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NCT03896152

Efficacy, Safety, Pharmacokinetics and Pharmacodynamics Study, Assessing Multiple LNP023 Doses in Adult Patients With Paroxysmal Nocturnal Hemoglobinuria

Completed Phase 2 Results posted Last updated 18 June 2024
What this trial tests

Phase 2 trial testing LNP023 in Paroxysmal Nocturnal Hemoglobinuria in 13 participants. Completed in 9 February 2022.

Timeline
5 April 2019
Primary endpoint
7 April 2020
9 February 2022

Quick facts

Lead sponsorNovartis Pharmaceuticals
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment13
Start date5 April 2019
Primary completion7 April 2020
Estimated completion9 February 2022
Sites5 locations across Taiwan, Singapore, Malaysia, South Korea

Drugs / interventions tested

Conditions studied

Sponsor

Novartis Pharmaceuticals — full company profile →

Who can join

18 and older, any sex, with Paroxysmal Nocturnal Hemoglobinuria. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Summary of Lactate Dehydrogenase (LDH) Responders Primary · Week 2, week 4, week 8 and week 12

A responder was defined as a patient with at least 60% reduction in LDH compared to Baseline or LDH below the upper limit of normal at any time up to and including Week 12 for that patient.

Responders at week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid6
LNP023 50 mg Bid/200 mg Bid5
Responders at week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid7
LNP023 50 mg Bid/200 mg Bid5
Responders at week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid7
LNP023 50 mg Bid/200 mg Bid5
Responders at week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid7
LNP023 50 mg Bid/200 mg Bid5
Percent Change From Baseline in LDH Levels Secondary · Baseline, week 2, week 4, week 8 and week 12

LDH was used as a hemolysis marker to determine the dose-response effect of iptacopan on the reduction of Paroxysmal nocturnal hemoglobinuria (PNH)-associated hemolysis. Active hemolysis is defined by an LDH value ≥ 1.5x upper limit of normal (ULN) Baseline LDH was calculated as the average of the last three screening values prior to randomization. Serum was used to calculate the LDH values

Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-76.52± 18.478
LNP023 50 mg Bid/200 mg Bid-84.98± 8.186
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-79.75± 16.025
LNP023 50 mg Bid/200 mg Bid-89.72± 5.430
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-81.73± 22.832
LNP023 50 mg Bid/200 mg Bid-88.30± 8.744
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-86.17± 8.896
LNP023 50 mg Bid/200 mg Bid-85.92± 9.013
Change From Baseline in Hemoglobin Secondary · Baseline, Week 2, week 4, week 8 and week 12

Hemoglobin was used as a hemolysis marker to determine the dose-response effect of iptacopan on the reduction of PNH-associated hemolysis. Whole blood was used to calculate the hemoglobin values.

Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid6.88± 5.812
LNP023 50 mg Bid/200 mg Bid31.83± 10.362
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid9.61± 11.857
LNP023 50 mg Bid/200 mg Bid36.58± 17.875
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid15.02± 9.154
LNP023 50 mg Bid/200 mg Bid38.08± 25.956
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid23.36± 14.378
LNP023 50 mg Bid/200 mg Bid37.11± 26.171
Change From Baseline in Free Hemoglobin Secondary · Baseline, Week 2, week 4, week 8 and week 12

Free hemoglobin was used as a hemolysis marker to determine the dose-response effect of iptacopan on the reduction of PNH-associated hemolysis. Whole blood was used to calculate the hemoglobin values.

Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-39.84± 26.521
LNP023 50 mg Bid/200 mg Bid-13.53± 5.093
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-31.88± 35.314
LNP023 50 mg Bid/200 mg Bid-29.26± 24.218
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-31.85± 27.517
LNP023 50 mg Bid/200 mg Bid-16.31± 48.877
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-39.58± 31.612
LNP023 50 mg Bid/200 mg Bid-14.75± 6.293
Change From Baseline in Carboxyhemoglobin Secondary · Baseline, Week 2, week 4, week 8 and week 12

Carboxyhemoglobin was used as a marker of intravascular and extravascular hemolysis to assess the effect of iptacopan. Whole blood was used to calculate the carboxyhemoglobin values.

Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-0.01± 0.516
LNP023 50 mg Bid/200 mg Bid-0.72± 0.697
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-0.36± 0.472
LNP023 50 mg Bid/200 mg Bid-0.98± 0.582
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-0.50± 0.664
LNP023 50 mg Bid/200 mg Bid-1.12± 0.916
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-0.95± 0.316
LNP023 50 mg Bid/200 mg Bid-0.78± 1.704
Change From Baseline in Absolute Reticulocyte Count (ARC) Secondary · Baseline, week 2, week 4, week 8 and week 12

Reticulocyte count was used as a marker of intravascular and extravascular hemolysis to assess the effect of iptacopan. Whole blood was used to calculate the absolute reticulocyte count.

Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-83.00± 78.750
LNP023 50 mg Bid/200 mg Bid-94.23± 112.649
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-118.44± 76.736
LNP023 50 mg Bid/200 mg Bid-132.63± 91.109
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-113.71± 72.300
LNP023 50 mg Bid/200 mg Bid-119.43± 117.048
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-93.00± 93.425
LNP023 50 mg Bid/200 mg Bid-84.92± 123.408
Red Blood Cell Count: Change From Baseline in Erythrocytes Secondary · Baseline, week 2, week 4, week 8 and week 12

Erythrocytes were used as a marker of intravascular and extravascular hemolysis to assess the effect of iptacopan. Whole blood was used to calculate erythrocytes values.

Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid0.49± 0.194
LNP023 50 mg Bid/200 mg Bid1.02± 0.407
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid0.74± 0.401
LNP023 50 mg Bid/200 mg Bid1.26± 0.619
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid1.16± 0.396
LNP023 50 mg Bid/200 mg Bid1.38± 0.796
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid1.38± 0.531
LNP023 50 mg Bid/200 mg Bid1.38± 0.770
Change From Baseline in C3 Fragment Deposition on PNH RBC Secondary · Baseline, week 2, week 4, week 8 and week 12

C3 fragment deposition on paroxysmal nocturnal hemoglobinuria red blood cell (PNH RBC) was used as a marker of intravascular and extravascular hemolysis to assess the effect of iptacopan. Accumulation of C3 fragments on red blood cells make them prone to phagocytosis causing extravascular hemolysis. Whole blood was used to calculate C3 fragment deposition on PNH RBC values.

Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-1.31± 0.932
LNP023 50 mg Bid/200 mg Bid-1.88± 1.457
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-1.43± 1.217
LNP023 50 mg Bid/200 mg Bid-2.74± 2.584
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-1.85± 1.293
LNP023 50 mg Bid/200 mg Bid-2.90± 2.654
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-1.65± 1.221
LNP023 50 mg Bid/200 mg Bid-2.75± 3.002
Mean Haptoglobin Levels Secondary · Baseline, week 2, week 4, week 8 and week 12

Haptoglobin levels were used as a hemolysis marker to determine the effect of iptacopan on the reduction of PNH-associated hemolysis. Serum was used to calculate haptoglobin levels.

Baseline
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid0.05± 0.000
LNP023 50 mg Bid/200 mg Bid0.05± 0.000
Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid0.27± 0.251
LNP023 50 mg Bid/200 mg Bid0.41± 0.499
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid0.24± 0.255
LNP023 50 mg Bid/200 mg Bid0.49± 0.490
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid0.38± 0.456
LNP023 50 mg Bid/200 mg Bid0.41± 0.374
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid0.25± 0.356
LNP023 50 mg Bid/200 mg Bid0.18± 0.225
Change From Baseline in Total Bilirubin Secondary · Baseline, week 2, week 4, week 8 and week 12

Bilirubin levels were used as a hemolysis marker to determine the effect of iptacopan on the reduction of PNH-associated hemolysis. Serum was used to calculate bilirubin levels.

Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-19.81± 7.855
LNP023 50 mg Bid/200 mg Bid-23.93± 16.735
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-19.95± 10.620
LNP023 50 mg Bid/200 mg Bid-25.93± 15.992
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-20.24± 12.612
LNP023 50 mg Bid/200 mg Bid-25.53± 16.471
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid-21.61± 5.998
LNP023 50 mg Bid/200 mg Bid-23.17± 18.195
Mean Platelets Count Secondary · Baseline, week 2, week 4, week 8 and week 12

Platelet counts were used as a marker of intravascular and extravascular hemolysis to assess the effect of iptacopan. Whole blood was used to calculate platelets count.

Baseline
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid190.45± 59.938
LNP023 50 mg Bid/200 mg Bid156.42± 52.321
Week 2
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid223.71± 76.707
LNP023 50 mg Bid/200 mg Bid158.20± 62.683
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid203.17± 68.520
LNP023 50 mg Bid/200 mg Bid138.20± 57.085
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid184.43± 50.856
LNP023 50 mg Bid/200 mg Bid141.20± 46.569
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid189.33± 54.617
LNP023 50 mg Bid/200 mg Bid140.75± 59.618
Mean Ferritin Levels Secondary · Baseline, Week 4, Week 8 and week 12

Ferritin levels were used as a marker of intravascular and extravascular hemolysis to assess the effect of iptacopan. Serum was used to calculate ferritin levels.

Baseline
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid176.97± 404.254
LNP023 50 mg Bid/200 mg Bid258.90± 418.114
Week 4
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid174.21± 431.042
LNP023 50 mg Bid/200 mg Bid287.88± 517.901
Week 8
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid178.31± 443.346
LNP023 50 mg Bid/200 mg Bid304.74± 521.535
Week 12
GroupValue95% CI
LNP023 25 mg Bid/100 mg Bid203.22± 454.296
LNP023 50 mg Bid/200 mg Bid320.40± 526.783

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse events were reported from first dose of study treatment until end of study treatment plus 7 days post treatment, up to a maximum duration of 115 weeks.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

