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    Summary
    EudraCT Number:2012-004072-19
    Sponsor's Protocol Code Number:Acti-INSP-001
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2013-09-05
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2012-004072-19
    A.3Full title of the trial
    A randomized, double-blind, parallel group, placebo controlled Phase II study to evaluate the safety and efficacy of two inhaled LASAG regimens and Placebo, applied three times daily in adult hospitalized patients with acute serious influenza
    Ensayo de fase II aleatorizado, doble ciego, de grupos paralelos, controlado con placebo para evaluar la seguridad y la eficacia de dos regímenes de LASAG y placebo inhalados, aplicados tres veces al día en pacientes adultos con gripe aguda grave hospitalizados
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A randomized, double-blind, parallel group, placebo controlled Phase II study to evaluate the safety and efficacy of two inhaled LASAG regimens and Placebo, applied three times daily in adult hospitalized patients with acute serious influenza
    Ensayo de fase II aleatorizado, doble ciego, de grupos paralelos, controlado con placebo para evaluar la seguridad y la eficacia de dos regímenes de LASAG y placebo inhalados, aplicados tres veces al día en pacientes adultos con gripe aguda grave hospitalizados
    A.4.1Sponsor's protocol code numberActi-INSP-001
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorActivaero GmbH
    B.1.3.4CountryGermany
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportActivaero GmbH
    B.4.2CountryGermany
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationActivaero GmbH
    B.5.2Functional name of contact pointProject Manager Clinical Studies
    B.5.3 Address:
    B.5.3.1Street AddressWohraer Strasse 37
    B.5.3.2Town/ cityGemuenden/Wohra
    B.5.3.3Post code35285
    B.5.3.4CountryGermany
    B.5.4Telephone number004964536481823
    B.5.5Fax number004964536481822
    B.5.6E-mailKarlheinz.Nocker@activaero.de
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Aspirin iv 500mg (composition: D,L-lysine acetylsalicylate ? glycine, LASAG)
    D.2.1.1.2Name of the Marketing Authorisation holderBayer Vital GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameLASAG (composition of Aspirin iv 500mg)
    D.3.4Pharmaceutical form Powder and solvent for nebuliser solution
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPInhalation use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNACETYLSALICYLIC ACID
    D.3.9.3Other descriptive nameACETYLSALICYLIC ACID
    D.3.9.4EV Substance CodeSUB12730MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboNebuliser solution
    D.8.4Route of administration of the placeboInhalation use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Influenza A and B
    Gripe A y B
    E.1.1.1Medical condition in easily understood language
    Flu
    Gripe
    E.1.1.2Therapeutic area Body processes [G] - Circulatory and Respiratory Physiological Phenomena [G09]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.1
    E.1.2Level PT
    E.1.2Classification code 10022000
    E.1.2Term Influenza
    E.1.2System Organ Class 10021881 - Infections and infestations
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective of this study is to evaluate the clinical efficacy of two different doses of inhaled LASAG plus standard of care compared to placebo plus standard of care in patients hospitalized due to acute serious influenza OR an influenza caused worsening of a primary medical condition measured by time to alleviation of influenza symptoms.
    Influenza symptoms are defined as:
    ? nasal congestion
    ? sore throat
    ? cough
    ? aches/myalgia
    ? fatigue
    ? headaches
    ? feverishness/chills/sweats
    Time to alleviation is defined as the time in hours from first inhalation of LASAG until at least 5 of 7 clinical influenza symptoms are rated with 0 (not present, i.e. like before the influenza) or 1 (mild) on the influenza symptom questionnaire without any use of symptom relief medication (i.e. acetaminophen) and remained so for at least 24 plus/minus 2 hours.
    Evaluar la eficacia clínica de dos dosis diferentes de LASAG inhalado más el tratamiento de referencia en comparación con placebo más el tratamiento de referencia en pacientes hospitalizados por gripe aguda grave O agravamiento de una afección clínica primaria causado por la gripe, determinada por el tiempo hasta el alivio de los síntomas gripales.
