Prof. Yanmei Xu (Peking Union Medical College, China) and co-investigators conducted a randomised-controlled phase 2 trial to compare the anti-CD38 monoclonal antibody CM313 with placebo in 45 patients with persistent or chronic primary ITP who had previously received glucocorticoid treatment and had responded to standard first-line therapy [1]. Prof. Xu mainly reported on improvements in platelet counts, bleeding, and safety.
At week 8, 83% of the participants in the experimental arm and 20% of those in the placebo arm had achieved the primary endpoint, which was defined as ‘at least 2 consecutive platelet counts ≥30x109/L, representing a doubling from baseline, in the absence of bleeding’. Moreover, the median time to attain a platelet count ≥50x109/L in the active arm was 1 week. Prof. Xu emphasised that the median cumulative duration of a platelet count ≥50x109/L was 18 weeks in the CM313 group and 3 weeks in the placebo group. In the CM313 arm, the bleeding rate had decreased from 37% at baseline to 13% at week 24, whereas this rate had increased from 27% to 33% in the placebo arm. Finally, Prof. Xu mentioned that treatment-emergent adverse event rates were around 80% in both groups. Infusion reactions were more common in the experimental arm (30% vs 13%), but petechiae were more frequently observed in the placebo group (27% vs 67%). The rates of upper respiratory tract infection were 13% in both groups.
“This experimental anti-CD38 targeted therapy rapidly boosted platelet levels by inhibiting antibody-dependent cell-mediated cytotoxicity on platelets,” concluded Prof. Xu. “The responses were durable due to a clearing of plasma cells.” The efficacy and safety results of CM313 are promising and warrant further testing in larger ITP populations.
- Xu Y, et al. Safety and efficacy of CM313 in adults with immune thrombocytopenia: a randomized, placebo-controlled trial. LB4004, EHA2025 Congress, 12–15 June, Milan, Italy.
Medical writing support was provided by Robert van den Heuvel.
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