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WAYRILZ (rilzabrutinib): LUNA-3 Clinical Study Design


WAYRILZ: LUNA-3 study design1-3

Diagram of LUNA-3 study design, showing Wayrilz (rilzabrutinib) vs placebo control over a 24-week double-blind treatment period followed by a 9-week open-label period.

Response Criteria

To qualify for continuation in the study through the end of the
DB period, patients had to have ≥1 platelet response of at least
50x109/L or ≥30x109/L and <50x109/L and at least doubled
from baseline by Week 13 without rescue therapy.1,2*

PRIMARY ENDPOINT: Durable platelet response

A platelet count ≥50x109/L for ≥5 of at least 8 non-missing weekly measurements during the last 12 weeks of the DB period, including ≥2 such responses in the last 6 weeks without rescue therapy.1*

Icon of a checkmark.

At Week 13, 64% of patients receiving WAYRILZ were responders (n=85) compared to 32% of patients in the placebo control group (n=22).1,2

*Rescue therapy= intravenous immunoglobulin (IVlg), high-dose CS, platelet infusion, or anti-D immunoglobulin infusion (anti-D).

WAYRILZ was studied in a wide range of patients1,2*

LUNA-3: A phase 3, randomized, double-blind, placebo-controlled, parallel-group, multicenter study to evaluate the efficacy and safety of oral WAYRILZ (400 mg BID) for 24 weeks, followed by a 28-week open-label extension (OLE) in adults with persistent or chronic ITP who had an insufficient response to either intravenous immunoglobulin (IVlg/anti-D) or corticosteroids (CS), or had a documented intolerance or insufficient response to any appropriate course of standard-of-care ITP therapy.1,2

Baseline demographics (N=202)1,2

 WAYRILZ (n=133)Placebo Control (n=69)
Median age (range)47 years (18-80)46 years (19-79)
Female, n (%)78 (59)49 (71)
Median duration of ITP (range)8.1 years (0.3-52.2)6.2 years (0.3-35.8)
Median baseline platelet count (range)15x109/L (1-32)15x109/L (1-54)
Prior splenectomy, n (%)37 (28)19 (28)
No concomitant treatment, n (%)53 (40)23 (33)
Concomitant CS, TPO-RA, or both, n (%)80 (60)46 (67)

Prior unique ITP medications (pooled)2†

Number of MedicationsPercentage of Patients (N=202)
1-229% (n=58)
3-425% (n=51)
≥546% (n=93)

*Including those with insufficient response to corticosteroids and/or multiple other treatments.1,2
Includes splenectomy. Multiple CS were counted as 1 therapy.2

Primary endpoint1,2

  • Durable platelet response at Week 25

Additional endpoints1,2

  • Time to first platelet response
  • Number of weeks with platelet response 
  • Percentage of patients who needed rescue therapy
Icon of a checkmark.

Patients with prior TEs were not excluded from the study population.2

Patient Disposition2

Diagram of patient disposition in the LUNA-3 study, including numbers of patients who were screened, randomized, and treated with Wayrilz or placebo, as well as discontinuations.

*Includes patients who entered as of the data cutoff. All patients in the 28-week open-label received WAYRILZ 400 mg BID.2

Learn how WAYRILZ targets key sources of ITP1-3

Explore the durable response results of WAYRILZ vs placebo control1

anti-D, anti-D immunoglobulin; BID, twice daily; CS, corticosteroids; DB, double-blind; ITP, immune thrombocytopenia; IVIg, intravenous immunoglobulin; MOA, mechanism of action; TE, thromboembolic event; TPO-RA, thrombopoietin receptor agonist.

INDICATION

WAYRILZ™ (rilzabrutinib) is indicated for the treatment of adult patients with persistent or chronic immune thrombocytopenia (ITP) who have had an insufficient response to a previous treatment.

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS
Serious Infections: An increased risk of serious infections (including bacterial, viral, or fungal) can occur in patients treated with Bruton’s tyrosine kinase (BTK) inhibitors, including WAYRILZ. Fatal pneumonia occurred in one participant treated with WAYRILZ in the LUNA-3 trial. Other serious infections [one each (0.8%)] included COVID-19 infection, wound infection, urinary tract infection and kidney abscess. Monitor patients for signs and symptoms of infection and treat appropriately.

Hepatotoxicity, Including Drug-Induced Liver Injury (DILI): Hepatotoxicity, including severe, life-threatening, and potentially fatal cases of DILI, can occur in patients treated with BTK inhibitors. Elevations of liver transaminases occurred with WAYRILZ in the ITP clinical trials and were generally mild to moderate in severity. Evaluate bilirubin and transaminases at baseline and as clinically indicated during treatment with WAYRILZ. For patients who develop abnormal liver tests after WAYRILZ, monitor more frequently. If DILI is suspected, withhold WAYRILZ. Upon confirmation of DILI, discontinue WAYRILZ.

Embryo-Fetal Toxicity: Based on findings from preliminary animal reproduction studies, WAYRILZ may cause fetal harm when administered to a pregnant woman. Verify pregnancy status of females of reproductive potential prior to initiating WAYRILZ treatment. Advise females of reproductive potential to use effective contraception while taking WAYRILZ and for 1 week after the final dose.

ADVERSE REACTIONS

Most common adverse reactions reported (incidence ≥10%) were diarrhea, nausea, headache, abdominal pain, and COVID-19.

DRUG INTERACTIONS

  • Avoid concomitant use of WAYRILZ with strong or moderate CYP3A inhibitors, which increases the risk of WAYRILZ adverse reactions. If short term use of these inhibitors cannot be avoided, interrupt treatment with WAYRILZ. Avoid concomitant use of grapefruit, starfruit and products containing these fruits, and Seville oranges with WAYRILZ.
  • Avoid concomitant use with a strong or moderate CYP3A inducer, which may reduce WAYRILZ efficacy.
  • Administer the dose of WAYRILZ at least 2 hours before administration of an antacid or histamine H2 receptor antagonist. Avoid concomitant use of proton pump inhibitors with WAYRILZ. Concomitant use of acid reducing agents may reduce WAYRILZ efficacy.
  • Rilzabrutinib is a moderate inhibitor of CYP3A and increases exposure of these substrates. Monitor for adverse reactions and consider dosage adjustment of the CYP3A substrate.
  • Rilzabrutinib is an inhibitor of P-gp, BCRP and OATP1B in vitro. The effect of concomitant use of WAYRILZ with OATP1B and BCRP substrates has not been established in clinical studies. Monitor for adverse reactions of the concurrently administered P-gp, BCRP, or OATP1B substrate more frequently where minimal substrate concentration changes may lead to serious adverse reactions.

USE IN SPECIFIC POPULATIONS

  • Lactation: Due to the potential for adverse reactions in a breastfed child from WAYRILZ, advise lactating women not to breastfeed while taking WAYRILZ and for at least 1 week after the final dose
  • Hepatic Impairment: Avoid administration of WAYRILZ in patients with moderate or severe hepatic impairment (Child-Pugh class B-C)
  • Renal Impairment: Avoid use in patients with severe renal impairment

Please see full Prescribing Information.

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INDICATION

IMPORTANT SAFETY INFORMATION

References: 1. WAYRILZ. Prescribing information. Sanofi, Inc. 2. Kuter DJ, Ghanima W, Cooper N, et al; LUNA3 Trial Group. Safety and efficacy of rilzabrutinib vs placebo in adults with immune thrombocytopenia: the phase 3 LUNA3 study. Blood. 2025;145(24):2914-2926. 3. Kuter DJ, Bussel JB, Ghanima W, et al. Rilzabrutinib versus placebo in adults and adolescents with persistent or chronic immune thrombocytopenia: LUNA 3 phase III study. Ther Adv Hematol. 2023;14:20406207231205431.

© 2025 Sanofi. All rights reserved. WAYRILZ, HemAssist, and Sanofi are trademarks of Sanofi or an affiliate. All other trademarks above are the property of their respective owners, who have no affiliation or relationship with Sanofi. MAT-US-2508447-v1.0-08/2025