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The study did not meet primary endpoint at Week 52. The study also did not meet key secondary efficacy endpoints. Pegcetacoplan (APL-2) was well tolerated in the study, and the data were consistent with the established safety profile.
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This is a 24-month, Phase 2, multicenter, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of pegcetacoplan in subjects with amyotrophic lateral sclerosis (ALS)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1,080 mg pegcetacoplan (APL-2) | Experimental | administered subcutaneously twice weekly |
|
| Placebo administered subcutaneously twice weekly | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pegcetacoplan (APL-2) | Drug | Complement (C3) Inhibitor |
| |
| Measure | Description | Time Frame |
|---|---|---|
| RTP: Combined Assessment of Function and Survival (CAFS) Rank Score (Joint-Rank Score) at Week 52 | The CAFS scale is a combined endpoint ranking subjects' clinical outcomes based on ALS Functional Rating Scale-Revised (ALSFRS-R-described below) and survival time. For ALSFRS-R, 12 functions were rated on 5-point ordinal rating scales (0 to 4) with a total score range of 0-48 (sum of all 12 items); higher score indicated better functioning. For survival time, longer the subject survives indicated better outcome. Each subject's outcome was compared to every other subject outcome in trial in series of pairwise comparisons, summed scores (sum of comparisons [+1 {better}, 0 {tie}, -1 {worse}]) were ranked and ranged from 001-247 (number of subjects in modified [m]ITT population).Reported values are the least squares mean rank scores in each group for the composite endpoint. Higher rank indicated better outcome. | Week 52 |
| RTP: Number of Subjects With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs) | An AE was any untoward medical occurrence associated with the use of a drug in humans, whether or not it was considered drug related. An SAE was any AE or suspected adverse reaction that, in the view of the investigator, resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or was a congenital anomaly or birth defect. TEAEs were AEs that started on or after first dose of study drug or started before first dose of study drug but increased in severity on or after the first dose of study drug up to 56 days post last dose of study drug. | From first dose of study drug (Day 1) up to 56 days post last dose of study drug, approximately 60 weeks |
| OLP: Number of Participants With Treatment-emergent Adverse Events and Treatment-emergent Serious Adverse Events | An AE was any untoward medical occurrence associated with the use of a drug in humans, whether or not it was considered drug related. An SAE was any AE or suspected adverse reaction that, in the view of the investigator, resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or was a congenital anomaly or birth defect. TEAEs were AEs that started on or after first dose of study drug or started before first dose of study drug but increased in severity on or after the first dose of study drug up to 56 days post last dose of study drug. |
| Measure | Description | Time Frame |
|---|---|---|
| RTP: Change From Baseline in the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) Score at Week 52 | The ALSFRS-R included 12 items for assessment of functional status: speech, salivation, swallowing, handwriting, cutting food and handling utensils, dressing and hygiene, turning in bed and adjusting bed clothes, walking, climbing stairs, dyspnea, orthopnea, and respiratory insufficiency. Each item ranged from 0 (no ability) to 4 (normal ability). Individual item scores were summed to produce a total score between 0 (worst) and 48 (best) with higher scores meaning better outcome. Least squares mean is presented here. Baseline was defined as the last available, non-missing observation prior to first study drug administration. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cedars-Sinai Medical Center | Los Angeles | California | 90048 | United States | ||
| University of Colorado |
Study consisted of 5 periods: 6-week screening period, 52-week randomized treatment period (RTP), 52-week open-label treatment period (OLP), 52-week long-term extension treatment period and a 6-week off-treatment follow-up period. Study was terminated early during OLP due to lack of efficacy as determined by the Week 52 data and no safety concerns.
This Phase 2, placebo-controlled study was conducted in subjects diagnosed with amyotrophic lateral sclerosis (ALS). A total of 249 subjects were randomized in a 2:1 ratio to either receive pegcetacoplan or placebo.
