Study to Assess the Safety, Pharmacokinetics, and Efficacy of KPL-404 in Participants With Rheumatoid Arthritis With Inadequate Response or Intolerance to at Least One Biologic Disease-modifying Anti-rheumatic Drug or a Janus Kinase Inhibitor

Last updated: January 31, 2025
Sponsor: Kiniksa Pharmaceuticals, Ltd.
Overall Status: Completed

Phase

2

Condition

Joint Injuries

Rheumatoid Arthritis

Treatment

Placebo

KPL-404

Clinical Study ID

NCT05198310
KPL-404-C211
2022-000169-42
  • Ages 18-80
  • All Genders

Study Summary

Phase 2 study of the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) and efficacy of KPL-404 in subjects with moderate to severe Rheumatoid Arthritis.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Body weight ≥ 40 to ≤ 140 kg for all cohorts.

  • Diagnosis of RA for ≥ 3 months fulfilling the 2010 American College of Rheumatology (ACR)/European Union League Against Rheumatism (EULAR) classification criteria forRA and that is categorized as ACR RA functional Class 1-3.

  • Treated with a biological disease-modifying anti-rheumatic drug (bDMARDs) AND/ORJanus kinase inhibitor (JAKi) therapy for RA for ≥ 3 months and had inadequateresponse or had to discontinue bDMARD AND/OR JAKi therapy due to intolerance ortoxicity, regardless of treatment duration.

  • Currently receiving conventional synthetic disease-modifying anti-rheumatic drugs (csDMARD) therapy ≥ 3 months and on a stable dose for ≥ 4 weeks before the firstdose of investigational product.

  1. The following csDMARDs are allowed: oral or parenteral methotrexate ([MTX]; 7.5to 25 mg/week), sulfasalazine (≤ 3000 mg/day), hydroxychloroquine (≤ 400mg/day), chloroquine (≤ 250 mg/day), and leflunomide (≤ 20 mg/day).

  2. A combination of up to 2 background csDMARDs is allowed, except the combinationof MTX and leflunomide.

  • Meets all of the following disease activity criteria:
  1. Six or more swollen joints (based on 66 joint counts) and ≥ 6 tender joints (based on 68 joint counts) at screening and baseline visits;

  2. Level of high-sensitivity C-reactive protein ≥ 3 mg/L (by central laboratory);

  3. Documented seropositivity for serum Rheumatoid Factor (RF) and/orAnti-citrullinated protein antibody (ACPA) (>ULN) at screening or by priorlaboratory evaluation.

  • Has completed a locally approved authorized COVID-19 vaccine regimen according tolocal guidance at least 3 weeks before the first dose of the InvestigationalProduct.

  • Must have discontinued all bDMARDs or JAKi prior to the first dose ofinvestigational product. The washout period for bDMARDs or JAKi prior to the firstdose of investigational product is specified below. For bDMARDs or JAKi not listedbelow washout should be at least 5 times the mean elimination half-life of a drug:

  1. ≥ 4 weeks for etanercept;

  2. ≥ 8 weeks for adalimumab, infliximab, certolizumab, golimumab, abatacept,tocilizumab, and sarilumab;

  3. ≥ 1 year for rituximab;

  4. ≥ 2 weeks for JAKi (either investigational or commercially availabletreatment).

  • Voluntarily sign and date an informed consent form approved by independent ethicscommittee/Institutional Review Board (IRB)

Exclusion

Exclusion Criteria:

  • Prior exposure to any other anti-CD40/CD40L agent.

  • Inadequate response to 5 or more classes of advanced targeted therapies (bDMARD ortsDMARD; e.g., TNF inhibitors, IL-6 receptor inhibitors, T-cell costimulatoryinhibitors, anti-CD-20 antibodies, JAK inhibitors). This does not include priordiscontinuation due to drug intolerance.

  • Injectable corticosteroids (including intra-articular) or treatment with > 10 mg/daydose oral prednisone or equivalent within 8 weeks prior to randomization.

  • History of any arthritis with onset prior to age 16 years or current diagnosis ofinflammatory joint disease other than RA (Current diagnosis of secondary Sjogren'ssyndrome is permitted).

  • History of thromboembolic event or a significant risk of future thromboembolicevents

  • Clinically significant active infection including signs/symptoms suggestive ofinfection, any significant recurrent or chronic infection, or subjects at a highrisk of infection

  • History of cancer within the last 5 years from screening, except for basal andsquamous cell carcinoma of the skin or in situ carcinoma of the cervix treated andconsidered cured.

  • History of any of the following cardiovascular conditions:

  1. Moderate to severe congestive heart failure (New York Heart Association classIII or IV);

  2. Recent (within past 6 months) cerebrovascular accident, myocardial infarction,coronary stenting;

  3. Uncontrolled hypertension as defined by a confirmed systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg.

  • Clinically relevant or significant electrocardiogram (ECG) abnormalities, includingECG with QT interval corrected for heart rate (QTc) > 500 msec.

Study Design

Total Participants: 145
Treatment Group(s): 2
Primary Treatment: Placebo
Phase: 2
Study Start date:
December 14, 2021
Estimated Completion Date:
May 06, 2024

Study Description

This is a 28-week (up to 4-week screening period, 12-week treatment period, and 12-week safety follow-up period), multicenter, randomized, double-blind, placebo-controlled, multiple dose, proof-of-concept study with PK lead-in designed to assess the safety, PK, efficacy and PD of KPL-404 in subjects with moderate to severe, active Rheumatoid Arthritis (RA) who have an inadequate response to or are intolerant to a Janus kinase inhibitor (JAKi) AND/OR at least one biologic disease-modifying anti-rheumatic drug (bDMARD). The objectives of the study are to evaluate safety, efficacy, and PD of KPL-404 compared with placebo across the estimated therapeutic range and to characterize PK across varying dose levels of KPL-404.

Connect with a study center

  • UMHAT "Dr. Georgi Stranski"

    Pleven, 5800
    Bulgaria

    Site Not Available

  • Medical center "Artmed" LTD

    Plovdiv, 4002
    Bulgaria

    Site Not Available

  • UMHAT Sveti Ivan Rilski

    Sofia, 1431
    Bulgaria

    Site Not Available

  • Vesalion s.r.o.

    Ostrava, 702 00
    Czechia

    Site Not Available

  • CCR Czech a.s.,

    Pardubice, 530 02
    Czechia

    Site Not Available

  • Revmatologicky Utsav

    Praha 2, 128 50
    Czechia

    Site Not Available

  • Medical Plus S.R.O.

    Uherské Hradiště, 686 01
    Czechia

    Site Not Available

  • Aleksandre Aladashvili Clinic LLC

    Tbilisi, 0102
    Georgia

    Site Not Available

  • JSC Evex Hospitals

    Tbilisi, 0159
    Georgia

    Site Not Available

  • LTD Georgian-Dutch Hospital

    Tbilisi, 0172
    Georgia

    Site Not Available

  • LTD Israel-Georgian Medical Research Clinic Helsicore

    Tbilisi, 0112
    Georgia

    Site Not Available

  • Universitätsklinikum Freiburg

    Freiburg, Baden-Württemberg 79106
    Germany

    Site Not Available

  • University Hospital Cologne AöR

    Cologne, Nordrhein-Westfalen 50934
    Germany

    Site Not Available

  • Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont

    Szeged, Csongrád 6725
    Hungary

    Site Not Available

  • Magyar Honvedseg Egeszsegugyi Kozpont

    Budapest, 1062
    Hungary

    Site Not Available

  • Qualiclinic Ltd (Qualiclinic Inc)

    Budapest, 1036-H
    Hungary

    Site Not Available

  • Debreceni Egyetem Klinikai Kozpont

    Debrecen, 4032
    Hungary

    Site Not Available

  • Porcika Klinika

    Hódmezővásárhely, 6800
    Hungary

    Site Not Available

  • Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktatokorhaz

    Nyíregyháza, 4400
    Hungary

    Site Not Available

  • Vita Verum Medical Egeszsegugy

    Székesfehérvár, 8000
    Hungary

    Site Not Available

  • Centrum Kliniczno-Badawcze

    Elblag, 82-300
    Poland

    Site Not Available

  • Silmedic sp. z o.o.

    Katowice, 40-282
    Poland

    Site Not Available

  • NZOZ Lecznica MAK-MED s.c.

    Nadarzyn, 05-830
    Poland

    Site Not Available

  • Prywatna Praktyka Lekarska Prof. UM dr hab.med. Pawel Hrycaj

    Poznan, 61-397
    Poland

    Site Not Available

  • RCMed Oddzial Sochaczew

    Sochaczew, 96-500
    Poland

    Site Not Available

  • Centrum Medyczne Reuma Park

    Warszawa,
    Poland

    Site Not Available

  • Clinresco Centres (Pty) Ltd

    Kempton Park, Gauteng 1619
    South Africa

    Site Not Available

  • Jacaranda Hospital

    Pretoria, Gauteng 0002
    South Africa

    Site Not Available

  • Umhlanga Hospital Medical Center

    Umhlanga, Kwazulu-Natal 4319
    South Africa

    Site Not Available

  • Panorama Medical Centre

    Cape Town, Western Cape 7500
    South Africa

    Site Not Available

  • Winelands Medical Research Cen

    Stellenbosch, Western Cape 7600
    South Africa

    Site Not Available

  • Pinnacle Research Group, LLC

    Anniston, Alabama 36207
    United States

    Site Not Available

  • Carewell Arthritis Center

    Apple Valley, California 92307
    United States

    Site Not Available

  • Attune Health Research Inc.

    Beverly Hills, California 90211
    United States

    Site Not Available

  • Wallace Rheumatic Studies Center, LLC

    Beverly Hills, California 90211
    United States

    Site Not Available

  • Medvin Clinical Research

    Covina, California 91722
    United States

    Site Not Available

  • TriWest Research Associates

    San Diego, California 92108
    United States

    Site Not Available

  • Medvin Clinical Research

    Tujunga, California 91042
    United States

    Site Not Available

  • Inland Rheumatology Clinical Trials

    Upland, California 91786
    United States

    Site Not Available

  • Medvin Clinical Research

    Whittier, California 90602
    United States

    Site Not Available

  • Tekton Research

    Fort Collins, Colorado 80525
    United States

    Site Not Available

  • International Medical Research

    Daytona Beach, Florida 32117
    United States

    Site Not Available

  • Sweet Hope Research Specialty, Inc.

    Hialeah, Florida 33016
    United States

    Site Not Available

  • San Marcus Research Clinic, Inc.

    Miami Lakes, Florida 33014
    United States

    Site Not Available

  • Millennium Research

    Ormond Beach, Florida 32174
    United States

    Site Not Available

  • West Broward Rheumatology Associates, Inc.

    Tamarac, Florida 33321
    United States

    Site Not Available

  • Center for Advanced Research & Education

    Gainesville, Georgia 30501
    United States

    Site Not Available

  • Graves Gilbert Clinic

    Bowling Green, Kentucky 42101
    United States

    Site Not Available

  • Bluegrass Community Research, Inc

    Lexington, Kentucky 40504
    United States

    Site Not Available

  • Accurate Clinical Research, Inc.

    Lake Charles, Louisiana 70605
    United States

    Site Not Available

  • Johns Hopkins University - Johns Hopkins Arthritis Center

    Baltimore, Maryland 21224
    United States

    Site Not Available

  • SUNY Downstate Medical Center

    Brooklyn, New York 11203
    United States

    Site Not Available

  • Northwell Health, Division of Rheumatology

    Great Neck, New York 11020
    United States

    Site Not Available

  • Paramount Medical Research & Consulting, LLC

    Middleburg Heights, Ohio 44130
    United States

    Site Not Available

  • Altoona Center for Clinical Research

    Duncansville, Pennsylvania 16635
    United States

    Site Not Available

  • West Tennessee Research Institute

    Jackson, Tennessee 38305
    United States

    Site Not Available

  • Saint Francis Hospital- Memphis

    Memphis, Tennessee 38119
    United States

    Site Not Available

  • Arthritis and Rheumatology Research Institute

    Allen, Texas 75013
    United States

    Site Not Available

  • Trinity Universal Research Assoc

    Carrollton, Texas 75007
    United States

    Site Not Available

  • Arthritis & Osteoporosis Center of Coastal Bend

    Corpus Christi, Texas 78404
    United States

    Site Not Available

  • Corpus Christi Rheumatology

    Corpus Christi, Texas 78404
    United States

    Active - Recruiting

  • Dallas Fort Worth Clinical Research Associates

    Fort Worth, Texas 76177
    United States

    Site Not Available

  • Southwest Rheumatology Research LLC

    Mesquite, Texas 75150
    United States

    Site Not Available

  • DM Clinical Research

    Tomball, Texas 77375
    United States

    Site Not Available

  • Rheumatology Clinic of Houston

    Tomball, Texas 77377
    United States

    Site Not Available

  • Rheumatology and Pulmonary Clinic

    Beckley, West Virginia 25801
    United States

    Site Not Available

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