A Phase 3 interventional study of ASP0113 and Placebo in Cytomegalovirus (CMV)-Positive Recipients and Allogeneic, Hematopoietic Cell Transplant (HCT), sponsored by Astellas Pharma Global Development, Inc.. Completed at 83 sites in 11 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-10-24.
Sponsored by Astellas Pharma Global Development, Inc. · Phase 3, Interventional, and Prevention
The purpose of the study was to evaluate the efficacy of ASP0113 compared with placebo as measured by a primary composite endpoint of overall mortality and CMV end organ disease (EOD) through 1 year post-transplant. Safety of ASP0113 in participants undergoing allogeneic HCT will also be evaluated.
Participants will be followed for 5.5 years post-transplant for long-term safety via an annual telephone contact.
359 studies on the registry are indexed under Cytomegalovirus Infections; 59 are open to participants now.
This study's enrollment of 514 is above the median of 60 across 233 interventional studies indexed under Cytomegalovirus Infections.
Browse Cytomegalovirus Infections studies →Astellas Pharma Global Development, Inc. is the lead sponsor of 204 studies on the registry; 25 are open to participants now.
Of its 80 completed or terminated interventional studies of FDA-regulated products, 38 (48%) have results posted.
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Participant is planned to undergo either of the following:
Participant has one of the following underlying diseases:
Exclusion Criteria:
Participants received 1 mL of 5 mg/mL of ASP0113 via intramuscular injection in the deltoid muscle alternating sides with each dose on days -14 to -3 pretransplant, 14 to 40, 60, 90 and 180 in relation to the day of transplant (Day 0).
Biological: ASP0113
Participants received 1 mL of 5 mg/mL of matching placebo via intramuscular injection in the deltoid muscle alternating sides with each dose on days -14 to -3 pretransplant, 14 to 40, 60, 90 and 180 in relation to the day of transplant (Day 0).
Drug: Placebo
Intramuscular injection
Intramuscular injection
Percentage of Participants With Composite of All-Cause Mortality and Adjudicated Cytomegalovirus End Organ Disease (CMV EOD) Through 1 Year Post Transplant
This was the composite of all-cause mortality and adjudicated CMV EOD through 1 year posttransplant, The CMV EOD was assessed by the independent and blinded adjudication committee, which counted events that were observed up to day 380 from transplantation. Deaths that occurred up to day 365 from transplant were also counted.
Time frame: From first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)
Percentage of Participants With Protocol-Defined CMV Viremia Through 1 Year Posttransplant
Protocol-defined CMV viremia was defined as a CMV plasma viral load ≥1000 IU/mL as assessed by the central laboratory. Rate was based on cumulative incidence function estimated at 1 year. The central laboratory had the lower limit of quantification \[LLOQ\] for CMV viral load assessment, so when the viral load was below the LLOQ the actual viral load reading was not possible and was denoted as ≤LLOQ. If participant had any CMV viral load assessments greater than the LLOQ it was classified as viremic.
Time frame: From first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)
Percentage of Participants With Adjudicated CMV-Specific Antiviral Therapy (AVT) Through 1 Year Posttransplant
The CMV-specific AVT use was adjudicated by the independent and blinded committee. When the CMV-specific AVT was initiated, a central CMV viral load was obtained weekly until it was discontinued. Participants without any CMV-specific AVT events were censored on the last study evaluation.
Time frame: From first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)
Percentage of Participants With a Composite Endpoint of Protocol-defined CMV Viremia and Adjudicated CMV-Specific AVT Use
Protocol-defined CMV viremia was as CMV plasma viral load ≥ 1000 IU/mL as assessed by the central laboratory. The CMV-specific AVT was determined by the adjudication committee. Participants with no posttransplant viral load data were excluded from the analysis.
Time frame: From first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)
Percentage of Participants With First Occurrence of Adjudicated CMV-specific AVT or Adjudicated Diagnosis of CMV EOD After Study Drug First Injection Through 1 Year Posttransplant
Rate was based on cumulative incidence function estimate at 1 year. Time to first CMV-specific AVT was defined as time to the start of AVT for CMV viremia or CMV EOD. CMV-specific AVT and EOD were determined by the adjudication committee. This endpoint was a composite endpoint based on the independent adjudication committee assessments of CMV-specific AVT and CMV EOD.
Time frame: From first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)
All-Cause Mortality at 1 Year Posttransplant
All-cause mortality through 1-year post-transplantation summary included all deaths and unknown survival status. For the known deaths, the adjudication committee assessed results and summarized them according to the following category: Mortality due to the participant's primary disease, and mortality due to causes unrelated to the participant's primary disease. Participants with unknown survival status at 1 year were considered dead for this analysis.
Time frame: From first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)
A total of 514 participants were enrolled across 11 countries. At least 30% of enrolled participants had cytomegalovirus (CMV) seronegative donor and underwent allogeneic hematopoietic cell transplant (HCT). After the primary study period (day 365) participants were monitored for 5.5 years post-transplant for long-term safety. After the primary period completion, 326 participants entered the long-term follow-up period.
| Milestone | Placebo | ASP0113 5mg |
|---|---|---|
| Started | 263 | 251 |
| Received treatment | 255 | 246 |
| Completed | 165 | 154 |
| Not completed | 98 | 97 |
| Withdrew: Death | 57 | 52 |
| Withdrew: Withdrawal by subject | 18 | 26 |
| Withdrew: Physician decision | 11 | 10 |
| Withdrew: Miscellaneous | 4 | 4 |
| Withdrew: Randomized but never received drug | 8 | 5 |
This was the composite of all-cause mortality and adjudicated CMV EOD through 1 year posttransplant, The CMV EOD was assessed by the independent and blinded adjudication committee, which counted events that were observed up to day 380 from transplantation. Deaths that occurred up to day 365 from transplant were also counted.
| Percentage of Participants | Placebo | ASP0113 |
|---|---|---|
| Participants With Composite Endpoint | 30.20 | 35.37 |
| All-Cause Mortality | 28.24 | 31.71 |
| Adjudicated CMV EOD | 3.53 | 6.10 |
Protocol-defined CMV viremia was defined as a CMV plasma viral load ≥1000 IU/mL as assessed by the central laboratory. Rate was based on cumulative incidence function estimated at 1 year. The central laboratory had the lower limit of quantification \[LLOQ\] for CMV viral load assessment, so when the viral load was below the LLOQ the actual viral load reading was not possible and was denoted as ≤LLOQ. If participant had any CMV viral load assessments greater than the LLOQ it was classified as viremic.
| Percentage of Participants | Placebo | ASP0113 |
|---|---|---|
| Percentage of Participants With Protocol-Defined CMV Viremia Through 1 Year Posttransplant | 58.6 (52.0 to 64.6) | 56.7 (50.1 to 62.8) |
The CMV-specific AVT use was adjudicated by the independent and blinded committee. When the CMV-specific AVT was initiated, a central CMV viral load was obtained weekly until it was discontinued. Participants without any CMV-specific AVT events were censored on the last study evaluation.
| Percentage of Participants | Placebo | ASP0113 |
|---|---|---|
| Percentage of Participants With Adjudicated CMV-Specific Antiviral Therapy (AVT) Through 1 Year Posttransplant | 53.2 (46.8 to 59.1) | 54.6 (48.1 to 60.6) |
Protocol-defined CMV viremia was as CMV plasma viral load ≥ 1000 IU/mL as assessed by the central laboratory. The CMV-specific AVT was determined by the adjudication committee. Participants with no posttransplant viral load data were excluded from the analysis.
| Percentage of Participants | Placebo | ASP0113 |
|---|---|---|
| Percentage of Participants With a Composite Endpoint of Protocol-defined CMV Viremia and Adjudicated CMV-Specific AVT Use | 60.78 | 60.98 |
Rate was based on cumulative incidence function estimate at 1 year. Time to first CMV-specific AVT was defined as time to the start of AVT for CMV viremia or CMV EOD. CMV-specific AVT and EOD were determined by the adjudication committee. This endpoint was a composite endpoint based on the independent adjudication committee assessments of CMV-specific AVT and CMV EOD.
| Percentage of Participants | Placebo | ASP0113 |
|---|---|---|
| Percentage of Participants With First Occurrence of Adjudicated CMV-specific AVT or Adjudicated Diagnosis of CMV EOD After Study Drug First Injection Through 1 Year Posttransplant | 54.4 (48.0 to 60.3) | 55.4 (48.9 to 61.5) |
All-cause mortality through 1-year post-transplantation summary included all deaths and unknown survival status. For the known deaths, the adjudication committee assessed results and summarized them according to the following category: Mortality due to the participant's primary disease, and mortality due to causes unrelated to the participant's primary disease. Participants with unknown survival status at 1 year were considered dead for this analysis.
| Percentage of Participants | Placebo | ASP0113 |
|---|---|---|
| All-Cause Mortality at 1 Year Posttransplant | 28.24 | 31.71 |
Collected over All cause-Mortality: Baseline up to 5.5 years post transplant. Adverse Events: From first dose of study drug up to 30 days after last dose of study drug (Day 365).. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Placebo | 100/255 (39.2%) | 221/255 (86.7%) | 254/255 (99.6%) |
| ASP0113 5mg | 105/246 (42.7%) | 221/246 (89.8%) | 244/246 (99.2%) |
| Event | Placebo | ASP0113 5mg |
|---|---|---|
| Acute graft versus host disease in skinImmune system disorders | 122/255 | 118/246 |
| Acute graft versus host disease in intestineImmune system disorders | 76/255 | 76/246 |
| Renal failure acuteRenal and urinary disorders | 41/255 | 28/246 |
| PyrexiaGeneral disorders | 23/255 | 26/246 |
| Acute graft versus host disease in liverImmune system disorders | 24/255 | 18/246 |
| SepsisInfections and infestations | 20/255 | 14/246 |
| PneumoniaInfections and infestations | 15/255 | 19/246 |
| Acute myeloid leukaemia recurrentNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 18/255 | 17/246 |
| Febrile neutropeniaBlood and lymphatic system disorders | 11/255 | 11/246 |
| VomitingGastrointestinal disorders | 7/255 | 11/246 |
| Event | Placebo | ASP0113 5mg |
|---|---|---|
| Injection site painGeneral disorders | 47/255 | 193/246 |
| NauseaGastrointestinal disorders | 177/255 | 178/246 |
| DiarrhoeaGastrointestinal disorders | 167/255 | 166/246 |
| VomitingGastrointestinal disorders | 122/255 | 125/246 |
| PyrexiaGeneral disorders | 128/255 | 123/246 |
| HypomagnesaemiaMetabolism and nutrition disorders | 113/255 | 113/246 |
| HeadacheNervous system disorders | 103/255 | 103/246 |
| ConstipationGastrointestinal disorders | 103/255 | 90/246 |
| Mucosal inflammationGeneral disorders | 101/255 | 75/246 |
| Cytomegalovirus viraemiaInfections and infestations | 96/255 | 87/246 |
The analysis population was the All Randomized which consisted of all randomized participants whether they received study drug or not.
| Age, Continuous(Year) | Placebo | ASP0113 | Total |
|---|---|---|---|
| Mean | 52.0 ± 13.15 | 51.8 ± 12.41 | 51.9 ± 12.78 |
| Sex: Female, Male(Participants) | Placebo | ASP0113 | Total |
|---|---|---|---|
| Female | 105 | 110 | 215 |
| Male | 158 | 141 | 299 |
| Ethnicity (NIH/OMB)(Participants) | Placebo | ASP0113 | Total |
|---|---|---|---|
| Hispanic or Latino | 11 | 19 | 30 |
| Not Hispanic or Latino | 252 | 232 | 484 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | Placebo | ASP0113 | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 47 | 50 | 97 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 6 | 7 | 13 |
| White | 189 | 177 | 366 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 21 | 17 | 38 |
| Strata(Participants) | Placebo | ASP0113 | Total |
|---|---|---|---|
| Related Seropositive Donor | 65 | 73 | 138 |
| Related Seronegative Donor | 30 | 26 | 56 |
| Non-related Seropositive Donor | 96 | 73 | 169 |
| Non-related Seronegative Donor | 72 | 79 | 151 |
| Primary Diagnosis(Participants) | Placebo | ASP0113 | Total |
|---|---|---|---|
| Acute Myeloid Leukemia (AML) | 126 | 97 | 223 |
| Acute Lymphoblastic Leukemia (ALL) | 34 | 34 | 68 |
| Acute Undifferentiated Leukemia (AUL) | 1 | 2 | 3 |
| Acute Biphenotypic Leukemia (ABL) | 2 | 2 | 4 |
| Chronic Myelogenous Leukemia (CML) | 6 | 12 | 18 |
| Chronic Lymphocytic Leukemia (CLL) | 7 | 10 | 17 |
| Myelodysplastic Syndrome | 46 | 51 | 97 |
| Primary or Secondary Myelofibrosis | 8 | 11 | 19 |
| Lymphoma | 33 | 31 | 64 |
| Missing | 0 | 1 | 1 |
| Conditioning Regimen(Participants) | Placebo | ASP0113 | Total |
|---|---|---|---|
| Myeloablative | 122 | 120 | 242 |
| Non-Myeloablative | 131 | 124 | 255 |
| Missing | 10 | 7 | 17 |
| Antithymocyte Globulin (ATG) Use(Participants) | Placebo | ASP0113 | Total |
|---|---|---|---|
| Yes | 45 | 43 | 88 |
| No | 218 | 208 | 426 |
2 further baseline measures are reported on the registry.
Documents are hosted by the registry — open the source record to download them.
Plan to share: Yes — Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as products terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.
Supporting information: Study protocol, Sap, Csr
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Astellas Pharma Global Development, Inc.