E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Autoimmune Addison's disease |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10001343 |
E.1.2 | Term | Adrenal cortical hypofunction |
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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 |
We wish to find out whether repeated stimulation of adrenocortical stem cells with synacthen (synthetic ACTH peptide) can regenerate adrenal function in established autoimmune Addison's disease (adrenal failure). This might be possible because stem cells are probably not destroyed by the autoimmune attack in Addison's disease, they likely remain dormant because ACTH levels drop following treatment with replacement steroids. |
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E.2.2 | Secondary objectives of the trial |
Is this a safe regimen of treatment |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Subjects between 16 and 65 years of age - Adrenocortical failure, as judged by a basal cortisol of less than 100nmol/l or peak ACTH-stimulated cortisol response of less than 300nmol/l that was established a minimum of 1 year previously and persists at run-in assessments - Elevation of ACTH at diagnosis or during testing in the run-in phase of the study - Positive adrenal antibodies at baseline or recorded during illness - Normal or atrophic adrenal glands on CT scan - Willingness to travel to Newcastle CRF for study - Willingness to attend education sessions about indications for parenteral glucocorticoid administration and technique of administration - Female participants of child-bearing age will be willing to take acceptable contraception during study, and for 3 months following last synacthen dose
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E.4 | Principal exclusion criteria |
- Significant cardio-respiratory, chronic renal or non-autoimmune liver disease; malignancy - Pregnancy, breast feeding or plan for pregnancy within 9 months - Known non-autoimmune cause for adrenal failure (haemorrhage, adrenoleukodystrophy etc.) - Known hypersensitivity or allergy to Synacthen, synacthen depot or zinc salts |
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E.5 End points |
E.5.1 | Primary end point(s) |
• Restoration of adrenocortical synthetic function, as judged by either: basal cortisol >400nmol/l (rise in 300nmol/l over pre-treatment), or synacthen-stimulated cortisol >550nmol/l (rise in 250nmol/l over pre-treatment) at 30 or 60 min after iv synacthen 250μg. |
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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 | Yes |
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) | Information not present in EudraCT |
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) | Information not present in EudraCT |
E.7.3 | Therapeutic confirmatory (Phase III) | Information not present in EudraCT |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | Information not present in EudraCT |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
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
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
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 | 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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Last participant, last visit |
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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 |