ClinicalTrials.gg
CompletedNCT04859608EspacECUUpdated Mar 25, 2025

Personalized Spacing of Eculizumab Infusions Based on Therapeutic Pharmacological Monitoring (EspacECU)

A Phase 3 interventional study of Spacing of Eculizumab infusions in Hemolytic-Uremic Syndrome, Atypical, sponsored by University Hospital, Tours. Completed at 18 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-03-25.

Sponsored by University Hospital, Tours · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Eculizumab is an anti-C5 monoclonal antibody approved for rare diseases including atypical haemolytic-uraemic syndrome. The maintenance phase dosing regimen is identical for all adult patients but several studies have shown a high interindividual kinetics variability. A tailored administration of eculizumab based on therapeutic drug monitoring will be compared with real-life administration in adults suffering from an atypical haemolytic uraemic syndrome. The objective is to improve efficiency of eculizumab administration.

Read the detailed description

Eculizumab is a very expensive drug (450 000 euros per year per patient). According to the usual administration scheme, the eculizumab is administrated by intravenous infusion, every 14 or 21 days in hospital. Studies have shown the possibility of extending the administration intervals in patients with a high concentration of eculizumab.

A personalized spacing of eculizumab infusions, based on a therapeutic drug monitoring, is expected to improve the patient's quality of life and lead to substantial savings.

For these reasons, the objective of this study is to explore the efficiency of a personalized spacing of eculizumab infusions compared to the usual administration scheme (without personalization) from the French health Insurance perspective. The efficiency will be assessed by estimating the incremental cost per QALY (Quality-Adjusted Life Year) gained at 18 months (duration of follow-up in the clinical trial) and at 5 years thanks to a Markov model.

The total duration of the study is 24 months (6 months of enrolment and 18 months of follow-up).

02

Conditions studied

  • Hemolytic-Uremic Syndrome, Atypical

Keywords

  • Hemolytic-Uremic Syndrome
  • Kidney Diseases
  • Thrombotic Microangiopathies
  • Therapeutic drug monitoring
  • Eculizumab tailoring
  • Cost-utility analysis
  • Markov model
03

In context

Atypical Hemolytic Uremic Syndrome

45 studies on the registry are indexed under Atypical Hemolytic Uremic Syndrome; 14 are open to participants now.

This study's enrollment of 40 is above the median of 34 across 26 interventional studies indexed under Atypical Hemolytic Uremic Syndrome.

Browse Atypical Hemolytic Uremic Syndrome studies →

Lead sponsor

University Hospital, Tours is the lead sponsor of 307 studies on the registry; 79 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Adults with an atypical Hemolytic and Uremic Syndrome defined by at least 2 of the following parameters:

    • Thrombopenia ( count \< 150 G/L)
    • Mechanical lytic anemia ( \< 10 g/L, Lactate dehydrogenase > , undetectable haptoglobin, presence of schistocytes on blood smear)
    • Acute renal failure
  2. Eculizumab treatment

    • Without project of withdrawal in the next 18 months
    • Started since at least 6 months
    • Administrated with an unchanged administration schedule since at least 3 months (initial episode or relapse)
  3. Atypical Hemolytic and Uremic Syndrome in remission
  4. Patients who give .

Exclusion criteria

Exclusion Criteria:

  1. Patients on dialysis.
  2. Women treated starting or planning a pregnancy.
  3. Patients suffering from a typical or secondary microangiopathic hemolytic anemia (drugs, , disease...)
  4. Patients under protection of a judicial authority
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
40 participants (actual)

Study arms

  • Experimental
    Therapeutic drug monitoring

    Tailored dosing schedule for eculizumab based on therapeutic drug monitoring

    Drug: Spacing of Eculizumab infusions

  • No intervention
    Control

    Initial eculizumab schedule is continued (real-life arm). No eculizumab dosages are performed in this arm.

Interventions

  • DrugSpacing of Eculizumab infusions

    Personalized spacing of eculizumab infusions using a pharmacokinetic population model to estimate eculizumab concentration ( a one-week spacing of eculizumab infusion will be decide if predicted eculizumab concentration in the event of spacing is \> 150 mg/L). Spacing of infusion can be decided every 3 months.

06

What researchers measure

Primary outcomes

  1. Incremental Cost-Utility Ratio (ICUR) at 18 months of a personalized spacing of eculizumab infusions compared to the usual administration scheme without personalization, from the French health insurance perspective.

    The ICUR will express the incremental cost per QALY (Quality-adjusted Life Years) gained over a 18-month time horizon. QALYs will be estimated from patient responses to the EQ-5D-5L instrument (EuroQol group - 5 Dimensions - 5 levels). Costs related to hospital care resources (medicalized information system program), transports (patient diary), eculizumab concentration dosing (cost estimation) will be estimated from the French Health Insurance perspective. Cost and QALY estimates will be used to estimate the within-trial ICUR.

    Time frame: 18 months

Secondary outcomes

  1. Incremental Cost-Utility Ratio at 5 years (incremental cost per QALY gained) of a personalized spacing of the eculizumab infusions compared to the usual administration scheme without personalization, estimated from a Markov model.

    A Markov model will represent the patient's clinical progression across different health states over a 5-year period. Markov modelling will use the within-trial data to estimate the transition probabilities, the state cost and utility values.

    Time frame: 5 years

  2. Financial impact per year and over a 5-year period of a personalized spacing of eculizumab infusions

    The financial impact of spreading the strategy of personalized spacing of eculizumab infusions, in patients in remission with atypical hemolytic uraemic syndrome requiring long-term treatment, will be estimated per year and over a 5-year period, from the French Health Insurance (using a budget impact model).

    Time frame: per year and over a 5-year period

  3. Quality of life measured over a 18-month period using different specific scales (KDQoL-SF, ReTransQoL-Version 2) dedicated to patients with renal disease

    KDQoL-SF (Kidney Disease and Quality of Life™ Short Form) survey is a kidney-disease-specific quality of life instrument that assesses four domains : health, kidney disease, effects of kidney disease on daily life, satisfaction with care. Scores for each dimension are reported within the range 0-100, higher scores indicating better health- related quality of life. RTQ-V2 (ReTransQoL-Version 2) survey is a specific quality of life instrument for renal transplant recipients. It comprises of 32 items describing five domains: Physical Health, Social Functioning, Medical Care, Treatment and Fear of Losing Graft. Scores for each dimension are reported within the range 0-100, higher scores indicating better health- related quality of life. KDQoL-SF survey will be used for all patients, and RTQ-V2 survey for kidney transplant patients only. The quality of life will be measured every three months.

    Time frame: at baseline, 3, 6, 9, 12, 15 and 18 months.

  4. Determining the factors of intra- and inter- individual variability of eculizumab concentrations.

    A study will be performed to determine whether biological and genetic (complement genetic variants reported as cause of HUS) parameters influence trough concentrations of eculizumab

    Time frame: 5 years

07

Study locations

18 sites
  • CHU Amiens Picardie
    Amiens, France
  • CHU d'Angers
    Angers, France
  • Hôpital Tenon
    APHP Tenon, France
  • CHU Besançon
    Besançon, France
  • Hôpital de la Côte de Nacre
    Caen, France
  • Hôpital Louis Pasteur
    Chartres, France
  • Hôpital Gabriel Montpied
    Clermont-Ferrand, France
  • Hospices Civils de Lyon
    Lyon, France
  • Hopital de la conception
    Marseille, France
  • Hôpitaux de Brabois
    Nancy, France
  • Hotel Dieu
    Nantes, France
  • Hopital Necker
    Necker, France
  • Hopital Pasteur 2
    Nice, France
  • Hôpital de la Milétrie
    Poitiers, France
  • Hôpital Maison Blanche
    Reims, France
  • Hôpital Pontchaillou
    Rennes, France
  • Hôpital de Bois-Guillaume
    Rouen, France
  • Nouvel Hôpital Civil
    Strasbourg, France
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Oct 2021 to primary completion in Jun 2022, 7 months.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 2, 2021
First posted
Apr 26, 2021
StartActual
Oct 20, 2021
Primary completionActual
Jun 16, 2022
CompletionActual
Dec 28, 2023
Last update
Mar 25, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 25, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04859608
Responsible party
Sponsor
First posted
Apr 26, 2021
Start date
Oct 20, 2021
Primary completion
Jun 16, 2022
Completion
Dec 28, 2023
Last update
Mar 25, 2025

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Mar 2025. You cannot join it, but the record below documents what was studied.

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