E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Active systemic manifestations of Systemic Juvenile Idiopathic Arthritis (SJIA) |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Musculoskeletal Diseases [C05] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10059176 |
E.1.2 | Term | Juvenile idiopathic arthritis |
E.1.2 | System Organ Class | 100000004859 |
|
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
•To assess the long-term safety, tolerability, and immunogenicity of
canakinumab
•To assess efficacy at an exploratory level by investigating disease
control defined by maintenance of at least an adapted ACR pediatric 30
during the extension PHASE
•To perform biomarker analyses to explore the characteristics of
response to canakinumab
treatment
•To introduce Juvenile Arthritis Disease Activity Score (JADAS) and
Disease Activity Score
(DAS) as exploratory assessments of efficacy
•To assess efficacy of canakinumab treatment based on adapted
pediatric ACR30 criteria in
patients who report previous Anakinra, tocilizumab or other biologic
treatment |
|
E.2.2 | Secondary objectives of the trial | |
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Parent's or legal guardian's written informed consent and child's
assent, if appropriate, or patient's informed consent for ≥ 18 years of
age before any study related activity is performed.
2.The following patients are eligible to participate in the open label
extension study (CACZ885G2301E1):
• Patients from study CACZ885G2305 or CACZ885G2301 who achieved
an adapted ACR pediatric 30 response 15 days after their initial dose of
canakinumab but clinically deteriorated AS DEFINED BY a minimum ACR
Pediatric 30 response not BEING maintained after Day 15 and
intervention is deemed necessary by the investigator.
• Patients in study CACZ885G2301 who are not eligible to enter Part II
(withdrawal part) because they were not able to meet the corticosteroid
entry criteria of 0.5 mg/kg oral prednisone (or equivalent) or were not
able to taper their steroids by at least 0.3 mg/kg (please refer to
CACZ885G2301 protocol for detailed rules)
• Responder patients in Part I or Part II who were maintaining their
minimum ACR pediatric 30 response or had not flared when
CACZ885G2301 was stopped.
• CACZ885G2301 patients who were responders in Part I (achieved and
maintained a minimum adapted ACR pediatric 30) but experienced a
flare in Part II.
• Treatment-naïve patients need to meet the following criteria:
- Confirmed diagnosis of Systemic Juvenile Idiopathic Arthritis as per
ILAR definition that must have occured at least 2 months prior to
enrollment with onset of disease < 16 years of age
- Male and female patients aged ≥ 2 TO < 20 years of age
- Active disease at the time of enrollment defined as having 2 or more of
the following:documented spiking, intermittent fever (body temperature
>38°C) for at least 1 day during the screening period and within 1 week
before first canakinumab dose; at least 2 joints with active arthritis; Creactive
protein (CRP) > 30 mg/l (normal range < 10 MG/L); rash;
serositis; lymphadenopathy and hepatosplenomegaly
- Naïve to canakinumab
OTHER PROTOCOL-DEFINED INCLUSION CRITERIA MAY APPLY |
|
E.4 | Principal exclusion criteria |
1. Pregnant or nursing (lactating) female patients
2. Female patients having reached sexual maturity UNLESS they are:
• female patients whose career, lifestyle, or sexual orientation precludes
intercourse with a male partner and/or
• using an acceptable method of contraception with a failure rate (Pearl
Index (PI)) < 1.
Reliable contraception should be maintained throughout the study and
for 3 months after study drug discontinuation.
3. History hypersensitivity to study drug or to biologics.
4. With active or recurrent bacterial, fungal or viral infection at the time
of enrollment
5. Risk factors for tuberculosis (TB)
6. With underlying metabolic, renal, hepatic, infectious or
gastrointestinal conditions which in the opinion of the investigator
immunocompromises the patient and/ or places the patient at
unacceptable risk for participation in an immunodulatory therapy. In
particular, clinical evidence or history of multiple sclerosis or other
demyelinating diseases, or Felty's syndrome
7. With neutropenia (absolute neutrophil count <1500/mm3) at
screening
8. With significant medical conditions, which in the opinion of the
Investigator will exclude the patient from the study (can be discussed on
a case by case basis with Novartis)
9. History of malignancy of any organ system (other than localized basal
cell carcinoma of the skin), treated or untreated, within the past 5 years,
regardless of whether there is evidence of local recurrence or
metastases
10. Live vaccinations within 3 months prior to the start of the study.
Killed or inactivated vaccines may be permitted according to the
investigator's discretion.
11. Donation or loss of blood (amount depending on age and weight, 10-
20% or more of volume, see Appendix 3 within 8 weeks prior to first
dosing, or longer if required by local regulation.
12. Familial and social conditions rendering regular medical assessment
not possible
13. History of drug or alcohol abuse within the 12 months prior to
dosing.
No additional exclusions may be applied by the investigator, in order to
ensure that the study population will be representative of all eligible
patients.
OTHER PROTOCOL-DEFINED INCLUSION/EXCLUSION CRITERIA MAY
APPLY. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
- Long-term safety, tolerability, and immunogenicity of canakinumab
- Disease control by maintenance of at least an adapted ACR pediatric 30
- Assess efficacy of canakinumab treatment based based on adapted ACR
Paediatric 30 criteria in patients who report previous anakinra,
tocilizumab or other biologic treatment |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
1) The number of patients that were able to taper steroid as per
protocol.
2) The number of patients who reached steroid free regimen
3) The number of patients who were able to reduce the canakinumab
dose to 2 mg/kg/4 week
4) The percentage of patients who will meet the definition of inactive
disease on medication and possible clinical remission on medication |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
tolerability and immunogenicity |
|
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 | No |
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 | 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.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 48 |
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 | No |
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 |
Argentina |
Austria |
Belgium |
Brazil |
Canada |
France |
Germany |
Greece |
Hungary |
Israel |
Italy |
Netherlands |
Peru |
Poland |
Russian Federation |
Spain |
Sweden |
Switzerland |
Turkey |
United Kingdom |
United States |
|
E.8.7 | Trial has a data monitoring committee | Yes |
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.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | |
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 | 9 |