TEPEZZA® (Teprotumumab-trbw) Post-Marketing Requirement Study

Recruiting

Trial ID: NCT05002998

Purpose

This is a double-masked, randomized, parallel-assignment, multicenter trial examining the safety and tolerability of teprotumumab in the treatment of Thyroid Eye Disease (TED) in adult participants. This international, Phase 3b/4 trial is being conducted to fulfill an FDA post-marketing requirement for a descriptive trial to evaluate the safety, efficacy and need for re-treatment of 3 different teprotumumab treatment durations for TED. In addition, serum samples from participants with a Baseline Clinical Activity Score (CAS) ≥3 will be evaluated for biomarkers of disease.

Official Title

A Phase 3b/4, Double-masked, Randomized, International, Parallel-assignment, Multicenter Trial in Patients With Thyroid Eye Disease to Evaluate the Safety and Tolerability of Different Dosing Durations of Teprotumumab

Stanford Investigator(s)

Andrea Lora Kossler, MD, FACS
Andrea Lora Kossler, MD, FACS

Assoc Professor of Ophthalmology

Sun Kim, M.D. M.S.
Sun Kim, M.D. M.S.

Associate Professor of Medicine (Endocrinology)

Eligibility


Inclusion Criteria:

   1. Written informed consent.

   2. Male or female between the ages of 18 and 80 years, inclusive, at Screening.

   3. Initial diagnosis of TED within 7 years prior to Screening.

   4. Proptosis ≥3 mm from baseline (prior to diagnosis of TED), as estimated by treating
   physician, and/or proptosis >3 mm above normal for race and gender.

   5. Participants must be euthyroid with the baseline disease under control or have mild
   hypo or hyperthyroidism (defined as free thyroxine and free triiodothyronine levels
   <50% above or below the normal limits) at Screening. Every effort should be made to
   correct the mild hypo- or hyperthyroidism promptly and to maintain the euthyroid state
   for the duration of the trial.

   6. Does not require immediate surgical ophthalmological intervention and is not planning
   corrective surgery/irradiation during the course of the trial.

   7. Diabetic participants must have HbA1c ≤8.0% at Screening.

   8. Participants with a history of IBD (ulcerative colitis or Crohn's disease) must be in
   clinical remission for at least 3 months, with no history of bowel surgery within 6
   months prior to Screening and no planned surgery during the trial. Concomitant stable
   therapies for IBD without modifications in the 3 months prior to Screening are
   allowed.

   9. Women of childbearing potential (including those with an onset of menopause <2 years
   prior to Screening, non-therapy-induced amenorrhea for <12 months prior to Screening
   or not surgically sterile [absence of ovaries and/or uterus]) must have a negative
   serum pregnancy test at Screening and negative urine pregnancy tests at all
   protocol-specified time points (i.e., prior to each dose and throughout the
   participant's participation in the Follow-up Period); participants who are sexually
   active with a non-vasectomized male partner must agree to use 2 reliable forms of
   contraception during the trial, 1 of which is recommended to be hormonal, such as an
   oral contraceptive. Hormonal contraception must be started at least 1 full cycle prior
   to Baseline and continue for 180 days after the last dose of teprotumumab. Highly
   effective contraceptive methods (with a failure rate <1% per year), when used
   consistently and correctly, include implants, injectables, combination oral
   contraceptives, some intrauterine devices, tubal ligation, sexual abstinence or
   vasectomized partner.

10. Willing and able to comply with the prescribed treatment protocol and evaluations for
   the duration of the trial.

Exclusion Criteria:

   1. Decreased best-corrected visual acuity due to optic neuropathy, as defined by a
   decrease in vision of 2 lines on the Snellen chart, new visual field defect or color
   defect secondary to optic nerve involvement within the last 6 months.

   2. Corneal decompensation unresponsive to medical management.

   3. Decrease in proptosis of ≥2 mm in the study eye between Screening and Baseline.

   4. Prior orbital irradiation, orbital decompression or strabismus surgery.

   5. Planned eyelid surgery during the course of the trial.

   6. Alanine aminotransferase or aspartate aminotransferase >3 × the upper limit of normal
   or estimated glomerular filtration rate ≤30 mL/min/1.73m2 at Screening.

   7. Use of any steroid (intravenous [IV], oral, steroid eye drops) for the treatment of
   TED or other conditions within 3 weeks prior to Screening. Steroids cannot be
   initiated during the trial. Exceptions include topical and inhaled steroids, as well
   as steroids used to treat infusion reactions.

   8. Any treatment with rituximab (Rituxan® or MabThera®) within 12 months prior to the
   first infusion of teprotumumab or tocilizumab (Actemra® or Roactemra®) within 6 months
   prior to the first infusion of teprotumumab. Use of any other non-steroid
   immunosuppressive agent within 3 months prior to the first infusion of teprotumumab.

   9. Any previous treatment with teprotumumab, including previous enrollment in this trial
   or participation in a prior teprotumumab trial.

10. Treatment with any mAb within 3 months prior to Screening.

11. Identified pre-existing ophthalmic disease that, in the judgment of the Investigator,
   would preclude trial participation or complicate interpretation of trial results.

12. Use of an investigational agent for any condition within 60 days or 5 half-lives,
   whichever is longer, prior to Screening or anticipated use during the course of the
   trial.

13. Malignant condition in the past 5 years (except successfully treated basal/squamous
   cell carcinoma of the skin or cervical cancer in situ).

14. Pregnant or lactating women.

15. Current drug or alcohol abuse or history of either within the previous 2 years, in the
   opinion of the Investigator or as reported by the participant.

16. Known hypersensitivity to any of the components of teprotumumab or prior
   hypersensitivity reactions to mAbs.

17. Human immunodeficiency virus, untreated or positive viral load for hepatitis C or
   hepatitis B infections.

18. Any other condition that, in the opinion of the Investigator, would preclude inclusion
   in the trial.

19. After 150 participants with a CAS <3 at Baseline have been randomized, an additional
   exclusion criterion will apply: CAS <3 at Baseline.

Intervention(s):

drug: Teprotumumab

drug: Placebo

Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305