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    Clinical Trial Results:
    A Randomized Controlled Study of Extracorporeal Photopheresis (ECP) Therapy with UVADEX TM for the Treatment of Patients with Moderate to Severe Chronic Graft-versus-Host Disease (cGvHD).

    Summary
    EudraCT number
    2010-022780-35
    Trial protocol
    GB   DE   AT   ES   IT   HU  
    Global end of trial date
    16 Mar 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    23 Feb 2020
    First version publication date
    23 Feb 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    10-005
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01380535
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Mallinckrodt
    Sponsor organisation address
    1425 U.S. Route 206, Bedminster, NJ, United States, 07921
    Public contact
    Medical Information Call Center, Mallinckrodt, +1 800-556-3314, ClinicalTrials@mnk.com
    Scientific contact
    Medical Information Call Center, Mallinckrodt, +1 800-556-3314, ClinicalTrials@mnk.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    19 May 2015
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    16 Mar 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To compare the efficacy of ECP (Extracorporeal photopheresis) as determined by the incremental improvement in cGvHD (chronic graft-versus-host disease) according to National Institutes of Healt (NIH) Consensus Response Criteria versus a control population.
    Protection of trial subjects
    The trial was conducted under the guidance of ICH E6 - Good Clinical Practices, which has its ethical foundation in the Declaration of Helsinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Nov 2011
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 1
    Country: Number of subjects enrolled
    United Kingdom: 2
    Country: Number of subjects enrolled
    Austria: 6
    Country: Number of subjects enrolled
    France: 10
    Country: Number of subjects enrolled
    Germany: 18
    Country: Number of subjects enrolled
    Hungary: 8
    Country: Number of subjects enrolled
    Italy: 3
    Country: Number of subjects enrolled
    United States: 12
    Worldwide total number of subjects
    60
    EEA total number of subjects
    48
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    56
    From 65 to 84 years
    4
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Patients were enrolled in Austria, France, Germany, Italy, Hungary, Spain, the United Kingdom, and the United States. Enrollment started in November 2011, and the last patient visit occurred in March 2015.

    Pre-assignment
    Screening details
    All participants enrolled were included in the safety analysis set

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Single blind
    Roles blinded
    Assessor [1]
    Blinding implementation details
    It was not possible to blind patient or investigator to the use of a machine, so the outcomes assessor was the single blind.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    ECP Methoxsalen + SoC
    Arm description
    Participants receive ECP methoxsalen in addition to standard of care
    Arm type
    Experimental

    Investigational medicinal product name
    Methoxsalen
    Investigational medicinal product code
    Other name
    UVADEX
    Pharmaceutical forms
    Solution for infusion in administration system
    Routes of administration
    Extracorporeal use
    Dosage and administration details
    UVADEX® (methoxsalen) Sterile Solution is a liquid methoxsalen (8-Methyoxypsoralen) for ex-vivo use in ECP therapy. It was developed to introduce methoxsalen as a liquid into the buffy coat bag during the ECP collection process followed by exposure of the cells to UVA light.

    Investigational medicinal product name
    Standard of Care (SoC)
    Investigational medicinal product code
    Other name
    Commonly oral prednizone with cyclosporine A (CsA) or tacrolimus (Tac)
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Institutional standard of care, which may include oral prednisone, which may be used simultaneously or on an alternate day schedule with cyclosporine A (CsA) or tacrolimus (Tac), is the commonly used SOC.

    Arm title
    Standard of Care
    Arm description
    Participants receive their institution's standard of care, commonly oral prednisone with cyclosporine A (CsA) or tacrolimus (Tac)
    Arm type
    Active comparator

    Investigational medicinal product name
    Standard of Care (SoC)
    Investigational medicinal product code
    Other name
    Commonly oral prednizone with cyclosporine A (CsA) or tacrolimus (Tac)
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Institutional standard of care, which may include oral prednisone, which may be used simultaneously or on an alternate day schedule with cyclosporine A (CsA) or tacrolimus (Tac), is the commonly used SOC.

    Notes
    [1] - The roles blinded appear inconsistent with a simple blinded trial.
    Justification: It was not possible to blind patient or investigator to the use of a machine, so the outcomes assessor was the single blind.
    Number of subjects in period 1
    ECP Methoxsalen + SoC Standard of Care
    Started
    29
    31
    Baseline Population
    29
    31
    Intent-to-treat Population
    29
    24
    Completed
    22
    16
    Not completed
    7
    15
         Consent withdrawn by subject
    1
    2
         Adverse event, non-fatal
    3
    3
         Death
    3
    -
         Study site closed
    -
    5
         Protocol deviation
    -
    2
         Lack of efficacy
    -
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    ECP Methoxsalen + SoC
    Reporting group description
    Participants receive ECP methoxsalen in addition to standard of care

    Reporting group title
    Standard of Care
    Reporting group description
    Participants receive their institution's standard of care, commonly oral prednisone with cyclosporine A (CsA) or tacrolimus (Tac)

    Reporting group values
    ECP Methoxsalen + SoC Standard of Care Total
    Number of subjects
    29 31 60
    Age categorical
    Units: Subjects
        Adults (18-44) years
    8 10 18
        Adults (45-64) years
    19 19 38
        Adults (65 and over) years
    2 2 4
    Gender categorical
    Units: Subjects
        Female
    7 13 20
        Male
    22 18 40
    Race, Customized
    Units: Subjects
        White
    22 24 46
        Black
    2 0 2
        Other
    1 1 2
        Not recorded
    4 6 10
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    2 2 4
        Not Hispanic or Latino
    24 24 48
        Not Recorded
    3 5 8

    End points

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    End points reporting groups
    Reporting group title
    ECP Methoxsalen + SoC
    Reporting group description
    Participants receive ECP methoxsalen in addition to standard of care

    Reporting group title
    Standard of Care
    Reporting group description
    Participants receive their institution's standard of care, commonly oral prednisone with cyclosporine A (CsA) or tacrolimus (Tac)

    Primary: Number of Patients With an Overall Response at Week 28

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    End point title
    Number of Patients With an Overall Response at Week 28
    End point description
    Patients with overall response included those with partial response or complete response, according to study staff who did not know which treatment they received (blinded assessment).
    End point type
    Primary
    End point timeframe
    28 Weeks
    End point values
    ECP Methoxsalen + SoC Standard of Care
    Number of subjects analysed
    29 [1]
    24 [2]
    Units: Patients
    20
    14
    Notes
    [1] - Intent to treat population
    [2] - Intent to treat population
    Statistical analysis title
    Comparison Group
    Comparison groups
    ECP Methoxsalen + SoC v Standard of Care
    Number of subjects included in analysis
    53
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.373
    Method
    Fisher exact
    Confidence interval

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Treatment emergent adverse events were recorded from the start of treatment through Week 28.
    Adverse event reporting additional description
    Treatment emergent adverse events (TEAEs) are unpleasant events not there before the medical treatment, or that were there, but got worse or happened more often after the treatment. Both serious and non-serious adverse events reported here are TEAEs.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16
    Reporting groups
    Reporting group title
    ECP Methoxsalen + SoC
    Reporting group description
    Participants in the safety analysis set who receive ECP methoxsalen in addition to standard of care

    Reporting group title
    Standard of Care
    Reporting group description
    Participants receive their institution's standard of care, commonly oral prednisone with cyclosporine A (CsA) or tacrolimus (Tac)

    Serious adverse events
    ECP Methoxsalen + SoC Standard of Care
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 28 (28.57%)
    9 / 28 (32.14%)
         number of deaths (all causes)
    4
    0
         number of deaths resulting from adverse events
    3
    0
    Cardiac disorders
    Cardiac Failure
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Polyneuropathy
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune system disorders
    Graft versus host disease in liver
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vocal cord polyp
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Depression
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Renal failure, acute
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocrine disorders
    Thyroiditis subacute
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thyroiditis, subacute
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Myopathy
         subjects affected / exposed
    0 / 28 (0.00%)
    2 / 28 (7.14%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Bronchopulmonary aspergillosis
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cytomegalovirus infection
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia infection
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Herpes simplex
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 28 (7.14%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Toxoplasmosis
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viraemia
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract infection viral
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 28 (3.57%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    0 / 28 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    ECP Methoxsalen + SoC Standard of Care
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    26 / 28 (92.86%)
    24 / 28 (85.71%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    9 / 28 (32.14%)
    4 / 28 (14.29%)
         occurrences all number
    9
    4
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    5 / 28 (17.86%)
    1 / 28 (3.57%)
         occurrences all number
    5
    1
    Oedema peripheral
         subjects affected / exposed
    2 / 28 (7.14%)
    4 / 28 (14.29%)
         occurrences all number
    2
    4
    Asthenia
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Pyrexia
         subjects affected / exposed
    0 / 28 (0.00%)
    4 / 28 (14.29%)
         occurrences all number
    0
    4
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    6 / 28 (21.43%)
    1 / 28 (3.57%)
         occurrences all number
    6
    1
    Dyspnoea
         subjects affected / exposed
    5 / 28 (17.86%)
    2 / 28 (7.14%)
         occurrences all number
    5
    2
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    2 / 28 (7.14%)
    3 / 28 (10.71%)
         occurrences all number
    2
    3
    Sleep disorder
         subjects affected / exposed
    2 / 28 (7.14%)
    1 / 28 (3.57%)
         occurrences all number
    2
    1
    Investigations
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    4 / 28 (14.29%)
    3 / 28 (10.71%)
         occurrences all number
    4
    3
    Platelet count decreased
         subjects affected / exposed
    3 / 28 (10.71%)
    2 / 28 (7.14%)
         occurrences all number
    3
    2
    Blood cholesterol increased
         subjects affected / exposed
    3 / 28 (10.71%)
    1 / 28 (3.57%)
         occurrences all number
    3
    1
    Blood creatinine increased
         subjects affected / exposed
    2 / 28 (7.14%)
    1 / 28 (3.57%)
         occurrences all number
    2
    1
    Blood pressure increased
         subjects affected / exposed
    1 / 28 (3.57%)
    3 / 28 (10.71%)
         occurrences all number
    1
    3
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Blood urea increased
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    4 / 28 (14.29%)
    2 / 28 (7.14%)
         occurrences all number
    4
    2
    Paraesthesia
         subjects affected / exposed
    2 / 28 (7.14%)
    2 / 28 (7.14%)
         occurrences all number
    2
    2
    Headache
         subjects affected / exposed
    2 / 28 (7.14%)
    1 / 28 (3.57%)
         occurrences all number
    2
    1
    Tremor
         subjects affected / exposed
    2 / 28 (7.14%)
    2 / 28 (7.14%)
         occurrences all number
    2
    2
    Blood and lymphatic system disorders
    Thrombocytopenia
         subjects affected / exposed
    2 / 28 (7.14%)
    4 / 28 (14.29%)
         occurrences all number
    2
    4
    Anaemia
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Eye disorders
    Dry eye
         subjects affected / exposed
    2 / 28 (7.14%)
    1 / 28 (3.57%)
         occurrences all number
    2
    1
    Gastrointestinal disorders
    Dry mouth
         subjects affected / exposed
    3 / 28 (10.71%)
    0 / 28 (0.00%)
         occurrences all number
    3
    0
    Diarrhoea
         subjects affected / exposed
    1 / 28 (3.57%)
    4 / 28 (14.29%)
         occurrences all number
    1
    4
    Constipation
         subjects affected / exposed
    1 / 28 (3.57%)
    3 / 28 (10.71%)
         occurrences all number
    1
    3
    Abdominal pain
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Skin and subcutaneous tissue disorders
    Dry skin
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    2 / 28 (7.14%)
    5 / 28 (17.86%)
         occurrences all number
    2
    5
    Muscle spasms
         subjects affected / exposed
    2 / 28 (7.14%)
    4 / 28 (14.29%)
         occurrences all number
    2
    4
    Myopathy
         subjects affected / exposed
    2 / 28 (7.14%)
    0 / 28 (0.00%)
         occurrences all number
    2
    0
    Pain in extremity
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Arthralgia
         subjects affected / exposed
    0 / 28 (0.00%)
    3 / 28 (10.71%)
         occurrences all number
    0
    3
    Infections and infestations
    Rhinitis
         subjects affected / exposed
    2 / 28 (7.14%)
    1 / 28 (3.57%)
         occurrences all number
    2
    1
    Epstein-Barr virus infection
         subjects affected / exposed
    1 / 28 (3.57%)
    3 / 28 (10.71%)
         occurrences all number
    1
    3
    Respiratory tract infection
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    3 / 28 (10.71%)
    4 / 28 (14.29%)
         occurrences all number
    3
    4
    Hypertriglyceridaemia
         subjects affected / exposed
    3 / 28 (10.71%)
    1 / 28 (3.57%)
         occurrences all number
    3
    1
    Hypokalaemia
         subjects affected / exposed
    2 / 28 (7.14%)
    1 / 28 (3.57%)
         occurrences all number
    2
    1
    Hypomagnesaemia
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2
    Hypoproteinaemia
         subjects affected / exposed
    1 / 28 (3.57%)
    2 / 28 (7.14%)
         occurrences all number
    1
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 May 2011
    - Clarified NIH Criteria by amending the test related to the NIH Consensus Criteria Clinical Assessment (Modified version) throughout the protocol. - Added Consensus Clinical Assessment terminology. - Clarified that the TSS will be completed for all subjects in order to avoid confusion between subjects with or without cutaneous involvement and those for whom the eCRF may have been incorrectly completed. - Clarified that increases in CsA dosing should only be in the setting of serum levels which are below the therapeutic level. - Added “Relapse of underlying malignancy” to the Safety Endpoint and Subject Withdrawal and Replacement sections. - Clarified the time of randomization and assessment of study evaluations and treatments. - Increased allowed exposure to corticosteroids before the Baseline Visit from 3 days to 4 days. - Added information regarding the use of topical skin and ophthalmic corticosteroids as concomitant medication in order to reflect clinical practice as well as to control duration. - Clarified subject hospitalization, expedited reporting, and elective hospitalization. - Added information regarding the external DSMB. - Added information regarding Data Quality Assurance.
    16 Mar 2012
    - Provided changes in sponsor signatories and to safety reporting centers in the US and Europe throughout the protocol. - Clarified that CsA treatment may be continuing, rather, than initiated, at the start of study treatment. - Revised the study synopsis consistent with revisions to the study exclusion criteria. - Clarified: -the inclusion of subjects with moderate or severe cGvHD as defined by the NIH Consensus Criteria. -exclusion criteria regarding the duration of previous treatment with systemic steroids for mild and moderate to severe cGvHD. -that subjects who have discontinued treatment with low absorption steroids or enema preparations prior to or at screening are still eligible for the study. -that subjects who have received DLI in the past are still eligible for the study. - Provided examples of prohibited TKIs, indicated that PUVA is prohibited during the study, and included tapering requirements for MMF. - Added TKI, PUVA, and UK to List of Abbreviations and Definition of Terms. - Clarified: -for subjects with aphakia, that if the eye with aphakia has no vision capabilities then the subject may be included in the study. -that the Screening Visit platelet count will be used for stratification of treatment arms. - Added quantity of blood to process during each treatment for subjects in the SoC + ECP treatment arm. - Updated drugs/therapies prohibited during the study based on revisions to exclusion criteria. - Removed inaccurate sentence regarding baseline and randomization timing from Section 6. 1. 2. - Clarified: -that for subjects randomized to SoC + ECP treatment arm, additional blood samples will be collected for hematocrit and hemoglobin tests, and samples will be sent to local laboratory to perform testing before ECP therapy. -that all visits should occur within ± 3 days of the scheduled visit including ECP therapy visits. -the start corticosteroid treatment with occurrencof Baseline Visit. - Corrected for readability
    02 Dec 2012
    - Revised inclusion criteria for allowed dose of corticosteroids for cGvHD to be consistent with revised exclusion criteria. - Included new inclusion criteria for emphasis on the already existing 1.0 mg/kg corticosteroid dose at baseline study requirement. - Expanded the subject population by allowing subjects who develop cGvHD for up to 3 years after their transplant to be included. - Expanded the subject population to include a more common subject type by altering the requirement for allowed treatment for mild cGvHD in the exclusion criteria. - Revised exclusion criteria to allow a higher corticosteroid dose for moderate to severe cGvHD prior to baseline. - Allowed more time for early study logistics by revising the exclusion criteria. - Added information and instruction for the optional long-term 2-year follow-up. - Expanded the SoC treatment to include the use of either Tac or CsA. - Expanded the possible number of countries and study centers for the study. - Revised the study synopsis to be consistent with revisions to the body of the protocol. - Revised eligibility criteria to ease enrollment requirements. - Clarified method (using the instrument display or the manual calculation with rounding) for determining dose. - Added DSMB and Tac to the List of Abbreviations and Definition of Terms. - Phase corrected from 2b to Early phase 1 (Pilot)

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Long term follow-up (LTFU) safety data were provided to health authorities in safety reports; not the 28-week protocol.

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/31332045
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