E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Severe asthma with oral streroids need |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10003553 |
E.1.2 | Term | Asthma |
E.1.2 | System Organ Class | 10038738 - Respiratory, thoracic and mediastinal 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 study objective is to compare the efficacy and the safety of masitinib at 6 mg/kg/day versus placebo in the treatment of patients with Severe Asthma uncontrolled with oral corticosteroids Primary endpoint: • Severe Asthma exacerbation rate adjusted on the available person-time (time to end of treatment) on full exposure (main period + extension/weaning period).
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E.2.2 | Secondary objectives of the trial |
• Overall asthma exacerbation rate (severe and moderate exacerbations) adjusted on the available person-time (time to end of treatment) on full exposure (main period + extension/weaning period). • Asthma Control Questionnaire (ACQ) Score at 12, 20, 28 and 36 weeks • Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), Forced Expiratory Flow between 25-75% of FVC (FEF25-75) at 12, 20, 28 and 36 weeks • Moderate and severe asthma exacerbation rate at 12, 20, 28 and 36 weeks • Severe asthma exacerbation rate at 12, 20, 28 and 36 weeks • Time to first asthma exacerbation (severe or moderate) • Percentage of patient experiencing at least one exacerbation at 12, 20, 28 and 36 weeks • Asthma symptom score at all time points • Morning and evening Peak Expiratory Flow Rate (PEFR) at 12, 20, 28 and 36 weeks • Use of rescue medication for asthma at 12, 20, 28 and 36 weeks • Quality of Life assessment: AQLQ score at each visit at 12, 20, 28 and 36 weeks
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Patient with Severe Asthma and already treated with oral corticosteroids at a minimal daily dose of 7.5 mg prednisone or equivalent for at least 3 months prior to screening visit 2. Patient treated during at least one period of 21 days with oral corticosteroids from one year prior to screening to 3 months before screening. 3. Patient with history of asthma ≥ 1 year prior to screening visit who also meet the following criteria: o baseline FEV1 35 to < 80% of the predicted normal value, demonstrated at least 6 hours after short-acting -2-agonist or 12 hours after long-acting -2-agonist o at least 2 asthma exacerbations within one year prior to screening visit including one severe asthma exacerbation as per protocol definition o uncontrolled asthma as defined as two or more of the following features within the week prior to screening visit (ACQ items)
Daytime symptoms More than twice/week Limitations of activities symptoms Any Nocturnal symptoms/awakening Any Need for reliever/rescue treatment More than twice/week
4. Patient with no significant change in the regular asthma medication, no severe asthma exacerbation for at least 4 weeks prior to screening visit 5. Non-smoker patient for at least one year and with a prior tobacco consumption < 10 packs/year 6. Patient with normal organ function defined as: • Absolute neutrophil count (ANC) ≥ 2.0 x 109/L • Haemoglobin ≥ 10 g/dL • Platelets (PTL) ≥ 100 x 109/L • AST and ALT ≤ 3 x ULN • Bilirubin ≤ 1.5x ULN • Creatinine clearance ≥ 60 mL/min (Cockcroft and Gault formula) • Albumin > 1 x LLN • Proteinuria < 30 mg/dL (1+) on the dipstick. In case of proteinuria ≥ 30 mg/dL, 24 hours proteinuria must be < 1.5 g/24 hours 7. Male or female patient aged 18 to 75 years 8. Patient weight > 50 kg and Body Mass Index (BMI) between 18 and 35 kg/m² 9. Female patient of childbearing potential (entering the study after a menstrual period and who has a negative pregnancy test), who agrees to use a highly effective method of contraception and an acceptable method of contraception by her male partner during the study and for 3 months after the last treatment intake.
• Male patient with a female partner of childbearing potential who agrees to use a highly effective method of contraception and an acceptable method of contraception by his female partner during the study and for 3 months after the last treatment intake OR who agrees to use an acceptable method of contraception and a highly effective method of contraception by his female partner during the study and for 3 months after the last treatment intake.
• Highly effective methods of contraception include: 1) Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation: oral, intravaginal, or transdermal 2) Progestogen-only hormonal contraception associated with inhibition of ovulation: oral, injectable, or implantable 4) Intrauterine device (IUD) 3) Intrauterine hormone-releasing system (IUS) 4) Bilateral tubal occlusion 5) Vasectomized male (azoospermia assessed medically) 6) Sexual abstinence (Its reliability should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient)
Acceptable methods of contraception include: 1) Progestogen-only oral hormonal contraception, where inhibition of ovulation is not the primary mode of action 2) Male or female condom with or without spermicide 10. 3) Cap, diaphragm or sponge with spermicidePatient able and willing to comply with study procedures as per protocol 11. Patient able to understand the patient card and to follow the patient card procedures in case of signs or symptoms of severe neutropenia or severe skin toxicity. 12. Patient able to understand, sign, and date the written informed consent form at screening visit prior to any protocol-specific procedures
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E.4 | Principal exclusion criteria |
1. Female patient who is pregnant or lactating 2. Asthmatic patient still exposed to allergens or to triggering factors influencing asthma control 3. Patient with history of acute infectious sinusitis or respiratory tract infection within 4 weeks prior to screening visit 4. Patient presenting with cardiac disorders defined by at least one of the following conditions will be excluded: a. Patient with recent cardiac history (within 6 months) of: i. Acute coronary syndrome ii. Acute heart failure (class III or IV of the NYHA classification) iii. Significant ventricular arrhythmia (persistent ventricular tachycardia, ventricular fibrillation, resuscitated sudden death) b. Patient with cardiac failure class III or IV of the NYHA classification c. Patient with severe conduction disorders which are not prevented by permanent pacing (atrio-ventricular block 2 and 3, sino-atrial block) d. Syncope without known aetiology within 3 months e. Uncontrolled severe hypertension, according to the judgment of the investigator, or symptomatic hypertension 5. Patient with active lung disease other than asthma (e.g. chronic bronchitis) 6. Patient who had a major surgery within 2 weeks prior to screening visit 7. Patient with life expectancy < 6 months 8. Patient with history of primary malignancy < 5 years, except treated basal cell skin cancer or cervical carcinoma in situ 9. Patient with any severe and/or uncontrolled medical condition 10. Patient with a known diagnosis of human immunodeficiency virus (HIV) infection 11. Patient with history of poor compliance or history of drug/alcohol abuse, or excessive alcohol beverage consumption that would interfere with the ability to comply with the study protocol, or current or past psychiatric disease that might interfere with the ability to comply with the study protocol or give informed consent 12. Patient with inadequate wash-out time at the screening visit: Wash-out time for prohibited concomitant asthma medications: Treatment with the following non-steroidal controllers has to be stopped about 24 h prior to screening visit: sustained-release theophylline, leukotriene antagonists, lipoxygenase inhibitors, inhaled anticholinergics, oral beta2-agonists, inhaled disodium cromoglycate, inhaled nedocromil. Wash-out time for allowed concomitant asthma medications • Long acting Beta agonists (12h prior to screening visit) • Short acting agonists (6h prior to screening visit) 13. Patient treated with prohibited medications
RANDOMISATION CRITERIA (to be checked at W0): 1. Good study treatment (i.e. placebo) compliance (≥80%) during the 2-week run-in period 2. Daily mean symptom score ≥ 2 during the 2-week run in period 3. No asthma exacerbation (moderate or severe) during the 2-week run in period
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E.5 End points |
E.5.1 | Primary end point(s) |
Severe Asthma exacerbation rate |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Adjusted on the available person-time (time to end of treatment) on full exposure (main period + extension/weaning period). |
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E.5.2 | Secondary end point(s) |
• Overall asthma exacerbation rate (severe and moderate exacerbations) adjusted on the available person-time (time to end of treatment) on full exposure (main period + extension/weaning period). • Asthma Control Questionnaire (ACQ) Score at 12, 20, 28 and 36 weeks • Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), Forced Expiratory Flow between 25-75% of FVC (FEF25-75) at 12, 20, 28 and 36 weeks • Moderate and severe asthma exacerbation rate at 12, 20, 28 and 36 weeks • Severe asthma exacerbation rate at 12, 20, 28 and 36 weeks • Time to first asthma exacerbation (severe or moderate) • Percentage of patient experiencing at least one exacerbation at 12, 20, 28 and 36 weeks • Asthma symptom score at all time points • Morning and evening Peak Expiratory Flow Rate (PEFR) at 12, 20, 28 and 36 weeks • Use of rescue medication for asthma at 12, 20, 28 and 36 weeks • Quality of Life assessment: AQLQ score at each visit at 12, 20, 28 and 36 weeks
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
• Overall asthma exacerbation rate (severe and moderate exacerbations) adjusted on the available person-time (time to end of treatment) on full exposure (main period + extension/weaning period). • Other end points at 12, 20, 28 and 36 weeks
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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 | 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 | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 100 |
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 |
Bulgaria |
Czech Republic |
Germany |
India |
Morocco |
Poland |
Romania |
Slovakia |
South Africa |
Spain |
Tunisia |
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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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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 | 6 |
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 | 6 |