E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
JUVENILE IDIOPATHIC ARTHRITIS |
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E.1.1.1 | Medical condition in easily understood language |
JUVENILE IDIOPATHIC ARTHRITIS |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10059176 |
E.1.2 | Term | Juvenile idiopathic arthritis |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue 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 |
To characterize the PK and safety of CP 690,550 following multiple oral doses in pediatric patients (from 2 to less than 18 years) with active JIA. |
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E.2.2 | Secondary objectives of the trial |
To evaluate taste acceptability of the oral formulation of CP 690,550 in pediatric patients with JIA. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patient eligibility should be reviewed and documented by an appropriately qualified member of the investigator’s study team before patients are included in the study. Patients must meet all of the following inclusion criteria to be eligible for enrollment into the study:
Pediatric patients with JIA aged from 2 to less than 18 years with active JIA (extended oligoarthritis, polyarthritis rheumatoid factor positive or negative, psoriatic arthritis, enthesitis related arthritis), in 5 or more joints (using ACR definition of active joint) at the time of the first study drug administration.
1. The patient has discontinued prohibited concomitant medications for the required time prior to the first dose of study drug, as defined in Appendix 4 of the protocol, and is taking only those concomitant medications in doses and frequency allowed by the protocol.
2. Fertility:
a. Sterile male, or non sterile male. If the patient is a non sterile male receiving MTX treatment and is sexually active with a female partner of child bearing potential, he and his partner must be using an acceptable method of contraception during the study, and after therapy for the duration according to the local drug label.
b. Females of childbearing potential must be using an acceptable method of contraception (abstinence being a possible option) starting at least 14 days prior to the first dose of study drug and continuing for at least one ovulatory cycle after the last dose of study drug.
3. For patients receiving MTX treatment, minimum duration of therapy is 4 months and dose stable for at least 6 weeks prior to first dose of study drug. MTX may be administered either orally or parenterally at doses up to the lesser of 20 mg/wk or 15 mg/m2/week.
4. A negative QuantiFERON® TB Gold In Tube test performed within the 3 months prior to screening. A negative PPD test can be substituted for the QuantiFERON® TB Gold In Tube test only if the central laboratory is unable to perform the test or cannot determine the results to be positive or negative and the Pfizer medical monitor approves it, on a case-by-case basis.
5. Written informed consent for study participation obtained from parents or legal guardian, with assent as appropriate by the patient, depending on the level of the patient’s understanding.
6. Patients who are willing and able to comply with all scheduled visits, treatment plan, laboratory tests, and other study procedures. |
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E.4 | Principal exclusion criteria |
1. Systemic JIA, persistent oligoarthritis, undifferentiated arthritis. 2. Hgb <11 g/dL or Hct <33% (b) WBC <3.0 x 10 to the power of 9/L ; Neutr count <1.2 x 10 to the power of 9/L; Platelet count <100 x 10 to the power of 9/L; lymphocyte count <0,5 to the power of 9/L 3. Estimated GFR <40 mL/min by Schwartz formula. 4. Current or recent history of uncontrol. clinical. signific. renal, hepatic, hematological, gastrointestinal, endocrine, pulmonary, cardiac, or neurological disease. 5. AST or ALT ≥1.5XULN or other clinically significant lab. abnormality. 6. History of any other rheumatic autoimmune diseas. 7. History or current sympt. suggestive of any lymphoproliferative disorder (eg, Epstein Barr Virus related lymphoproliferative disorder, history of lymphoma, leukemia, or signs and sympt. suggestive of current lymphatic disease). 8. Infections: Latent or active TB or any history of previous TB; Chronic infect; Any infection requiring hosp., parenteral antimicrobial therapy or judged to be opportunistic by the invest. within the 6 months prior to the first dose of study drug; Any treated infections within 2 weeks; Infection with human immunodeficiency virus (HIV), hepatitis B or hepatitis C virus; History of infected joint prosthesis with prosthesis still in situ. 9. History of recurrent or disseminated herpes zoster or disseminated herpes simplex. 10. Any condition possibly affecting drug absorption. 11. Potent and moderate CYP3A4 inhibitors. 12. Potent and moderate CYP3A4 inducers. 13. Following treatments are disallowed during this study and must be discontinued prior to first dose of study drug for at least: Anakinra and Etanercept, for 4 weeks; Adalimumab, for 6 weeks; Infliximab, for 8 weeks; Golimumab, for 10 weeks; Abatacept, tocilizumab and certolizumab pegol, for 12 weeks; Auranofin (oral gold), aurothioglucose (injectable gold), aurothiomalate (injectable gold), for 8 weeks; Sulfasalazine, d penicillamine, azathioprine, chloroquine, hydroxychloroquine, cyclosporine, tacrolimus, and staphylococcal protein A immuno absorbant pheresis columns, for 4 weeks 14. Following treatments are disallowed during this study and must be discontinued prior to first dose of study drug for at least: Leflunomide, for 8 weeks. Alternatively, a washout procedure may be used; Ustekinumab, for 12 weeks; Alefacept must be discontinued for 8 weeks; UVB phototherapy for at least 2 weeks. Psoralens + UVA phototherapy (PUVA) for 4 weeks 15. Participation in studies of investigational compounds within 4 weeks or 5 half lives (whichever is longer) prior to the first dose of study drug or at any time during the study. 16. Any prior treatment with non B cell specific lymphocyte depleting agents/therapies [eg, almetuzuma, alkylating agents (eg, cyclophosphamide or chlorambucil), total lymphoid irradiation, etc]. Subjects who have received rituximab or other selective B lymphocyte depleting agents (including experimental agents) are eligible if they have not received such therapy for at least 1 year prior to study baseline and have normal CD 19/20+ counts by FACS analysis. 17. Pregnant or nursing females; females of childbearing potential unwilling or unable to use an acceptable method of contraception from at least 14 days prior to the first dose of study drug and for least one ovulatory cycle after the last dose 18. Intramuscular, intravenous or intraarticular corticosteroids in the 4 weeks preceding first dose of study drug 19. Vaccination with live or attenuated vaccines within the 6 weeks prior to the first dose of study drug or is vaccination with these vaccines at any time during treatment or within 6 weeks following discontinuation of study drug 20. Use of prohibited prescription or nonprescription drugs and dietary supplements within 7 days or 5 half lives (whichever is longer) prior to the first dose of study drug 21. Herbal supplements must be discontinued at least 28 days prior to the first dose of study drug 2. Hist. of sensitivity to heparin or heparin-induced thrombocytopenia 23. 1. degree relative with a hereditary immunodeficiency 24. Malignancy or with a hist. of malignancy with the exception of adequately treated or excised non metastatic basal cell or squamous cell cancer of the skin or cervical carcinoma in situ 25. Recent (within 28 days prior to 1. dose of study drug) signif. trauma or major surgery 26. Unwilling or unable to comply with the Lifestyle Guidelines 27. 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 patient inappropriate for entry into this study 28. Patients who are investigational site staff members or relatives of those site staff members or patients who are Pfizer employees directly involved in the conduct of the trial |
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E.5 End points |
E.5.1 | Primary end point(s) |
- Oral clearance (CL/F) on Day 5.
- Safety and tolerability.
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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) |
- AUCt, Cmax, tmax and half life.
-Evaluation of taste acceptability of oral formulation.
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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 | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
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 | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Pharmacokinetics, safety and tolerability |
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E.7.2 | Therapeutic exploratory (Phase II) | No |
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) | 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
| Information not present in EudraCT |
E.8.4 | The trial involves multiple sites in the Member State concerned | Information not present in EudraCT |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 12 |
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 |
Argentina |
Czech Republic |
Germany |
Hungary |
Italy |
Mexico |
Poland |
Russian Federation |
Serbia |
Slovakia |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 3 |
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 | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |