E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Efficacy, Safety and Tolerabilty of Neramexane in Patients with subjective Tinnitus |
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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 | 10042398 |
E.1.2 | Term | Subjective tinnitus |
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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 |
The objective of this study is to evaluate the efficacy, safety and tolerability of neramexane in comparison to placebo in patients with subjective tinnitus. |
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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 written informed consent obtained from the patient 2) Patients with a clinical diagnosis of first onset, persistent (i.e. tinnitus should never be absent for > 24 hours in a row), subjective, uni- or bilateral tinnitus present for at least 3 months but not more than 12 months. In case of bilateral tinnitus this criterion applies to both ears. 3) Outpatients (male or female) between 18 and 75 years of age (inclusively) at screening 4) For females of childbearing potential (last menses less than one year prior to enrolment): negative pregnancy test at screening and at baseline (i.e. prior to entry in the double-blind treatment phase); not breast-feeding; either surgically sterile or agreement to use a medically accepted, highly effective contraception during the entire duration of the study 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. 5) TBF-12 total score ≥ 9 6) HADS depression subscore ≤ 10 and HADS anxiety subscore ≤ 10 7) Physical examination and laboratory evaluations from the screening visit must be normal, or abnormal findings must be judged either “not clinically relevant” or “clinically relevant but of no concern” by the Investigator 8) Patient must be willing and able to comply with the protocol and study procedures |
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E.4 | Principal exclusion criteria |
1) Clinical diagnosis of intermittent or pulsatile tinnitus 2) Patients who have tinnitus as a concomitant symptom of an otological/neurological disease (such as otitis media, Menière’s disease, otosclerosis, etc) 3) Hearing impairment related to disturbance of sound conduction (air conduction threshold more than 20 decibel (dB) worse than in bone conduction in at least two tested frequencies) 4) Patients with evidence of clinically relevant and active -Pulmonary -Cardiovascular (e.g. sinus bradycardia < 41 bpm, sinus pauses, ventricular fibrillation, non-sustained sinus bradycardia, 2:1 AV block, complete heart block, first degree AV block if > 300 msec, AV block Mobitz II, prolonged QTc if > 500 msec, WPW syndrome, ST elevation, abnormal U wave, cardiac insufficiency NYHA III-IV or a history of myocardial ischaemia/infarction within the last 6 months) -Renal -Hepatic -Gastrointestinal -Neurological (e.g. epileptic seizures, multiple sclerosis, serious head/cervical trauma with residual deficits) -Psychiatric (e.g. dementia, schizophrenia, current major depressive episode) -Infectious (e.g. HIV infection/AIDS, tuberculosis) -Endocrine disorder of concern or other severe or uncontrolled systemic diseases which might interfere with the trial (patients with controlled diabetes who are normoglycemic under treatment may be included). 5) A systolic blood pressure (while seated) greater than 180 mmHg or less than 90 mmHg or diastolic blood pressure (while seated) greater than 105 mmHg or less than 45 mmHg 6) Patients with an oncology diagnosis (hematology or solid tumor) who are undergoing treatment, who have completed treatment within the last six months, and/or who still have evidence of active disease. (Patients with localized, benign dermatologic lesions may be included) 7) Former treatment with memantine, neramexane, rimantadine, amantadine 8) Documented history of hypersensitivity or intolerance to NMDA antagonists 9) Known hypersensitivity to the study drug or one of the ingredients of the formulation 10) Current absence from work due to tinnitus or application for a pension/retirement pay or granted pension/retirement because of tinnitus 11) Concomitant drugs and supplements intended for tinnitus treatment as well as non-pharmacological tinnitus treatments, e.g. biofeedback, maskers, noisers, acupuncture, hyperbaric oxygen therapy, low-power laser therapy, autogenic training, behavioural or psychotherapy during the last 28 days, 12) Patients who are taking any non-authorised concomitant medication as defined in Appendix 6 of the study protocol 13) Patients who plan to undergo elective surgery under local or general anaesthesia during the trial 14) Known or suspected alcoholism or drug abuse within the last three years 15) Patients who have participated in an investigational drug study or who have received treatment with an investigational drug within 30 days (or 5 half-lifes, whichever is longer) of screening 16) Pregnant or breastfeeding women 17) Employees or direct relatives of an employee of the CRO, the investigational site or Merz Pharmaceuticals 18) Patients who are lawfully kept in an institution or are imprisoned 19) Previous participation in this clinical study 20) Evidence or suspicion that the patient might not comply with the study directives and/or that he/she is not reliable or trustworthy. 21) Evidence or suspicion that the patient is not willing or unable to understand the information that is given to him/her as part of the informed consent, in particular regarding the risks and discomfort to which he/she would agree to be exposed. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint is the change in the TBF-12 score from baseline to end of treatment (EOT). The confirmatory analysis will be performed using an ANCOVA model with treatment, country and gender as factors and baseline TBF-12 as covariate to compare placebo and neramexane. |
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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 | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
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) | 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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 65 |
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 | 2 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |