E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10063399 |
E.1.2 | Term | Relapsing-remitting multiple sclerosis |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10063400 |
E.1.2 | Term | Secondary progressive multiple sclerosis |
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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 |
To rule out a major increase in inflammatory disease activity by s.c. hGH using high-frequency contrast-enhanced brain MRI |
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E.2.2 | Secondary objectives of the trial |
To demonstrate clinical safety of s.c. hGH in MS
To provide initial data on therapeutic efficacy of hGH in MS (surrogate marker) |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Imaging of human remyelination by non-conventional MRI:
MRI examinations at screening, baseline, months 3 and 6 will include acquisition of short T2 relaxation sequences, MR spectroscopy, diffusion tensor imaging and magnetization transfer imaging. These quantitative, longitudinal data will be related to a) the process of relapsing and remitting focal inflammation, b) the evolution of VEP latencies, and c) the administration of s.c. rhGH. Correlation to the time course of inflammation will result in better understanding of the interplay of inflammation and remyelination, and to an improved estimation of the time point at which attempts at remyelination should be initiated. A correlation of improvements in VEP latency and MRI measures will support the value of the latter as an imaging procedure to evaluate clinical trials of remyelinating agents. Significant relations between hGH treatment and improvement in either of the variables (VEP or MRI) can be taken as supportive data in terms of remyelination induction by rhGH.
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E.3 | Principal inclusion criteria |
Age 18-55 years (included), female or male
MS according to McDonald criteria, 2005 revision (Polman et al., 2005)
Relapsing-remitting (RRMS) or secondary progressive (SPMS) course
EDSS 0 – 5.5 (included)
Time since resolution of the last relapse or dose of corticosteroid treatment at least six weeks
Time since onset of a clinically manifest episode of optic neuritis at least one year
Pathological prolongation of visual evoked potentials on at least one eye, documented to be stable for at least three months
On screening MRI, at least three supratentorial lesions in T2/FLAIR
All patients must give written consent for participation in the study prior to the screening |
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E.4 | Principal exclusion criteria |
Primary progressive course of MS (PPMS)
More than four Gd contrast enhancing lesions on screening MRI
Ophthalmologic condition associated with impaired visual acuity, visual field cuts or other impairment of visual function, other than related to MS; glaucoma stable under regular treatment is acceptable
Treatment with an immunosuppressive agent (azathioprine, mitoxanthrone, methotrexate), natalizumab or any monoclonal antibody within six months before start of rhGH treatment
History of chronic disease of the immune system other than MS or of a known immunodeficiency syndrome
Diabetes mellitus, pathological percentage of HbA1c at screening
Patients with a history of malignancy or lymphoproliferative disorder, or current malignant tumor of any type or location
Patients unable to undergo MRI scans, including claustrophobia or history of severe hypersensitivity to gadolinium
Dementia/severe cognitive deficits
Patients with thyroid diseases (unless an individual consultion with an endocrinologist justifies participation)
Contraindication to the planned therapy (e. g. hypersensitivity to trial medication or one of its components)
Ongoing drug abuse
HIV positive
Pregnant or nursing women
Women with child bearing potential without effective contraception (a highly effective method of birth control is defined as those which result in a low failure rate (i.e. less than 1% per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some IUDs, sexual abstinence or vasectomised partner. For subjects using a hormonal contraceptive method, information regarding the product under evaluation and its potential effect on the contraceptive should be addressed).
Expected low compliance
Concomitant participation in other clinical trials
Contraindication to the planned therapy as per Summary of Prescribing Information (Fachinformation): Suspected progression or reappearance of intra-cranial mass lesions; patients suffering from acute major disease, which resulted from experiencing complications after heart or abdominal surgery, after multiple accidental trauma or respiratory failure; Prader-Willi-Syndrome |
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E.5 End points |
E.5.1 | Primary end point(s) |
Cumulative number of active (new or gadolinium-enhancing) lesions on brain MRI performed every four weeks during the 12-week baseline period and the first 12 weeks of the treatment period. That is, numbers of active lesions from week –8, week –4 and baseline will be compared to numbers of active lesions from week 4, week 8 and week 12. |
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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 | Yes |
E.6.3 | Therapy | Yes |
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 | No |
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 | 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 | Yes |
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 | Yes |
E.8.2.3.1 | Comparator description |
single cross-over, i.e. patients serve as their own control (baseline vs. treatment period) |
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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 | 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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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 | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |