Recruiting
Phase 3

Mavorixafor

Sponsor:

X4 Pharmaceuticals

Code:

NCT06056297

Conditions

Neutropenia

Eligibility Criteria

Sex: All

Age: 12+

Healthy Volunteers: Not accepted

Interventions

Mavorixafor

Placebo

Study Details

Brief summary:

The purpose of this study is to demonstrate the efficacy and evaluate the safety and tolerability of mavorixafor in participants with congenital or acquired primary autoimmune and idiopathic chronic neutropenic disorders who are experiencing recurrent and/or serious infections as assessed by demonstrating its clinical benefit and increasing levels of circulating neutrophils.

Conditions

Neutropenia

Study ID

NCT06056297

Start date

Jun 6, 2024

Status verified date

Aug, 2026

Completion date

Nov, 2027

Anticipated

Primary completion date

Sep, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 12+

Healthy Volunteers: Not accepted

Key Inclusion Criteria:

  • Diagnosis of congenital or acquired primary autoimmune and idiopathic chronic neutropenic disorder ≥6 months prior to the screening visit that is not attributable to medications, active or recent infections or malignancy.
  • Congenital Neutropenia, including but not limited to these classifications:

1. Isolated with a permanent (non-cyclic) presentation, for example, elastase, neutrophil expressed (ELANE), colony stimulating factor 3 receptor (CSF3R), C-X-C chemokine receptor 2 (CXCR2), Wiskott-Aldrich syndrome (WAS)
2. Associated with extra-hematologic manifestations, for example, Barth syndrome, Cohen syndrome, glucose-6-phosphatase catalytic subunit 3 (G6PC3), Kostmann disease
3. Associated with metabolic disorders, for example, glycogen storage disease 1b (GSD1b)
4. Shwachman-Diamond syndrome
  • Acquired Primary Neutropenia

1. Chronic idiopathic neutropenia
2. Primary autoimmune neutropenia. Other chronic neutropenia (CN) disorders that may be eligible for enrollment can be clarified and approved upon discussion with study Medical Monitor.
  • Have an ANC <1000 cells/µL during screening (single ANC value from hematology) and confirmed trough mean ANC (mean value of multiple ANC measurements over 6 hours) at baseline visit, with no clinical evidence of systemic infection.
  • Prior history of recurrent and/or serious infections during the 12 months preceding the screening visit (that is, suffering sequelae of chronic neutropenia), as defined by having at least 2 infections in the last 12 months that meet the following criteria:
  • Infection requiring the use of antibiotics (intravenous \[IV\]/oral); OR
  • Infection requiring a visit to healthcare facility (including but not limited to emergency room visit, urgent care facility, primary care physician's office, or in-patient hospitalization);

AND for all potential participants:

  • Infections considered by the Investigator to be likely related to the potential participant's CN disorder.
  • Participants who are on G-CSF or other active background therapy must have been receiving these therapies during the previous 12 months while continuing to suffer from infections, be on a stable dose and dosing schedule for ≥4 weeks prior to screening visit and remain on this dose and dosing schedule throughout the study (unless ANC >10,000 cells/µL for ≥4 weeks).
  • Participants must be willing to keep their G-CSF or other background therapy doses/regimens stable (other than for safety reasons) for the duration of the study.

Key Exclusion Criteria:

  • A diagnosis of secondary neutropenia including those due to:

1. Hypersplenism
2. Infection
3. Malignancy
4. Autoimmune disease, for example, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, graft-versus-host disease, thyroid disease
5. Nutritional deficiency, for example, vitamin B12, folic acid, copper, caloric malnutrition
6. Drug-induced cause, for example, chemotherapy, clozapine, antiretrovirals, antibiotics, monoclonal antibodies.
  • A diagnosis of any of the following:

1. Aplastic anemia
2. Warts, hypogammaglobulinemia, infections, and myelokathexis (WHIM) syndrome
3. Certain CNs, including but not limited to these classifications are excluded:

1. Isolated with a cyclic presentation, for example, elastase, neutrophil expressed (ELANE)
2. Associated with immune dysregulation, for example, common variable immunodeficiency (CVID), autoimmune lymphoproliferative syndrome (ALPS), familial hemophagocytic lymphohistiocytosis, Chédiak-Higashi syndrome, GATA-binding protein 2 (GATA2) deficiency syndrome
3. Associated with bone marrow failure, for example, Fanconi anemia, Diamond-Blackfan anemia
4. Neutropenia associated with a Duffy-null phenotype (formerly known as benign ethnic neutropenia). However, a participant with an autosomal dominant pathogenic variant in a gene associated with CN on a Duffy-null background may be eligible for inclusion
  • A medical or personal condition that may potentially compromise the safety of the participant, may preclude the participant's successful completion of the clinical study, or could, in the opinion of the Investigator or the Medical Monitor, interfere with the objectives of the study.
  • Received more than 1 dose of mavorixafor in the past.
  • Received C-X-C chemokine receptor 4 (CXCR4) antagonist (other than mavorixafor) in the past 6 months.
  • Participants taking pegylated-G-CSF unless they have a diagnosis of congenital neutropenia confirmed at screening.
  • Participant is currently taking or has taken other investigational drug <30 days prior to the screening visit or 5 half-lives, whichever is longer.

Note: Other protocol-defined inclusion and exclusion criteria may apply.

Study Design

Enrollment

176 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Mavorixafor

Participants will receive mavorixafor orally once daily starting from Day 1 through Week 52.

placebo comparator: Placebo

Participants will receive placebo to match mavorixafor orally once daily starting from Day 1 through Week 52.

Interventions

Mavorixafor

Mavorixafor will be administered per schedule specified in the arm description.

Placebo

Placebo will be administered per schedule specified in the arm description.

Primary outcome measure

  • Co-primary Endpoint: Annualized Infection Rate Based on Infections Adjudicated by Blinded Infection Adjudication Committee (BIAC) During the Treatment Period [ Time Frame: Up to 52 Weeks ]
  • Co-primary Endpoint: Number of Participants Meeting the Definition of a Positive Absolute Neutrophil Count (ANC) Response [ Time Frame: Up to 52 weeks ]

Central Contacts and Locations

Central contacts

Locations

Phoenix Children's Hospital

Recruiting

Phoenix, Arizona, United States, 85016

UC Irvine

Recruiting

Irvine, California, United States, 92697

Orso Health

Recruiting

La Jolla, California, United States, 92037

University of California, Los Angeles-UCLA

Recruiting

Los Angeles, California, United States, 90095

University of Southern Florida

Recruiting

St. Petersburg, Florida, United States, 33701

Children's Healthcare of Atlanta (CHOA)

Recruiting

Atlanta, Georgia, United States, 30322

University of Iowa

Recruiting

Iowa City, Iowa, United States, 52242

Boston Children's Cancer Center

Recruiting

Boston, Massachusetts, United States, 02143

University of Michigan

Recruiting

Ann Arbor, Michigan, United States, 48109

Washington University

Recruiting

St Louis, Missouri, United States, 63130

Duke University Medical Center

Recruiting

Durham, North Carolina, United States, 27710

Cincinnati Children's Hospital Medical Center

Recruiting

Cincinnati, Ohio, United States, 45229

Cleveland Clinic

Recruiting

Cleveland, Ohio, United States, 44195

The Children's Hospital of Philadelphia

Recruiting

Philadelphia, Pennsylvania, United States, 19104

St. Jude Childrens; Research Hospital

Recruiting

Memphis, Tennessee, United States, 38105

UT Southwestern Medical Center

Recruiting

Dallas, Texas, United States, 75390

Cook Children's Medical Center

Recruiting

Fort Worth, Texas, United States, 76104

Texas Children's Hospital/ Baylor College of Medicine

Recruiting

Houston, Texas, United States, 77030

Sarah Cannon Research Institute

Recruiting

Woodland, Texas, United States, 77380

University of Utah

Recruiting

Salt Lake City, Utah, United States, 84112

Froedtert And Medical College Of Wisconsin

Recruiting

Milwaukee, Wisconsin, United States, 53226

University of Alberta Hospital

Recruiting

Edmonton, Canada, AB T6G 2R3

BC Children's Hospital

Recruiting

Vancouver, Canada, V5Z 4H4

More Information

Sponsor

X4 Pharmaceuticals

Last update posted

Aug 6, 2026

Last verified

Aug, 2026

Keywords

  • Mavorixafor
  • Chronic neutropenia
  • Chronic idiopathic neutropenia
  • Severe Congenital Neutropenia (SCN)
  • C-X-C chemokine receptor 4 (CXCR4)
  • Congenital and acquired neutropenia
  • Autoimmune disease
  • Cohen syndrome
  • Barth syndrome
  • ELANE
  • G6PC3
  • GSD1b
  • Kostmann disease
  • Shwachman-Diamond syndrome
  • Autoimmune neutropenia (AIN)

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-08. This information was provided to ClinicalTrials.gov by X4 Pharmaceuticals on 2026-08-06.