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Immunomodulator

Extended vs Short-Term Abatacept Dosing for Graft-versus-Host Disease (ABA3 Trial)

Phase 2
Recruiting
Research Sponsored by Boston Children's Hospital
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Karnofsky performance score or Lanskey Play-Performance Scale score >/= 80.
Must be at least 2 years old and weigh 10 kg.
Must not have
For patients with MDS, those with >5% blasts will be excluded.
HIV infection.
Timeline
Screening 3 weeks
Treatment Varies
Follow Up 2 years

Summary

This trial is testing whether an extended dosing regimen of abatacept, when added to standard calcineurin inhibitor + methotrexate-based prophylaxis, will improve outcomes in patients who have received transplants from 7 of 8 HLA matched donors.

Who is the study for?
This trial is for patients at least 2 years old, weighing over 10 kg, with certain hematologic malignancies treatable by HCT and in remission. They need a partially matched unrelated donor and must not have severe psychiatric diseases, active infections, HIV, or inherited predispositions to cancer or transplant morbidities.
What is being tested?
The study compares extended versus short-term dosing of Abatacept added to standard GVHD prophylaxis in patients receiving transplants from mismatched donors. It aims to determine which regimen better prevents severe acute and chronic GVHD without relapse post-transplant.
What are the potential side effects?
Potential side effects are not explicitly listed but may include reactions related to immune system suppression such as increased risk of infection, possible infusion-related reactions, and any typical complications associated with bone marrow transplantation.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I am mostly able to carry out normal activities without assistance.
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I am at least 2 years old and weigh more than 10 kg.
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My blood cancer is in remission and can be treated with a stem cell transplant.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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My MDS does not have more than 5% blasts.
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I am HIV positive.
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I have had a stem cell transplant from a donor.
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I do not have Chronic Lymphocytic Leukemia, Myeloma, or Primary Myelofibrosis.
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My leukemia has minimal residual disease above 0.01%, making me ineligible.
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I have not had severe acute or chronic graft-versus-host disease, nor has my condition worsened.
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My kidney function is reduced, with a GFR under 50.
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I do not have genetic conditions like Fanconi Anemia or Down Syndrome.
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My cancer has returned and is active.
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My lung function is very low or I need extra oxygen.
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I do not have genetic conditions like Li-Fraumeni syndrome or BRCA mutations.
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I do not have any ongoing serious infections.
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I am currently being treated for active tuberculosis.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~2 years
This trial's timeline: 3 weeks for screening, Varies for treatment, and 2 years for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.
Primary study objectives
Severe AGVHD-free, severe CGVHD-free, relapse-free survival (SGRFS)
Secondary study objectives
Non-relapse mortality
Relapse-Free survival
Graft-vs-Host Disease

Side effects data

From 2023 Phase 3 trial • 657 Patients • NCT03086343
24%
UPPER RESPIRATORY TRACT INFECTION
24%
HYPERTENSION
18%
BRONCHITIS
12%
ACUTE RESPIRATORY FAILURE
12%
RASH
12%
INFLUENZA
12%
ARTHRALGIA
12%
URINARY TRACT INFECTION
12%
WEIGHT INCREASED
12%
FALL
12%
SINUSITIS
12%
MUSCLE SPASMS
12%
CHOLELITHIASIS
12%
NASOPHARYNGITIS
12%
LIVER FUNCTION TEST INCREASED
12%
OROPHARYNGEAL PAIN
6%
SEBORRHOEIC KERATOSIS
6%
HEADACHE
6%
NAUSEA
6%
HIP FRACTURE
6%
PHARYNGITIS
6%
BLOOD CREATINE PHOSPHOKINASE INCREASED
6%
HYPOKALAEMIA
6%
SJOGREN'S SYNDROME
6%
RHINORRHOEA
6%
PNEUMONIA BACTERIAL
6%
ASTHMA
6%
NASAL CONGESTION
6%
PULMONARY EMBOLISM
6%
CONSTIPATION
6%
HYPONATRAEMIA
6%
HEPATIC STEATOSIS
6%
DEHYDRATION
6%
PHOTODERMATOSIS
6%
BLOOD PRESSURE INCREASED
6%
COUGH
6%
BONE CONTUSION
6%
VOMITING
6%
PERIPHERAL SWELLING
6%
STAPHYLOCOCCAL INFECTION
6%
ORAL CANDIDIASIS
6%
HAEMOGLOBIN DECREASED
6%
RHEUMATOID ARTHRITIS
6%
PARAESTHESIA
6%
FEELING HOT
6%
COSTOCHONDRITIS
6%
LEUKOCYTOSIS
6%
TACHYCARDIA
6%
STOMATITIS
6%
PATELLA FRACTURE
6%
ACTINIC KERATOSIS
6%
GLAUCOMA
6%
BACTERIAL SEPSIS
6%
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
6%
ATRIOVENTRICULAR BLOCK FIRST DEGREE
6%
CHEST PAIN
6%
FATIGUE
6%
CANDIDA INFECTION
6%
SKIN LACERATION
6%
COVID-19
6%
CATARACT
6%
INFECTIOUS PLEURAL EFFUSION
6%
DYSPHAGIA
6%
SWELLING
6%
ACUTE KIDNEY INJURY
6%
HERPES ZOSTER
6%
PNEUMONIA
6%
OSTEOARTHRITIS
6%
NON-CARDIAC CHEST PAIN
6%
RHINITIS
6%
FEMUR FRACTURE
6%
LIGAMENT RUPTURE
6%
SUPRAVENTRICULAR TACHYCARDIA
6%
SCRATCH
6%
EYE HAEMATOMA
6%
INSOMNIA
6%
ERYTHEMA
6%
PRURITUS
6%
DERMATITIS ALLERGIC
6%
BACK PAIN
6%
DIZZINESS
6%
FLANK PAIN
6%
SCIATICA
6%
ANAEMIA
6%
BILIARY COLIC
6%
DERMATITIS CONTACT
6%
DRUG HYPERSENSITIVITY
6%
HERPES SIMPLEX
6%
LOCALISED INFECTION
6%
VULVOVAGINAL MYCOTIC INFECTION
6%
DIABETES MELLITUS
6%
VITAMIN D DEFICIENCY
6%
OSTEOPENIA
100%
80%
60%
40%
20%
0%
Study treatment Arm
Period 2, 30 mg Cohort: Upadacitinib 30 mg QD/Upadacitinib 30 mg QD
Period 2, Primary Cohort: Upadacitinib 15 mg QD/Upadacitinib 15 mg QD
Period 2, Primary Cohort: Abatacept/Upadacitinib 15 mg QD
Period 2, 30 mg Cohort: Abatacept/Upadacitinib 30 mg QD
Period 1, 30 mg Cohort: Upadacitinib 30 mg QD
Period 2, 30 mg Cohort: Upadacitinib 30 mg QD/Upadacitinib 30 mg QD/Upadacitinib 15 mg QD
Period 2, 30 mg Cohort: Abatacept/Upadacitinib 30 mg QD/Upadacitinib 15 mg QD
Period 1, Primary and 30 mg Cohorts: Abatacept
Period 1, Primary Cohort: Upadacitinib 15 mg QD

Trial Design

2Treatment groups
Experimental Treatment
Placebo Group
Group I: Standard GVHD Prophylaxis + Abatacept Extended dosingExperimental Treatment1 Intervention
Standard GVHD prophylaxis of calcineurin inhibitor (cyclosporine or tacrolimus) and methotrexate + 8 doses of Abatacept.
Group II: Standard GVHD Prophylaxis + Abatacept + PlaceboPlacebo Group2 Interventions
Standard GVHD prophylaxis of calcineurin inhibitor (cyclosporine or tacrolimus) and methotrexate + 4 doses of Abatacept (investigational product) + 4 doses of Placebo.
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Abatacept
2005
Completed Phase 4
~112250

Find a Location

Who is running the clinical trial?

Boston Children's HospitalLead Sponsor
789 Previous Clinical Trials
5,582,787 Total Patients Enrolled
Bristol-Myers SquibbIndustry Sponsor
2,696 Previous Clinical Trials
4,098,911 Total Patients Enrolled

Media Library

Abatacept (Immunomodulator) Clinical Trial Eligibility Overview. Trial Name: NCT04380740 — Phase 2
Graft-versus-Host Disease Research Study Groups: Standard GVHD Prophylaxis + Abatacept + Placebo, Standard GVHD Prophylaxis + Abatacept Extended dosing
Graft-versus-Host Disease Clinical Trial 2023: Abatacept Highlights & Side Effects. Trial Name: NCT04380740 — Phase 2
Abatacept (Immunomodulator) 2023 Treatment Timeline for Medical Study. Trial Name: NCT04380740 — Phase 2
~13 spots leftby Apr 2025