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    Summary
    EudraCT Number:2008-004460-39
    Sponsor's Protocol Code Number:248.644
    National Competent Authority:Germany - BfArM
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2008-09-11
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedGermany - BfArM
    A.2EudraCT number2008-004460-39
    A.3Full title of the trial
    A randomized, double-blind, placebo-controlled, flexible dose study to evaluate efficacy and safety of Pramipexole IR (0.0625-0.5 mg/day) versus placebo for 6 weeks in children and adolescents (age 6-17 inclusive) diagnosed with Tourette Disorder according to DSM-IV criteria
    A.4.1Sponsor's protocol code number248.644
    A.7Trial is part of a Paediatric Investigation Plan Information not present in EudraCT
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorBoehringer Ingelheim Pharma GmbH & Co. KG
    B.1.3.4CountryGermany
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing support
    B.4.2Country
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisation
    B.5.2Functional name of contact point
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.2Product code SND 919 CL2 Y
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation Information not present in EudraCT
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNpramipexole dihydrochloride monohydrate
    D.3.9.2Current sponsor codeSND 919 CL2 Y
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.0625 (salt)
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Information not present in EudraCT
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Information not present in EudraCT
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Information not present in EudraCT
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Sifrol
    D.2.1.1.2Name of the Marketing Authorisation holderBoehringer Ingelheim International GmbH
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameSifrol
    D.3.2Product code SND 919 CL2 Y
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation Information not present in EudraCT
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNpramipexole dihydrochloride monohydrate
    D.3.9.2Current sponsor codeSND 919 CL2 Y
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.125 (salt)
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Information not present in EudraCT
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Information not present in EudraCT
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Information not present in EudraCT
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Sifrol
    D.2.1.1.2Name of the Marketing Authorisation holderBoehringer Ingelheim International GmbH
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameSifrol
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation Information not present in EudraCT
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNpramipexole dihydrochloride monohydrate
    D.3.9.2Current sponsor codeSND 919 CL2 Y
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.25 (salt)
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Information not present in EudraCT
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Information not present in EudraCT
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Information not present in EudraCT
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 3
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Tourette's Syndrome
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 9.1
    E.1.2Level LLT
    E.1.2Classification code 10044127
    E.1.2Term Tourette's syndrome
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective of this trial is to evaluate the safety and efficacy of the non ergot dopamine agonist pramipexole for the treatment of tics in children and adolescents (age 6-17 years inclusive) diagnosed with Tourette Disorder according to DSM-IV criteria.
    The primary efficacy measure will be the Total Tic Score (TTS) of the YGTSS at 6 weeks.
    E.2.2Secondary objectives of the trial
    Secondary efficacy measures:
    YGTSS, total score; TTS of the YGTSS; CGI-I responder rate; CGI-S; PGI-I responder rate.
    Safety measures:
    Incidence of adverse events, proportion of withdrawals due to adverse events, vital signs, weight, ECG assessments as well as safety laboratory parameters.
    The following additional assessments will be included to further assess the safety of study medication:
    DuPaul ADHD rating scale IV; Child Depression Inventory-Short Version (CDI-S);
    The Child Behavior Checklist (CBCL) for 6-18 year olds; The Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS); Tanner Staging; MASC.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Male or female patients ages 6 years-17 years;
    2. Written informed consent provided by the patient’s parent (or legal guardian) and
    assent provided by the patient consistent with ICH/GCP and Local Institutional
    Review Board requirements for children obtained prior to any study procedures being
    performed;
    3. Ability and willingness to comply with study treatment regimen and to attend study
    assessments;
    4. Diagnosed with Tourette’s Disorder as per the below DSM-IV criteria and with a
    score ≥22 on the Total Tic Score (TTS) of the YGTSS at baseline:
    • Both multiple motor and one or more vocal tics have been present at some time
    during the illness, although not necessarily concurrently. (A tic is a sudden, rapid,
    recurrent, non-rhythmic, stereotyped motor movement or vocalization.)
    • The tics occur many times a day (usually in bouts) nearly every day or
    intermittently throughout a period of more than 1 year, and during this period
    there was never a tic-free period of more than 3 consecutive months
    • The onset is before age 18 years
    • The disturbance is not due to the direct physiological effects of a substance (e.g.,
    stimulants) or a general medical condition (e.g., Huntington’s disease or post-viral
    encephalitis)
    • The disturbance causes marked distress or significant impairment in social,
    occupational, or other important areas of functioning
    5. Diagnosis of Tourette’s Disorder when administering the Diagnostic Interview
    Schedule for Children (DISC-IV);
    6. Women of childbearing potential must have a negative serum Beta-HCG pregnancy
    test at the Screening (Baseline) visit unless surgically sterile;
    7. Either a de novo patient (not on current treatment for TS), or a patient who has been diagnosed with TS, but who the investigator feels, has not been adequately managed using current therapy, or has failed current therapy, whereby the patient may benefit in the use of pramipexole and, if on current therapy, can be safely discontinued from such therapy prior to enrollment into this study;
    8. Women of childbearing potential must be using a medically accepted contraceptive
    method. Acceptable methods of birth control are limited to: Intra-Uterine Device
    (IUD), oral, implantable, injectable contraceptives and estrogen patch, double barrier
    method (spermacide + diaphragm), or abstinence at the discretion of the investigator;
    9. Having a body weight ≥20 kg.
    E.4Principal exclusion criteria
    1. Any women of childbearing potential having a positive serum pregnancy test at
    screening;
    2. Clinically significant renal disease or serum creatinine out of this range: 0.3-1.0 mg/dL for patients aged 6-12 years and 0.5-1.4 mg/dL for patients aged 13+ years;
    3. Any of the following lab results at screening:
    ▪ Hemoglobin (Hgb) below lower limit of normal (LLN) which is determined to be
    clinically significant.
    ▪ Basal thyroid stimulating hormone (TSH), triiodothyronine (T3) or thyroxine (T4)
    clinically significantly (at the investigator’s discretion) out of normal range at
    screening (if not caused by substitution therapy according the investigator’s
    opinion).
    ▪ Patients with any clinically significant abnormalities in laboratory parameters at
    screening at the investigator’s discretion.
    4. Other clinically significant metabolic-endocrine, hematological, gastrointestinal
    disease, pulmonary disease (such as severe asthma) in the opinion of the investigator which would preclude the patient from participating in this study;
    5. History of schizophrenia or any psychotic disorder, history of mental disorders or any present Axis I psychiatric disorder according DSM IV (using the DISC-IV assessment interview) requiring any medical therapy except for TS, except for patients with a diagnosis of ADHD or OCD who are not on therapy;
    6. History of/or clinical signs of epilepsy or seizures other than fever related seizures in early childhood;
    7. History of/or clinical signs of any malignant neoplasm including suspicious
    undiagnosed skin lesion (which may be melanoma), melanoma, or a history of
    melanoma;
    8. Any other conditions that in the opinion of the investigator would interfere with the evaluation of the results or constitute a health hazard for the patient;
    9. Allergic response to pramipexole or the inactive ingredients in its tablet formulation;
    10. Had previous treatment with dopamine agonists other than pramipexole within
    14 days prior to baseline visit;
    11. Had any other medical treatment for TS besides the study medication within 28 days prior to baseline visit (14 days for guanfacine and clonidine; 14 days for dopamine agonists; 14 days for L-Dopa);
    12. Had withdrawal symptoms of any medication at screening or at the baseline visit;
    13. Having a K BIT2 IQ score <70 at screening;
    14. Having a CY-BOCS score >15 at baseline;
    15. Patients who meet criteria for Restless Legs Syndrome and/or Periodic Limb
    Movement disorder;
    16. Patients with a history of severe asthma or pulmonary complications. Patients with asthma that is well-controlled are not excluded;
    17. Patients that have initiated psychotherapy for Tourette Syndrome, OCD or ADHD
    within 3 months prior to starting the trial;
    18. Patients receiving psychological, cognitive and/or behavioral treatments greater than 3 months prior to starting the trial for Tourette Syndrome, OCD and/ or ADHD
    symptoms who will have changes in their treatment plan or treatment course during
    the trial as well as those patients who will require the initiation of such treatments
    during the trial.
    19. Concurrent participation in another clinical trial or any investigational therapy within thirty days prior to start of this study.
    E.5 End points
    E.5.1Primary end point(s)
    Change from baseline of the TTS of the YGTSS after 6 weeks of treatment.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other 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.8.4.1Number of sites anticipated in Member State concerned2
    E.8.5The trial involves multiple Member States No
    E.8.5.1Number of sites anticipated in the EEA2
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    E.8.7Trial 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
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years0
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years0
    E.8.9.2In all countries concerned by the trial months15
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) Yes
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.2Adults (18-64 years) No
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state10
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 10
    F.4.2.2In the whole clinical trial 54
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    expected normal treatment
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2008-11-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2008-11-10
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2009-06-23
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