E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Multiple Sclerosis patients who have participated in cladribine tablets clinical trials |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10028245 |
E.1.2 | Term | Multiple sclerosis |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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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 |
The main purpose of the registry is to collect long-term safety data on oral cladribine in subjects with MS and to estimate the frequency of serious adverse drug reactions (SADR) over a period of time, extending beyond cladribine exposure, in a population of subjects who have been exposed to oral cladribine. Subjects participating in selected Sponsor cladribine clinical trials in MS or in corresponding cladribine extension studies will be eligible for enrollment. The focus will be on SADR (which include malignancies and serious infections), AEs in the ‘Blood and Lymphatic System Disorders’ and ‘Neoplasms Benign, Malignant, and Unspecified’ System Organ Classes (SOCs), pregnancies among exposed women and pregnancy outcomes, including congenital anomalies or other important health conditions in the offspring. Resolution of persistent lymphopenia will also be assessed among subjects with persistent lymphopenia. |
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E.2.2 | Secondary objectives of the trial |
• To quantify and characterize the risk (cumulative incidence) of SADR, including malignancies and serious infections • To assess time to resolution of lymphopenia among registry participants with persistent lymphopenia; • To quantify and characterize the risk (cumulative incidence) of AE in the ‘Blood and Lymphatic System Disorders’ and ‘Neoplasms Benign, Malignant, and Unspecified’ System Organ Classes (SOCs).
Secondary Objective • To assess pregnancy outcomes, including congenital malformations or other important health conditions in the offspring born to women exposed to oral cladribine. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
The registry target population includes all subjects who participated in Sponsor oral cladribine phase I to III clinical trials in MS associated with a protocol approved prior to the time of submission of the marketing application and completed (last patient, last visit) after November 2008.
All subjects in the target population described in section 5.1 will be eligible for enrollment in the registry once their participation in the clinical trial has ended. The following inclusion criteria must be fulfilled: • Prior enrollment into selected clinical trials, regardless of randomization to either IMP or placebo, once participation in the clinical trial or in the clinical trial extension has ended • Written informed consent is given. |
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E.4 | Principal exclusion criteria |
The following reasons will exclude subjects from registry participation: • Subjects who cannot be reached by phone; • Subjects who are unable to answer the registry questionnaires and who do not have a next of kin or caregiver available to answer the registry questionnaires; • Subjects who – either during the lag interval or subsequently – enter an interventional study. |
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E.5 End points |
E.5.1 | Primary end point(s) |
• Cumulative incidence of serious adverse drug reactions (SADR), including malignancies and serious infections • Time to resolution of lymphopenia, among registry participants with persistent lymphopenia • Cumulative incidence of AE in the ‘Blood and Lymphatic System Disorders’ and ‘Neoplasms Benign, Malignant, and Unspecified’ System Organ Classes (SOCs). |
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E.5.2 | Secondary end point(s) |
• Pregnancy outcomes, including congenital malformations, spontaneous abortion, elective abortion, stillbirth, ectopic pregnancy, molar pregnancy, and other important health conditions in the offspring. |
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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 | Yes |
E.6.5 | Efficacy | No |
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 | Yes |
E.6.13.1 | Other scope of the trial description |
Prospective observational safety registry with no IMP administration |
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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 | No |
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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Information not present in EudraCT |
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 | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 130 |
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 |
Australia |
Austria |
Belgium |
Bosnia and Herzegovina |
Brazil |
Bulgaria |
Canada |
Croatia |
Czech Republic |
Denmark |
Estonia |
Finland |
France |
Georgia |
Germany |
Greece |
India |
Italy |
Korea, Republic of |
Latvia |
Lebanon |
Lithuania |
Macedonia, the former Yugoslav Republic of |
Morocco |
Netherlands |
Norway |
Poland |
Portugal |
Romania |
Russian Federation |
Saudi Arabia |
Serbia |
Singapore |
Spain |
Sweden |
Switzerland |
Taiwan |
Thailand |
Tunisia |
Turkey |
Ukraine |
United Arab Emirates |
United Kingdom |
United States |
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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
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The duration of follow-up for all subjects will extend up to the end of the registry, which is planned for 2018, or 8 years after enrollment into the first cladribine clinical trial (first visit), whichever occurs first. |
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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 | 7 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 8 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |