E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
ANEMIE EMOLITICHE AUTOIMMUNI IDIOPATICHE |
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MedDRA Classification |
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 evaluate the activity (in terms of overall clinical response, complete response and partial response) of low-dose (LD) rituximab associated with standard oral prednisone as first line therapy in newly diagnosed idiopathic autoimmune hemolytic anemia (AIHA), and as second line therapy in AIHA relapsed after standard oral prednisone To evaluate the efficacy (in terms of overall clinical response, complete response and partial response) of LD rituximab as first line therapy in newly diagnosed idiopathic cold hemagglutinin disease (CHD), alone or in association with oral prednisone, in the judgment of the doctor. |
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E.2.2 | Secondary objectives of the trial |
To assess the duration of the response (sustained response) To evaluate the response according to the type of the hemolytic anemia (warm or cold) In relapsed patients, to compare the amount of past steroid therapy with the steroid administration associated with LD rituximab To correlate the clinical response with biological parameters [direct antiglobulin test (DAT) and mitogen stimulated-DAT positivity, in vitro cytokine production, T-lymphocyte activation markers, B-lymphocyte oligoclonality, FCgRIII polymorphism] |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Newly diagnosed warm or cold AIHA, defined by symptomatic anemia and positive DAT, in the absence of underlying lymphoproliferative, infectious or neoplastic disease (according to the single Center diagnostic criteria). Idiopathic warm or cold AIHA relapsed after first line treatment with oral prednisone. Aged >18 years ECOG performance status grade 0, 1 or 2 No psychiatric illness that precludes understanding concepts of the trial or signing informed consent Patients who have provided written informed consent prior to study participation, with the understanding that the consent may be withdrawn by the patient at any time without prejudice |
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E.4 | Principal exclusion criteria |
Cell or humoral immunologic deficit (congenital or acquired) Any other co-existing medical or psychological condition that would preclude participation in the study or compromise ability to give informed consent Active bacterial, viral, or fungal infection requiring systemic therapy HIV or HbsAg positive (with HBV-DNA+) or HCV-Ab positive (with HCV-RNA+) patients History of malignancies within 3 years prior to study entry Concomitant immunosuppressive or cytotoxic treatment Positive pregnancy test, lactation The presence of associated organ-specific autoimmune diseases do not constitute exclusion criteria. Previous splenectomy does not constitute exclusion criteria |
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E.5 End points |
E.5.1 | Primary end point(s) |
To evaluate the activity (in terms of overall clinical response, complete response and partial response) of low-dose (LD) rituximab associated with standard oral prednisone as first line therapy in newly diagnosed idiopathic autoimmune hemolytic anemia (AIHA), and as second line therapy in AIHA relapsed after standard oral prednisone To evaluate the efficacy (in terms of overall clinical response, complete response and partial response) of LD rituximab as first line therapy in newly diagnosed idiopathic cold hemagglutinin disease (CHD), alone or in association with oral prednisone, in the judgment of the doctor. |
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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 | No |
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 | No |
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 | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
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 | 4 |
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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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 | |
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 |