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| ID | Title | Description |
|---|---|---|
| FG000 | RTP: Pegcetacoplan | Subjects received pegcetacoplan 1080 milligram (mg) subcutaneous (SC) injection/infusion twice per week for 52 weeks. |
| FG001 | RTP: Placebo | Subjects received placebo matching pegcetacoplan as SC injection/infusion twice per week for 52 weeks. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| RTP (Up to Week 52) |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 13, 2023 | Feb 25, 2025 |
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| Placebo |
| Other |
Sterile solution of equal volume to active arm |
|
| From first dose of study drug (Week 52) up to 56 days post last dose of study drug, approximately 60 weeks |
| RTP: Number of Subjects With Positive Response to Columbia-Suicide Severity Rating Scale (C-SSRS) up to Week 52 | The C-SSRS is a measure used to identify and assess individuals at risk for suicide and included "yes" or "no" responses for assessment of suicidal ideation (SI) and suicidal behavior (SB).C-SSRS SI items are classified on 5-item scale:1 (wish to be dead),2 (non-specific active suicidal thoughts),3 (active SI with any methods without intent to act),4 (active SI with some intent to act, without specific plan) and 5 (active SI with a specific plan and intent).C-SSRS SB items are classified on 5-item scale: 1 (preparatory acts or behavior), 2 (aborted attempt), 3 (interrupted attempt), 4 (actual attempt [non-fatal]) and 5 (completed suicide). Numeric ratings were provided for SI (1 to 5) and SB (1 to 5) with 5 being more severe for each. Number of subjects with a response of 'yes' to SI only, SB only & SI and SB are reported. Baseline: last available, non-missing observation prior to first study drug administration. | Baseline (Day 1) up to Week 52 |
| OLP: Number of Subjects With Positive Response to Columbia-Suicide Severity Rating Scale up to Week 104 | The C-SSRS is a measure used to identify and assess individuals at risk for suicide and included "yes" or "no" responses for assessment of SI and SB.C-SSRS SI items are classified on 5-item scale:1 (wish to be dead),2 (non-specific active suicidal thoughts),3 (active SI with any methods without intent to act),4 (active SI with some intent to act, without specific plan) and 5 (active SI with a specific plan and intent).C-SSRS SB items are classified on 5-item scale:1 (preparatory acts or behavior),2 (aborted attempt), 3 (interrupted attempt), 4 (actual attempt [non-fatal]) and 5 (completed suicide). Numeric ratings were provided for SI (1 to 5) and SB (1 to 5) with 5 being more severe for each. Number of subjects with a response of 'yes' to SI only, SB only & SI and SB are reported. Baseline: last available, non-missing observation prior to first study drug administration in OLP. | From Baseline (Week 52) up to Week 104 |
| Baseline (Day 1) and Week 52 |
| RTP: Change From Baseline in Percent Predicted Slow Vital Capacity (%SVC) at Week 52 | SVC is a pulmonary function test and predictor of functional loss in ALS. It was conducted at clinic visits with the clinic spirometer which reflected the maximum amount of air that could be exhaled slowly. %SVC is the actual volume exhaled in the first 1 second, divided by the normal value for that actual value for a person of that age, gender, height and weight. Baseline was defined as the last available, non-missing observation prior to first study drug administration. | Baseline (Day 1) and Week 52 |
| RTP: Change From Baseline in Muscle Strength at Week 52 | Muscle strength was measured using handheld dynamometry (HHD) and assessed the following muscles: first dorsal interosseous, wrist extension, elbow extension, elbow flexion, shoulder flexion, knee extension, knee flexion, and ankle dorsiflexion, on both sides of the body. Baseline was defined as the last available, non-missing observation prior to first study drug administration. | Baseline (Day 1) and Week 52 |
| RTP: Number of Subjects With an Event of Death or Permanent Tracheostomy or Permanent Assisted Ventilation at Week 52 | Subjects with an event (that is, either death or permanent tracheostomy or permanent assisted ventilation) in RTP are reported. | Baseline (Day 1) up to Week 52 |
| RTP: Change From Baseline in ALS Assessment Questionnaire (ALSAQ)-40 at Week 52 | The ALSAQ-40 was a 40-item validated questionnaire designed to assess health related quality of life (QoL) over the previous 2 weeks in subjects with ALS. It represented 5 dimensions of health status; each scored from 0 (never, or best) to 4 (always, or worst). 5 dimensions evaluated were: physical mobility (10 items: 1-10; possible score of 0-40); activities of daily living/independence (10 items: 11-20; possible score of 0-40); eating and drinking (3 items: 21-23; possible score of 0-12); communication (7 items: 24-30; possible score: 0-28) and emotional functioning (10 items: 31-40; possible score: 0-40). The total score 0 (no impairment) to 160 (severe impairment) was calculated by adding the 5 dimension scores; least squares mean is presented here. Higher scores indicated worse QoL. | Baseline (Day 1) and Week 52 |
| OLP: Change From Baseline in the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised Score at Week 104 | The ALSFRS-R included 12 items for assessment of functional status: speech, salivation, swallowing, handwriting, cutting food and handling utensils, dressing and hygiene, turning in bed and adjusting bed clothes, walking, climbing stairs, dyspnea, orthopnea, and respiratory insufficiency. Each item ranged from 0 (no ability) to 4 (normal ability). Individual item scores were summed to produce a total score between 0 (worst) and 48 (best) with higher scores meaning better outcome. Mean is presented here. Baseline was defined as the last observed value for the efficacy assessment prior to taking the first dose of study drug in OLP. | Baseline (Week 52) and Week 104 |
| OLP: Change From Baseline in Percent Predicted Slow Vital Capacity at Week 104 | SVC is a pulmonary function test and predictor of functional loss in ALS. It was planned to be conducted at clinic visits with the clinic spirometer which reflected the maximum amount of air that could be exhaled slowly. %SVC is the actual volume exhaled in the first 1 second, divided by the normal value for that actual value for a person of that age, gender, height and weight. Baseline was defined as the last available, non-missing observation prior to first study drug administration. | Baseline (Week 52) and Week 104 |
| OLP: Change From Baseline in Muscle Strength at Week 104 | Muscle strength was planned to be measured using HHD and assessed the following muscles: first dorsal interosseous, wrist extension, elbow extension, elbow flexion, shoulder flexion, knee extension, knee flexion, and ankle dorsiflexion, on both sides of the body. Baseline was defined as the last available, non-missing observation prior to first study drug administration. | Baseline (Week 52) and Week 104 |
| OLP: Number of Subjects With an Event of Death or Permanent Tracheostomy or Permanent Assisted Ventilation at Week 104 | Subjects with an event of death are reported. Subjects were planned to be assessed for permanent tracheostomy or permanent assisted ventilation in OLP; however, that data was not collected as study was terminated early. | Baseline (Week 52) and Week 104 |
| OLP: Change From Baseline in ALS Assessment Questionnaire-40 at Week 104 | The ALSAQ-40 was a 40-item validated questionnaire designed to assess health related QoL over the previous 2 weeks in subjects with ALS. It represented 5 dimensions of health status; each scored from 0 (never, or best) to 4 (always, or worst). 5 dimensions evaluated were: physical mobility (10 items: 1-10; possible score of 0-40); activities of daily living/independence (10 items: 11-20; possible score of 0-40); eating and drinking (3 items: 21-23; possible score of 0-12); communication (7 items: 24-30; possible score: 0-28) and emotional functioning (10 items: 31-40; possible score: 0-40). The total score 0 (no impairment) to 160 (severe impairment) was planned to be calculated by adding the 5 dimension scores. Higher scores would have indicated worse QoL. | Baseline (Week 52) and Week 104 |
| Number of Subjects With an Event of Death During the Study | Total number of subjects who died in the study are reported. | RTP: Baseline (Day 1) up to Week 52; OLP: Baseline (Week 52) up to Week 104 |
| Aurora |
| Colorado |
| 80045 |
| United States |
| University of South Florida | Tampa | Florida | 33612 | United States |
| Augusta University | Augusta | Georgia | 30912 | United States |
| Indiana University | Indianapolis | Indiana | 46202 | United States |
| Johns Hopkins | Baltimore | Maryland | 21205 | United States |
| The Berman Center | Minneapolis | Minnesota | 55415 | United States |
| Hospital for Special Surgery | New York | New York | 10021 | United States |
| Austin Neuromuscular Center | Austin | Texas | 78756 | United States |
| University of Vermont Medical Center | Burlington | Vermont | 05401 | United States |
| Brain and Mind Centre | Camperdown | New South Wales | 2050 | Australia |
| Central Coast Neurosciences Research | Erina | New South Wales | 2250 | Australia |
| Royal Brisbane and Women's Hospital | Herston | Queensland | 4029 | Australia |
| Gold Coast University Hospital | Southport | Queensland | 4215 | Australia |
| Nueor-Immunology Clinical Researh Education and Support Service (N-CRESS), Austin Health | Heidelberg | Victoria | 3084 | Australia |
| AZ Sint-Lucas & Volkskliniek | Ghent | B-9000 | Belgium |
| Universitaire Ziekenhuizen Leuven (UZ Leuven) | Leuven | B-3000 | Belgium |
| Vseobecna fakultni nemocnice v Praze | Prague | 128 21 | Czechia |
| FORBELI s.r.o. | Prague | 160 00 | Czechia |
| Hopital Pellegrin | Bordeaux | 33076 | France |
| Hôpital Neurologique Pierre Wertheimer | Bron | 69677 | France |
| CHU Gabriel Montpied | Clermont-Ferrand | 63000 | France |
| Hôpital Roger Salengro | Lille | 59037 | France |
| CHU de Limoges Dupuytren 1 | Limoges | 87042 | France |
| CHU de Nice Hôpital Pasteur | Nice | 6300 | France |
| Charité - Universitätsmedizin Berlin | Berlin | D-13353 | Germany |
| Medizinische Hochschule Hannover Klinik für Neurologie | Hanover | 30625 | Germany |
| Universitätsklinikum Jena | Jena | 07747 | Germany |
| Universitätsmedizin Rostock, Klinik und Poliklinik für Neurologie | Rostock | 18147 | Germany |
| University of Ulm | Ulm | 89081 | Germany |
| Beaumont Hospital | Dublin | DO9 V2NO | Ireland |
| Ospedale Niguarda - Nemo Clinical Center - Fondazione Serena Onlus | Milan | 20162 | Italy |
| Ospedale Civile S. Agostino Estense di Modena, Azienda Ospedaliero Universitaria di Modena | Modena | 41126 | Italy |
| AOUP "P. Giaccone" | Palermo | 90129 | Italy |
| Azienda Ospedaliera Universitaria di Torino - Città della Salute e della Scienza di Torino | Torino | 10126 | Italy |
| National Hospital Organization Higashinagoya National Hospital | Aichi | 465-8620 | Japan |
| National Hospital Organization Omuta National Hospital | Fukuoka | 837-0911 | Japan |
| National Hospital Organization Asahikawa Medical Center | Hokkaido | 070-8644 | Japan |
| National Hospital Organization Hyogo-Chuo National Hospital | Hyōgo | 669-1592 | Japan |
| National Hospital Organization Iou National Hospital | Ishikawa | 920-0192 | Japan |
| National Hospital Organization Matsumoto Medical Center | Matsumoto | 399-8701 | Japan |
| Niigata National Hospital National Hospital Organization | Niigata | 945-8585 | Japan |
| National Hospital Organization Okinawa National Hospital | Okinawa | 901-2214 | Japan |
| National Hospital Organization Higashisaitama National Hospital | Saitama | 349-0196 | Japan |
| Shizuoka Institute of Epilepsy and Neurological Disorders | Shizuoka | 420-8688 | Japan |
| Juntendo University Hospital | Tokyo | 113-8431 | Japan |
| Tokyo Medical University Hospital | Tokyo | 160-0023 | Japan |
| University Medical Center Utrecht | Utrecht | 3584 CX | Netherlands |
| Uniwersytecki Szpital Kliniczny w Olsztynie Klinika Neurologii | Olsztyn | 10-082 | Poland |
| Centrum Medyczne NeuroProtect | Warsaw | 01-684 | Poland |
| City Clinic Sp. z o.o. | Warsaw | 02-473 | Poland |
