E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Upper facial lines (horizontal forehead lines, glabellar frown lines, and lateral periorbital lines) |
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E.1.1.1 | Medical condition in easily understood language |
Moderate to severe wrinkles in the upper face |
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E.1.1.2 | Therapeutic area | Diseases [C] - Skin and Connective Tissue Diseases [C17] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 15.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10040954 |
E.1.2 | Term | Skin wrinkling |
E.1.2 | System Organ Class | 10040785 - Skin and subcutaneous 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 investigate the efficacy and safety of 54 to 64 Units of NT 201 intramuscularly administered in subjects with moderate to severe upper facial lines. |
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E.2.2 | Secondary objectives of the trial |
To evaluate the safety of the combined treatment |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Outpatients (male or female) 18 years of age or older. • Calculated cut-off score below 0 in evaluation based on the Freiburg Life Quality Assessment - 'Lebensqualität, Haut und Kosmetik' Questionnaire [FLQA-k]). • HFL, GFL, and symmetrical LPL of moderate to severe intensity at maximum contraction as assessed by the investigator according to the Merz Aesthetics Scales. • Stable medical condition. |
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E.4 | Principal exclusion criteria |
Main Period: • Previous treatment with Botulinum toxin of any serotype in the forehead, glabellar, and/or periorbital area within the last 6 months before injection. • Previous treatment with any facial cosmetic procedure (e.g. dermal filling,chemical peeling, photo rejuvenation) in the forehead, glabellar, and/or periorbitalarea within the last 8 months before injection. • Any previous insertion of permanent material in the forehead, glabellar, and/or periorbital area (regardless of the time between previous treatment and this study). • Planned treatment with Botulinum toxin of any serotype in the face during the study period. • Any other planned facial cosmetic procedure in the face during the study period. • Very severe lines (HFL, GFL, and/or LPL) at maximum contraction as assessed by the investigator according to the Merz Aesthetics Scales. • Inability to substantially lessen UFL (HFL, GFL, LPL) by physically spreading them apart. • Any surgery or scars in the forehead, glabellar, or periorbital area. • Marked facial asymmetry. • Eyelid ptosis. • Marked brow ptosis. • History of facial nerve palsy. • Any infection and/or inflammation at the planned injection points. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Main period only: • Response at maximum contraction for the three treated areas, as assessed by the investigator according to the Merz Aesthetics Scales, i.e. a score of none (0) or mild (1). • Response at maximum contraction simultaneously for all three treatment areas, as assessed by the investigator according to the Merz Aesthetics Scales, i.e. a sum score of 3 or lower. |
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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) |
Main period: • Response at maximum contraction and at rest at days 8, 60, 90, and 120 for the three treated areas, as assessed by the investigator's rating and by the subject according to the Merz Aesthetics Scales, i.e. a score of none (0) or mild (1). • Response at maximum contraction and at rest at days 8, 30, 60, 90, and 120 for the three treated areas, as assessed independently from each other by the investigator's and the subject's rating according to the Merz Aesthetics Scales, i.e. an improvement of at least 1 point. • Response at day 30 for the overall appearance of the upper face, as assessed independently from each other by the investigator and the subject according to the Global Impression of Change Scale, i.e. a score of much improved (+2) or very much improved (+3). • Onset of effect after each treatment for all three treated areas. Open-Label Extension (OLEX) period: • Response at maximum contraction and at rest at days 8, 30, 75, and 120 for the three treated areas, as assessed by the investigator's rating and by the subject according to the Merz Aesthetics Scales, i.e. a score of none (0) or mild (1). • Response at maximum contraction and at rest at days 8, 30, 75, and 120 for the three treated areas, as assessed independently from each other by the investigator's and subject's rating according to the Merz Aesthetics Scales, i.e. an improvement of at least 1 point. • Response at day 30 for the overall appearance of the upper face, as assessed independently from each other by the investigator and the subject according to the Global Impression of Change Scale, i.e. a score of much improved (+2) or very much improved (+3). • Onset of effect after each treatment for each of the three treated areas. |
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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 | 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 | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Main period as above and as indicated in E8-2. OLEX period: Open label uncontrolled extension |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 10 |
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 | 1 |
E.8.9.1 | In the Member State concerned months | 2 |
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 | 2 |
E.8.9.2 | In all countries concerned by the trial days | 0 |