E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with Primary Biliary Cirrhosis at risk of disease progression |
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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 | 10036680 |
E.1.2 | Term | Primary biliary cirrhosis |
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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 compare the efficacy and tolerability of a combination therapy with ursodeoxycholic acid (12-16 mg/kg body weight/d) plus budesonide (9 mg/d) vs. ursodeoxycholic acid (12-16 mg/kg body weight/d) plus placebo in the treatment of PBC.
- To study safety and tolerability in the form of adverse events and laboratory parameters.
- To assess patients’ Quality of Life.
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E.2.2 | Secondary objectives of the trial | |
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Signed informed consent 2. Age ≥ 18 years 3. UDCA treatment for at least 6 months prior to inclusion 4. Liver biopsy compatible with PBC 5. Liver biopsy performed within the last 6 months prior to inclusion 6. PBC patients at risk of disease progression based on one or more of the following criteria: -PBC patients at risk of disease progression based on one or more of the following criteria: - Serum alkaline phosphatase ≥ 3 times upper limit of normal (corresponding to 312 U/L for women and 387 U/L for men) at any time since diagnosis of PBC or - ALT or AST ≥ 2 times upper limit of normal (corresponding to 70 U/L for women and100 U/L for men) at inclusion or - Total Bilirubin ≥ 1.0 mg/dl (≥ 17 µmol/L) or - Moderate to severe periportal or periseptal lymphocytic interface hepatitis or- Periportal and portal fibrosis with numerous septa (Ludwig stage III) without cirrhosis 7. Type 2 anti-mitochondrial antibodies > 1:40 by indirect immunofluorescence 8. Women of child-bearing potential have to apply appropriate contraceptive methods, e.g., hormonal contraception, intrauterine device (IUD), double-barrier method of contraception (e.g., use of a condom and spermicide), partner has undergone vasectomy and subject is in monogamous relationship. The investigator is responsible for determining whether the subject has adequate birth control for study participation |
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E.4 | Principal exclusion criteria |
1. Histologically proven cirrhosis 2. Positive Hepatitis B or C serology 3. Positive HIV serology 4. Primary Sclerosing Cholangitis 5. Wilson’s-Disease 6. Celiac Disease (if not controlled) 7. α1–anti-Trypsin-deficiency 8. Haemochromatosis 9. Autoimmune-Hepatitis (AIH; defined by an Alvarez score > 15 without treatment or ≥ 17 with treatment); Note: PBC/AIH overlap disease, treated insufficiently with UDCA monotherapy may be enrolled 10. Treatment with corticosteroids (except inhalative corticosteroids) within the last 2 months prior to inclusion and/or treatment with any of the following drugs within the last 3 months prior to inclusion: colchicine, azathioprine or other immunosuppressive drugs (e.g. cyclosporine, methotrexate), chlorambucil, D-penicillamine, fibrates, or antihyperlipidemic drugs 11. Treatment with ketoconazole or other CYP3A inhibitors within the last 4 weeks before baseline; rifampicin (up to 600 mg/d) is allowed to treat pruritus until baseline 12. Sonographic or endoscopic signs of portal hypertension 13. Ascites or history of ascites 14. Hepatic encephalopathy or history of hepatic encephalopathy 15. Total bilirubin > 3.0 mg/dl (> 50 µmol/L) 16. Albumin < 36 g/L 17. Prothrombin time < 70% 18. Platelet count < 135.000/mm3 19. Osteoporosis proven by bone densitometry 20. Diabetes mellitus (defined as B-Glucose > 125 mg/dl on an empty stomach), even when controlled 21. Hypertension, defined as persistent raised blood pressure > 140/90 mmHg 22. Suspected non-compliance of the patient (suspected difficulties to comply with the study period of 36 months) 23. Severe co-morbidity substantially reducing life expectancy 24. Known intolerance/hypersensitivity/resistance to study drugs or drugs of similar chemical structure or pharmacological profile 25. Existing or intended pregnancy or breast-feeding 26. Participation in another clinical trial within the last 30 days, simultaneous participation in another clinical trial, or previous participation in this trial |
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E.5 End points |
E.5.1 | Primary end point(s) |
Rate of patients without treatment failure after 3 years of treatment. Treatment failure is defined as: · Death, or · Registration on the liver transplant waiting list, or · Cirrhosis defined by histology (staging according to Ludwig), or · Presence of esophageal varices and/or ascites |
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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 | 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 | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
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 | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 34 |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
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 | 4 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |