Phase 3b Study to Assess the Efficacy, Safety, and Tolerability of Remibrutinib in Comparison to Placebo, With Omalizumab as Active Control, in Adult CSU Patients, Followed by an Open-label 52-week Optional Extension.

Last updated: March 10, 2026
Sponsor: Novartis Pharmaceuticals
Overall Status: Active - Not Recruiting

Phase

3

Condition

Hives (Urticaria)

Urticaria

Treatment

Placebo to remibrutinib

Placebo to omalizumab

Remibrutinib

Clinical Study ID

NCT06042478
CLOU064A2304
2022-000518-32
2022-502161-19-00
  • Ages 18-100
  • All Genders

Study Summary

The purpose of the core phase of the trial is to assess the efficacy, safety and tolerability of remibrutinib (LOU064) 25 milligrams (mg) twice a day (b.i.d.) over placebo for 24 weeks and in comparison to omalizumab 300 mg every 4 weeks (q4w) for 52 weeks in participants with chronic spontaneous urticaria (CSU) inadequately controlled by H1-antihistamines (H1-AH).

The purpose of the open-label extension phase is to assess efficacy, safety and tolerability up to two years for patients treated with remibrutinib and patients transitioned from omalizumab to remibrutinib at Week 52. In the extension phase, treatment will be with remibrutinib only (i.e., no background therapy). The extension phase will also fulfill the Novartis commitment to provide post-trial access to participants of the previous core phase.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Male and female adult participants ≥18 years of age at the time of signing theinformed consent.

  • CSU duration for ≥ 6 months prior to screening.

  • Diagnosis of CSU inadequately controlled by second generation H1-AH at the time ofrandomization, defined as:

  • The presence of itch and hives for ≥6 consecutive weeks prior to screening, despitethe use of second-generation H1-AH during this time period.

  • UAS7 score (range 0-42) ≥16, ISS7 score (range 0-21) ≥ 6 and HSS7 score (range 0-

  1. ≥ 6 during the 7 days prior to randomization (Day 1).
  • Documentation of hives within three months before randomization.

  • Willing and able to complete an Urticaria Patient Daily Diary (UPDD) for theduration of the study and adhere to the study protocol.

  • Participants must not have had more than one missing UPDD entry (either morning orevening) in the 7 days prior to randomization (Day 1).

Exclusion

Exclusion Criteria:

  • Prior exposure to ligelizumab, omalizumab and other biologics with any effect inCSU, including anti-IgE therapies.

  • Significant bleeding risk or coagulation disorders.

  • History of gastrointestinal bleeding.

  • Requirement for anti-platelet or anti-coagulant medication.

  • History or current hepatic disease.

  • Evidence of clinically significant cardiovascular, neurological, psychiatric,pulmonary, renal, hepatic, endocrine, metabolic, hematological disorders,gastrointestinal disease or immunodeficiency that, in the investigator's opinion,would compromise the safety of the participant, interfere with the interpretation ofthe study results or otherwise preclude participation or protocol adherence of theparticipant.

  • Evidence of helminthic parasitic infection as evidenced by stools being positive fora pathogenic organism according to local guidelines.

  • Documented history of anaphylaxis.

  • Pregnant or nursing (lactating) women.

Study Design

Total Participants: 470
Treatment Group(s): 4
Primary Treatment: Placebo to remibrutinib
Phase: 3
Study Start date:
November 15, 2023
Estimated Completion Date:
July 20, 2027

Study Description

The study consists of 4 periods, and the total study duration is up to 112 weeks. Approximately 468 adult participants with CSU are expected to be randomized in the study.

Screening period: A screening period of up to 4 weeks will allow for the assessment of eligibility, determination of baseline disease activity and wash-out of prohibited medications.

Core Phase Treatment Period (52 weeks):

The treatment period will be double-dummy and double-blind, with placebo injections matching omalizumab 300 mg s.c. given to participants in the remibrutinib arm and placebo tablets matching remibrutinib 25 mg given to participants in the omalizumab arm (double-dummy). At the randomization visit, eligible participants will be randomized to one of four treatment arms.

Extension Phase Treatment Period (52 weeks): Optional open-label extension where patients receive treatment with open-label remibrutinib 25 mg, for 52 weeks.

Follow-up period:

For patients that do not enter the extension phase, there will be a 16-week, treatment-free, safety follow-up period.

Patients that enter extension phase will have a 4-week treatment-free safety follow-up period at the end of the extension phase.

All participants will be on a stable, local label-approved standard dose of a second-generation H1-AH ("background therapy") throughout the entire core phase (starting a minimum of 7 days prior to randomization until the end of the core phase).

In addition, to treat unbearable symptoms of CSU flare-ups, participants will be allowed to use a different second-generation H1-AH on an as-needed basis ("rescue therapy").

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    Site Not Available

  • Novartis Investigative Site

    Barcelona, Catalonia 08003
    Spain

    Site Not Available

  • Novartis Investigative Site

    Pozuelo de Alarcon, Madrid 28223
    Spain

    Site Not Available

  • Novartis Investigative Site

    Barcelona 3128760, 08035
    Spain

    Site Not Available

  • Novartis Investigative Site

    Cordoba, 14004
    Spain

    Site Not Available

  • Novartis Investigative Site

    Córdoba, 14004
    Spain

    Site Not Available

  • Novartis Investigative Site

    Córdoba 2519240, 14004
    Spain

    Site Not Available

  • Novartis Investigative Site

    Las Palmas GC, 35010
    Spain

    Site Not Available

  • Novartis Investigative Site

    Las Palmas de Gran Canaria, 35010
    Spain

    Site Not Available

  • Novartis Investigative Site

    Madrid, 28046
    Spain

    Site Not Available

  • Novartis Investigative Site

    Valencia, 46026
    Spain

    Site Not Available

  • Novartis Investigative Site

    Valencia 2509954, 46026
    Spain

    Site Not Available

  • Novartis Investigative Site

    Geneve, 1205
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Geneve 14, 1211
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    St Gallen, 9007
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Zuerich, 8006
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Zurich, 8091
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Zurich 2657896, 8091
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Taipei, 10002
    Taiwan

    Site Not Available

  • Novartis Investigative Site

    Taipei 1668341, 10002
    Taiwan

    Site Not Available

  • Novartis Investigative Site

    Taoyuan, 33305
    Taiwan

    Site Not Available

  • Novartis Investigative Site

    Taoyuan District, 33305
    Taiwan

    Site Not Available

  • Novartis Investigative Site

    Taoyuan District 1667905, 33305
    Taiwan

    Site Not Available

  • Novartis Investigative Site

    Bangkoknoi, Bangkok 10700
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Songkhla, Hat Yai 90110
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Songkhla 1606147, Hat Yai 90110
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Khon Kaen, THA 40002
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Khon Kaen 1609776, THA 40002
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Bangkok, 10700
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Bangkok 1609350, 10700
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Chiang Mai, 50200
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Chiang Mai 1153671, 50200
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Istanbul, TUR 34098
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Aydin, 09100
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Denizli, 20070
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Fatih / Istanbul, 34093
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Fatih-Istanbul, 34093
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Sakarya, 54290
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Sakarya, Adapazari 54290
    Turkey (Türkiye)

    Site Not Available

  • Novartis Investigative Site

    Sakarya 302114, Adapazari 54290
    Turkey (Türkiye)

    Site Not Available

  • Novartis Investigative Site

    Aydin, Efeler 09100
    Turkey (Türkiye)

    Site Not Available

  • Novartis Investigative Site

    Aydin 322830, Efeler 09100
    Turkey (Türkiye)

    Site Not Available

  • Novartis Investigative Site

    Istanbul, Fatih 34098
    Turkey (Türkiye)

    Site Not Available

  • Novartis Investigative Site

    Istanbul 745044, Fatih 34093
    Turkey (Türkiye)

    Site Not Available

  • Novartis Investigative Site

    Denizli, Kinikli 20070
    Turkey (Türkiye)

    Site Not Available

  • Novartis Investigative Site

    Denizli 317109, Kinikli 20070
    Turkey (Türkiye)

    Site Not Available

  • Novartis Investigative Site

    Westbruy On Trym, Bristol BS10 5NB
    United Kingdom

    Site Not Available

  • Novartis Investigative Site

    Leeds, West Yorkshire LS9 7TF
    United Kingdom

    Site Not Available

  • Novartis Investigative Site

    Birmingham, B9 5SS
    United Kingdom

    Site Not Available

  • Novartis Investigative Site

    Birmingham 2655603, B9 5SS
    United Kingdom

    Site Not Available

  • Novartis Investigative Site

    Oxford, OX3 7LE
    United Kingdom

    Site Not Available

  • Novartis Investigative Site

    Hanoi, 100000
    Vietnam

    Site Not Available

  • Novartis Investigative Site

    Hanoi 1581130, 100000
    Vietnam

    Site Not Available

  • Novartis Investigative Site

    Ho Chi Minh, 7000
    Vietnam

    Site Not Available

  • Novartis Investigative Site

    Ho Chi Minh City, 700000
    Vietnam

    Site Not Available

  • Novartis Investigative Site

    Ho Chi Minh City 1566083, 700000
    Vietnam

    Site Not Available

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