Transfusion Dependent Diamond Blackfan Anemia

NCT01464164 | Terminated Phase 1 Results DMC FDA Drug

• 1 other identifier: 11-02-199 - 06A
• Study Type: interventional
• Target: 19
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine the safety and dosing of drug Sotatercept, as a subcutaneous injection, to stimulate production of red blood cell production. To be given every 28 days for up to four doses.

Conditions

Diamond Blackfan Anemia

Keywords

Diamond Blackfan anemia; DBA; Blackfan Diamond anemia; Congenital pure red cell aplasia; Aase-Smith II Syndrome; Aase Syndrome; Anemia, Congenital Pure Red Cell; Aplasia, Congenital Pure Red Cell; BDA; Congenital Hypoplastic Anemia; Erythrogenesis Imperfecta; Hypoplastic Congenital Anemia; Inherited Erythroblastopenia; pure red cell aplasia; bone marrow failure syndrome

Outcome Measures

Primary Outcomes (1)

• Number of Participants With Complete Response and Partial Response

  Complete response is transfusion independence with hemoglobin \>9 gm/dl; partial response is transfusion dependence with hemoglobin \< 9gm/dl with an increase in reticulocyte count over baseline

  9 months

Secondary Outcomes (1)

• Severe Adverse Events Attributable to Study Drug

  9 months

Study Arms (2)

Sotatercept

EXPERIMENTAL

Sotatercept to be given as a subcutaneous injection once a month for 4 consecutive months, using a dose escalation scale among 3 cohorts. \*Protocol Amendment: Two additional cohorts will be given Sotatercept 0.75mg/kg and 1 mg/kg as a subcutaneous injection once every 3 weeks.

Drug: Sotatercept

Sotatercept with prednisone boost

EXPERIMENTAL

Protocol Amendment: Two additional cohorts will be given Sotatercept 0.75mg/kg and 1 mg/kg as a subcutaneous injection once every 3 weeks along with a prednisone boost of 1 mg/kg daily for 3 weeks (max of 60 mg).

Drug: Sotatercept with prednisone boost

Interventions

Sotatercept DRUG

Cohort 4a: 3 patients on Sotatercept 0.75 mg/kg every 3 weeks. If the patients have no untoward events in the Patients in Dose Level 4 by the end of 3 of the 6 doses, then additional patients (Dose Level 5) will be enrolled at the next dose level: Cohort 5a: 3 patients on Sotatercept 1 mg/kg every 3 weeks

Also known as: ACE-011

Sotatercept

Sotatercept with prednisone boost DRUG

Cohort 4b: 3 patients on Sotatercept 0.75 mg/kg every 3 weeks with a three week prednisone boost of 1 mg/kg/day (max 60 mg). If the patients have no untoward events in the Patients in Dose Level 4 by the end of 3 of the 6 doses, then additional patients (Dose Level 5) will be enrolled at the next dose level: Cohort 5b: 3 patients on Sotatercept 1 mg/kg every 3 weeks with a 3 week prednisone boost of 1 mg/kg/day (max 60 mg).

Also known as: ACE-011 and Prednisone

Sotatercept with prednisone boost

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \>/= 18 years of age
• DBA diagnosed
• RBC transfusion- dependence (defined as \>/= 10 cc/kg of RBC per 28 days average)
• Karnofsky performance scale \>/= 70
• Females of childbearing potential are to use birth control during study participation and for 112 days following the last dose of sotatercept
• Males must agree to use a latex condom during any sexual contact with females of childbearing potential while participating in the study and for 112 days following the last dose of sotatercept
• Agreement to adhere to the study visit schedule, understand and comply with all protocol requirements
• Understand and sign a written informed consent

You may not qualify if:

• Creatinine clearance \< 30 ml/min
• SGOT \> 3x upper limit of normal, SGPT \> 3x upper limit normal, or bilirubin \>3x upper limit normal
• Heart disease (NY Heart Association classification of \>/= 3
• History of hypertension
• Subjects currently responsive to corticosteroids for treatment of Diamond Blackfan anemia
• Treatment with another investigational drug or device \<56 days pre-study entry
• Pregnant or lactating females
• Cancer

Sponsors & Collaborators

• Northwell Health: lead

Study Sites (1)

North Shore- LIJ campus of The Feinstein Institute for Medical Research

Manhasset, New York, 11030, United States

Location

Related Publications (30)

• Abkowitz JL, Schaison G, Boulad F, Brown DL, Buchanan GR, Johnson CA, Murray JC, Sabo KM. Response of Diamond-Blackfan anemia to metoclopramide: evidence for a role for prolactin in erythropoiesis. Blood. 2002 Oct 15;100(8):2687-91. doi: 10.1182/blood.V100.8.2687.

  PMID: 12351372 BACKGROUND

• Diamond LK, Wang WC, Alter BP. Congenital hypoplastic anemia. Adv Pediatr. 1976;22:349-78.

  PMID: 773132 BACKGROUND

• Ball SE, McGuckin CP, Jenkins G, Gordon-Smith EC. Diamond-Blackfan anaemia in the U.K.: analysis of 80 cases from a 20-year birth cohort. Br J Haematol. 1996 Sep;94(4):645-53. doi: 10.1046/j.1365-2141.1996.d01-1839.x.

  PMID: 8826887 BACKGROUND

• Bastion Y, Bordigoni P, Debre M, Girault D, Leblanc T, Tchernia G, Ball S, McGuckin C, Gordon-Smith EC, Bekassy A, et al. Sustained response after recombinant interleukin-3 in diamond blackfan anemia. Blood. 1994 Jan 15;83(2):617-8. No abstract available.

  PMID: 8286756 BACKGROUND

• Cmejla R, Cmejlova J, Handrkova H, Petrak J, Pospisilova D. Ribosomal protein S17 gene (RPS17) is mutated in Diamond-Blackfan anemia. Hum Mutat. 2007 Dec;28(12):1178-82. doi: 10.1002/humu.20608.

  PMID: 17647292 BACKGROUND

• Da Costa L, Moniz H, Simansour M, Tchernia G, Mohandas N, Leblanc T. Diamond-Blackfan anemia, ribosome and erythropoiesis. Transfus Clin Biol. 2010 Sep;17(3):112-9. doi: 10.1016/j.tracli.2010.06.001. Epub 2010 Jul 23.

  PMID: 20655265 BACKGROUND

• Doherty L, Sheen MR, Vlachos A, Choesmel V, O'Donohue MF, Clinton C, Schneider HE, Sieff CA, Newburger PE, Ball SE, Niewiadomska E, Matysiak M, Glader B, Arceci RJ, Farrar JE, Atsidaftos E, Lipton JM, Gleizes PE, Gazda HT. Ribosomal protein genes RPS10 and RPS26 are commonly mutated in Diamond-Blackfan anemia. Am J Hum Genet. 2010 Feb 12;86(2):222-8. doi: 10.1016/j.ajhg.2009.12.015. Epub 2010 Jan 28.

  PMID: 20116044 BACKGROUND

• Draptchinskaia N, Gustavsson P, Andersson B, Pettersson M, Willig TN, Dianzani I, Ball S, Tchernia G, Klar J, Matsson H, Tentler D, Mohandas N, Carlsson B, Dahl N. The gene encoding ribosomal protein S19 is mutated in Diamond-Blackfan anaemia. Nat Genet. 1999 Feb;21(2):169-75. doi: 10.1038/5951.

  PMID: 9988267 BACKGROUND

• Farrar JE, Nater M, Caywood E, McDevitt MA, Kowalski J, Takemoto CM, Talbot CC Jr, Meltzer P, Esposito D, Beggs AH, Schneider HE, Grabowska A, Ball SE, Niewiadomska E, Sieff CA, Vlachos A, Atsidaftos E, Ellis SR, Lipton JM, Gazda HT, Arceci RJ. Abnormalities of the large ribosomal subunit protein, Rpl35a, in Diamond-Blackfan anemia. Blood. 2008 Sep 1;112(5):1582-92. doi: 10.1182/blood-2008-02-140012. Epub 2008 Jun 5.

  PMID: 18535205 BACKGROUND

• Gale RP, Barosi G, Barbui T, Cervantes F, Dohner K, Dupriez B, Gupta V, Harrison C, Hoffman R, Kiladjian JJ, Mesa R, Mc Mullin MF, Passamonti F, Ribrag V, Roboz G, Saglio G, Vannucchi A, Verstovsek S. What are RBC-transfusion-dependence and -independence? Leuk Res. 2011 Jan;35(1):8-11. doi: 10.1016/j.leukres.2010.07.015. Epub 2010 Aug 7.

  PMID: 20692036 BACKGROUND

• Gazda HT, Grabowska A, Merida-Long LB, Latawiec E, Schneider HE, Lipton JM, Vlachos A, Atsidaftos E, Ball SE, Orfali KA, Niewiadomska E, Da Costa L, Tchernia G, Niemeyer C, Meerpohl JJ, Stahl J, Schratt G, Glader B, Backer K, Wong C, Nathan DG, Beggs AH, Sieff CA. Ribosomal protein S24 gene is mutated in Diamond-Blackfan anemia. Am J Hum Genet. 2006 Dec;79(6):1110-8. doi: 10.1086/510020. Epub 2006 Nov 2.

  PMID: 17186470 BACKGROUND

• Gazda HT, Sheen MR, Vlachos A, Choesmel V, O'Donohue MF, Schneider H, Darras N, Hasman C, Sieff CA, Newburger PE, Ball SE, Niewiadomska E, Matysiak M, Zaucha JM, Glader B, Niemeyer C, Meerpohl JJ, Atsidaftos E, Lipton JM, Gleizes PE, Beggs AH. Ribosomal protein L5 and L11 mutations are associated with cleft palate and abnormal thumbs in Diamond-Blackfan anemia patients. Am J Hum Genet. 2008 Dec;83(6):769-80. doi: 10.1016/j.ajhg.2008.11.004.

  PMID: 19061985 BACKGROUND

• Glader BE, Backer K, Diamond LK. Elevated erythrocyte adenosine deaminase activity in congenital hypoplastic anemia. N Engl J Med. 1983 Dec 15;309(24):1486-90. doi: 10.1056/NEJM198312153092404.

  PMID: 6646173 BACKGROUND

• Gustavsson P, Skeppner G, Johansson B, Berg T, Gordon L, Kreuger A, Dahl N. Diamond-Blackfan anaemia in a girl with a de novo balanced reciprocal X;19 translocation. J Med Genet. 1997 Sep;34(9):779-82. doi: 10.1136/jmg.34.9.779.

  PMID: 9321770 BACKGROUND

• Leblanc TM, Da Costa L, Marie I, Demolis P, Tchernia G. Metoclopramide treatment in DBA patients: no complete response in a French prospective study. Blood. 2007 Mar 1;109(5):2266-7. doi: 10.1182/blood-2006-08-039545. No abstract available.

  PMID: 17312003 BACKGROUND

• Lipton JM, Atsidaftos E, Zyskind I, Vlachos A. Improving clinical care and elucidating the pathophysiology of Diamond Blackfan anemia: an update from the Diamond Blackfan Anemia Registry. Pediatr Blood Cancer. 2006 May 1;46(5):558-64. doi: 10.1002/pbc.20642.

  PMID: 16317735 BACKGROUND

• Lipton JM, Kudisch M, Gross R, Nathan DG. Defective erythroid progenitor differentiation system in congenital hypoplastic (Diamond-Blackfan) anemia. Blood. 1986 Apr;67(4):962-8.

  PMID: 3955239 BACKGROUND

• Liu JM, Ellis SR. Ribosomes and marrow failure: coincidental association or molecular paradigm? Blood. 2006 Jun 15;107(12):4583-8. doi: 10.1182/blood-2005-12-4831. Epub 2006 Feb 28.

  PMID: 16507776 BACKGROUND

• Murata M, Onomichi K, Eto Y, Shibai H, Muramatsu M. Expression of erythroid differentiation factor (EDF) in Chinese hamster ovary cells. Biochem Biophys Res Commun. 1988 Feb 29;151(1):230-5. doi: 10.1016/0006-291x(88)90583-9.

  PMID: 3348775 BACKGROUND

• Narla A, Vlachos A, Nathan DG. Diamond Blackfan anemia treatment: past, present, and future. Semin Hematol. 2011 Apr;48(2):117-23. doi: 10.1053/j.seminhematol.2011.01.004.

  PMID: 21435508 BACKGROUND

• Nishiura H, Tanase S, Shibuya Y, Futa N, Sakamoto T, Higginbottom A, Monk P, Zwirner J, Yamamoto T. S19 ribosomal protein dimer augments metal-induced apoptosis in a mouse fibroblastic cell line by ligation of the C5a receptor. J Cell Biochem. 2005 Feb 15;94(3):540-53. doi: 10.1002/jcb.20318.

  PMID: 15543555 BACKGROUND

• Ohene-Abuakwa Y, Orfali KA, Marius C, Ball SE. Two-phase culture in Diamond Blackfan anemia: localization of erythroid defect. Blood. 2005 Jan 15;105(2):838-46. doi: 10.1182/blood-2004-03-1016. Epub 2004 Jul 6.

  PMID: 15238419 BACKGROUND

• Perrien DS, Akel NS, Edwards PK, Carver AA, Bendre MS, Swain FL, Skinner RA, Hogue WR, Nicks KM, Pierson TM, Suva LJ, Gaddy D. Inhibin A is an endocrine stimulator of bone mass and strength. Endocrinology. 2007 Apr;148(4):1654-65. doi: 10.1210/en.2006-0848. Epub 2006 Dec 28.

  PMID: 17194739 BACKGROUND

• Quarello P, Garelli E, Carando A, Brusco A, Calabrese R, Dufour C, Longoni D, Misuraca A, Vinti L, Aspesi A, Biondini L, Loreni F, Dianzani I, Ramenghi U. Diamond-Blackfan anemia: genotype-phenotype correlations in Italian patients with RPL5 and RPL11 mutations. Haematologica. 2010 Feb;95(2):206-13. doi: 10.3324/haematol.2009.011783. Epub 2009 Sep 22.

  PMID: 19773262 BACKGROUND

• Rivier J, Spiess J, McClintock R, Vaughan J, Vale W. Purification and partial characterization of inhibin from porcine follicular fluid. Biochem Biophys Res Commun. 1985 Nov 27;133(1):120-7. doi: 10.1016/0006-291x(85)91849-2.

  PMID: 4074357 BACKGROUND

• Ruckle J, Jacobs M, Kramer W, Pearsall AE, Kumar R, Underwood KW, Seehra J, Yang Y, Condon CH, Sherman ML. Single-dose, randomized, double-blind, placebo-controlled study of ACE-011 (ActRIIA-IgG1) in postmenopausal women. J Bone Miner Res. 2009 Apr;24(4):744-52. doi: 10.1359/jbmr.081208.

  PMID: 19049340 BACKGROUND

• Vlachos A, Ball S, Dahl N, Alter BP, Sheth S, Ramenghi U, Meerpohl J, Karlsson S, Liu JM, Leblanc T, Paley C, Kang EM, Leder EJ, Atsidaftos E, Shimamura A, Bessler M, Glader B, Lipton JM; Participants of Sixth Annual Daniella Maria Arturi International Consensus Conference. Diagnosing and treating Diamond Blackfan anaemia: results of an international clinical consensus conference. Br J Haematol. 2008 Sep;142(6):859-76. doi: 10.1111/j.1365-2141.2008.07269.x. Epub 2008 Jul 30.

  PMID: 18671700 BACKGROUND

• Vlachos A, Muir E. How I treat Diamond-Blackfan anemia. Blood. 2010 Nov 11;116(19):3715-23. doi: 10.1182/blood-2010-02-251090. Epub 2010 Jul 22.

  PMID: 20651069 BACKGROUND

• Vlachos A, Federman N, Reyes-Haley C, Abramson J, Lipton JM. Hematopoietic stem cell transplantation for Diamond Blackfan anemia: a report from the Diamond Blackfan Anemia Registry. Bone Marrow Transplant. 2001 Feb;27(4):381-6. doi: 10.1038/sj.bmt.1702784.

  PMID: 11313667 BACKGROUND

• Vlachos A, Klein GW, Lipton JM. The Diamond Blackfan Anemia Registry: tool for investigating the epidemiology and biology of Diamond-Blackfan anemia. J Pediatr Hematol Oncol. 2001 Aug-Sep;23(6):377-82. doi: 10.1097/00043426-200108000-00015.

  PMID: 11563775 BACKGROUND

MeSH Terms

Conditions

Anemia, Diamond-Blackfan; Anemia, Hypoplastic, Congenital; Aase Smith syndrome 2; Red-Cell Aplasia, Pure; Bone Marrow Failure Disorders

Interventions

ACE-011; Prednisone

Condition Hierarchy (Ancestors)

Anemia, Aplastic; Anemia; Hematologic Diseases; Hemic and Lymphatic Diseases; Congenital Bone Marrow Failure Syndromes; Bone Marrow Diseases; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities

Intervention Hierarchy (Ancestors)

Pregnadienediols; Pregnadienes; Pregnanes; Steroids; Fused-Ring Compounds; Polycyclic Compounds

Limitations and Caveats

Early termination of 3 subjects lead to small numbers of subjects analyzed, as does the early closure of the study. Time to response was unable to be evaluated as no subjects attained response. Response duration was also not evaluated as no subjects responded.

Results Point of Contact

• Title: Adrianna Vlachos, MD
• Organization: Feinstein Institutes for Medical Research

avlachos@northwell.edu

516-562-1506

Study Officials

• Adrianna Vlachos, MD

  Northwell Health/Feinstein Institute for Medical Research

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: October 31, 2011
• First Posted: November 3, 2011
• Study Start: January 1, 2012
• Primary Completion: April 13, 2021
• Study Completion: April 13, 2021
• Last Updated: March 17, 2023
• Results First Posted: December 21, 2021

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)