E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Uncomplicated preterm labour |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 8.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10023555 |
E.1.2 | Term | Labour premature |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
1. To describe the maternal safety and tolerability of GSK221149A administered intravenously to healthy pregnant women in PTL between 340/7 and 356/7 weeks' gestation 2. To describe the fetal safety and tolerability of GSK221149A administered intravenously to healthy pregnant women in PTL between 340/7 and 356/7 weeks gestation 3. To evaluate the pharmacodynamics of GSK221149A in pregnant women in pre-term labor between 340/7 and 356/7 weeks' gestation 4. To characterize the pharmacokinetics of GSK221149A administered intravenously to pregnant females in pre-term labor between 340/7 and 356/7 weeks gestation |
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E.2.2 | Secondary objectives of the trial |
1. To explore the use of uterine EMG (electromyography) as a measurement of pharmacodynamic effect of GSK221149A 2. To describe the effect of maternal treatment with GSK221149A on neonatal growth and development 3. To characterize the pharmacokinetics of GSK221149A administered orally to pregnant females in pre-term labor between 340/7 and 356/7 weeks' gestation as data permit 4. To assess fetal drug exposure, if parturition occurs within 24 hours of therapy 5. To determine to what extent GSK221149A is excreted in the breast milk if parturition occurs within 24 hours of therapy (if the mother is lactating) 6. To characterize the effect of acute therapy with GSK221149A on time to parturition |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Aged at least 18 years 2. 340/7 -356/7 weeks (best obstetric estimate, preferably first trimester ultrasound) with singleton pregnancy 3. Symptoms of pre-term labor: ≥6 uterine contractions per hour, each of at least 30 sec in duration with cervical dilatation ≤3cm, as measured by tocodynamometry 4. Intact fetal membranes 5. Positive cervicovaginal fetal fibronectin test and/or ultrasonographic cervical length ≤20mm |
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E.4 | Principal exclusion criteria |
1. Any clinically relevant abnormality identified on the screening examination or any other medical condition or circumstance making the patient (mother and/or fetus) unsuitable for participation in the study 2. Any clinically relevant pre-existing or pregnancy-related co-morbid condition that may affect maternal pregnancy outcome or neonatal outcome (eg. hypertension, diabetes mellitus, bleeding/clotting diathesis) 3. Known fetal intrauterine growth restriction or fetal congenital anomaly 4. Abnormal modified biophysical profile (NST is non-reactive and AFI <5) 5. Participation in another clinical trial during the current pregnancy 6. Abuse of alcohol, defined as an average weekly intake of greater than 14 units or an average daily intake of greater than 2 units. One unit is equivalent to a half-pint (220mL) of beer or 1 (25mL) measure of spirits, or 1 glass (125mL of wine). 7. History of anaphylaxis or anaphylactoid reactions, severe allergic responses to drugs 8. Known to be positive for hepatitis C antibody, hepatitis B surface antigen or HIV on prenatal labs 9. Use of any prescription drugs (other than prenatal vitamins, beta-lactam antibiotics or antenatal steroids) within 7 days or 5 half-lives (whichever is longer) prior to first dose of medication 10. Use of dietary/herbal supplements including (but not limited to) St. John's wort, kava, ephedra (ma huang), gingko biloba, DHEA, yohimbe, saw palmetto, ginseng, and red yeast rice (2-fold greater than the recommended daily allowance) within 14 days prior to first dose of medication 11. Consumption of grapefruit or grapefruit juice within 3 days prior to first dose of medication 12. QTc > 450 msec (either QTcb or QTcf, machine or manual overread, on single or average QTc value of triplicate ECGs obtained over a brief recording period.) 13. QTc > 480 msec for patients with Bundle Branch Block 14. Use of illicit drugs or positive urine drug screen during pregnancy 15. Any tocolytic therapy within 24 hours 16. Any contraindication to tocolytic therapy, including (but not limited to) suspected intrauterine infection, vaginal bleeding, pre-eclampsia/eclampsia 17. Trauma within 48 hours of presentation in preterm labor |
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Maternal safety and tolerability, (vital signs, ECGs, clinical laboratory tests, adverse events) during acute therapy and for approximately 24 hours after the initiation of therapy compared to placebo and baseline 2. Assessment of fetal heart rate before, during and after therapy and amniotic fluid index (AFI) before, during and after therapy with GSK221149A compared to placebo and baseline 3. Percent of patients achieving uterine contractions <4/hour (sustained for 1 hour) OR reduced duration of contractions to <30 sec (sustained for 1 hour) with cervical change <1 cm at the end of up to 12 hours of intravenous treatment 4. Elucidation of the concentrations vs effect relationship for GSK221149A, using number of contractions/hour as the pharmacodynamic end-point. |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
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 | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
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 | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | No |
E.8.5.1 | Number of sites anticipated in the EEA | 5 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
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 | |
E.8.9.1 | In the Member State concerned months | 36 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 36 |