A Study To Evaluate The Efficacy, Safety, Pharmacokinetics, And Pharmacodynamics Of Satralizumab In Patients With Anti-N-Methyl-D-Aspartic Acid Receptor (NMDAR) Or Anti-Leucine-Rich Glioma-Inactivated 1 (LGI1) Encephalitis

Purpose

The purpose of this study is to assess the efficacy, safety, pharmacokinetics, and pharmacodynamics of satralizumab in participants with anti-N-methyl-D-aspartic acid receptor (NMDAR) and anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis.

Conditions

  • NMDAR Autoimmune Encephalitis
  • LGI1 Autoimmune Encephalitis

Eligibility

Eligible Ages
Over 12 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Reasonable exclusion of tumor or malignancy before baseline visit (randomization) - Onset of autoimmune encephalitis (AIE) symptoms <=9 months before randomization - Meet the definition of "New Onset" or "Incomplete Responder" AIE - For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use adequate contraception during the treatment period and for at least 3 months after the final dose of satralizumab or placebo - For participants enrolled in the extended China enrollment phase at National Medical Products Administration (NMPA)-recognized sites: participants who are current residents of mainland China, Hong Kong, or Taiwan, and of Chinese ancestry N-methyl-D-aspartic acid receptor (NMDAR) AIE Cohort - Age >=12 years - Diagnosis of probable or definite NMDAR encephalitis Leucine-rich glioma-inactivated 1 (LGI1) AIE Cohort - Age >=18 years - Diagnosis of LGI1 encephalitis

Exclusion Criteria

  • Any untreated teratoma or thymoma at baseline visit (randomization) - History of carcinoma or malignancy, unless deemed cured by adequate treatment with no evidence of recurrence for >=5 years before screening - For patients with NMDAR AIE, history of negative anti-NMDAR antibody in cerebrospinal fluid (CSF) using a cell-based assay within 9 months of symptom onset - Historically known positivity to an intracellular antigen with high cancer association or GAD-65 - Historically known positivity to any cell surface neuronal antibodies other than NMDAR and LGI1 - Confirmed paraneoplastic encephalitis - Confirmed central or peripheral nervous system demyelinating disease - Alternative causes of associated symptoms - History of herpes simplex virus encephalitis in the previous 24 weeks - Any previous/concurrent treatment with IL-6 inhibitory therapy (e.g., tocilizumab), alemtuzumab, total body irradiation, or bone marrow transplantation - Any previous treatment with anti-CD19 antibody, complement inhibitors, neonatal Fc receptor antagonists, anti-B-lymphocyte stimulator monoclonal antibody - Any previous treatment with T-cell depleting therapies, cladribine, or mitoxantrone - Treatment with oral cyclophosphamide within 1 year prior to baseline Treatment with any investigational drug (including bortezomib) within 24 weeks prior to screening - Concurrent use of more than one IST as background therapy - Contraindication to all of the following rescue treatments: rituximab, IVIG, high-dose corticosteroids, or intravenous (IV) cyclophosphamide - Any surgical procedure, except laparoscopic surgery or minor surgeries within 4 weeks prior to baseline, excluding surgery for thymoma or teratoma removal - Planned surgical procedure during the study - Evidence of progressive multifocal leukoencephalopathy - Evidence of serious uncontrolled concomitant diseases that may preclude patient participation - Congenital or acquired immunodeficiency, including HIV infection - Active or presence of recurrent bacterial, viral, fungal, mycobacterial infection, or other infection - Infection requiring hospitalization or treatment with IV anti-infective agents within 4 weeks prior to baseline visit - Positive hepatitis B (HBV) and hepatitis C (HCV) test at screening - Evidence of latent or active tuberculosis (TB) - History of drug or alcohol abuse within 1 year prior to baseline - History of diverticulitis or concurrent severe gastrointestinal (GI) disorders that, in the investigator's opinion, may lead to increased risk of complications such as GI perforation - Receipt of live or live-attenuated vaccine within 6 weeks prior to baseline visit - History of blood donation (1 unit or more), plasma donation or platelet donation within 90 days prior to screening - History of severe allergic reaction to a biologic agent - Active suicidal ideation within 6 months prior to screening, or history of suicide attempt within 3 years prior to screening - Any serious medical condition or abnormality in clinical laboratory tests that, in the investigator's judgment, precludes safe participation in and completion of the study - Pregnant or breastfeeding, or intending to become pregnant during the study or within 3 months after the final dose of study drug - Laboratory abnormalities at Screening

Study Design

Phase
Phase 3
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
NMDAR autoimmune encephalitis (AIE) cohort 		Adults and adolescents with definite or probable NMDAR encephalitis
  • Drug: Satralizumab
    In Part 1, study drug will be administered after all other study related procedures have been performed at a site visit at Weeks 0, 2, 4, and Q4W thereafter. Participants will receive satralizumab according to body weight. Study drug will be administered by SC injection in the abdominal or femoral region after all other study-related procedures have been performed at a site visit. In Part 2, participants will be asked to choose from one of the following options: Option 1: continue on randomized, double-blind study drug; Option 2: start open-label satralizumab based on body weight; Option 3: stop study treatment and continue follow-up assessments
Experimental
LGI1 AIE cohort 		Adults with LGI1 encephalitis
  • Drug: Satralizumab
    In Part 1, study drug will be administered after all other study related procedures have been performed at a site visit at Weeks 0, 2, 4, and Q4W thereafter. Participants will receive satralizumab according to body weight. Study drug will be administered by SC injection in the abdominal or femoral region after all other study-related procedures have been performed at a site visit. In Part 2, participants will be asked to choose from one of the following options: Option 1: continue on randomized, double-blind study drug; Option 2: start open-label satralizumab based on body weight; Option 3: stop study treatment and continue follow-up assessments
Placebo Comparator
NMDAR autoimmune encephalitis (AIE) Placebo cohort 		Adults and adolescents with definite or probable NMDAR encephalitis
  • Other: Placebo
    Satralizumab placebo PFS is identical in composition to satralizumab PFS, but does not contain the satralizumab active ingredient and will be identical in appearance and packaging to satralizumab. A PFS (assembled with an NSD and extended finger flange) filled with 0.5 mL of solution, corresponding to 60 mg satralizumab, may be used in Part 2 once it becomes available at the study site.
Placebo Comparator
LGI1 AIE Placebo cohort 		Adults with LGI1 encephalitis
  • Other: Placebo
    Satralizumab placebo PFS is identical in composition to satralizumab PFS, but does not contain the satralizumab active ingredient and will be identical in appearance and packaging to satralizumab. A PFS (assembled with an NSD and extended finger flange) filled with 0.5 mL of solution, corresponding to 60 mg satralizumab, may be used in Part 2 once it becomes available at the study site.

Recruiting Locations

University of Alabama at Birmingham
Birmingham, Alabama 35294-3300

More Details

Status
Recruiting
Sponsor
Hoffmann-La Roche

Study Contact

Reference Study ID Number: WN43174, https://forpatients.roche.com/
888-662-6728 (U.S.)
global-roche-genentech-trials@gene.com