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This is a multicenter, randomized, open-label, active-controlled Phase IV clinical trial in participants with active thyroid eye disease (TED). Approximately 92 eligible participants will be randomized to the teprotumumab N01 group and the intravenous glucocorticoid (IVGC) group in a 1:1 ratio on Day 1. The randomization stratification factor is diplopia at baseline (Gorman diplopia score ≥1 vs. Gorman diplopia score = 0).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intravenous glucocorticoid (IVGC) group | Active Comparator |
| |
| Teprotumumab N01 group | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Teprotumumab N01 | Biological | A total of 8 intravenous infusions of Teprotumumab N01 injection will be adminsitered: 10 mg/kg on Day1, followed by 20 mg/kg in Week3-21, once every 3 weeks(Q3W). |
| Measure | Description | Time Frame |
|---|---|---|
| The proptosis responder rate of the study eye | The proptosis response rate of the study eye was defined as the percentage of participants with a ≥ 2 mm reduction in proptosis of the study eye from baseline and without a ≥ 2 mm increase in proptosis of the fellow eye. Proptosis assessment: protrusion of the eye from the orbital rim as measured using a Hertel exophthalmometer. | Week15 |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in proptosis of the study eye | Proptosis assessment: protrusion of the eye from the orbital rim as measured using a Hertel exophthalmometer. | Weeks 15, 24 and 48 |
| The overall response rate of the study eye |
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Inclusion Criteria:
Key Inclusion Criteria:
Written informed consent.
Male or female subject between the ages of 18 and 80 years at screening.
Weight between 45 kg and 100 kg.
Moderate-to-severe active TED:
Exophthalmos ≥ 16 mm in the study eye at baseline.
Infertile female participants or fertile female participants with negative blood pregnancy test results during the screening period and agree to take contraceptive measures from screening to 120 days after the last dose; male participants should agree to use contraceptive measures from screening to 120 days after the last dose.
Exclusion Criteria:
Key Exclusion Criteria:
Participants to be excluded (Participants meeting any of the following criteria will be regarded as ineligible):
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lily Zhang | Contact | 13603216253 | lily.zhang@innoventbio.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine | Shanghai | Shanghai Municipality | 200125 | China |
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| ID | Term |
|---|---|
| D049970 | Graves Ophthalmopathy |
| ID | Term |
|---|---|
| D015785 | Eye Diseases, Hereditary |
| D005128 | Eye Diseases |
| D006111 | Graves Disease |
| D005094 | Exophthalmos |
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| ID | Term |
|---|---|
| D008775 | Methylprednisolone |
| ID | Term |
|---|---|
| D011239 | Prednisolone |
| D011246 | Pregnadienetriols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
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| Methylprednisolone | Drug | A total of 12 intravenous infusions of methylprednisolone will be administered: 500 mg for the first six doses (on Day 1 and weekly throughout Weeks 1-5), and then 250 mg for the following six doses (weekly throughout Weeks 6-11). Based on disease deterioration and treatment response, participants will receive individualized treatment after IVGC therapy. |
|
The overall response rate of the study eye was defined as the percentage of participants with a decrease in Clinical Activity Score [CAS] of ≥ 2 points from baseline in the study eye and a decrease in proptosis of ≥ 2 mm from baseline in the study eye, without deterioration in the fellow eye [deterioration is defined as an increase in CAS of ≥ 2 points or an increase in proptosis of ≥ 2 mm].
| Weeks 15, 24 and 48 |
| Change from baseline in proptosis of the study eye on MRI imaging | Proptosis of the study eye as measured on orbital MRI imaging. | Week15 |
| The proptosis response rate of the study eye | The proptosis response rate of the study eye was defined as the percentage of participants with a ≥ 2 mm reduction in proptosis of the study eye from baseline and without a ≥ 2 mm increase in proptosis of the fellow eye. | Weeks 24 and 48 |
| The composite effective rate of the study eye | The composite effective rate of the study eye was defined as the percentage of participants with improvement in 2 or more of the 4 indicators [a. ≥2 mm reduction of lid aperture; b. ≥1 point decrease in the five-item CAS (redness of eyelids, swelling of eyelids, redness of conjunctiva, chemosis, and swelling of caruncle or plica); c. ≥2 mm reduction in proptosis; d. ≥8° improvement in ocular motility] in the study eye and without corresponding deterioration in the fellow eye. | Weeks 15, 24 and 48 |
| Change from baseline in CAS of the study eye | According to the 7-item European Group on Graves' Ophthalmopathy (EUGOGO) amendment, CAS was used to evaluate clinical activity. For each of the following items, one point is given: spontaneous orbital pain, gaze evoked orbital pain, eyelid swelling, eyelid erythema, conjunctival redness, chemosis, and inflammation of caruncle or plica. The sum of these points is the total score, with 0 indicating no clinical activity and 7 indicating the most severe clinical activity. | Weeks 15, 24 and 48 |
| Rate of CAS of 0 or 1 in the study eye | According to the 7-item European Group on Graves' Ophthalmopathy (EUGOGO) amendment, CAS was used to evaluate clinical activity. For each of the following items, one point is given: spontaneous orbital pain, gaze evoked orbital pain, eyelid swelling, eyelid erythema, conjunctival redness, chemosis, and inflammation of caruncle or plica. The sum of these points is the total score, with 0 indicating no clinical activity and 7 indicating the most severe clinical activity. | Weeks 15, 24 and 48 |
| The diplopia response rate | The diplopia response rate was defined as the percentage of participants with an improvement in Gorman diplopia score of ≥ 1 grade | Weeks 15, 24 and 48 |
| The diplopia resolution rate | The diplopia resolution rate was defined as the percentage of participants with Gorman diplopia score = 0 | Weeks 15, 24 and 48 |
| Change from baseline in proptosis of the fellow eye | Proptosis assessment: protrusion of the eye from the orbital rim as measured using a Hertel exophthalmometer. | Weeks 15, 24 and 48 |
| Change from baseline of the Graves' Ophthalmopathy Quality of Life (GO-QoL) questionnaire score | Change from baseline of the total GO-QoL score, GO-QoL visual functioning subscale and appearance subscale scores | Weeks 15, 24 and 48 |
| The safety and tolerability of Teprotumumab N01 and IVGC | Number, incidence, severity, and correlation with the investigational drug or treatment of all ocular and systemic adverse events (AE), treatment-emergent adverse events (TEAE), and serious adverse events (SAE). | After receiving Teprotumumab N01 or IVGC treatment for 48 weeks |
| D009916 |
| Orbital Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D006042 | Goiter |
| D013959 | Thyroid Diseases |
| D004700 | Endocrine System Diseases |
| D006980 | Hyperthyroidism |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D013256 |
| Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |