Results from multinational phase 3 studies of ravulizumab (ALXN1210) versus eculizumab in adults with paroxysmal nocturnal hemoglobinuria: subgroup analysis of Japanese patients

Ken Ishiyama, Shinji Nakao, Kensuke Usuki, Yuji Yonemura, Takayuki Ikezoe, Michihiro Uchiyama, Yasuo Mori, Tetsuya Fukuda, Masaya Okada, Shin ichiro Fujiwara, Hideyoshi Noji, Scott Rottinghaus, Rasha Aguzzi, Jun Yokosawa, Jun Ichi Nishimura, Yuzuru Kanakura, Shinichiro Okamoto

Research output: Contribution to journalArticlepeer-review

Abstract

Ravulizumab demonstrated noninferior efficacy and comparable safety to eculizumab in two open-label, phase 3 studies in patients with paroxysmal nocturnal hemoglobinuria (PNH) who complement inhibitor-naive (Study 301) or were previously treated with eculizumab (Study 302). This subgroup analysis assessed ravulizumab’s efficacy and safety in Japanese patients in Studies 301 and 302, who are known to have different clinicopathologic features from white patients. Patients were randomly assigned (1:1) to eculizumab every-two-weeks or weight-based dosing of ravulizumab every-eight-weeks for 26 weeks. Co-primary endpoints were transfusion avoidance and lactate dehydrogenase (LDH) normalization in Study 301 and percentage change in LDH levels from baseline to day 183 in Study 302. Thirty-three Japanese patients (n = 18 ravulizumab; n = 15 eculizumab) enrolled in Study 301; 12 enrolled in Study 302 (n = 5 ravulizumab; n = 7 eculizumab). In the Study 301 ravulizumab group, 83.3% (15/18) of patients avoided transfusion; the adjusted prevalence of LDH normalization was 52.1%. In the Study 302 ravulizumab group, the least-squares-mean percentage change from baseline in LDH was 8.34%. No deaths or meningococcal infections occurred during the 6-month primary evaluation period in either study. In conclusion, ravulizumab’s efficacy and safety were consistent in the Japanese and global patient populations with PNH in the phase 3 studies. Clinical Trial Identifier: NCT02946463; NCT03056040

Original languageEnglish
Pages (from-to)466-476
Number of pages11
JournalInternational journal of hematology
Volume112
Issue number4
DOIs
Publication statusPublished - Oct 1 2020

All Science Journal Classification (ASJC) codes

  • Hematology

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