E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Subjects with known or suspected vascular disease of the supra-aortic vessels |
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E.1.1.1 | Medical condition in easily understood language |
Known or suspected disease of the supra-aortic vessels |
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E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Diagnosis [E01] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 13.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10007687 |
E.1.2 | Term | Carotid artery stenosis |
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 primary efficacy evaluation will be based on three primary efficacy variables: • Assessability • Sensitivity • Specificity which will be calculated for both gadobutrol-enhanced MRA and non-contrast ToF MRA. These will be used to evaluate five co-primary endpoints: - Proportion of assessable vascular segments - Sensitivity for detection of clinically significant disease [70 to 99% stenosis] on a segmental basis - Specificity for exclusion of clinically significant disease [70 to 99% stenosis] on a segmental basis - The two minimum gadobutrol performance criteria: Sensitivity > 50% Specificity > 50%
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E.2.2 | Secondary objectives of the trial |
A further objective of this study is to confirm the safety profile of gadobutrol for this indication.
The secondary efficacy assessments will include the following: • Minimum diameter of the segment • Location and length of stenotic segments with ≥ 70% stenosis • Secondary radiologic indicators for diagnosis of clinically significant disease • Artifacts by type (segmental) • Diagnostic confidence (segmental) • Additional imaging studies recommended (example: CTA, CE MRA, Ultrasound, Nuclear Medicine)
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Male or female subjects, aged 18 years and older - Any of the following: - Known or suspected supra-aortic arterial disease based on: - Prior stroke - Transient ischemic attack (TIA) - Amaurosis Fugax (transient monocular blindness) - Referred for evaluation of any supra-aortic vessel (for clinically significant stenosis) - Follow-up for a stent in a supra-aortic vessel - Prior imaging study (Computed Tomographic Angiography [CTA] or ultrasound) showing ≥ 50% stenosis of a supra-aortic vessel segment (within 60 days before consent). [Note:Any CTA must meet the specifications provided in the protocol. If the CTA does not meet the specifications, then the CTA has to be repeated as part of the study or the subject cannot be enrolled.] - Willingness to undergo the routine Contrast Enhanced Magnetic Resonance Angiography [CE MRA] examination with gadobutrol - Willingness and ability to follow directions and complete all study procedures specified in the protocol - Females of childbearing potential only: Negative pregnancy test on the day of the MRA before the administration of study drug
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E.4 | Principal exclusion criteria |
- Pregnant or nursing (including pumping for storage and feeding) - Received any other investigational product or participation in any other clinical trial within 30 days before enrollment into this study - Previous enrollment into this study or into any other Bayer sponsored study using gadobutrol - Contraindication to the MRA examinations (e.g. inability to hold breath; severe arrhythmias; very low cardiac output, severe claustrophobia, defibrillators or other metallic devices not approved for MRI) - Contraindication to the use of Gd-containing contrast agents (including subjects with suspicion for or known to have Nephrogenic Systemic Fibrosis [NSF]) - History of severe allergic or anaphylactoid reaction to any allergen including drugs and contrast agents - Received any contrast agent within 72 hours before the study MRA, or scheduled receipt of any contrast agent within 24 hours after the study MRA (Note: This applies also to a CTA potentially scheduled during the course of the study.) - Estimated glomerular filtration rate (eGFR) value < 30 ml/min/1.73 m2 derived from a serum creatinine result within 2 weeks before the gadobutrol injection. Any subject on hemodialysis or peritoneal dialysis is excluded from participation. Use the value obtained prior to and closest to the time of the MRA, if there are multiple creatinine values. (Do not use the core lab value if not available prior to the MRA.) - Acute renal insufficiency of any intensity, either due to hepato-renal syndrome or occurring in the peri-operative liver transplantation period - Severe cardiovascular disease (e.g. acute myocardial infarction [< 14 days], unstable angina, congestive heart failure New York Heart Association class IV) or known long QT syndrome - Suspected clinical instability or unpredictability of the clinical course during the study period (e.g. due to previous surgery) - Scheduled or potentially expected for the period between the CTA and gadobutrol MRA: - Any procedure that may alter the MRA or CTA interpretation, or - Any interventional or surgical procedure involving the supra-aortic vessels
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E.5 End points |
E.5.1 | Primary end point(s) |
The following co-primary efficacy endpoints are based on the proportion of assessable vascular segments, and the sensitivity and specificity of clinically significant disease: - Superiority in the proportion of assessable segments with gadobutrol enhanced MRA compared to non-contrast MRA - Non-inferior detection of clinically significant disease based on sensitivity [70 to 99% stenosis] on a segmental basis - Non-inferior exclusion of clinically significant disease based on specificity [70 to 99% stenosis] on a segmental basis - The two minimum gadobutrol performance criteria (both sensitivity and specificity should exceed 50%) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Approximately 15 months after LPLV |
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E.5.2 | Secondary end point(s) |
The following secondary efficacy variables will be summarized: - Minimum diameter of the segment - Location and length of stenotic segments with ≥ 70% stenosis - Secondary radiologic indicators for diagnosis of clinically significant disease - Artifacts by type (segmental) - Diagnostic confidence (segmental) - Additional imaging studies recommended (example: CTA, CE MRA, Ultrasound, Nuclear Medicine) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Approximately 15 months after LPLV |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Yes |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
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) | 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 | Yes |
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.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 26 |
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 |
Australia |
Austria |
China |
Czech Republic |
France |
Germany |
Italy |
Korea, Republic of |
Poland |
Sweden |
Switzerland |
Turkey |
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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For each participating EU country, the end of the study (according to the EU Clinical Trial Directive) will be reached when the last visit of the last subject for all centers in the respective country has occurred. As for this study, the primary outcome will be collected after last patient (or subject) last visit (LPLV), the end of the study as a whole will be the date when the clean data base is available. |
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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 | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |