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    Summary
    EudraCT Number:2009-011593-15
    Sponsor's Protocol Code Number:WA19977
    National Competent Authority:Netherlands - Competent Authority
    Clinical Trial Type:EEA CTA
    Trial Status:Not Authorised
    Date on which this record was first entered in the EudraCT database:2009-09-30
    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 ConcernedNetherlands - Competent Authority
    A.2EudraCT number2009-011593-15
    A.3Full title of the trial
    A 24 week randomized double-blind, placebo controlled withdrawal trial with a 16 week open label lead-in phase, and 64 week open label follow-up, to evaluate the efficacy and safety of tocilizumab in patients with active polyarticular-course juvenile idiopathic arthritis
    A.4.1Sponsor's protocol code numberWA19977
    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 SponsorF. Hoffmann-La Roche Ltd
    B.1.3.4CountrySwitzerland
    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 Yes
    D.2.1.1.1Trade name RoActemra
    D.2.1.1.2Name of the Marketing Authorisation holderRoche Registration Limited, UK
    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.3.2Product code Ro 487-7533/F01
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation Information not present in EudraCT
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTocilizumab
    D.3.9.1CAS number 375823-41-9
    D.3.9.2Current sponsor codeRO4877533
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    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 Yes
    D.3.11.13.1Other medicinal product typeIL-6 receptor inhibitor, humanized monoclonal antibody
    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 placeboConcentrate for solution for infusion
    D.8.4Route of administration of the placeboIntravenous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    polyarticular-course juvenile idiopathic arthritis
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 9.1
    E.1.2Level LLT
    E.1.2Classification code 10059176
    E.1.2Term Juvenile idiopathic arthritis
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Primary Objective (from Part II)
    To compare the proportion of patients on tocilizumab versus placebo who develop a JIA ACR30 flare (compared to week 16) by week 40.
    E.2.2Secondary objectives of the trial
    • To evaluate the efficacy of open-label tocilizumab therapy (Part I),
    • To evaluate the long-term effect of tocilizumab on the maintenance of clinical response and safety in patients with pcJIA (Part III)
    • To evaluate the efficacy and safety of 8 mg/kg vs 10 mg/kg in patients < 30 kg (Parts I, II and III)
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Documented evidence of polyarticular-course juvenile idiopathic arthritis (pcJIA):
    • Rheumatoid Factor Positive or Rheumatoid Factor Negative JIA polyarthritis subset (pJIA) for at least 6 months -or -
    • extended oligoarticular JIA (eoJIA) with active polyarticular course for at least 6 months
    prior to study entry according to ILAR Criteria
    2. Polyarticular-course JIA requiring presence of active disease with at least five joints with active arthritis (joints that are swollen or if no swelling is present limitation of movement accompanied by pain tenderness or both) at both screening and baseline (with a least three of the active joints having limitation of motion).
    3. Age 2 years up to and including age 17 years at the time of enrollment
    4. Must meet one of the following:
    • Have had an inadequate response to MTX or
    • Inability to tolerate MTX
    5. Must meet one of the following:
    • not receiving MTX for at least 4 weeks prior to baseline visit, -or-
    • taking MTX for at least 12 weeks immediately prior to the baseline visit and on a stable dose of ≥10 to ≤20 mg/m2 for at least 8 weeks prior to the baseline visit, together with either folic acid or folinic acid.
    6. Must meet one of the following:
    • Not currently receiving oral corticosteroids –or-
    • taking oral corticosteroids at a stable dose for a minimum of 4 weeks prior to the baseline visit at no more than 10 mg/day or 0.2 mg/kg/day whichever is less;
    8. Must meet one of the following:
    • Not taking NSAIDs –or-
    • taking no more than 1 type of NSAID at a stable dose for a minimum of 2 weeks prior to the baseline visit and is less than or equal to the maximum recommended daily dose;
    9. Must meet one of the following
    • Never treated with biologics –or-,
    • If previously treated must have discontinued anakinra ≥ 1 week prior to baseline, etanercept ≥ 2 weeks prior to baseline, rilonacept ≥ 5 weeks prior to baseline, infliximab or adalimumab ≥ 8 weeks prior to baseline, abatacept ≥ 12 weeks prior to baseline or canakinumab ≥ 20 weeks prior to baseline.
    E.4Principal exclusion criteria
    1. Wheelchair bound or bedridden or has little or no ability for self-care;
    2. Any other auto-immune, rheumatic disease or overlap syndrome other than the permitted polyarticular-course JIA subsets; Rheumatoid Factor Positive polyarticular JIA, Rheumatoid Factor Negative polyarticular JIA, and extended oligoarticular JIA. The excluded illnesses include but are not limited to systemic juvenile idiopathic arthritis, Lyme disease, enthesitis-related arthritis; psoriatic arthritis, Reiter’s syndrome, systemic lupus erythematosus, infectious or reactive arthritis or parvovirus infections
    3. History of significant allergic or infusion reactions to prior biologic therapy;
    4. Evidence of serious uncontrolled concomitant diseases including but not limited to the cardiovascular, pulmonary, nervous, renal, hepatic or endocrine system
    5. Any active acute, subacute, chronic or recurrent bacterial, mycobacterial, viral or systemic fungal infection or opportunistic infection
    6. Active TB requiring treatment within 2 years prior to screening visit or currently active TB;
    7. Positive PPD at screen unless chest radiograph is negative for active tuberculosis at screen and patient treated with anti-tuberculosis therapy for at least 4 weeks prior to receiving study medication
    8. Any major episode of infection requiring hospitalization or treatment during screening or treatment with IV antibiotics completed within 4 weeks of the screening visit or oral antibiotics completed within 2 weeks of the screening visit;
    9. Known active current or history of recurrent infectious disease, including but not limited to, chronic renal infection, chronic chest infections, (e.g. bronchiectasis, ), an open or draining or infected skin wound, sinusitis, recurrent urinary tract infection ( e.g. recurrent pyelonephritis )
    10. History or concurrent serious gastrointestinal disorders such as ulcer or inflammatory bowel disease, Crohn’s disease, ulcerative colitis or other symptomatic lower gastrointestinal conditions, including ulcer and perforation;
    11. Active uveitis (absence of uveitis must be documented by a slit lamp ophthalmology examination within 12 weeks prior to baseline).
    12. Previous treatment with tocilizumab;
    13. Serum creatinine >1.5 ULN (upper limit of normal for age and sex);
    14. AST or ALT > 1.5 ULN (upper limit of normal for age and sex);
    15. Total bilirubin > 1.3 mg/dL (> 23 umol/L);
    16. Platelet count < 150 x 10e3/µL (< 150,000/mm3);
    17. Hemoglobin < 9.0 g/dL (< 3.7 mmol/L);
    18. WBC count < 5,000/mm3 (< 5.0 x 10e9/L);
    19. Neutrophil count < 2,500/ mm3 (< 2.5 x 10e9/L);

    E.5 End points
    E.5.1Primary end point(s)
    Part II
    Proportion of patients who develop a JIA ACR30 flare (relative to week 16) in the period from week 16 up to and including week 40.
    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 Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Immunogenicity, QoL Assessments
    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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    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 Yes
    E.8.1.7.1Other trial design description
    Part I: lead in period; Part II: randomized double blind; Part III: open-label
    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 Yes
    E.8.5.1Number of sites anticipated in the EEA31
    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 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
    see section 3.5 'End of Study'
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    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 years3
    E.8.9.2In all countries concerned by the trial months6
    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 Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    The study will recruit paediatric patients from 2 years of age. Written Informed Consent for study participation will be obtained from Parent/Guardian plus assent depending on the level of the patient's understanding.
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state3
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 82
    F.4.2.2In the whole clinical trial 185
    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)
    see sections 3.5 'End of Study', 4.1 'Overview' and 5.9 'Post-Study Provisional Care'
    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 Decision2009-11-23
    N.Ethics Committee Opinion of the trial applicationNot-Favourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    Not specified
    N.Date of Ethics Committee Opinion2010-02-09
    P. End of Trial
    P.End of Trial StatusNot Authorised
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