Ibrutinib in Combination With Corticosteroids vs Placebo in Combination With Corticosteroids in Participants With New Onset Chronic Graft Versus Host Disease (cGVHD)

Purpose

To evaluate the safety and efficacy of ibrutinib in combination with prednisone in subjects with newly diagnosed moderate to severe cGVHD.

Condition

  • Chronic Graft Versus Host Disease

Eligibility

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

Inclusion Criteria

  • New onset moderate or severe cGVHD as defined by the 2014 National Institutes of Health (NIH) Consensus Development Project Criteria - Need for systemic treatment with corticosteroids for cGVHD - No previous systemic treatment for cGVHD (including extracorporeal photopheresis [ECP]) - Participants may be receiving other immunosuppressants for the prophylaxis or treatment of acute GVHD but if the subject is receiving prednisone for prophylaxis or treatment of acute GVHD it must be at or below 0.5 mg/kg/d - Age ≥12 years old - Karnofsky or Lansky (subjects <16 years) performance status ≥60

Exclusion Criteria

  • Received any previous systemic treatment for cGVHD with the exception of corticosteroids administered for cGVHD within the 72 hours prior to signing the informed consent form. - Inability to begin a prednisone dose ≥0.5 mg/kg/d for the treatment of cGVHD - Any uncontrolled infection or active infection requiring ongoing systemic treatment - Progressive underlying malignant disease or any post-transplant lymphoproliferative disease - Known bleeding disorders - Active hepatitis C virus (HCV) or hepatitis B virus (HBV)

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
Ibrutinib + Prednisone
Ibrutinib (420 mg) given orally once daily continuously starting on Week 1 Day 1 until cGVHD progression, progression of underlying malignancy, participant begins another systemic treatment for cGVHD or unacceptable toxicity. The 420 mg dose was adjusted for cytochrome P450 [CYP] inhibitors or hepatic dysfunction as applicable. Prednisone 1 mg/kg/d given orally once daily continuously starting on Week 1 Day 1 until unacceptable toxicity or until participant is successfully tapered from the prednisone. Starting prednisone dose may be as low as 0.5 mg/kg/d if a participant cannot tolerate higher doses.
  • Drug: ibrutinib
    Ibrutinib capsules administered orally daily
    Other names:
    • IMBRUVICA®
    • PCI-32765
  • Drug: Prednisone
    Prednisone administered daily
Placebo Comparator
Placebo + Prednisone
Placebo given orally once daily continuously starting on Week 1 Day 1 until cGVHD progression, progression of underlying malignancy, participant begins another systemic treatment for cGVHD or unacceptable toxicity. Prednisone 1 mg/kg/d given orally once daily continuously starting on Week 1 Day 1 until unacceptable toxicity or until participant is successfully tapered from the prednisone. Starting prednisone dose may be as low as 0.5 mg/kg/d if a participant cannot tolerate higher doses.
  • Drug: Placebo
    Placebo capsules administered orally daily
  • Drug: Prednisone
    Prednisone administered daily

More Details

Status
Completed
Sponsor
Pharmacyclics LLC.

Study Contact