Title

A Study of IMR-687 in Subjects With Beta Thalassemia
A Phase 2 Study to Evaluate the Safety and Tolerability of IMR-687 in Subjects With Beta Thalassemia
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    IMR-687 ...
  • Study Participants

    122
A Study to Evaluate the Safety and Tolerability of IMR-687 in Subjects with Beta Thalassemia
A phase 2, randomized, double-blind, placebo-controlled study to evaluate the safety, tolerability, PK, and PD of IMR-687 (phosphodiesterase (PDE) 9 inhibitor) administered once daily (qd) orally for 36 weeks in 2 populations of adult subjects with β-thalassemia: Population 1 (Transfusion Dependent Thalassemia (TDT) subjects) and Population 2 (Non-Transfusion Dependent Thalassemia (NTDT) subjects).
Study Started
Oct 16
2020
Primary Completion
Mar 11
2022
Study Completion
May 04
2022
Results Posted
Jun 30
2022
Last Update
Mar 08
2023

Drug IMR-687

Oral administration of once daily IMR-687

Drug Placebo

Oral administration of once daily Placebo

Lower Dose IMR-687 Experimental

Oral administration of once daily IMR-687

Higher dose IMR-687 Experimental

Oral administration of once daily IMR-687

Placebo Placebo Comparator

Oral administration of once daily placebo

Criteria

Inclusion Criteria:

Documented diagnosis of β-thalassemia or HbE/ β-thalassemia in their medical history. Concomitant alpha gene deletion, duplication, or triplication is allowed.
Documentation of the dates of transfusion events and the number of all pRBC units per event within the 12 weeks prior to the Baseline (Day 1) visit. .
Must be willing and able to complete all study assessments and procedures, and to communicate effectively with the investigator and site staff.
TDT Subjects: subjects must be regularly transfused, defined as >3 to 10 pRBC units in the12 weeks prior to Baseline (Day 1) visit and no transfusion-free period for >35 days during that period.
NTDT subjects: Subjects must be transfusion independent, defined as 0 to ≤3 units of pRBCs received during the 12-week period prior to the Baseline (Day 1) visit, must not be on a regular transfusion program, must be RBC transfusion-free for at least ≥ 4 weeks prior to randomization, and must not be scheduled to start a regular
hematopoietic stem cell transplantation within 9 months.
NTDT subjects: Subjects must have Hb ≤10.0 g/dL at Screening; the screening Hb sample must be collected 7 to 28 days prior to randomization. Hb values within 21 days post-transfusion will be excluded.
ECOG performance score of 0 to 1
Female subjects must not be pregnant, or breastfeeding and be highly unlikely to become pregnant. Male subjects must be unlikely to impregnate a partner.

Exclusion Criteria:

Diagnosis of α-thalassemia (e.g., hemoglobin H [HbH]) or hemoglobin S (HbS)/ β thalassemia.
Body mass index (BMI) <17.0 kg/m2 or a total body weight <45 kg; or BMI >35 kg/m2
Subjects with known active hepatitis A, hepatitis B, or hepatitis C, with active or acute event of malaria, or who are known to be positive for human immunodeficiency virus (HIV).
Stroke requiring medical intervention ≤24 weeks prior to randomization.
Platelet count >1000 × 109/L.
Participated in another clinical study of an investigational agent (or device) within 30 days or 5-half-lives of date of informed consent, whichever is longer, or is currently participating in another study.
For Subjects on iron chelation therapy (ICT) at the time of ICF signing, initiation of ICT less than 24 weeks before the predicted randomization date.
Prior exposure to sotatercept or luspatercept, IMR-687, or gene therapy within 6 months prior to randomization (Day 1).
Subjects who have major organ damage

Summary

TDT Low Dose

TDT Placebo

NTDT High Dose

NTDT Low Dose

NTDT Placebo

TDT High Dose

All Events

Event Type Organ System Event Term TDT High Dose TDT Low Dose TDT Placebo NTDT High Dose NTDT Low Dose NTDT Placebo

IMR-687 Safety and Tolerability

Incidence and severity of Adverse Events Incidence and severity of Serious Adverse Events

TDT High Dose

Grade 3 or greater treatment emergent Adverse Event

Treatment emergent Adverse Event related to study drug

Treatment emergent Adverse Events

TDT Low Dose

Grade 3 or greater treatment emergent Adverse Event

Treatment emergent Adverse Event related to study drug

Treatment emergent Adverse Events

TDT Placebo

Grade 3 or greater treatment emergent Adverse Event

Treatment emergent Adverse Event related to study drug

Treatment emergent Adverse Events

NTDT High Dose

Grade 3 or greater treatment emergent Adverse Event

Treatment emergent Adverse Event related to study drug

Treatment emergent Adverse Events

NTDT Low Dose

Grade 3 or greater treatment emergent Adverse Event

Treatment emergent Adverse Event related to study drug

Treatment emergent Adverse Events

NTDT Placebo

Grade 3 or greater treatment emergent Adverse Event

Treatment emergent Adverse Event related to study drug

Treatment emergent Adverse Events

TDT Patients: Reduction in Red Blood Cell (RBC) Transfusion Burden With ≥33% Hematological Improvement From Week 12 to Week 24

Proportion of patients with ≥33% hematological improvement (as measured by reduced transfusion burden) from Week 12 to Week 24 compared to the 12 weeks prior to Baseline (Day 1)

TDT High Dose

TDT Low Dose

TDT Placebo

NTDT Patients: Proportion of Subjects With an Increase From Baseline of Hb at Week 12 to Week 24 in the Absence of Transfusions.

Proportion of subjects with an increase from baseline of ≥1.0 g/dL in mean Hb values at Week 12 to Week 24 in the absence of transfusions.

NTDT High Dose

NTDT Low Dose

NTDT Placebo

NTDT Patients: Proportion of Subjects With an Increase From Baseline of ≥3% in Mean HbF Values at Week 12 to Week 24 in Absence of Transfusions

Proportion of subjects with an increase from baseline of ≥3% in mean HbF values at Week 12 to Week 24 in absence of transfusions

NTDT High Dose

NTDT Low Dose

NTDT Placebo

TDT Patients: Reduction in Red Blood Cell (RBC) Transfusion Burden With ≥33% Hematological Improvement From Week 24 to Week 36

Proportion of patients with ≥33% hematological improvement from Week 24 to Week 36 compared to the 12 weeks prior to Baseline (Day 1)

TDT High Dose

TDT Low Dose

TDT Placebo

TDT Patients: Reduction in Red Blood Cell (RBC) Transfusion Burden With ≥50 % Hematological Improvement From Week 12 to Week 24

Proportion of patients with ≥50% hematological improvement from Week 12 to Week 24 compared to the 12 weeks prior to Baseline (Day 1)

TDT High Dose

TDT Low Dose

TDT Placebo

TDT Patients: Reduction in Red Blood Cell (RBC) Transfusion Burden With ≥50% Hematological Improvement From Week 24 to Week 36

Proportion of patients with ≥50% hematological improvement from Week 24 to Week 36 compared to the 12 weeks prior to Baseline (Day 1)

TDT High Dose

TDT Low Dose

TDT Placebo

NTDT Patients: Proportion of Subjects With an Increase From Baseline of Hb at Week 24 to Week 36 in the Absence of Transfusions

Proportion of subjects with an increase from baseline of ≥1.0 g/dL in mean Hb values at Week 24 to Week 36 in the absence of transfusions.

NTDT High Dose

NTDT Low Dose

NTDT Placebo

NTDT: Proportion of Subjects With an Increase From Baseline of ≥3% in Mean HbF Values at Week 24 to Week 36 in Absence of Transfusions

Proportion of subjects with an increase from baseline of ≥3% in mean HbF values at Week 24 to Week 36 in absence of transfusions

NTDT High Dose

NTDT Low Dose

NTDT Placebo

Total

122
Participants

Age, Continuous

31.9
Years (Mean)
Standard Deviation: 10.69

BMI

22.0873
kg/m2 (Mean)
Standard Deviation: 3.1573

Serum Ferritin

1726.69
micrograms per liter (Mean)
Standard Deviation: 2740.18

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

TDT High Dose

TDT Low Dose

TDT Placebo

NTDT High Dose

NTDT Low Dose

NTDT Placebo