Resumen del Estudio
La Enfermedad Relacionada con IgG4 (ER-IgG4) es una condición inflamatoria sistémica que a menudo requiere el uso prolongado de corticoides (glucocorticoides), los cuales pueden generar efectos secundarios significativos. Este estudio clínico de Fase 3 busca evaluar la eficacia de Rilzabrutinib, un medicamento oral diseñado para modular el sistema inmune, comparándolo con un placebo en pacientes adultos con esta enfermedad activa. El objetivo principal es determinar si el tratamiento con Rilzabrutinib permite mantener la enfermedad bajo control y prevenir nuevos brotes (recaídas) mientras se reduce progresivamente la dosis de corticoides. La participación implica un seguimiento de 52 semanas con evaluaciones médicas periódicas, análisis de laboratorio e imágenes para monitorear tanto la seguridad del paciente como la respuesta del tratamiento en los órganos afectados.
Criterios de Elegibilidad
Resumen de Elegibilidad:Criterios de inclusión: Adultos (18+) con diagnóstico confirmado de ER-IgG4 activa en al menos un órgano (páncreas, vías biliares, glándulas salivales, etc., excluyendo solo ganglios), que estén controlados con corticoides pero dispuestos a intentar reducir la dosis. Criterios de exclusión: Personas con fibrosis retroperitoneal como única manifestación, cáncer activo o reciente (últimos 5 años), infecciones graves activas, enfermedad hepática crónica no relacionada con IgG4 o trasplantes de órganos previos.
- Participants must have an adjudicated clinical diagnosis of IgG4-RD
- Participants meeting Step 1 Entry criteria of 2019 ACR/EULAR classification criteria for IgG4-RD and Total inclusion points are ≥20
- Participants with active disease at screening in at least one organ system, excluding lymph nodes, as an IgG4-RD Responder Index total activity score ≥ 2
- Participants with history or current involvement of at least 1 organ/site (excluding lymph nodes) affected with IgG4-RD.
- Participants with active IgG4-RD controlled for at least 2 weeks while on a stable dose of GC.
- Participants willing to taper off GC after starting IMP.
- Participants willing and able to participate in repeated study protocol mandated or clinically indicated imaging procedures to assess IgG4-RD such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or ultrasound.
- Participants who have an up-to-date vaccination status as per local guidelines. The last dose of live vaccines should be received at least 30 days before Day 1.
- Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
- History of retroperitoneal fibrosis, sclerosing mesenteritis, fibrosing mediastinitis, or other overwhelmingly fibrotic expression of IgG4-RD that is the sole disease manifestation.
- Active malignancy or history of malignancy within 5 years before Day 1, except completely treated in situ carcinoma of the cervix, completely treated, and resolved nonmetastatic squamous or basal cell carcinoma of the skin.
- Known or suspected immunodeficiency, including history of invasive opportunistic infections (eg, histoplasmosis, listeriosis, coccidioidomycosis, pneumocystosis, and aspergillosis) despite infection resolution, or otherwise recurrent infections of abnormal frequency or prolonged duration suggesting an immune compromised status, as judged by the Investigator.
- History of serious infections with the potential for recurrence (as judged by the Investigator), with less than 4 weeks interval between resolution of serious infection and first dose of study drug, or currently active moderate to severe infection at Screening (Grade 2 or higher).
- Current or chronic history of liver disease unrelated to IgG4-RD.
- Refractory nausea and vomiting, malabsorption, external biliary shunt, bariatric surgery, or significant bowel resection that would preclude adequate rilzabrutinib/placebo absorption.
- History of solid organ transplant.
- Planned major surgical procedure during the participation in this study.
- History of drug abuse within the previous 12 months.
- Alcoholism or excessive alcohol use, defined as regular consumption of more than approximately 3 standard drinks per day.
- Prior participation in any rilzabrutinib studies or other BTK inhibitor studies.
- History of treatment with an investigational drug within 6 months or 5 half-lives of the investigational drug, whichever is longer.
- Laboratory abnormalities at the screening visit identified by the central laboratory The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.