LNP023 25mg Bid - Period 1
Serious: 0/7 (0%)
Deaths: 0/7
LNP023 50mg Bid - Period 1
Serious: 0/6 (0%)
Deaths: 0/6
LNP023 100mg Bid - Period 2
Serious: 0/7 (0%)
Deaths: 0/7
LNP023 200mg Bid - Period 2
Serious: 0/5 (0%)
Deaths: 0/5
LNP023 100mg Bid - Period 3
Serious: 0/7 (0%)
Deaths: 0/7
LNP023 200mg Bid - Period 3
Serious: 0/5 (0%)
Deaths: 0/5
Other adverse events (52 terms — click to expand)

ReactionSystemLNP023 25mg Bid - Period 1LNP023 50mg Bid - Period 1LNP023 100mg Bid - Period 2LNP023 200mg Bid - Period 2LNP023 100mg Bid - Period 3LNP023 200mg Bid - Period 3
HeadacheNervous system disorders
Abdominal discomfortGastrointestinal disorders
Abdominal painGastrointestinal disorders
PyrexiaGeneral disorders
Upper respiratory tract infectionInfections and infestations
CoughRespiratory, thoracic and mediastinal disorders
Breakthrough haemolysisBlood and lymphatic system disorders
EosinophiliaBlood and lymphatic system disorders
HaemolysisBlood and lymphatic system disorders
NeutropeniaBlood and lymphatic system disorders
VertigoEar and labyrinth disorders
Autoimmune thyroiditisEndocrine disorders
HypothyroidismEndocrine disorders
Abdominal distensionGastrointestinal disorders
Dry mouthGastrointestinal disorders
DyspepsiaGastrointestinal disorders
EnterocolitisGastrointestinal disorders
FlatulenceGastrointestinal disorders
NauseaGastrointestinal disorders
PainGeneral disorders
COVID-19Infections and infestations
GastroenteritisInfections and infestations
NasopharyngitisInfections and infestations
Urinary tract infectionInfections and infestations
Upper limb fractureInjury, poisoning and procedural complications
Alanine aminotransferase increasedInvestigations
Antinuclear antibody increasedInvestigations
Blood alkaline phosphatase increasedInvestigations
Blood creatinine increasedInvestigations
Blood luteinising hormone increasedInvestigations
Blood uric acid increasedInvestigations
Blood urine presentInvestigations
Gamma-glutamyltransferase increasedInvestigations
Haematocrit increasedInvestigations
Haemoglobin increasedInvestigations
Reverse tri-iodothyronine increasedInvestigations
Thyroxine free increasedInvestigations
GoutMetabolism and nutrition disorders
Impaired fasting glucoseMetabolism and nutrition disorders
Back painMusculoskeletal and connective tissue disorders

Data from ClinicalTrials.gov NCT03896152 adverse events section.

Sponsor's own description

This was a Phase II randomized, open-label, multicenter, efficacy, safety, pharmacokinetic and pharmacodynamic study assessing four iptacopan doses in adult Paroxysmal nocturnal hemoglobinuria (PNH) patients with active hemolysis who were not on eculizumab or any other complement inhibitor less than 3 months prior to first iptacopan dose. Active hemolysis was defined by a lactate dehydrogenase (LDH) value ≥ 1.5 × ULN.

Publications & conference data

7 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Iptacopan monotherapy in patients with paroxysmal nocturnal hemoglobinuria: a 2-cohort open-label proof-of-concept study.
    Jang JH, Wong L, Ko BS, Yoon SS, et al · · 2022 · cited 64× · PMID 35561315 · DOI 10.1182/bloodadvances.2022006960
  2. How we('ll) treat paroxysmal nocturnal haemoglobinuria: diving into the future.
    Risitano AM, Peffault de Latour R. · · 2022 · cited 48× · PMID 34355382 · DOI 10.1111/bjh.17753
  3. Low-molecular weight inhibitors of the alternative complement pathway.
    Schubart A, Flohr S, Junt T, Eder J. · · 2023 · cited 27× · PMID 36217774 · DOI 10.1111/imr.13143
  4. A review of advances in the understanding of lupus nephritis pathogenesis as a basis for emerging therapies.
    Yung S, Yap DY, Chan TM. · · 2020 · cited 22× · PMID 32789005 · DOI 10.12688/f1000research.22438.1
  5. Complement Inhibition in Paroxysmal Nocturnal Hemoglobinuria (PNH): A Systematic Review and Expert Opinion from Central Europe on Special Patient Populations.
    Bodó I, Amine I, Boban A, Bumbea H, et al · · 2023 · cited 15× · PMID 37072660 · DOI 10.1007/s12325-023-02510-4
  6. Targeting of G-protein coupled receptors in sepsis.
    Rehman A, Baloch NU, Morrow JP, Pacher P, et al · · 2020 · cited 11× · PMID 32197794 · DOI 10.1016/j.pharmthera.2020.107529
  7. Factor B as a therapeutic target for the treatment of complement-mediated diseases.
    Kavanagh D, Barratt J, Schubart A, Webb NJA, et al · · 2025 · cited 10× · PMID 40028332 · DOI 10.3389/fimmu.2025.1537974

Verify or expand the search:

Other trials of LNP023

Trials testing the same drug.

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Trials by the same sponsor.

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing