E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
PATIENTS WITH CYSTIC FIBROSIS |
PAZIENTI AFFETTI DA FIBROSI CISTICA |
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E.1.1.1 | Medical condition in easily understood language |
PATIENTS WITH CYSTIC FIBROSIS |
PAZIENTI AFFETTI DA FIBROSI CISTICA |
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E.1.1.2 | Therapeutic area | Diseases [C] - Hormonal diseases [C19] |
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 | 10011766 |
E.1.2 | Term | Cystic fibrosis pancreatic |
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 |
To evaluate changes in AUCG, AUCI, insulinogenic index, WBISI calculated from an OGTT during the period of treatment, and to assess changes in FPIR and AIR calculated from an IVGTT. |
Verificare i cambiamenti nell’ area sotto la curva per il glucosio (AUCG) e l’insulina (AUCI), l’indice insulino-genico il whole body insulin sensitivity index (WBISI) calcolati dai dati del test da caric orale di glucosio (OGTT) durante il periodo di trattamento e valutare le modificazioni della FPIR e della AIR calcolati dai dati del test da carico endovenoso di glucosio (IVGTT). |
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E.2.2 | Secondary objectives of the trial |
1. To evaluate changes in ESR, hs-CRP, and IL-6 serum concentrations in response to IGF-I treatment.2. To evaluate the changes in IGF-I, IGFBP-1, IGFBP-2 in response to IGF-I treatment.serum concentrations. |
1. Valutare i cambiamenti negli indici di flogosi VES, hs-PCR ed IL-6 in risposta in risposta al trattamento con IGF-I.2. Valutare i cambiamenti nei fattori di crescita insulino-simili e nelle proteine leganti (IGF-I, IGFBP-1, IGFBP-2) nel siero in risposta al trattamento con IGF-I. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
APPROXIMATELY 20 PATIENTS WILL BE ENROLLED CONSECUTIVELY AT THE REGIONAL CYSTIC FIBROSIS CENTRE IN PARMA (HEAD: DR G. PISI) OVER A 6-12 MONTH-PERIOD, BOTH F508DEL HOMOZYGOTE AND HETEROZYGOTE, BOTH WITH NORMAL AND IMPAIRED GLUCOSE TOLERANCE. PATIENTS MUST BE IN STABLE CLINICAL CONDITIONS AT ENROLEMENT. |
SARANNO ARRUOLATI PRESSO IL CENTRO REGIONALE PER LA FIBROSI CISTICA DI PARMA (RESPONSABILE: DR G. PISI) IN UN PERIODO DO 6-12 MESI CIRCA 20 PAZIENTI SIA CON CARATTERIZZAZIONE GENETICA F508DEL IN OMOZIGOSI CHE IN ETEROZIGOSI, SIA CON NORMALE CHE RIDOTTA TOLLERANZA GLUCIDICA. I PAZIENTI DOVRANNO ESSERE IN CONDIZIONI CLINICHE STABILI AL MOMENTO DELL’ARRUOLAMENTO. |
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E.4 | Principal exclusion criteria |
EXCLUSION CRITERIA WILL BE THE PRESENCE OF ACUTE ILLNESS TREATED BY INTRAVENOUS ANTIBIOTICS WITHIN SIX WEEKS PRIOR TO THE STUDY, A 10% DECREASE IN FEV1 COMPARED TO THE PREVIOUSLY RECORDED VALUE, LIVER DYSFUNCTION AND BURKHOLDERIA CEPACIA INFECTION. STEROID AND AZYTROMYCIN TREATMENTS WILL BE CAREFULLY RECORDED AS WELL AS PSEUDOMONAS AERUGINOSA INFECTION FOR FURTHER ANALYSES. PATIENTS AFFECTED BY ANY DEGREE OF DIABETIC RETINOPATHY WILL BE EXCLUDED AS WELL. DISEASE ACTIVITY AT ENROLEMENT AND DURING TREATMENT WILL BE ASSESSED USING THE SCHWACHMAN-KULCZYCKI SCORE, WHICH ASSESSES GENERAL DISEASE ACTIVITY, PHYSICAL EXAMINATION, NUTRITION AND X-RAY FINDINGS (SCHWACHMAN ET AL., 1958). THE SCORE WILL BE ASSESSED BY A SINGLE PHYSICIAN (GP). SUBJECTS WITH A SCORE BELOW 41 WILL BE CONSIDERED UNSUITABLE FOR THE STUDY AND WILL BE EXCLUDED FOR ETHICAL REASONS. |
SARANNO CRITERI DI ESCLUSIONE LA PRESENZA DI UNA CONDIZIONE MORBOSA ACUTA TRATTATA CON ANTIBIOTICI PER VIA ENDOVENOSA NELLE 6 SETTIMANE PRECEDENTI L’ARRUOLAMENTO, UNA RIDUZIONE DEL 10% DEL FEV1 RISPETTO AL PRECEDENTE CONTROLLO, INSUFFICIENZA EPATICA, NFEZIONE DA BURKHOLDERIA CEPACIA, QUALSIASI GRADO DI RETINOPATIA DIABETICA. VERRANNO ESCLUSI SOGGETTI CON SCHWACHMAN-KULCZYCKI SCORE INFERIORE A 41 (MISURA DEL GRADO DI ATTIVITÀ DI MALATTIA). VERRANNO ATTENTAMENTE REGISTRATI I TRATTAMENTI STEROIDEI E CON AZITROMICINA COSÌ COME LE INFEZIONI DA PSEUDOMONAS AERUGINOSA PER ULTERIORI ANALISI . |
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E.5 End points |
E.5.1 | Primary end point(s) |
TO EVALUATE CHANGES IN AREA UNDER THE CURVE FOR BLOOD GLUCOSE CONCENTRATION (AUCG), AREA UNDER THE CURVE FOR INSULIN (AUCI), INSULINOGENIC INDEX(IGI), WHOLE BODY INSULIN SENSITIVITY INDEX (WBISI) CALCULATED FROM AN OGTT DURING THE PERIOD OF TREATMENT |
VALUTARE I CAMBIAMENTI NELL’AREA SOTTESA ALLA CURVA PER LE CONCENTRAZIONI GLUCIDICHE (AUCG), PER L’INSULINA (AUCI), L’INDICE INSULINOGENICO (IGI), L’INDICE DI SENSIBILITÀ INSULINICA SISTEMICO (WBISI) CALCOLATO A PARTIRE DALL’OGTT DURANTE IL PERIODO DI TRATTAMENTO |
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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) |
ASSESSMENT OF INDICES OF INSULIN SENSITIVITY SUCH AS HOMEOSTASIS MODEL ASSESSMENT (HOMA)-IR, QUANTITATIVE INSULIN SENSIVITY CHECK (QUICKI), AND THE FASTING GLUCOSE/INSULINE RATIO (FGIR)- ASSESSMENT OF INFLAMMATORY MARKERS- ASSESSMENT OF HOSPITALIZATION RATE FOR INFECTIONS.- SAFETY ENDPOINTS AND ADVERSE EVENTS EVALUATIONS : THE FIRST THREE DAYS OFTREATMENT PATIENTS WILL UNDERGO IGF-I ADMINISTRATION AT THE HOSPITAL WITH GLUCOSE DETECTION 2 TO 4 HOURS AFTER THE INJECTION. THEREFORE PATIENTS WILL RECEIVE A GLUCOMETER TO CONTINUE A REGULAR GLUCOSE MONITORING AT HOME IF NECESSARY. ALL PATIENTS WILL BE TRAINED ON ADEQUATE CARBOHYDRATES INTAKE DURING BREAKFAST.BIOCHEMICAL EVALUATION WILL BE PERFORMED EVERY 3 MONTHS, INCLUDING GLUCOSE DETECTION, AND ABNORMAL LABORATORY FINDINGS WILL BE RECORDED. CHANGES IN FUNDOSCOPIC EXAMINATIONS WILL BE PROMPTLY EVALUATED.BEFORE ENTERING THE PROTOCOL PATIENTS WILL SIGN A INFORMED CONSENT SPECIFYING ANY POSSIBLE ADVERSE EVENT (AE) RELATED TO THE TREATMENT. THEY WILL BE ASKED TO RECORD ANY CLINICAL AE AND TO IMMEDIATELY REFER IT TO THEIR PHYSICIAN WHO’LL BE RESPONSIBLE FOR THE OFFICIAL RECORD OF IT FOLLOWING THE PHARMACOVIGILANCE PROCEDURE. ANY UNDESIRABLE MEDICAL CONDITION OR THE DETERIORATION OF A PRE-EXISTING MEDICAL CONDITION WILL LEAD TO DRUG DISCONTINUATION OR TO A CAREFUL CLINICAL AND BIOCHEMICAL FOLLOW UP ACCORDING TO THE SEVERITY OF THE SINGLE CONDITION. |
VALUTAZIONE DEGLI INDICI DI INSULINO SENSIBILITA TRA CUI HOMEOSTASIS MODEL ASSESSMENT (HOMA)-IR, IL QUANTITATIVE INSULIN SENSIVITY CHECK (QUICKI), E LA FASTING GLUCOSE/INSULIN RATIO (FGIR).ENDPOINT DI SICUREZZA ED EVENTI AVVERSI : DURANTE I PRIMI 3 GIORNI DI TRATTAMENTO LA SOMMINISTRAZIONE DI RHIGF-I AVVERRA’ IN OSPEDALE CON VALUTAZIONE DEI VALORI GLICEMICI DOPO 2-4 ORE DALLA SOMMINISTRAZIONE. SUCCESSIVAMENTE I PAZIENTI RICEVERANNO UN GLUCOMETRO PER MONITORARE LE GLICEMIE CAPILLARI AL DOMICILIO SE NECESSARIO. TUTTI I PAZIENTI VERRANNO ADEGUATAMENTE ISTRUITI SULLA CORRETTA ASSUNZIONE DI CARBOIDRATI CON LA COLAZIONE.LE VALUTAZIONI BIOCHIMICHE VERRANNO ESEGUITE OGNI 3 MESI INCLUSA LA DETERMINAZIONE DEI VALORI GLICEMICI, E VERRANNO REGISTRATE EVENTUALI ANOMALIE NEI RISULTATI. VARIAZIONI NELLA FUNDOSCOPIA VERRANNO PRONTAMENTE VALUTATE.PRIMA DELL’ARRUOLAMENTO AI PAZIENTI VERRA’ SOTTOPOSTO UN CONSENSO INFORMATO IN CUI SONO DESCRITTI I POSSIBILI EVENTI AVVERSI FARMACO-RELATI (AE). AI PAZIENTI VERRA’ CHIESTO DI REGISTRARE QUALSIASI EVENTO E PRONTAMENTE SEGNALARLO AL MEDICO CHE SARA’ RESPONSABILE DELLA REGISTRAZIONE UFFICIALE DEL AE E DELLE PROCEDURE DI FARMACOVIGILANZA. OGNI CONDIZIONE CLINICA DI NEORISCONTRO E OGNI PEGGIORAMENTO DELLA PRE-ESISTENTE PATOLOGIA DI BASE CONDURRANNO ALLA SOSPENSIONE DEL FARMACO O AD UN ATTENTO MONITORAGGIO BIOCHIMICO IN RELAZIONE ALLA SEVERITA’ DELLA SPECIFICA CONDIZIONE. -VALUTAZIONE DEI MARKER INFIAMMATORI - VALUTAZIONE DEL TASSO DI OSPEDALIZZAZIONE PER INFEZIONI |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | No |
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) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
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 | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
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 | 0 |
E.8.9.1 | In the Member State concerned months | 24 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 24 |
E.8.9.2 | In all countries concerned by the trial days | 0 |