Clinical Trial Results:
A Phase 2, Randomized, Double-Masked, Placebo-Controlled, Parallel-Group Study of the Safety and Efficacy of Daily CF101 Administered Orally in Subjects with Elevated Intraocular Pressure
Summary
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EudraCT number |
2011-002777-27 |
Trial protocol |
BG |
Global end of trial date |
10 Feb 2016
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Results information
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Results version number |
v1(current) |
This version publication date |
16 Feb 2020
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First version publication date |
16 Feb 2020
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
CF101-231GL
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
- | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Can Fite Biopharma Ltd
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Sponsor organisation address |
10 Bareket St., Tikva, Israel,
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Public contact |
Medical Director, Can-Fite BioPharma Ltd., +972 39241114, info@canfite.co.il
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Scientific contact |
Medical Director, Can-Fite BioPharma Ltd., +972 39241114, info@canfite.co.il
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
10 Feb 2016
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
10 Feb 2016
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Global end of trial reached? |
Yes
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Global end of trial date |
10 Feb 2016
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
Determine the effects of oral CF101 in lowering intraocular pressure (IOP) when administered twice daily for 16 weeks in subjects with elevated IOP; and Determine the safety of oral CF101 in this subject population
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Protection of trial subjects |
The study was conducted in compliance with applicable International Conference on Harmonisation (ICH) guidelines, the ICH E6 Good Clinical Practice (GCP) guideline,
and regulations, guidelines, and applicable laws and regulations of the locale and country where the study was conducted. The study was conducted with the approval of a duly constituted institutional review board (IRB) or ethics committee (EC) in accordance with the requirement of United States regulation Title 21 Code of Federal Regulations (CFR) Part 56 - Institutional Review Boards. The nature and risks of the study were fully explained to each subject and written consent obtained in accordance with the requirements of 21 CFR 50 - Protection of Human Subjects. Subjects were informed of their rights, including the right to withdraw from the study at any time.
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Background therapy |
None | ||
Evidence for comparator |
Placebo as control | ||
Actual start date of recruitment |
27 Sep 2012
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Romania: 55
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Country: Number of subjects enrolled |
Bulgaria: 32
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Country: Number of subjects enrolled |
Israel: 2
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Worldwide total number of subjects |
89
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EEA total number of subjects |
87
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
60
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From 65 to 84 years |
29
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85 years and over |
0
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Recruitment
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Recruitment details |
There were 89 subjects enrolled and randomised in 14 sites in 3 countries (Romania [7], Bulgaria [6], and Israel [1]) and included in the study between 02 Nov 2010 and 24 Sep 2015 | ||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
At a Screening Visit subjects who provided written informed consent and fulfilled the inclusion criteria (notably: Ocular hypertension or open-angle glaucoma in at least 1 eye) underwent specified procedures. | ||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Baseline (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||||||||||||
Roles blinded |
Subject, Investigator, Monitor, Data analyst | ||||||||||||||||||||||||||||
Blinding implementation details |
Treatment was allocated in a double-blinded (double-masked) fashion. The Investigator was supplied with sealed envelopes, each one containing the treatment allocation for the treatment assignment (randomization) number that appeared on the outside of the envelope.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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CF101 1 mg | ||||||||||||||||||||||||||||
Arm description |
Medication was taken orally BID for 16 weeks in a double-blinded fashion | ||||||||||||||||||||||||||||
Arm type |
Active comparator | ||||||||||||||||||||||||||||
Investigational medicinal product name |
Methyl 1-[N6-(3-iodobenzyl)-adenin-9-yl]-β-D-ribofuronamide
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
1 mg tablet BID
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Arm title
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CF101 2 mg | ||||||||||||||||||||||||||||
Arm description |
Medication was taken orally BID for 16 weeks in a double-blinded fashion | ||||||||||||||||||||||||||||
Arm type |
Active comparator | ||||||||||||||||||||||||||||
Investigational medicinal product name |
Methyl 1-[N6-(3-iodobenzyl)-adenin-9-yl]-β-D-ribofuronamide
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
2 mg tablet BID
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Arm title
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Placebo | ||||||||||||||||||||||||||||
Arm description |
Medication was taken orally BID for 16 weeks in a double-blinded fashion | ||||||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo, matching for methyl 1-[N6-(3-iodobenzyl)-adenin-9-yl]-β-D-ribofuronamide
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Matching CF101 placebo tablet BID
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Baseline characteristics reporting groups
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Reporting group title |
CF101 1 mg
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Reporting group description |
Medication was taken orally BID for 16 weeks in a double-blinded fashion | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
CF101 2 mg
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Reporting group description |
Medication was taken orally BID for 16 weeks in a double-blinded fashion | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Medication was taken orally BID for 16 weeks in a double-blinded fashion | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Subject analysis sets
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Subject analysis set title |
Safety Population
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Subject analysis set type |
Safety analysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
The Safety Population consists of all subjects who received at least one dose of study medication and the opportunity for at least one safety assessment, ie, at least one post-Baseline visit. A listing of all subjects excluded from the Safety Population, including subjects who failed re-qualification at Baseline, will be provided.
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Subject analysis set title |
Intent-to-Treat
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Subject analysis set type |
Intention-to-treat | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
The intent-to-treat (ITT) population consists of all randomized subjects who received at least one dose of study medication with assessments sufficient to determine IOP for at least one post-baseline visit. Determination of the ITT population will be based on observed data, without imputation of missing data.
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End points reporting groups
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Reporting group title |
CF101 1 mg
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Reporting group description |
Medication was taken orally BID for 16 weeks in a double-blinded fashion | ||
Reporting group title |
CF101 2 mg
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Reporting group description |
Medication was taken orally BID for 16 weeks in a double-blinded fashion | ||
Reporting group title |
Placebo
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Reporting group description |
Medication was taken orally BID for 16 weeks in a double-blinded fashion | ||
Subject analysis set title |
Safety Population
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Subject analysis set type |
Safety analysis | ||
Subject analysis set description |
The Safety Population consists of all subjects who received at least one dose of study medication and the opportunity for at least one safety assessment, ie, at least one post-Baseline visit. A listing of all subjects excluded from the Safety Population, including subjects who failed re-qualification at Baseline, will be provided.
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Subject analysis set title |
Intent-to-Treat
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Subject analysis set type |
Intention-to-treat | ||
Subject analysis set description |
The intent-to-treat (ITT) population consists of all randomized subjects who received at least one dose of study medication with assessments sufficient to determine IOP for at least one post-baseline visit. Determination of the ITT population will be based on observed data, without imputation of missing data.
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End point title |
Change from Baseline in IOP (Target Eye) at Week 16 [1] | ||||||||||||||||
End point description |
Change from Baseline in Intraocular Pressure (Target Eye) at Week 16
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End point type |
Primary
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End point timeframe |
Baseline to Week 16
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Notes [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: The primary analysis for this study was limited to change from baseline in each arm as the planned comparisons to placebo did not show any significant difference. The p values were as follows: 0.628 for 1 mg v placebo and 0.428 for 2 mg v placebo. |
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Adverse events that occurred during the study (Weeks 0 to 16).
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Adverse event reporting additional description |
AEs were coded using MedDRA. All TEAEs were summarized by treatment group. Counts and percent were presented by treatment group for each observed SOC and preferred term as defined in MedDRA.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
9.0
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Reporting groups
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Reporting group title |
CF101 2 mg
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Reporting group description |
Analysed as the Safety Population during the treatment period (Weeks 0 to 16). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
CF101 1 mg
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Reporting group description |
Analysed as the Safety Population during the treatment period (Weeks 0 to 16). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Analysed as the Safety Population during the treatment period (Weeks 0 to 16). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 0% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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21 Apr 2010 |
• Amendment #1, Version 2.0, dated 21 April 2010: This amendment made 2 minor modifications in clinical procedures that enhanced feasibility and subject safety without affecting the efficacy objectives of the trial:
o First, the type of tonometer was no longer limited to a single instrument, so that the protocol was more readily implemented at multiple sites. Since each
subject served as his/her own control for tonometry measurements over the course of the trial, and since the same tonometer was always to be used within
any given study site, intra-ocular pressure data analyses would not be affected.
o Second, for purposes of safety monitoring, visual field (VF) testing was added at Week 8, and corneal pachymetry was added at Weeks 8 and 16.
o This amendment also modified the inclusion criteria to further enhance subject safety by eliminating from consideration potential enrollees who would have
had to discontinue previously efficacious ocular anti-hypertensive medication to qualify for the trial.
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24 May 2010 |
• Amendment #2, Version 3.0, dated 24 May 2010: This amendment clarified the Exclusion Criteria by removing redundancy and introducing more precision
about which patient population certain criteria applied to.
o The Exclusion Criterion reading “Mean VF pattern standard deviation (PSD), on reliable testing, of ≥2.0 dB in either eye” was removed because it was applicable
only to patients with ocular hypertension, who were already well defined in Inclusion Criterion #1.a and Exclusion Criterion #5 (in this amendment); and
contradicted Inclusion Criterion #1.b, because most glaucoma patients have a mean VF PSD of >2.0 dB. It was therefore removed because it was redundant and
potentially confusing.
o The Exclusion Criterion relating to “advanced VF defect in either eye” (Exclusion Criterion #4 in this amendment) was modified to refer specifically to patients
with glaucoma, because it was not relevant to patients with ocular hypertension. Likewise, the Exclusion Criterion relating to the “Ocular Hypertension
Treatment Study Group and European Glaucoma Prevention Study Group Primary Open-Angle Glaucoma Risk Table” (Exclusion Criterion #5 in this amendment)
was modified to refer specifically to patients with ocular hypertension, because it is used only in this population to stratify risk.
o In sum, these changes were made to ensure consistency of patient population definitions and application of the entry criteria, and did not impact upon patient
safety.
o Additional editorial changes were made to clarify screening and inclusion procedures and details of selected ophthalmologic examinations. None altered the
nature or the conduct of the protocol.
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15 Feb 2011 |
• Amendment #3, Version 4.0, dated 15 February 2011 (Israel only): The purpose of this amendment was to specify the expected enrollment in the 2 countries
involved in this trial for informational and regulatory purposes. There were no changes to any protocol procedures, and patient safety was not affected. |
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03 Jul 2012 |
• Amendment #4, Version 5.0, dated 03 July 2012: The purpose of this amendment was to specify the 3 countries involved in this trial for informational and
regulatory purposes and allow the enrollment of a more representative patient population without compromising the trial’s safety or efficacy objectives. |
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03 Jan 2013 |
• Amendment #5, Version 6.0, dated 03 January 2013: The purpose of this Amendment was to facilitate protocol enrollment and operations, without affecting
subject risk. Since both ophthalmologists and patients were accustomed to treating elevated IOP and glaucoma with available therapies, it had been difficult to
enroll untreated patients under the original protocol entry criteria, despite the rigorous safety incorporated into the trial. These original criteria excluded
concomitant ocular hypotensive treatments, in an attempt to isolate the pharmacologic activity of CF101 monotherapy in this population. Amendment 5
allowed CF101 to be used in combination with standard topical regimens, and was therefore expected to facilitate enrollment without interfering with the
efficacy objectives of the trial. In recognition of the fact that subjects would now enter the trial already receiving standard ocular hypotensive therapy, the
minimum entry IOP was reduced from 24 to 22 mmHg. Since the sample size calculation was based not on absolute IOP values but on relative differences
between active and placebo groups, no change in sample size was necessary. Amendment 5 also made several minor editorial and administrative modifications
and clarifications, reconciled the use of “subject” and “patient”, and removed the names of participating countries to allow for flexibility. |
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20 May 2013 |
• Amendment #6, Version 7.0, dated 20 May 2013: At the request of study sites, the sponsor clarified the examination procedures. |
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23 Jun 2014 |
• Amendment #7, Version 8.0, dated 23 June 2014: The initial rationale for this clinical trial is described in protocol Section 6.6. Since the launch of CF101-231GL,
the Sponsor completed enrollment in protocol CF101-301KCS, a Phase 3 trial in 237 subjects with keratoconjunctivitis sicca. Analysis of IOP data from that trial
indicated that the 1 mg BID dose of CF101 was less effective in reducing IOP than initially found in protocol CF101-201KCS (see protocol Section 6.6). It should be
noted that in that trial, all enrolled subjects were ocularly normotensive, and that IOP was measured as a safety, not an efficacy, assessment. Thus, even though
Segment 1 of the current trial had not completed or been reviewed by the planned Data Review Committee, there were data from an external source strongly
suggesting that a higher dose range of CF101 needed to be explored in subjects with elevated IOP. Therefore, this Amendment did the following:
o Eliminated the possibility of a CF101 0.1 mg dose group, based on data suggesting this dose will be too low to be effective;
o Formalized the CF101 2.0 mg dose group, to explore a higher and perhaps more efficacious dose level and to better define the dose-range of CF101 in this
patient population; and
o Eliminated the requirement for the Data Review Committee, as no new dosing decisions would have to be made based on current knowledge.
o Given existing and accumulating data from Phase 2 trials in other indications (see current Clinical Investigator Brochure), no new risks to subjects are anticipated
from the dosing changes proposed in this Amendment.
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None |