| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated | 
| Erythropoietic Protoporphyria (EPP) |  | 
| 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 | 10015289 |  
| E.1.2 | Term | Erythropoietic protoporphyria |  | 
| 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 determine whether afamelanotide can reduce the severity of phototoxic reactions in patients with EPP. |  | 
| E.2.2 | Secondary objectives of the trial | 
| - To determine whether afamelanotide can reduce the number of phototoxic reactions in patients with EPP - To evaluate the safety and tolerability of afamelanotide by measuring treatment-emergent adverse events (AEs)
 - To determine whether afamelanotide can improve the quality of life of EPP patients
 - To determine the effect of afamelanotide on free protoporphyrin IX levels
 |  | 
| E.2.3 | Trial contains a sub-study | No | 
| E.3 | Principal inclusion criteria | 
| To be eligible to enter the study, patients must meet the following inclusion criteria: - Male or female subjects with a positive diagnosis of EPP (confirmed by elevated free protoporphyrin in peripheral erythrocytes)
 - Aged 18-70 years (inclusive)
 - Provide written Informed Patient Consent prior to the performance of any study-specific procedure.
 
 |  | 
| E.4 | Principal exclusion criteria | 
| To be eligible to enter the study, patients must not meet any of the following exclusion criteria: - Allergy to afamelanotide or the polymer contained in the implant or to lignocaine or other local anaesthetic to be used during the administration of the study medication
 - EPP patients with significant hepatic involvement
 - Personal history of melanoma or dysplastic nevus syndrome.
 - Current Bowen’s disease, basal cell carcinoma, squamous cell carcinoma, or other malignant or premalignant skin lesions.
 - Any other photodermatosis such as PLE, DLE or solar urticaria.
 - Any evidence of clinically significant organ dysfunction or any clinically significant deviation from normal in the clinical or laboratory determinations.
 - Acute history of drug or alcohol abuse (in the last 12 months).
 - Patient assessed as not suitable for the study in the opinion of the Investigator (e.g. noncompliance history, allergic to local anaesthetics, faints when given injections or giving blood).
 - Female who is pregnant (confirmed by positive serum β-HCG pregnancy test prior to baseline) or lactating.
 - Females of child-bearing potential (pre-menopausal, not surgically sterile) not using adequate contraceptive measures (i.e. oral contraceptives, diaphragm plus spermicide, intrauterine device).
 - Sexually active men with partners of child bearing potential not using barrier contraception during the trial and for a period of three months thereafter.
 - Participation in a clinical trial for an investigational agent within 30 days prior to the screening visit.
 - Prior and concomitant therapy with medications which may interfere with the objectives of the study, including drugs that cause photosensitivity or skin pigmentation.
 
 |  | 
| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| -Efficacy Endpoints: Efficacy will be assessed by:
 - Number and severity of phototoxic reactions
 - Quality of life measured with DLQI questionnaire and supplementary EPP specific questions
 - Free protoporphyrin IX in peripheral erythrocytes
 
 Safety and Tolerability Endpoints:
 Treatment-emergent adverse events (coded as MedDRA Preferred Terms).
 Changes in hematology, serum chemistry and urinalysis measurements from Screening to Study Days 60, 120 and 180.
 
 |  | 
| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis | No | 
| E.6.2 | Prophylaxis | Yes | 
| E.6.3 | Therapy | No | 
| 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 | 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 | Yes | 
| 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 | No | 
| E.8.4.1 | Number of sites anticipated in Member State concerned | 1 | 
| E.8.5 | The trial involves multiple Member States | Yes | 
| E.8.5.1 | Number of sites anticipated in the EEA | 6 | 
| 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 |  | 
| 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 |  | 
| E.8.9.1 | In the Member State concerned months | 8 | 
| E.8.9.1 | In the Member State concerned days |  | 
| E.8.9.2 | In all countries concerned by the trial months | 8 |