ZURAW, B., W. R. LUMRY, D. T. JOHNSTON, E. AYGOREN-PURSUN, A. BANERJI, J. A. BERNSTEIN, S. C. CHRISTIANSEN, J. S. JACOBS, K. V. SITZ, R. G. GOWER, R. GAGNON, H. J. WEDNER, T. KINACIYAN, Roman HAKL, Jana HANZLIKOVA, J. T. ANDERSON, D. L. MCNEIL, S. B. FRITZ, W. H. YANG, R. TACHDJIAN, P. J. BUSSE, T. J. CRAIG, H. H. LI, H. FARKAS, J. M. BEST, D. CLEMONS, M. CORNPROPST, S. M. DOBO, H. A. IOCCA, D. KARGL, E. NAGY, S. C. MURRAY, P. COLLIS, W. P. SHERIDAN, M. MAURER and M. A. RIEDL. Oral once-daily berotralstat for the prevention of hereditary angioedema attacks: A randomized, double-blind, placebo-controlled phase 3 trial. Journal of allergy and clinical immunology. New York: Mosby-Elsevier, 2021, vol. 148, No 1, p. "164"-"172.e9", 18 pp. ISSN 0091-6749. Available from: https://dx.doi.org/10.1016/j.jaci.2020.10.015.
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Basic information
Original name Oral once-daily berotralstat for the prevention of hereditary angioedema attacks: A randomized, double-blind, placebo-controlled phase 3 trial
Authors ZURAW, B., W. R. LUMRY, D. T. JOHNSTON, E. AYGOREN-PURSUN, A. BANERJI, J. A. BERNSTEIN, S. C. CHRISTIANSEN, J. S. JACOBS, K. V. SITZ, R. G. GOWER, R. GAGNON, H. J. WEDNER, T. KINACIYAN, Roman HAKL (203 Czech Republic, belonging to the institution), Jana HANZLIKOVA (203 Czech Republic), J. T. ANDERSON, D. L. MCNEIL, S. B. FRITZ, W. H. YANG, R. TACHDJIAN, P. J. BUSSE, T. J. CRAIG, H. H. LI, H. FARKAS, J. M. BEST, D. CLEMONS, M. CORNPROPST, S. M. DOBO, H. A. IOCCA, D. KARGL, E. NAGY, S. C. MURRAY, P. COLLIS, W. P. SHERIDAN, M. MAURER and M. A. RIEDL.
Edition Journal of allergy and clinical immunology, New York, Mosby-Elsevier, 2021, 0091-6749.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30225 Allergy
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 14.290
RIV identification code RIV/00216224:14110/21:00122116
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.jaci.2020.10.015
UT WoS 000669906700024
Keywords in English BCX7353; berotralstat; C1 inhibitor; efficacy; HAE; hereditary angioedema; kallikrein inhibitor; long-term prophylaxis; prophylaxis; safety
Tags 14110114, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 18/8/2021 13:36.
Abstract
Background: Berotralstat (BCX7353) is an oral, once-daily inhibitor of plasma kallikrein in development for the prophylaxis of hereditary angioedema (HAE) attacks. Objective: Our aim was to determine the efficacy, safety, and tolerability of berotralstat in patients with HAE over a 24-week treatment period (the phase 3 APeX-2 trial). Methods: APeX-2 was a double-blind, parallel-group study that randomized patients at 40 sites in 11 countries 1:1:1 to receive once-daily berotralstat in a dose of 110 mg or 150 mg or placebo (Clinicaltrials.gov identifier NCT03485911). Patients aged 12 years or older with HAE due to C1 inhibitor deficiency and at least 2 investigator-confirmed HAE attacks in the first 56 days of a prospective run-in period were eligible. The primary efficacy end point was the rate of investigator-confirmed HAE attacks during the 24-week treatment period. Results: A total of 121 patients were randomized; 120 of them received at least 1 dose of the study drug (n = 41, 40, and 39 in the 110-mg dose of berotralstat, 150-mg of dose berotralstat, and placebo groups, respectively). Berotralstat demonstrated a significant reduction in attack rate at both 110 mg (1.65 attacks per month; P = .024) and 150 mg (1.31 attacks per month; P<.001) relative to placebo (2.35 attacks per month). The most frequent treatment-emergent adverse events that occurred more with berotralstat than with placebo were abdominal pain, vomiting, diarrhea, and back pain. No drug-related serious treatment-emergent adverse events occurred. Conclusion: Both the 110-mg and 150-mg doses of berotralstat reduced HAE attack rates compared with placebo and were safe and generally well tolerated. The most favorable benefit-to-risk profile was observed at a dose of 150 mg per day.
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