| Hospital Universitari Vall d'Hebron | Barcelona | 08035 | Spain |
| Bellvitge University Hospital | Barcelona | 08907 | Spain |
| Hospital Universitari I Politecnic La Fe | Valencia | 46026 | Spain |
| SI Institute of Neurology, Psychiatry and Narcology of NAMSU | Kharkiv | 61068 | Ukraine |
| Centre of Reconstructive and Restorative Medicine (University Clinic) Odessa National Medical University | Odesa | 65062 | Ukraine |
| Zaporizhzhya Regional Clinical Hospital | Zaporizhzhya | 69600 | Ukraine |
| University Hospitals Sussex NHS Foundation Trust | Brighton | BN2 5BE | United Kingdom |
| Maurice Wohl Clinical Neuroscience Institute, King's College London | London | SE5 9RX | United Kingdom |
| St George's University Hospitals NHS Foundation Trust | London | SW17 0WT | United Kingdom |
| FG002 | OLP: Pegcetacoplan/Pegcetacoplan | Eligible subjects who had received pegcetacoplan in RTP entered OLP and continued to receive pegcetacoplan 1080 mg SC injection/infusion twice per week for 52 weeks. |
| FG003 | OLP: Placebo/Pegcetacoplan | Eligible subjects who had received placebo matching pegcetacoplan in RTP entered OLP to receive pegcetacoplan 1080 mg SC injection/infusion twice per week for 52 weeks. |
| COMPLETED | Completed RTP |
|
| NOT COMPLETED |
|
|
| OLP (From Week 52 up to Week 104) |
|
|
The intent-to-treat (ITT) population included all randomized subjects who received at least 1 dose of randomized treatment (pegcetacoplan or placebo).
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | RTP: Pegcetacoplan | Subjects received pegcetacoplan 1080 milligram (mg) subcutaneous (SC) infusion twice per week for 52 weeks in the RTP. Eligible subjects entered OLP and continued to receive pegcetacoplan 1080 mg SC infusion twice per week up to 104 weeks. Those subjects experiencing clinical benefit as per investigator continued to receive pegcetacoplan 1080 mg SC infusion twice per week up to 156 weeks in the open-label long-term extension treatment period. |
| BG001 | RTP: Placebo | Subjects received placebo matched to pegcetacoplan SC infusion twice per week for 52 weeks in the RTP. Eligible subjects entered OLP to receive pegcetacoplan 1080 mg SC infusion twice per week up to 104 weeks. Those subjects experiencing clinical benefit as per investigator continued to receive pegcetacoplan 1080 mg SC infusion twice per week up to 156 weeks in the open-label long-term extension treatment period. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants | No |
| |||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants | No |
| |||||||||||||||
| Race/Ethnicity, Customized | Count of Participants | Participants | No |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | RTP: Combined Assessment of Function and Survival (CAFS) Rank Score (Joint-Rank Score) at Week 52 | The CAFS scale is a combined endpoint ranking subjects' clinical outcomes based on ALS Functional Rating Scale-Revised (ALSFRS-R-described below) and survival time. For ALSFRS-R, 12 functions were rated on 5-point ordinal rating scales (0 to 4) with a total score range of 0-48 (sum of all 12 items); higher score indicated better functioning. For survival time, longer the subject survives indicated better outcome. Each subject's outcome was compared to every other subject outcome in trial in series of pairwise comparisons, summed scores (sum of comparisons [+1 {better}, 0 {tie}, -1 {worse}]) were ranked and ranged from 001-247 (number of subjects in modified [m]ITT population).Reported values are the least squares mean rank scores in each group for the composite endpoint. Higher rank indicated better outcome. | mITT set included all randomized subjects who received at least 1 dose of randomized treatment (pegcetacoplan or placebo) and who died or had a postbaseline assessment of endpoint that was used in CAFS. Only subjects with data collected at Week 52 are reported. | Posted | Least Squares Mean | Standard Error | score on a scale | Week 52 |
|
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| Primary | RTP: Number of Subjects With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs) | An AE was any untoward medical occurrence associated with the use of a drug in humans, whether or not it was considered drug related. An SAE was any AE or suspected adverse reaction that, in the view of the investigator, resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or was a congenital anomaly or birth defect. TEAEs were AEs that started on or after first dose of study drug or started before first dose of study drug but increased in severity on or after the first dose of study drug up to 56 days post last dose of study drug. | The safety set for RTP included all subjects who received at least 1 dose of study drug: pegcetacoplan or placebo. | Posted | Count of Participants | Participants | No | From first dose of study drug (Day 1) up to 56 days post last dose of study drug, approximately 60 weeks |
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary | OLP: Number of Participants With Treatment-emergent Adverse Events and Treatment-emergent Serious Adverse Events | An AE was any untoward medical occurrence associated with the use of a drug in humans, whether or not it was considered drug related. An SAE was any AE or suspected adverse reaction that, in the view of the investigator, resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or was a congenital anomaly or birth defect. TEAEs were AEs that started on or after first dose of study drug or started before first dose of study drug but increased in severity on or after the first dose of study drug up to 56 days post last dose of study drug. | The safety set for the OLP included only those subjects who received at least 1 dose of the open-label treatment. | Posted | Count of Participants | Participants | No | From first dose of study drug (Week 52) up to 56 days post last dose of study drug, approximately 60 weeks |
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| Primary | RTP: Number of Subjects With Positive Response to Columbia-Suicide Severity Rating Scale (C-SSRS) up to Week 52 | The C-SSRS is a measure used to identify and assess individuals at risk for suicide and included "yes" or "no" responses for assessment of suicidal ideation (SI) and suicidal behavior (SB).C-SSRS SI items are classified on 5-item scale:1 (wish to be dead),2 (non-specific active suicidal thoughts),3 (active SI with any methods without intent to act),4 (active SI with some intent to act, without specific plan) and 5 (active SI with a specific plan and intent).C-SSRS SB items are classified on 5-item scale: 1 (preparatory acts or behavior), 2 (aborted attempt), 3 (interrupted attempt), 4 (actual attempt [non-fatal]) and 5 (completed suicide). Numeric ratings were provided for SI (1 to 5) and SB (1 to 5) with 5 being more severe for each. Number of subjects with a response of 'yes' to SI only, SB only & SI and SB are reported. Baseline: last available, non-missing observation prior to first study drug administration. | The safety set for RTP included all subjects who received at least 1 dose of study drug: pegcetacoplan or placebo. | Posted | Count of Participants | Participants | No | Baseline (Day 1) up to Week 52 |
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| Primary | OLP: Number of Subjects With Positive Response to Columbia-Suicide Severity Rating Scale up to Week 104 | The C-SSRS is a measure used to identify and assess individuals at risk for suicide and included "yes" or "no" responses for assessment of SI and SB.C-SSRS SI items are classified on 5-item scale:1 (wish to be dead),2 (non-specific active suicidal thoughts),3 (active SI with any methods without intent to act),4 (active SI with some intent to act, without specific plan) and 5 (active SI with a specific plan and intent).C-SSRS SB items are classified on 5-item scale:1 (preparatory acts or behavior),2 (aborted attempt), 3 (interrupted attempt), 4 (actual attempt [non-fatal]) and 5 (completed suicide). Numeric ratings were provided for SI (1 to 5) and SB (1 to 5) with 5 being more severe for each. Number of subjects with a response of 'yes' to SI only, SB only & SI and SB are reported. Baseline: last available, non-missing observation prior to first study drug administration in OLP. | The safety set for the OLP included only those subjects who received at least 1 dose of the open-label treatment. | Posted | Count of Participants | Participants | No | From Baseline (Week 52) up to Week 104 |
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| Secondary | RTP: Change From Baseline in the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) Score at Week 52 | The ALSFRS-R included 12 items for assessment of functional status: speech, salivation, swallowing, handwriting, cutting food and handling utensils, dressing and hygiene, turning in bed and adjusting bed clothes, walking, climbing stairs, dyspnea, orthopnea, and respiratory insufficiency. Each item ranged from 0 (no ability) to 4 (normal ability). Individual item scores were summed to produce a total score between 0 (worst) and 48 (best) with higher scores meaning better outcome. Least squares mean is presented here. Baseline was defined as the last available, non-missing observation prior to first study drug administration. | The ITT set for RTP included all randomized subjects who received at least 1 dose of randomized treatment (pegcetacoplan or placebo). Only those subjects with data collected at Baseline and Week 52 are reported. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline (Day 1) and Week 52 |
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| Secondary | RTP: Change From Baseline in Percent Predicted Slow Vital Capacity (%SVC) at Week 52 | SVC is a pulmonary function test and predictor of functional loss in ALS. It was conducted at clinic visits with the clinic spirometer which reflected the maximum amount of air that could be exhaled slowly. %SVC is the actual volume exhaled in the first 1 second, divided by the normal value for that actual value for a person of that age, gender, height and weight. Baseline was defined as the last available, non-missing observation prior to first study drug administration. | The ITT set for RTP included all randomized subjects who received at least 1 dose of randomized treatment (pegcetacoplan or placebo). Only those subjects with data collected at baseline and Week 52 are reported. | Posted | Least Squares Mean | Standard Error | percentage of predicted SVC | Baseline (Day 1) and Week 52 |
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| Secondary | RTP: Change From Baseline in Muscle Strength at Week 52 | Muscle strength was measured using handheld dynamometry (HHD) and assessed the following muscles: first dorsal interosseous, wrist extension, elbow extension, elbow flexion, shoulder flexion, knee extension, knee flexion, and ankle dorsiflexion, on both sides of the body. Baseline was defined as the last available, non-missing observation prior to first study drug administration. | The ITT set for RTP included all randomized subjects who received at least 1 dose of randomized treatment (pegcetacoplan or placebo). Only those subjects with data collected at baseline and Week 52 are reported. | Posted | Least Squares Mean | Standard Error | pounds | Baseline (Day 1) and Week 52 |
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| Secondary | RTP: Number of Subjects With an Event of Death or Permanent Tracheostomy or Permanent Assisted Ventilation at Week 52 | Subjects with an event (that is, either death or permanent tracheostomy or permanent assisted ventilation) in RTP are reported. | The ITT set for RTP included all randomized subjects who received at least 1 dose of randomized treatment (pegcetacoplan or placebo). | Posted | Count of Participants | Participants | No | Baseline (Day 1) up to Week 52 |
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| Secondary | RTP: Change From Baseline in ALS Assessment Questionnaire (ALSAQ)-40 at Week 52 | The ALSAQ-40 was a 40-item validated questionnaire designed to assess health related quality of life (QoL) over the previous 2 weeks in subjects with ALS. It represented 5 dimensions of health status; each scored from 0 (never, or best) to 4 (always, or worst). 5 dimensions evaluated were: physical mobility (10 items: 1-10; possible score of 0-40); activities of daily living/independence (10 items: 11-20; possible score of 0-40); eating and drinking (3 items: 21-23; possible score of 0-12); communication (7 items: 24-30; possible score: 0-28) and emotional functioning (10 items: 31-40; possible score: 0-40). The total score 0 (no impairment) to 160 (severe impairment) was calculated by adding the 5 dimension scores; least squares mean is presented here. Higher scores indicated worse QoL. | The ITT set for RTP included all randomized subjects who received at least 1 dose of randomized treatment (pegcetacoplan or placebo). Only those subjects with data collected at baseline and Week 52 are reported. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline (Day 1) and Week 52 |
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| Secondary | OLP: Change From Baseline in the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised Score at Week 104 | The ALSFRS-R included 12 items for assessment of functional status: speech, salivation, swallowing, handwriting, cutting food and handling utensils, dressing and hygiene, turning in bed and adjusting bed clothes, walking, climbing stairs, dyspnea, orthopnea, and respiratory insufficiency. Each item ranged from 0 (no ability) to 4 (normal ability). Individual item scores were summed to produce a total score between 0 (worst) and 48 (best) with higher scores meaning better outcome. Mean is presented here. Baseline was defined as the last observed value for the efficacy assessment prior to taking the first dose of study drug in OLP. | The ITT set for OLP included all randomized subjects who received at least 1 dose of open label treatment. Only those subjects with data collected at specified timepoints are reported. | Posted | Mean | Standard Deviation | score on a scale | Baseline (Week 52) and Week 104 |
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| Secondary | OLP: Change From Baseline in Percent Predicted Slow Vital Capacity at Week 104 | SVC is a pulmonary function test and predictor of functional loss in ALS. It was planned to be conducted at clinic visits with the clinic spirometer which reflected the maximum amount of air that could be exhaled slowly. %SVC is the actual volume exhaled in the first 1 second, divided by the normal value for that actual value for a person of that age, gender, height and weight. Baseline was defined as the last available, non-missing observation prior to first study drug administration. | Analysis was planned to be performed on the ITT population. Data was not collected for this outcome measure as the study was terminated early since it did not meet key secondary efficacy endpoints criteria. | Posted | Baseline (Week 52) and Week 104 |
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| Secondary | OLP: Change From Baseline in Muscle Strength at Week 104 | Muscle strength was planned to be measured using HHD and assessed the following muscles: first dorsal interosseous, wrist extension, elbow extension, elbow flexion, shoulder flexion, knee extension, knee flexion, and ankle dorsiflexion, on both sides of the body. Baseline was defined as the last available, non-missing observation prior to first study drug administration. | Analysis was planned to be performed on the ITT population. Data was not collected for this outcome measure as the study was terminated early since it did not meet key secondary efficacy endpoints criteria. | Posted | Baseline (Week 52) and Week 104 |
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| Secondary | OLP: Number of Subjects With an Event of Death or Permanent Tracheostomy or Permanent Assisted Ventilation at Week 104 | Subjects with an event of death are reported. Subjects were planned to be assessed for permanent tracheostomy or permanent assisted ventilation in OLP; however, that data was not collected as study was terminated early. | The ITT set for OLP included all randomized subjects who received at least 1 dose of open label treatment. | Posted | Count of Participants | Participants | No | Baseline (Week 52) and Week 104 |
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| Secondary | OLP: Change From Baseline in ALS Assessment Questionnaire-40 at Week 104 | The ALSAQ-40 was a 40-item validated questionnaire designed to assess health related QoL over the previous 2 weeks in subjects with ALS. It represented 5 dimensions of health status; each scored from 0 (never, or best) to 4 (always, or worst). 5 dimensions evaluated were: physical mobility (10 items: 1-10; possible score of 0-40); activities of daily living/independence (10 items: 11-20; possible score of 0-40); eating and drinking (3 items: 21-23; possible score of 0-12); communication (7 items: 24-30; possible score: 0-28) and emotional functioning (10 items: 31-40; possible score: 0-40). The total score 0 (no impairment) to 160 (severe impairment) was planned to be calculated by adding the 5 dimension scores. Higher scores would have indicated worse QoL. | Analysis was planned to be performed on the ITT population. Data was not collected for this outcome measure as the study was terminated early since it did not meet key secondary efficacy endpoints criteria. | Posted | Baseline (Week 52) and Week 104 |
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| Secondary | Number of Subjects With an Event of Death During the Study | Total number of subjects who died in the study are reported. | The ITT set for RTP included all randomized subjects who received at least 1 dose of randomized treatment (pegcetacoplan or placebo). The ITT set for OLP included all randomized subjects who received at least 1 dose of open label treatment. | Posted | Count of Participants | Participants | No | RTP: Baseline (Day 1) up to Week 52; OLP: Baseline (Week 52) up to Week 104 |
|
TEAEs, TESAEs and deaths were collected from first dose of study drug (RTP: Day 1/OLP: Week 52) up to 56 days post last dose of study drug, approximately 60 weeks each for RTP and OLP.
RTP: Safety set included all subjects who received at least 1 dose of study treatment, pegcetacoplan or placebo. OLP: Safety set included only subjects who received at least 1 dose of the open-label treatment. RTP reporting groups: MedDRA 23.0.
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | RTP: Pegcetacoplan | Subjects received pegcetacoplan 1080 mg SC injection/infusion twice per week for 52 weeks. | 26 | 169 | 57 | 169 | 124 | 169 |
| EG001 | RTP: Placebo | Subjects received placebo matching pegcetacoplan as SC injection/infusion twice per week for 52 weeks. | 11 | 80 | 27 | 80 | 55 | 80 |
| EG002 | OLP: Pegcetacoplan/Pegcetacoplan | Eligible subjects who had received pegcetacoplan in RTP entered OLP and continued to receive pegcetacoplan 1080 mg SC injection/infusion twice per week for 52 weeks. | 10 | 97 | 24 | 97 | 31 | 97 |
| EG003 | OLP: Placebo/Pegcetacoplan | Eligible subjects who had received placebo matching pegcetacoplan in RTP entered OLP to receive pegcetacoplan 1080 mg SC injection/infusion twice per week for 52 weeks. | 6 | 50 | 14 | 50 | 20 | 50 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pericarditis | Cardiac disorders | 23.0 | Systematic Assessment |
| |
| Angina Pectoris | Cardiac disorders | 23.1 | Systematic Assessment |
| |
| Atrial Fibrillation | Cardiac disorders | 23.1 | Systematic Assessment |
| |
| Cardiac Failure Acute | Cardiac disorders | 23.1 | Systematic Assessment |
| |
| Cardio-Respiratory Arrest | Cardiac disorders | 23.1 | Systematic Assessment |
| |
| Optic Atrophy | Eye disorders | 23.1 | Systematic Assessment |
| |
| Dysphagia | Gastrointestinal disorders | 23.1 | Systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | 23.1 | Systematic Assessment |
| |
| Diarrhoea | Gastrointestinal disorders | 23.1 | Systematic Assessment |
| |
| Gastritis | Gastrointestinal disorders | 23.1 | Systematic Assessment |
| |
| Abdominal Pain | Gastrointestinal disorders | 23.1 | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | 23.1 | Systematic Assessment |
| |
| Disease Progression | General disorders | 23.1 | Systematic Assessment |
| |
| Cholecystitis Acute | Hepatobiliary disorders | 23.1 | Systematic Assessment |
| |
| Hepatitis | Hepatobiliary disorders | 23.1 | Systematic Assessment |
| |
| Hypersensitivity | Immune system disorders | 23.1 | Systematic Assessment |
| |
| Covid-19 | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Pneumonia | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Covid-19 Pneumonia | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Urinary Tract Infection | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Febrile Infection | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Gastroenteritis | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Pneumonia Moraxella | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Respiratory Tract Infection | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Tonsillitis | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Sepsis | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Stoma Site Infection | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Pneumonia Bacterial | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Urosepsis | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Viral Rash | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Concussion | Injury, poisoning and procedural complications | 23.1 | Systematic Assessment |
| |
| Humerus Fracture | Injury, poisoning and procedural complications | 23.1 | Systematic Assessment |
| |
| Head Injury | Injury, poisoning and procedural complications | 23.1 | Systematic Assessment |
| |
| Ankle Fracture | Injury, poisoning and procedural complications | 23.1 | Systematic Assessment |
| |
| Craniocerebral Injury | Injury, poisoning and procedural complications | 23.1 | Systematic Assessment |
| |
| Weight Decreased | Investigations | 23.1 | Systematic Assessment |
| |
| Hypoglycaemia | Metabolism and nutrition disorders | 23.1 | Systematic Assessment |
| |
| Dehydration | Metabolism and nutrition disorders | 23.1 | Systematic Assessment |
| |
| Food Refusal | Metabolism and nutrition disorders | 23.1 | Systematic Assessment |
| |
| Hepatic Cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 23.1 | Systematic Assessment |
| |
| Metastatic Uterine Cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 23.1 | Systematic Assessment |
| |
| Colon Cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 23.1 | Systematic Assessment |
| |
| Invasive Ductal Breast Carcinoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 23.1 | Systematic Assessment |
| |
| Musculoskeletal Chest Pain | Musculoskeletal and connective tissue disorders | 23.1 | Systematic Assessment |
| |
| Amyotrophic Lateral Sclerosis | Nervous system disorders | 23.1 | Systematic Assessment |
| |
| Headache | Nervous system disorders | 23.1 | Systematic Assessment |
| |
| Syncope | Nervous system disorders | 23.1 | Systematic Assessment |
| |
| Bulbar Palsy | Nervous system disorders | 23.1 | Systematic Assessment |
| |
| Acute Stress Disorder | Psychiatric disorders | 23.1 | Systematic Assessment |
| |
| Confusional State | Psychiatric disorders | 23.1 | Systematic Assessment |
| |
| Device Dislocation | Product Issues | 23.1 | Systematic Assessment |
| |
| Nephrolithiasis | Renal and urinary disorders | 23.1 | Systematic Assessment |
| |
| Haematuria | Renal and urinary disorders | 23.1 | Systematic Assessment |
| |
| Renal Colic | Renal and urinary disorders | 23.1 | Systematic Assessment |
| |
| Renal Failure | Renal and urinary disorders | 23.1 | Systematic Assessment |
| |
| Respiratory Failure | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Pneumonia Aspiration | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Pulmonary Embolism | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Respiratory Disorder | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Acute Respiratory Failure | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Hypoxia | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Obstructive Airways Disorder | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Pleural Effusion | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Respiratory Distress | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Sleep Apnoea Syndrome | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Respiratory Symptom | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Bronchial Secretion Retention | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Ischaemic Skin Ulcer | Skin and subcutaneous tissue disorders | 23.1 | Systematic Assessment |
| |
| Hospitalisation | Surgical and medical procedures | 23.1 | Systematic Assessment |
| |
| Gastrostomy | Surgical and medical procedures | 23.1 | Systematic Assessment |
| |
| Deep Vein Thrombosis | Vascular disorders | 23.1 | Systematic Assessment |
| |
| Hypovolaemic Shock | Vascular disorders | 23.1 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Constipation | Gastrointestinal disorders | 23.1 | Systematic Assessment |
| |
| Diarrhoea | Gastrointestinal disorders | 23.1 | Systematic Assessment |
| |
| COVID-19 | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Upper Respiratory Tract Infection | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Urinary Tract Infection | Infections and infestations | 23.1 | Systematic Assessment |
| |
| Fall | Injury, poisoning and procedural complications | 23.1 | Systematic Assessment |
| |
| Insomnia | Psychiatric disorders | 23.1 | Systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Hypertension | Vascular disorders | 23.1 | Systematic Assessment |
| |
| Pneumonia aspiration | Respiratory, thoracic and mediastinal disorders | 23.1 | Systematic Assessment |
| |
| Back pain | Musculoskeletal and connective tissue disorders | 23.1 | Systematic Assessment |
| |
| Pneumonia | Infections and infestations | 23.1 | Systematic Assessment |
|
The study was terminated early, during the OLP, due to lack of efficacy as determined by the Week 52 data and no safety concerns.
Not provided
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Apellis Clinical Trial Information Line | Apellis Pharmaceuticals, Inc | 1-833-284-6361 | clinicaltrials@apellis.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Apr 12, 2023 | Feb 25, 2025 | SAP_001.pdf |
Not provided
| ID | Term |
|---|---|
| D000690 | Amyotrophic Lateral Sclerosis |
| D016472 | Motor Neuron Disease |
| ID | Term |
|---|---|
| D013118 | Spinal Cord Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D019636 | Neurodegenerative Diseases |
| D057177 | TDP-43 Proteinopathies |
| D009468 | Neuromuscular Diseases |
| D057165 | Proteostasis Deficiencies |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| C000716074 | pegcetacoplan |
Not provided
Not provided
Not provided
| Withdrawal by Subject |
|
| Sponsor request |
|
| Physician Decision |
|
| Death |
|
| Male |
|
| Not Hispanic or Latino |
|
| Unknown or Not Reported |
|
| Black or African American |
|
| North East Asian |
|
| South East Asian |
|
| Other |
|
| Unknown |
|
| Units | Counts |
|---|---|
| Participants |
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|
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|
|
|
Eligible subjects who had received placebo matching pegcetacoplan in RTP entered OLP to receive pegcetacoplan 1080 mg SC injection/infusion twice per week for 52 weeks.
|
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| Units | Counts |
|---|---|
| Participants |
|
|
|
| Participants |
|
|
|
|
|
|
|
|
|
|
|
| Units |
|---|
| Counts |
|---|
| Participants |
|
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|
|
Eligible subjects who had received placebo matching pegcetacoplan in RTP entered OLP to receive pegcetacoplan 1080 mg SC injection/infusion twice per week for 52 weeks. |
|
|