E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To investigate sarcoidosis activity by FDG-PET scan and chest x-ray in treatment refractory patients, in whom treatment with adalimumab (Humira®) is initiated. |
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E.2.2 | Secondary objectives of the trial |
Changes in lung function including FEV1, FVC, VCexp, VCinsp, TLC and DLCO from baseline to weeks 4, 8, 12, 16, 20, and 24. Changes in Short Form-36 health status survey (SF-36) from baseline to weeks 12 and 24. Changes in biochemistry markers for disease activity including B-haemoglobin, B-platelets, B-leukocytes, B-leukocyte count, B-CD4 lymphocytes, B-CD8 lymphocytes, P-IgG, P-IgA, P-IgM, P-IgE, S-angiotensin converting enzyme (SACE), S-soluble-interleukin-2-receptor (S-sIL-2R), S-YKL-40, P-creatinine, P-aspartate aminotransferase, P-alkaline phosphatase, P-bilirubin, INR, P-ionized calcium, P-total calcium, P-albumin from baseline to weeks 4, 8, 12, 16, 20, and 24. To demonstrate the safety of adalimumab treatment of patients with sarcoidosis by registering the number and severity of adverse events reported during this trial. |
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
A person may participate in this trial if he/she fulfils the following criteria: - Patients (>= 18 years) with verified biopsy of sarcoidosis according to The Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis (WASOG) criteria. - Clinically and/or biochemical disease activity in one or more organ systems defined as decreased lung function (FEV1 <70% of expected value and/or DLCO <70% of expected value; hypercalcaemia; impact on liver (elevated alkaline phosphatase and bilirubin and/or aspartate aminotranferase. - Previous treatment with prednisolon tablets 5-10 mg/week for at least 6 months with inadequate clinical and/or biochemical response as judged by Investigator. - Pathological increased FDG uptake on PET imaging corresponding to at least one known focus at first FDG PET scan. - Negative pregnancy test (serum HCG) for women of childbearing potential prior to trial start. (Non-fertile women defined as postmenopausal for at least 1 year or surgical sterilisation (bilateral tubal ligation, bilateral ooforectomy or hystorectomy)). Fertile women included in the trial should use contraceptives during the entire trial period (i.e. one of the following methods: Oral contraceptives, intrauterine device (IUD), depot injection of progesterone, subdermal implantation, contraceptive vaginal ring, transdermal depot plaster). Contraceptives should also be used for a period of 150 days after any discontinuation of trial medicine. - Ability and willingness to inject the s.c. injections him/herself or to have a person available for giving the injections. - Ability and willingness to give written informed consent and meet the requirements in the trial protocol.
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E.4 | Principal exclusion criteria |
A person may not participate in this trial, if he/she fulfils one or more of the following criteria: - Positive serology for Hepatitis B or C indicating active infection. - Medical history with positive HIV status. - Medical history with tuberculosis, histoplasmosis or listeriosis. - Persons with latent TB (positive Mantoux skin-test, positive Quantiferon-Gold test, positive inoculation of mycobacterium in tissue samples and/or chest x-ray indicating TB) or other risk factors for activating latent TB. - Active or recurrent infections or severe infections requiring hospitalization or treatment with i.v. antibiotics within the last 30 days or oral antibiotics within the last 14 days prior to inclusion. - Previous cancer or lymph proliferative disease except from completely well treated squamous cell carcinoma, basal cell carcinoma or cervix dysplasia. - Diabetes, unstable ischemic heart disease, heart insufficiency (NYHA III-IV), active chronic inflammatory intestinal disease, recent cerebral apoplexia (within 3 months), chronic leg ulcus or any other condition (e.g. catheter à demeure) imposing an increased risk to the subject, if he/she participates in the protocol, as judged by Investigator. - Pregnancy or breast-feeding. - Clinically significant drug or alcohol abuse during the last year. - Previous diagnosis or signs of demyelinized disease in the CNS system (e.g. optic neuritis, visual disorder, difficulty in walking/ataxia, facial paresis, apraxia). - No pathological increased FDG PET imaging at first FDG PET scan.
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E.5 End points |
E.5.1 | Primary end point(s) |
FDG-PET: FDG-PET positive foci will be determined both qualitatively and semi-quantitatively. Qualitatively: Pathological foci will be described from visual determination indicating anatomic localisation by means of fusion of FDG-PET with low dose CT (organ/lymph node region). Metabolism of any of the most substantial focus in the lungs, mediastinum and extra pulmonary will be determined quantitatively by calculation of Standardized Uptake Value (SUV) which states the imaging in focus compared to the mean whole body imaging. Finally, the patient’s two scans (blinded) will be compared (are they similar or which scan shows the most pronounced activity) with the purpose of assessing whether the changes have worsened, improved or are unchanged. The percentage of change between the first and second examination will be determined by the SUV values. Lung function: The lung function parameters will be stated in absolute values and in % of expected value compared to the European normal material. Each parameter value will be compared over the time period of the examination and change from first to second examination will be determined. A correlation analysis of change in FDG PET and lung function will be performed: % change in FDG SUV for most substantial focus will be correlated with change in DLCO and VC insp.
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 0 |