E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Clinically diagnosed distal subungual onychomycosis of the toenails caused by dermatophytes confirmed by positive mycology (culture and potassium hydroxide [KOH] visualization) (tinea unguium). |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10030338 |
E.1.2 | Term | Onychomycosis |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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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 |
To compare complete cure rates for onychomycosis at Week 52 for TDT 067 versus non-Transfersome® placebo. If the comparison between TDT 067 and non-Transfersome® placebo is statistically significant in favor of TDT 067 (at a 2-sided P<0.05), the following secondary objective will become an additional primary efficacy objective: To compare complete cure rates for onychomycosis at Week 52 for TDT 067 versus Transfersome® vehicle. |
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E.2.2 | Secondary objectives of the trial |
To compare complete cure rates for onychomycosis at Weeks 48 and 60 for TDT 067 versus non-Transfersome® placebo and Transfersome® vehicle To compare effective treatment rates at Weeks 48 52, and 60 for TDT 067 versus non-Transfersome® placebo and Transfersome® vehicle To compare mycological cure rates at Weeks 48, 52, and 60 for TDT 067 versus non-Transfersome® placebo and Transfersome® vehicle To compare complete cure rates at Weeks 48, 52, and 60, effective treatment rates at Weeks 48, 52, and 60, and mycological cure rates at Weeks 48, 52, and 60 for Transfersome® vehicle versus non-Transfersome® placebo |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patients must meet all of the following inclusion criteria to be eligible for enrollment into the study: 1. Patients must be between 18 and 75 years of age inclusive, of any race, and of either sex. Female patients must be either surgically sterile, postmenopausal (no menses for the previous 12 months), or must be practicing a highly effective method of birth control and must agree to continue to use this method of birth control while participating in the study. A highly effective method of birth control is defined as one which results in a low failure rate (i.e. <1% per year) when used consistently and correctly. Acceptable methods of birth control are oral, injectable, or implanted hormonal contraceptive, intrauterine device, and diaphragm with spermicide. 2. Patients must have at least 1 great toenail (target toenail) with clinically diagnosed distal subungual onychomycosis involving between 25% and 65%, inclusive, of the nail and confirmed by KOH visualization and fungal culture positive for dermatophytes. (Patients with culture positive for dermatophytes alone or dermatophytes and non-dermatophytes are eligible to participate.) If both great toenails meet inclusion criteria, the one with the greater involvement will be designated the target nail. 3. Patients must be able to understand the requirements of the study, abide by the restrictions, and return for all of the required examinations. 4. Patients must be willing to sign a statement of informed consent. 5. Patients must have a target great toenail with the capability to grow as determined by history of nail cutting. 6. Patients must be willing to refrain from using any nail polish products and other nail cosmetic products on any of the toenails and must be willing to refrain from professional pedicures for the duration of this study (from screening visit until follow-up Week 60).
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E.4 | Principal exclusion criteria |
Patients with any of the following exclusion criteria will not be eligible for enrollment into the study: 1. Patients who have been treated with an investigational drug within 1 month prior to Screening. 2. Patients who are pregnant or planning to become pregnant or who are lactating. 3. Patients with hypersensitivity to terbinafine or to any other ingredients of the formulation. 4. Patients who are unable to spray their toenails and the surrounding tissues on the affected foot without assistance. 5. Patients with symptomatic tinea pedis requiring treatment. 6. Patients using oral terbinafine within 6 months prior to Screening; patients who have received other oral antifungals within 3 months. 7. Patients using topical antifungal treatments for onychomycosis within 1 month prior to Screening; patients using topical antifungal treatments for the feet within 1 month prior to Screening. 8. Patients with any nail dystrophy that will interfere with the assessment of a clear nail. Patients who have toenail abnormalities or dystrophies that could prevent the restoration of a normal appearing nail in spite of a mycological cure, including patients with psoriasis, lichen planus, malignancy or pigmentation disorders involving the nail unit, chemical damage, or onychodystrophy due to trauma or other structural deformities. 9. Patients with superficial white or proximal subungual onychomycosis. 10. Patients with a toenail infection involving a non-dermatophyte alone. 11. Patients with involvement of the matrix (lunula) or the proximal 2 mm of nail as measured from the proximal nail fold. 12. Patients who have a nail plate with thickness greater than 2 mm or total thickness of the nail plus subungual debris measuring greater than 3 mm. 13. Patients with yellow streaks or dermatophytoma of the target toenail. 14. Patients with a history of peripheral arterial disease or diabetes mellitus. 15. Patients with any condition that in the opinion of the Investigator renders the patient unsuitable for participation in this study. 16. Patients with alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels greater than 2 times the upper limit of normal without clinical reason, unless, in the opinion of the Investigator, participation in this study would not place the patient at undue risk. 17. Patients with a reported history of immunodeficiency and patients with a reported history of cutaneous or systemic lupus erythematosus.
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E.5 End points |
E.5.1 | Primary end point(s) |
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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 | Yes |
E.6.6 | Pharmacokinetic | Yes |
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 | 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 | Yes |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
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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.8.4.1 | Number of sites anticipated in Member State concerned | 8 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 12 |
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 |
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E.8.7 | Trial has a data monitoring committee | No |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | 18 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 18 |