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    Summary
    EudraCT Number:2010-023802-10
    Sponsor's Protocol Code Number:B1801023
    National Competent Authority:Netherlands - Competent Authority
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2011-11-07
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedNetherlands - Competent Authority
    A.2EudraCT number2010-023802-10
    A.3Full title of the trial
    AN OPEN LABEL EXTENSION STUDY TO ASSESS THE LONG TERM SAFETY OF ETANERCEPT IN CHILDREN AND ADOLESCENTS WITH EXTENDED OLIGOARTICULAR JUVENILE IDIOPATHIC ARTHRITIS, ENTHESITIS RELATED ARTHRITIS, OR PSORIATIC ARTHRITIS WHO WERE PREVIOUSLY ENROLLED IN PROTOCOL 0881A1 3338 WW(B1801014)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study Evaluation of the Long Term Safety of Etanercept In 3 Sub-types
    of Childhood Arthritis
    A.3.2Name or abbreviated title of the trial where available
    Clipper 2
    A.4.1Sponsor's protocol code numberB1801023
    A.7Trial is part of a Paediatric Investigation Plan Yes
    A.8EMA Decision number of Paediatric Investigation PlanP/241/2011
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorPfizer Inc., 235 East 42nd Street, New York, NY 10017, United States
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportPfizer Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPfizer Inc
    B.5.2Functional name of contact pointClinical Trials.gov Call Center
    B.5.3 Address:
    B.5.3.1Street Address235 E 42nd Street
    B.5.3.2Town/ cityNew York
    B.5.3.3Post codeNY 10017, USA
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1 800 7181021
    B.5.5Fax number+1 303 739 1119
    B.5.6E-mailClinicalTrials.govCallCentre@pfizer.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name ENBREL 25 mg/ml polvo y disolvente para solución inyectable para uso pediátrico
    D.2.1.1.2Name of the Marketing Authorisation holderPFIZER LTD.
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Powder and solvent for suspension for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNETANERCEPT
    D.3.9.1CAS number 185243690
    D.3.9.2Current sponsor codeB1801023
    D.3.9.3Other descriptive nameETANERCEPT
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name ENBREL 50 mg solución inyectable en jeringas precargadas
    D.2.1.1.2Name of the Marketing Authorisation holderPFIZER LTD.
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNETANERCEPT
    D.3.9.1CAS number 185243690
    D.3.9.2Current sponsor codeB1801023
    D.3.9.3Other descriptive nameETANERCEPT
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Oligoarticular juvenile idiopathic arthritis, enthesistis related arthritis, or psoriatic arthritis
    ARTRITIS IDIOPÁTICA JUVENIL OLIGOARTICULAR EXTENDIDA, ARTRITIS ASOCIADA A ENTESITIS O ARTRITIS PSORIÁSICA
    E.1.1.1Medical condition in easily understood language
    3 Sub-types of Childhood Arthritis (Extended Oligoarticular Arthritis,
    Enthesitis-Related Arthritis, and Psoriatic Arthritis)
    3 Subtipos de Artritis en la Infancia (Artritis Oligoarticular Extendida, Artritis asociada a Entesistis y Artritis Psoriásica
    E.1.1.2Therapeutic area Diseases [C] - Immune System Diseases [C20]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10059176
    E.1.2Term Juvenile idiopathic arthritis
    E.1.2System Organ Class 10028395 - Musculoskeletal and connective tissue disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To monitor the occurrence of malignancy in pediatric subjects with extended oligoarticular JIA, ERA, or PsA.
    Vigilar la incidencia de neoplasias malignas en niños y adolescentes con AIJ oligoarticular extendida, ARE o APs.
    E.2.2Secondary objectives of the trial
    - To assess the long-term safety profile of etanercept;
    - To evaluate the long-term effect of etanercept on clinical benefit and physical
    function.
    Exploratory Objectives
    - To evaluate clinical benefit and physical function after withdrawal of etanercept;
    - To evaluate effect of etanercept on clinical benefit and physical function after disease relapse.
    - Evaluar el perfil de seguridad a largo plazo de etanercept.
    - Evaluar el efecto a largo plazo de etanercept sobre el beneficio clínico y la función física.
    Objetivos Exploratorios
    - Evaluar el beneficio clínico y la función física tras la retirada de etanercept;
    - Evaluar el efecto de etanercept sobre el beneficio clínico y la función física tras la recidiva de la enfermedad.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Inclusion Criteria for All Subjects at Baseline: Subject eligibility should be reviewed and documented by an appropriately qualified member of the investigator?s study team before subjects are included in the study. Subjects must meet all of the following inclusion criteria to be eligible for enrollment into the study:
    1. Evidence of a personally signed and dated informed consent document (and assent document, as applicable) indicating that the subject (and/or a legal representative/guardian(s) as applicable according to subject age and local guidelines) has been informed of all pertinent aspects of the period of the study in which participation is being considered.
    2. Subjects who are willing and able to comply with all applicable aspects of the period of the study in which participation is being considered, including scheduled visits, treatment plan, laboratory tests, and other study procedures.
    3. Receipt of at least 1 dose of investigational product and participation for
    approximately 96 weeks in study 0881A1-3338.
    Additional Inclusion Criteria for Subjects Planning to Continue Investigational
    Product in the Active Treatment Period
    Subjects must meet the following additional inclusion criteria at the baseline visit to be eligible to continue investigational product in study B1801023:
    1. Have completed approximately 96 weeks of investigational product in study 0881A1-3338 and, in the investigator?s judgment, is appropriate to continue treatment with etanercept.
    2. Either the subject or an available adult must be capable (according to the investigator?s judgment) of reconstituting and administering injections of subcutaneous (SC) etanercept.
    3. The subject, parent, or legal representative/guardian of the subject must be able to read and complete the protocol-specified efficacy assessments.
    4. The first dose of investigational product in study B1801023 must be administered
    within 6 weeks of receiving the last dose of investigational product in the study
    0881A1-3338.
    Additional Inclusion Criteria for Subjects Planning to Enter in the Withdrawal/Re-treatment Period
    1. Evidence of a personally signed and dated informed consent document (and assent document, as applicable) indicating that the subject (and/or a legal
    representative/guardian(s) as applicable according to subject age and local guidelines) has been informed of all aspects of the withdrawal/re-treatment period of the study. Only one informed consent document/assent will be signed and dated for the withdrawal/re-treatment period.
    2. The subject is willing and able to comply with all applicable aspects of the withdrawal/re-treatment period of the study, including scheduled visits, treatment
    plan, laboratory tests, and other study procedures.
    3. The subject and/or the parent or legal representative/guardian of the subject must be able to provide contact information, including primary care physician or other treating physician.
    4. For subjects entering directly into the withdrawal/re-treatment period, have completed approximately 96 weeks of investigational product in study 0881A1-3338.
    5. For subjects entering directly into the withdrawal/re-treatment period, the baseline visit in study B1801023 must be completed within 14 days of the last dose of investigational product in study 0881A1-3338.
    6. The subject has met the Wallace definition for clinically inactive disease for at least 6 months on investigational product (etanercept) or, in the investigator?s judgment, has had a good clinical response and would benefit from withdrawal from investigational product.
    7. The subject, parent, or legal representative/guardian of the subject must be able to read and complete the protocol-specified efficacy assessments.
    Additional Inclusion Criteria for Subjects Planning to Restart Investigational Product in the Re-treatment Period
    1. Re-treatment with investigational product should be based on the investigator?s clinical judgment as long as all other inclusion/exclusion criteria for re-treatment period are met.
    2. Either the subject or an available adult must be capable (according to the investigator?s judgment) of reconstituting and administering injections of subcutaneous (SC) etanercept.
    Criterios de inclusión para todos los pacientes en la visita basal: Un miembro debidamente cualificado del equipo del estudio del investigador analizará y documentará la elegibilidad de los pacientes antes de su inclusión en el estudio. Los pacientes deberán cumplir todos los criterios de inclusión siguientes para poder participar en el estudio:
    1. Existencia de un documento de consentimiento informado (y un documento de asentimiento, si procede), firmado y fechado personalmente, que indique que se ha informado al paciente (o a su representante legal, si procede según la edad del paciente y la normativa local) de todos los aspectos pertinentes del período del estudio para el cual se considere la participación.
    2. Pacientes dispuestos a cumplir todos los aspectos aplicables del período del estudio para el que se considere la participación, como las visitas programadas, el plan de tratamiento, las evaluaciones analíticas y otros procedimientos del estudio, y capaces de hacerlo.
    3. Recepción de al menos una dosis del producto en investigación y participación durante aproximadamente 96 semanas en el estudio 0881A1-3338.
    4. El paciente y/o el progenitor o el representante/tutor legal del paciente deben proporcionar información de contacto, incluido el médico de atención primaria u otro médico encargado de su tratamiento.
    Otros criterios de inclusión para los pacientes en los que esté previsto seguir con el producto en investigación en el período de tratamiento activo
    Los pacientes deben cumplir los siguientes criterios de inclusión adicionales en la visita basal para poder continuar con el producto en investigación en el estudio B1801023:
    1. Haber completado aproximadamente 96 semanas con el producto en investigación en el estudio 0881A1-3338 y cuando, en opinión del investigador, procede seguir con el tratamiento con etanercept.
    2. El paciente o un adulto disponible deberán ser capaces (según el criterio del investigador) de reconstituir y administrar inyecciones de etanercept por vía subcutánea (SC).
    3. El paciente, los padres o el representante/tutor legal del paciente deberán saber leer y completar las evaluaciones de eficacia especificadas en el protocolo.
    4. La primera dosis de producto en investigación en el estudio B1801023 debe administrarse en las 6 semanas siguientes a la última dosis de producto en investigación en el estudio 0881A1-3338.
    Otros criterios de inclusión para los pacientes en los que esté prevista su incorporación al período de retirada/retratamiento
    1. Existencia de un documento de consentimiento informado (y un documento de asentimiento, si procede), firmado y fechado personalmente, que indique que se ha informado al paciente (o a su representante legal, si procede según la edad del paciente y la normativa local) de todos los aspectos del período de retirada/retratamiento del estudio. Se firmará y fechará sólo un documento de consentimiento/asentimiento para el período de retirada/retratamiento.
    2. Paciente dispuesto a cumplir todos los aspectos aplicables del período de retirada/retratamiento del estudio, como las visitas programadas, el plan de tratamiento, las evaluaciones analíticas y otros procedimientos del estudio, y capaces de hacerlo.
    3. El paciente y el progenitor o el representante/tutor legal del paciente deben proporcionar información de contacto, incluido el médico de atención primaria u otro médico encargado de su tratamiento.
    4. Los pacientes que se incorporen directamente al período de retirada/retratamiento tendrán que haber completado aproximadamente 96 semanas de tratamiento con el producto en investigación en el estudio 0881A1-3338.
    5. En los pacientes que se incorporen directamente al período de retirada/retratamiento, la visita basal del estudio B1801023 deberá realizarse en el plazo de 14 días tras la última dosis de producto en investigación en el estudio 0881A1-3338.
    6. El paciente ha cumplido la definición de Wallace para la enfermedad clínicamente inactiva durante al menos 6 meses en tratamiento con el producto en investigación (etanercept) o, a juicio del investigador, presenta una buena respuesta clínica y puede beneficiarse de la retirada del producto en investigación.
    7. El paciente, los padres o el representante/tutor legal del paciente deberán saber leer y completar las evaluaciones de eficacia especificadas en el protocolo.
    Otros criterios de inclusión para los pacientes en los que esté previsto reanudar el producto en investigación en el período de retratamiento
    1. El retratamiento con el producto en investigación debe basarse en el juicio clínico del investigador, siempre y cuando se cumplan todos los demás criterios de inclusión/exclusión para el período de retratamiento.
    2. El paciente o un adulto disponible deberán ser capaces (según el criterio del investigador) de reconstituir y administrar inyecciones de etanercept por vía subcutánea (SC).
    E.4Principal exclusion criteria
    Exclusion Criteria for All Subjects at Baseline: Subjects presenting with any of the following will not be included in the study:
    1. Subjects who are investigational site staff members or subjects who are Pfizer
    employees directly involved in the conduct of the trial.
    Additional Exclusion Criteria for Subjects Planning to Continue Investigational
    Product in the Active Treatment Period
    Subjects who completed approximately 96 weeks of investigational product in study
    0881A1-3338 and present with any of the following will not be allowed to continue
    investigational product in study B1801023:
    1. Withdrawal from investigational product in study 0881A1-3338 for any reason.
    2. History of malignancy other than squamous cell, basal cell carcinoma or cervical carcinoma in situ.
    3. Participation in other clinical studies of investigational drugs or investigational
    combinations of approved drugs between the week 96 visit in study 0881A1-3338 and the baseline visit in study B1801023 or during participation in the active treatment
    period of study B1801023.
    4. Pregnant or breastfeeding female subjects.
    5. Receipt of any of the following between the week 96 visit in study 0881A1-3338 and the baseline visit in study B1801023:
    - Any immunosuppressive biologic drugs, including but not limited to TNF
    inhibitors (other than etanercept), abatacept, rituximab, anakinra and
    tocilizumab;
    - Immunosuppressive drugs (excluding corticosteroids) (eg, cyclophosphamide,
    cyclosporine, azathioprine);
    - Leflunomide;
    - Use of more than 1 of the non-biologic DMARDs permitted in study 0881A1-3338 (ie, methotrexate, hydroxychloroquine, chloroquine, sulfasalazine) in subjects <18 years of age;
    - Use of more than 2 of the non-biologic DMARDs permitted in study 0881A1-3338 (ie, methotrexate, hydroxychloroquine, chloroquine, sulfasalazine) or hydroxychloroquine and chloroquine taken at the same time in subjects >=18 years of age;
    - Non-biologic DMARDs other than those permitted in study 0881A1-3338 (ie, methotrexate, hydroxychloroquine, chloroquine, sulfasalazine), or those not
    listed under other exclusion criteria;
    - Any live (attenuated) vaccines.
    6. Other severe acute or chronic medical or psychiatric condition or laboratory
    abnormality that may increase the risk associated with study participation or
    investigational product administration or may interfere with the interpretation of
    study results and, in the judgment of the investigator, would make the subject
    inappropriate for entry into this study.
    7. Signs and symptoms or suspicion of active tuberculosis.
    Additional Exclusion Criteria for Subjects Planning to Enter in the Withdrawal/Re-treatment Period
    1. Withdrawal from investigational product in study 0881A1-3338 for any reason.
    2. Prior and/or current participation in the observational period of study B1801023.
    3. Prior and/or current participation in the withdrawal/re-treatment period of study
    B1801023.
    Additional Exclusion Criteria for Subjects Planning to Restart Investigational
    Product in the Re-treatment Period: Please, refer to the protocol for more detail.
    Criterios de exclusión para todos los pacientes en la visita basal: No podrán participar en el estudio los pacientes que se encuentren en cualquiera de las circunstancias siguientes:
    1. Sujetos que sean miembros del personal del centro de investigación o empleados de Pfizer directamente implicados en la realización del ensayo.
    Otros criterios de exclusión para los pacientes en los que esté previsto seguir con el producto en investigación en el período de tratamiento activo: Los pacientes que completen aproximadamente 96 semanas de tratamiento con el producto en investigación en el estudio 0881A1-3338 y que presenten cualquiera de las circunstancias siguientes no podrán continuar recibiendo dicho producto en el estudio B1801023:
    1. Suspensión del producto en investigación en el estudio 0881A1-3338 por cualquier motivo.
    2. Antecedentes de neoplasia maligna distinta del carcinoma espinocelular, carcinoma basocelular o carcinoma del cuello uterino in situ.
    3. Participación en otros estudios clínicos de fármacos en investigación o combinaciones en investigación de fármacos aprobados entre la visita de la semana 96 del estudio 0881A1-3338 y la visita basal en el estudio B1801023 o durante la participación en el período de tratamiento activo del estudio B1801023.
    4. Mujeres embarazadas o lactantes.
    5. Tratamiento con cualquiera de lo siguiente entre la visita de la semana 96 del estudio 0881A1-3338 y la visita basal del estudio B1801023:
    - Cualquier fármaco biológico inmunodepresor, entre otros los inhibidores del TNF (excepto etanercept), abatacept, rituximab, anakinra y tocilizumab;
    - Inmunodepresores (excepto corticosteroides) (por ejemplo, ciclofosfamida, ciclosporina o azatioprina);
    - Leflunomida;
    - Uso de más de uno de los FARME no biológicos permitidos en el estudio 0881A1-3338 (es decir, metotrexato, hidroxicloroquina, cloroquina o sulfasalazina) en pacientes < 18 años;
    - Uso de más de dos de los FARME no biológicos permitidos en el estudio 0881A1-3338 (es decir, metotrexato, hidroxicloroquina, cloroquina o sulfasalazina) o hidroxicloroquina y cloroquina administradas al mismo tiempo en pacientes >= 18 años;
    - FARME no biológicos distintos de los permitidos en el estudio 0881A1-3338 (es decir, metotrexato, hidroxicloroquina, cloroquina o sulfasalazina) o que no se mencionen en otros criterios de exclusión;
    - Cualquier vacuna de microbios vivos (atenuados).
    6. Cualquier otro trastorno médico o psiquiátrico grave, agudo o crónico, o cualquier anomalía analítica que aumente el riesgo asociado a la participación en el estudio o a la administración del producto en investigación o interfiera en la interpretación de los resultados del estudio y, en opinión del investigador, impida la participación en el mismo.
    7. Signos y síntomas o sospecha de tuberculosis activa.
    Otros criterios de exclusión para los pacientes en los que esté prevista su incorporación al período de retirada/retratamiento
    1. Suspensión del producto en investigación en el estudio 0881A1-3338 por cualquier motivo.
    2. Participación previa o actual en el período de observación del estudio B1801023.
    3. Participación previa o actual en el período de retirada/retratamiento del estudio B1801023.
    Otros criterios de exclusión para los pacientes en los que esté previsto reanudar el producto en investigación en el período de retratamiento: Por favor, refiéranse al protocolo para más dealle.
    E.5 End points
    E.5.1Primary end point(s)
    Occurrence of malignancy over the course of the study.
    Aparición de una neoplasia maligna a lo largo del estudio.
    E.5.1.1Timepoint(s) of evaluation of this end point
    At minimum every 2 years
    Como mínimo cada 2 años
    E.5.2Secondary end point(s)
    Secondary Endpoints for Subjects in the Observational Period
    - Occurrence of serious adverse events, including serious infections;
    - Occurrence of medically important infections (ie, an infection requiring
    hospitalization and /or parenteral [intravenous (IV), intra-muscular (IM)]
    anti-infective agents).
    Secondary Endpoints for Subjects in the Active Treatment Period, and
    Withdrawal/Re-treatment Period
    - Occurrence of serious adverse events, including serious infections;
    - Occurrence of medically important infections (ie, an infection requiring
    hospitalization and /or parenteral [intravenous (IV), intra-muscular (IM)]
    anti-infective agents);
    - Occurrence of all adverse events, including infections, infections considered
    preventable by vaccination, and injection site reactions;
    - Occurrence of withdrawals from investigational product due to adverse events;
    - Laboratory evaluations;
    Growth parameters;
    - Tanner Stage Assessment for selected subjects;
    - ACR Pediatric 30, 50, 70, 90, and 100, defined as >= 30% (and 50%, 70%, 90%,
    100%, respectively) improvement from baseline in at least 3 of the 6 following
    variables, with no more than 1 of the remaining variables worsening by > 30 %:
    - Physician?s Global Assessment (PGA) of Disease Activity on a 21-circle visual analogue scale (VAS);
    - Patient/Parent Global Assessment on a 21-circle VAS;
    - Childhood Health Assessment Questionnaire (CHAQ)/Health Assessment
    Questionnaire (HAQ);
    - Number of joints with active arthritis, defined as joints that are swollen or, in
    the absence of swelling, joints with limited range of motion accompanied by
    pain and/or tenderness;
    - Number of joints with limited range of motion;
    - Laboratory measure of inflammation, c-reactive protein (CRP);
    - Individual components of the ACR Pediatric Assessments;
    - Pain Assessment on a 21-circle VAS;
    - Duration of morning stiffness in minutes
    - Clinically inactive disease defined as follows per Wallace Criteria:12
    - No joints with active arthritis (defined as joints that are swollen or, in the
    absence of swelling, joints with limited range of motion accompanied by pain
    and/or tenderness);
    - No fever, rash, serositis, splenomegaly, or generalized lymphadenopathy
    attributable to JIA;
    - No active uveitis;
    - CRP level within normal limits in the laboratory where tested or, if elevated,
    not attributable to JIA;
    - PGA of disease activity score of best possible on the scale used;
    - Duration of morning stiffness of <= 15 minutes;
    - The Juvenile Arthritis Disease Activity Score (JADAS), using 4 components (PGA of Disease Activity, Patient/Parent Global Assessment, number of joints with active
    arthritis and CRP).20
    Additional Secondary Endpoints for ERA Subjects
    - Overall Back Pain and Nocturnal Back Pain on a 100 mm VAS;
    - Bath Ankylosing Spondylitis Metrology Index (BASMI) and its components
    (Intermalleolar Distance, Cervical Rotation, Modified Schober?s Test, Lateral Flexion, and Tragus to Wall Distance).
    Additional Secondary Endpoints for PsA Subjects
    - Body Surface Area (BSA);
    - PGA of Psoriasis.
    Criterios de valoración secundarios para los pacientes en el periodo de observación
    - Incidencia de acontecimientos adversos graves, incluyendo infecciones graves;
    - Incidencia de las infecciones médicamente importantes (es decir, una infección que requiera hospitalización o antiinfecciosos por vía parenteral [intravenosos (IV) o intramusculares (IM)]).
    Criterios de valoración secundarios para los pacientes en el período de tratamiento activo y el período de retirada/ retratamiento
    - Incidencia de acontecimientos adversos graves, incluyendo infecciones graves;
    - Incidencia de las infecciones médicamente importantes (es decir, una infección que requiera hospitalización o antiinfecciosos por vía parenteral [intravenosos (IV) o intramusculares (IM)]);
    - Incidencia de todos los acontecimientos adversos, incluidas las infecciones consideradas evitables con vacunas, y las reacciones en el lugar de inyección;
    - Incidencia de suspensiones del producto en investigación por acontecimientos adversos;
    - Estudios analíticos;
    - Parámetros del crecimiento;
    - Evaluación del estadio de Tanner en determinados pacientes.
    - ACR pediátrica 30, 50, 70, 90 y 100, definida como una mejoría >= 30% (y 50%, 70%, 90%, 100%, respectivamente) con respecto al valor basal de al menos 3 de las 6 variables siguientes, sin que haya un empeoramiento > 30% en más de 1 de las variables restantes:
    - Evaluación global por el médico (PGA) de la actividad de la enfermedad en una escala analógica visual de 21 círculos (EAV);
    - Evaluación global por el paciente/progenitor en una EAV de 21 círculos;
    - Cuestionario de evaluación de la salud infantil (CHAQ)/Cuestionario de evaluación de la salud (HAQ);
    - Número de articulaciones con artritis activa, definidas como articulaciones con hinchazón o, en ausencia de hinchazón, articulaciones con rango de movimientos limitado acompañado de dolor y/o sensibilidad;
    - Número de articulaciones con rango de movimiento limitado;
    - Medición analítica de la inflamación, proteína C-reactiva (CRP);
    - Componentes individuales de la evaluación ACR pediátrica;
    - Evaluación del dolor en una EAV de 21 círculos;
    - Duración de la rigidez matutina en minutos;
    - Enfermedad clínicamente inactiva definida del modo siguiente según los criterios de Wallace12:
    - Ninguna articulación con artritis activa (definida como articulación con hinchazón o, en ausencia de hinchazón, articulación con rango de movimientos limitado acompañado de dolor y/o sensibilidad);
    - Ausencia de fiebre, exantema, esplenomegalia o linfadenopatía generalizada atribuibles a la AIJ;
    - Ausencia de uveítis activa;
    - Valor de CRP dentro de los límites de referencia del laboratorio que realiza el análisis o, si está elevado, no atribuible a la AIJ;
    - Puntuación de mejor posible en la evaluación global por el médico (PGA) de la actividad de la enfermedad en la escala usada;
    - Duración de la rigidez matutina ? 15 minutos;
    - Puntuación de la actividad de la enfermedad articular juvenil (JADAS) utilizando 4 componentes (PGA de la actividad de la enfermedad, evaluación global por el paciente/progenitor, número de articulaciones con artritis activa y CRP)20.
    Criterios de valoración secundarios adicionales para los pacientes con ARE
    - Dolor de espalda global y dolor de espalda nocturno en una EAV de 100 mm;
    - Índice de metrología de Bath para la espondilitis anquilosante (BASMI) y sus componentes (distancia intermaleolar, rotación cervical, prueba de Schober modificada, flexión lateral y distancia trago-pared).
    Criterios de valoración secundarios adicionales para los pacientes con APs
    - Superficie corporal (BSA);
    - PGA de la psoriasis.
    E.5.2.1Timepoint(s) of evaluation of this end point
    At minimum every 2 years
    Como mínimo cada 2 años
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    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.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA28
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Belgium
    Colombia
    Czech Republic
    France
    Germany
    Hungary
    Italy
    Latvia
    Lithuania
    Mexico
    Netherlands
    Norway
    Poland
    Russian Federation
    Serbia
    Slovakia
    Slovenia
    Spain
    E.8.7Trial 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
    As per protocol
    Según protocolo
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years8
    E.8.9.1In the Member State concerned months7
    E.8.9.1In the Member State concerned days12
    E.8.9.2In all countries concerned by the trial years9
    E.8.9.2In all countries concerned by the trial months3
    E.8.9.2In all countries concerned by the trial days12
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    F.1.1Number of subjects for this age range: 99
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) Yes
    F.1.1.5.1Number of subjects for this age range: 32
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 67
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 24
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    Subject, parent, or legally authorized representative/guardian of the
    subject must be able to read and complete the protocol specified efficacy assessments.
    Sujeto, padre o representante legal / tutor del sujeto deben ser capaces de comprender y completar las evaluaciones de eficacia específicas del protocolo.
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state3
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 109
    F.4.2.2In the whole clinical trial 123
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    After subjects particpation in the trial, he/she will receive the normal standard of care for their disease.
    Después de la participación de sujetos en el estudio, el/ella recibirá el cuidado normal de su enfermedad
    G. Investigator Networks to be involved in the Trial
    G.4 Investigator Network to be involved in the Trial: 1
    G.4.1Name of Organisation No aplica
    G.4.3.4Network Country Spain
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2011-11-03
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2012-05-07
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2021-02-04
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