E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Children suffering from severe Osteogenesis Imperfecta |
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E.1.1.1 | Medical condition in easily understood language |
Children suffering from severe Osteogenesis Imperfecta |
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E.1.1.2 | Therapeutic area | Diseases [C] - Musculoskeletal Diseases [C05] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10031243 |
E.1.2 | Term | Osteogenesis imperfecta |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this trial is to assess the change in lumbar spine bone mineral density Z-score at month 24 relative to baseline in zoledronic acid treated infants with severe osteogenesis imperfecta aged between 2 weeks to 1 year of age at entry, compared to historical controls. The efficacy of zoledronic acid will be demonstrated if it is shown to be a gain in z-score of at least 1. |
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E.2.2 | Secondary objectives of the trial |
To assess the effect of zoledronic acid
• on the change in whole body bone mineral content after 12 and 24 months of treatment relative to baseline compared to historical controls in infants 2 weeks to 1 year of age.
• on the number of clinical fractures that occur over a two year period compared to untreated historical controls in infants 2 weeks to 1 year of age.
• on the number of vertebral compression fractures that occur over a two-year period compared to untreated historical controls in infants 2 weeks to 1 year of age as assessed by vertebral morphometry.
•on the change in bone resorption markers after 12 and 24 months of treatment relative to baseline compared to untreated historical controls by measuring urine N-terminal telopeptide of type I collagen (u-NTX) in infants 2 weeks to 1 year of age.
•Change in bone pain, assessed monthly, using a pain rating scale relative to baseline in infants 2 weeks to 1 year of age.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Children, male or female 2 weeks to < 12 months of age, at least at 38 weeks gestational age.
• Any child with phenotypic OI type II, III or IV.
• No previous treatment with bisphosphonates.
• Negative urine protein as measured by dipstick. One repeat assessment of the urine protein will be allowed. The assessment will be made 2 weeks after the first assessment and the sample must be a urine collection after a 4-hour fast.
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E.4 | Principal exclusion criteria |
• Blood oxygen saturation of less than 90% in room air.
• Serum creatinine level greater than 56 µmol/L.
• Any clinically significant clinical laboratory abnormalities at screening.
• Treatment with any investigational drug within the past 30 days.
• Patients who are unlikely to be able to complete the study or comply with the visit schedule.
• Any disease or planned therapy which will interfere with the procedures or data collection of this trial.
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E.5 End points |
E.5.1 | Primary end point(s) |
The efficacy of zoledronic acid will be demonstrated if it is shown to be a gain in z-score of at least 1. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
To assess the effect of zoledronic acid
• change in whole body bone mineral content
• number of clinical fractures
• number of vertebral compression fractures
•change in bone resorption markers
•Change in bone pain using a pain rating scale |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
• change in whole body bone mineral content after 12 and 24 months
• number of clinical fractures that occur over a two year period
• number of vertebral compression fractures that occur over a two-year period
•change in bone resorption markers after 12 and 24 months
•Change in bone pain, assessed monthly, using a pain rating scale |
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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 | Yes |
E.6.3 | Therapy | Yes |
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.8.3 |
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.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 1 |
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 |
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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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Reasons that a patient may discontinue participation in a clinical study are considered to constitute one of the following:
1. adverse event(s)
2. abnormal laboratory value(s)
3. abnormal test procedure result(s)
4. unsatisfactory therapeutic effect
5. subject's condition no longer requires study treatment
6. protocol violation
7. subject withdrew consent
8. lost to follow-up
9. administrative problems
10. death
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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 | 4 |
E.8.9.1 | In the Member State concerned months | 1 |
E.8.9.1 | In the Member State concerned days | 1 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 1 |
E.8.9.2 | In all countries concerned by the trial days | 1 |