    Síntomas gripales se define como:
    - congestión nasal
    - dolor de garganta
    - tos
    - malestar/mialgia
    - fatiga
    - cefalea
    - fiebre/escalofríos/sudor

    Tiempo hasta el alivio se define como el tiempo en horas desde la primera inhalación de LASAG hasta la valoración de por lo menos 5 de 7 síntomas clínicos de gripe con 0 (ausente, es decir, como antes de la gripe) o 1 (leve) en el cuestionario de síntomas de la gripe sin uso de ninguna medicación para el alivio de los síntomas (es decir, acetaminofeno) y que permaneció así durante por lo menos 24 más/menos 2 horas
    E.2.2Secondary objectives of the trial
    The main secondary objective is to evaluate the clinical efficacy of two different doses of inhaled LASAG plus standard of care compared to placebo plus standard of care in patients hospitalized due to acute serious influenza OR an influenza caused worsening of a primary medical condition as measured by time to alleviation of the following clinical influenza signs:
    1. Body Temperature
    ? ? 37.2 °C (? 99 °F) oral
    ? ? 37.8°C (? 100°F) rectal or tympanic
    2. Oxygen saturation
    ? ? 92% (without oxygen feed)
    3. Respiratory rate
    ? ? 24/minute
    4. Heart rate
    ? ? 100/minute
    5. Systolic BP
    ? ? 90 mm Hg
    Time to alleviation is defined as the time in hours from first inhalation of LASAG until resolution of at least 4 of the 5 clinical signs within resolution criteria given above and maintained for at least 24±2 hours without use of symptomatic relief medication (i.e. acetaminophen). 2 of the 4 resolution criteria have to be body temperature and oxygen saturation.
    Evaluar la eficacia clínica de 2 dosis diferentes de LASAG inhalado más el tratamiento de referencia en comparación con placebo más el tratamiento de referencia en pacientes hospitalizados por gripe aguda grave o agravamiento de una afección clínica primaria causado por la gripe, determinada por
    a) el tiempo hasta el alivio de los signos clínicos de la gripe.
    Los signos clínicos de la gripe y los criterios de resolución se definen por Temperatura corporal, saturación de oxígeno, frecuencia respiratoria, frecuencia cardíaca y PA sistólica.
    Tiempo hasta el alivio se define como el tiempo en horas desde la 1ª inhalación de LASAG hasta la resolución de por lo menos 4 de los 5 signos clínicos descriptos precedentemente en los criterios de resolución definidos y que se mantengan durante por lo menos 24±2 horas sin uso de medicación para el alivio de los síntomas (es decir, acetaminofeno). 2 de los 4 criterios de resolución deben ser la temperatura corporal y la saturación de oxígeno.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1) Age ? 18 and ? 80 years
    2) Ability to provide written informed consent prior to performance of any study-related procedure
    3) Ability to perform controlled inhalations with the AKITA JET device according to the investigator?s opinion
    4) Indication for hospitalization due to suspected acute severe influenza OR patients with another medical condition (e.g. diabetes mellitus, COPD or other chronic lung disease) worsened by influenza and leading to indication for hospitalization
    5) Living in a community with documented current influenza transmission, confirmed by viral culture or RT-PCR OR patients with influenza like illness with positive rapid antigen test or RT-PCR at screening
    NOTE: An influenza outbreak may be documented in the catchment area of the hospital via one of the following methods:
    1) local confirmation of influenza A or B infection in the current influenza season by
    a) the institution's local laboratory (by means of RT-PCR or viral culture), or
    b) the local public health system, or
    c) the national public health system, or
    d) a laboratory of a recognized multinational influenza surveillance scheme such as the European Influenza Surveillance Network (EISN) or Pan American Health Organization (PAHO);
    2) prior enrollment of a PCR positive subject into this study at the same institution in the current influenza season
    6) Presence of at least one respiratory symptom (nasal congestion, sore throat or cough) of any severity (mild, moderate, or severe) and present admission to hospital due to (suspected) influenza
    7) Presence of at least one constitutional symptom (aches/myalgia, fatigue headache or feverishness/chills/sweat) of any severity (mild, moderate, or severe) and present admission to hospital due to (suspected) influenza
    8) Presence of fever at time of screening of ? 38.0 °C taken orally, or ? 38.5 °C taken rectally or tympanic OR history of documented fever or patient reported symptom of feverishness at any time during 48 hours prior to screening
    NOTE: Axillary temperature measurement is not allowed
    9) Patient reported onset of illness less than 72 hours before first study drug application
    NOTE: Time of onset of illness is defined as either (1) the time when the temperature (either oral or rectal or tympanic) was first measured as elevated (at least one degree (°C) of elevation in comparison to first temperature measurement), OR (2) the time when the subject experienced the presence of at least one moderate respiratory symptom AND the presence of at least one moderate constitutional symptom. Axillary temperature measurement is not allowed
    10) Female participants of childbearing (reproductive) potential must have a negative urine pregnancy test at screening and agree to use an acceptable method of contraception throughout their participation in the study. Acceptable methods of contraception (a Pearl Index < 1%) include:
    - hormonal methods (oral contraceptives, patches or medroxyprogesterone acetate)
    - An intrauterine device (IUD) with a documented failure rate of less than 1% per year
    - Abstinence may be considered an acceptable method of contraception at the discretion of the investigator
    NOTE: Females who have been surgically sterilized (e.g., hysterectomy or bilateral tubal ligation) or who are postmenopausal (total cessation of menses for >1 year) will not be considered as ?females of childbearing potential.?
    1) Edad ? 18 y ? 80 años
    2) Capacidad de proporcionar el consentimiento informado escrito antes de la realización de cualquier procedimiento relacionado con el ensayo
    3) Capacidad de realizar inhalaciones controladas con el inhalador AKITA JET de acuerdo con la opinión del investigador
    4) Indicación de hospitalización por sospecha de influenza grave aguda O pacientes con otra afección clínica (por ej. diabetes mellitus, EPOC u otra enfermedad pulmonar crónica) agravada por la gripe y que dé lugar a la indicación de hospitalización
    5) Pacientes que viven en una comunidad con transmisión actual de gripe documentada, confirmada mediante cultivo viral o RT-PCR O pacientes con enfermedad similar a la gripe con una prueba rápida de antígenos o RT-PCR positiva en la selección
    NOTA: Un brote de gripe en el área de cobertura del hospital puede documentarse a través de uno de los siguientes métodos:
    1) confirmación local de gripe A o B en la temporada actual de gripe mediante
    a) el laboratorio local de la institución (a través de RT-PCR o cultivo viral), o
    b) el sistema de salud pública local, o
    c) el sistema de salud pública nacional, o
    d) un laboratorio con un esquema de vigilancia de la gripe multinacional reconocido como por ejemplo la Red Europea para la Vigilancia de la Gripe (EISN, por sus siglas en inglés) o la Organización Panamericana de la Salud (OPS);
    2) incorporación previa en este ensayo de un sujeto con un resultado positivo en la PCR en la misma institución en la temporada actual de gripe
    6) Presencia de por lo menos un síntoma respiratorio (congestión nasal, dolor de garganta o tos) de cualquier intensidad (leve, moderado, o grave) y hospitalización actual por (sospecha de) gripe
    7) Presencia de por lo menos un síntoma constitucional (malestar/mialgia, fatiga, cefalea o fiebre/escalofríos/sudor) de cualquier intensidad (leve, moderado, o grave) y hospitalización actual por (sospecha de) gripe
    8) Presencia de temperatura oral ?38,0 °C en la selección, o temperatura rectal o timpánica ?38,5 °C O antecedentes de fiebre documentada o síntoma de fiebre informado por el paciente en cualquier momento durante las 48 horas previas a la selección
    NOTA: No se permite la medición de la temperatura axilar
    9) Comienzo de la enfermedad informado por el paciente menos de 72 horas antes de la primera administración de la medicación en ensayo
    NOTA: El momento de comienzo de la enfermedad se define como (1) el momento de la primera medición de temperatura (oral, rectal o timpánica) alta (aumento de por lo menos un grado (°C) en comparación con la primera medición de la temperatura), O (2) momento en que el sujeto experimentó por lo menos un síntoma respiratorio moderado Y por lo menos un síntoma constitucional moderado. No se permite la medición de la temperatura axilar
    10) Las mujeres fértiles (con potencial reproductivo) deben tener una prueba de embarazo en orina negativa en la selección y aceptar usar un método anticonceptivo efectivo a lo largo de su participación en el ensayo. Los métodos anticonceptivos efectivos (índice de Pearl <1%) incluyen:
    - métodos hormonales (anticonceptivos orales, parches o acetato de medroxiprogesterona)
    - dispositivo intrauterino (DIU) con una tasa de fracaso anual documentada inferior al 1%
    - la abstinencia puede considerarse un método anticonceptivo efectivo a criterio del investigador
    NOTA: Las mujeres esterilizadas quirúrgicamente (por ej., histerectomía o ligadura de trompas bilateral) o que sean posmenopáusicas (cese total de la menstruación >1 año) no se considerarán ?mujeres con potencial reproductivo.?
    E.4Principal exclusion criteria
    1) Current clinical evidence or suspicion of an acute non-influenza infectious illness at the time of screening and baseline visit
    2) Subjects who have been hospitalized due to a condition other than acute influenza and in whom influenza is diagnosed during hospitalization
    3) Known allergy or hypersensitivity against Acetylsalicylic Acid (ASA) or LASAG
    4) ASA induced asthma or patients with insufficiently controlled bronchial asthma
    5) Presence of any chronic lung condition requiring either continuous or intermittent oxygen therapy
    NOTE: Subjects who are determined to require acute supplemental oxygen therapy at the time of hospital admission may be enrolled, if exclusion criteria regarding mechanical ventilation (see below) are not applicable
    6) Requirement for acute or chronic mechanical ventilation, either via oral or nasotracheal intubation or via tracheostomy, or chronic or intermittent requirement for BiPAP (bilevel positive airway pressure) at screening
    NOTE: Subjects who require overnight Continuous Positive Airway Pressure (CPAP) treatment for sleep apnea (without oxygen supplementation) may be enrolled
    7) Respiratory instability requiring ICU admission resulting in inability to breathe from a nebulizer
    8) Immunized against influenza with live attenuated virus vaccine in the previous 4 weeks (=4x7 = 28 days)
    9) Presence of one of the following uncontrolled or unstable cardiovascular diseases: stroke, ECG confirmed acute ischemia or myocardial infarction and/or clinically significant dysrhythmia
    10) Presence of cardiac signs or symptoms compatible with NYHA Class IV functional status for congestive heart failure
    11) Known history of gastrointestinal bleeding, uncontrolled peptic or uncontrolled duodenal ulcer
    12) Known history of moderate or severe renal impairment and/or previous clinical laboratory data indicating an estimated creatinine clearance <30 mL/min during the last 12 months (=12x28 days = 336 days)
    13) Known history of clinically significant proteinuria ( ? 1000 mg/24 hrs) during the last 12 months (=12x28 days = 336 days)
    14) Presence of currently uncontrolled hyperuricaemia and/or diminished excretion of uric acid without appropriate pharmacotherapy during the last 12 months (=12x28 days = 336 days)
    15) Known history of unstable cirrhosis or unstable advanced liver disease (Child-Pugh class B or C)
    16) Known history of hemophilia or other bleeding disorders
    17) History of organ transplantation, congenital immunodeficiency
    18) Use of immunosuppressive therapies with a 10mg or more prednisolone-equivalent dose during the last 6 months (=6x28 days = 168 days). Use of inhaled glucocorticoids is permitted
    19) Known history of human immunodeficiency virus (HIV) infection
    20) Patients currently on or likely to require anticoagulation with coumarin, heparin, warfarin or similar products
    NOTE: 1) chronic oral use of ASA (acetylsalicylic acid) at doses of 100mg/day for the purpose of anticoagulation e.g. in patients with coronary artery disease is allowed 2) Heparin (respectively Low Molecular Weight Heparin (LMWH)) for deep venous thrombosis prophylaxis is allowed
    21) Expected explicit need for NSAIDs (non-steroidal anti-inflammatory drugs) during the study that cannot be covered by symptomatic acetaminophen (i.e. paracetamol) therapy (e.g. patients with chronic rheumatic conditions)
    NOTE: For the relief of influenza symptoms, acetaminophen (paracetamol) must be used. Ibuprofen is prohibited. If Ibuprofen is used before screening, medication has to be switched to acetaminophen (paracetamol)
    22) Presence of any cancer type (hematologic or solid tumor), that requires chemotherapy or radiation therapy, with the exception of localized non-melanoma skin cancer
    23) Known history of alcohol abuse or drug addiction during the last 12 months (=12x28 days = 336 days)
    24) Presence of a psychiatric illness or dementia that would preclude ability to use a nebulizer or complete the symptom questionnaire
    25) Use of intravenous or intramuscular medications, containing acetylsalicylic acid within 72 hours prior first LASAG inhalation
    26) Participation in a clinical study using an experimental medication during the last 4 weeks (=4x7 days = 28 days)
    27) Women who are pregnant, breast-feeding or who are willing to become pregnant during the course of the study
    28) Vulnerable patients who are not able to give informed consent or who might depend on the clinical study site or investigator
    1) Evidencia o sospecha clínica actual de una enfermedad infecciosa aguda que no sea gripe en la selección y la visita basal
    2) Sujetos que hayan sido hospitalizados por una afección que no sea gripe aguda y en los cuales se diagnostique gripe durante la hospitalización
    3) Alergia o hipersensibilidad conocida al ácido acetilsalicílico (AAS) o LASAG
    4) Asma inducido por AAS o pacientes con asma bronquial no controlado adecuadamente
    5) Presencia de alguna afección pulmonar crónica que requiera oxigenoterapia continua o intermitente
    NOTA: Se pueden incorporar sujetos en los cuales se determina que requieren oxigenoterapia complementaria aguda al momento de la admisión hospitalaria, si no cumplen con los criterios de exclusión sobre asistencia respiratoria mecánica (ver abajo)
    6) Requerimiento de asistencia respiratoria mecánica aguda o crónica, ya sea oral o por intubación nasotraqueal o traqueostomía, o requerimiento de BiPAP (presión positiva binivel en la vía aérea) crónica o intermitente en la selección
    NOTA: Pueden incorporarse sujetos que requieren tratamiento con presión positiva continua de la vía aérea (CPAP) durante la noche por apnea del sueño (sin suplemento de oxígeno)
    7) Inestabilidad respiratoria que requiera admisión en la UCI e impida hacer nebulizaciones
    8) Sujeto inmunizado contra la gripe con una vacuna de virus vivos atenuados dentro de las 4 semanas previas (=4x7 = 28 días)
    9) Presencia de una de las siguientes enfermedades cardiovasculares no controladas o inestables: accidente cerebrovascular, isquemia aguda o infarto de miocardio confirmados mediante ECG y/o disritmia clínicamente significativa
    10) Presencia de signos o síntomas cardíacos compatibles con estado funcional Clase IV de la NYHA para insuficiencia cardíaca congestiva
    11) Antecedentes conocidos de hemorragia digestiva, úlcera péptica no controlada o úlcera duodenal no controlada
    12) Antecedentes conocidos de insuficiencia renal moderada o grave y/o datos de laboratorio previos que indiquen depuración de creatinina estimada <30 mL/min en los últimos 12 meses (=12x28 días = 336 días)
    13) Antecedentes conocidos de proteinuria clínicamente significativa (?1000 mg/24 h) en los últimos 12 meses (=12x28 días = 336 días)
    14) Presencia de hiperuricemia actualmente no controlada y/o disminución de la excreción de ácido úrico sin farmacoterapia apropiada en los últimos 12 meses (=12x28 días = 336 días)
    15) Antecedentes conocidos de cirrosis inestable o enfermedad hepática avanzada inestable (clase B o C de Child-Pugh)
    16) Antecedentes conocidos de hemofilia u otros trastornos hemorrágicos
    17) Antecedentes de trasplante de órganos, inmunodeficiencia congénita
    18) Uso de tratamientos inmunosupresores a una dosis equivalente de prednisona de 10 mg o más en los últimos 6 meses (=6x28 días = 168 días). Se permite el uso de glucocorticoides inhalados
    19) Antecedentes conocidos de infección por el virus de inmunodeficiencia humana (VIH)
    20) Pacientes que actualmente reciban o tengan la probabilidad de requerir anticoagulación con cumarina, heparina, warfarina, o productos similares
    NOTA: 1) se permite el uso oral crónico de AAS (ácido acetilsalicílico) en dosis de 100 mg/día para anticoagulación, por ej. en pacientes con arteriopatía coronaria 2) se permite el uso de heparina (heparina de bajo peso molecular (HBPM)) para profilaxis de trombosis venosa profunda
    21) Necesidad explícita prevista de AINEs (antiinflamatorios no esteroides) durante el ensayo que no pueda cubrirse con tratamiento sintomático con acetaminofeno (es decir, paracetamol) (por ej. pacientes con afecciones reumáticas crónicas)
    NOTA: Para el alivio de los síntomas gripales se debe usar acetaminofeno (paracetamol). Se prohíbe el uso de ibuprofeno. Si se usa ibuprofeno antes de la selección, la medicación debe cambiarse por acetaminofeno (paracetamol)
    22) Presencia de cualquier tipo de cáncer (hematológico o tumor sólido) que requiera quimioterapia o radioterapia, con la excepción de cáncer de piel no melanoma localizado
    23) Antecedentes conocidos de abuso de alcohol o drogadicción en los últimos 12 meses (=12x28 días = 336 días)
    24) Presencia de una enfermedad psiquiátrica o demencia que impidiera usar un nebulizador o completar el cuestionario de síntomas
    25) Uso de medicación intravenosa o intramuscular que contenga ácido acetilsalicílico dentro de las 72 horas previas a la primera inhalación de LASAG
    26) Participación en un ensayo clínico que use un fármaco experimental en las últimas 4 semanas (=4x7 días = 28 días)
    27) Mujeres embarazadas, en período de lactancia o que deseen quedar embarazadas durante el curso del ensayo
    28) Pacientes vulnerables que no puedan proporcionar el consentimiento informado o podrían depender del centro del ensayo clínico o del investigador
    E.5 End points
    E.5.1Primary end point(s)
    Time to alleviation of clinical influenza symptoms which is defined as the time in hours from first inhalation of LASAG until at least 5 of 7 clinical influenza symptoms are rated with 0 (not present, i.e. like before the influenza) or 1 (mild) on the influenza symptom questionnaire without any use of symptom relief medication (i.e. acetaminophen) and remained so for at least 24±2 hours. Influenza symptoms are defined as:
    ? nasal congestion
    ? sore throat
    ? cough
    ? aches/myalgia
    ? fatigue
    ? headaches
    ? feverishness/chills/sweats
    Evaluar la eficacia clínica de dos dosis diferentes de LASAG inhalado más el tratamiento de referencia en comparación con placebo más el tratamiento de referencia en pacientes hospitalizados por gripe aguda grave O agravamiento de una afección clínica primaria causado por la gripe, determinada por el tiempo hasta el alivio de los síntomas gripales.
    Síntomas gripales se define como:
    ? congestión nasal
    ? dolor de garganta
    ? tos
    ? malestar/mialgia
    ? fatiga
    ? cefalea
    ? fiebre/escalofríos/sudor
    E.5.1.1Timepoint(s) of evaluation of this end point
    Time to alleviation of clinical influenza symptoms which is defined as the time in hours from first inhalation of LASAG until at least 5 of 7 clinical influenza symptoms are rated with 0 (not present, i.e. like before the influenza) or 1 (mild) on the influenza symptom questionnaire without any use of symptom relief medication (i.e. acetaminophen) and remained so for at least 24±2 hours. Influenza symptoms are defined as:
    ? nasal congestion
    ? sore throat
    ? cough
    ? aches/myalgia
    ? fatigue
    ? headaches
    ? feverishness/chills/sweats
    Tiempo hasta el alivio se define como el tiempo en horas desde la primera inhalación de LASAG hasta la valoración de por lo menos 5 de 7 síntomas clínicos de gripe con 0 (ausente, es decir, como antes de la gripe) o 1 (leve) en el cuestionario de síntomas de la gripe sin uso de ninguna medicación para el alivio de los síntomas (es decir, acetaminofeno) y que permaneció así durante por lo menos 24±2 horas.
    Síntomas gripales se define como:
    ? congestión nasal
    ? dolor de garganta
    ? tos
    ? malestar/mialgia
    ? fatiga
    ? cefalea
    ? fiebre/escalofríos/sudor
    E.5.2Secondary end point(s)
    1) Time from start of treatment to alleviation of at least 4 of 5 clinical influenza signs maintained for at least 24±2 hours and without use of symptomatic relief medicines (i.e. acetaminophen)
    2) Percentage of subjects whose influenza symptoms have completely resolved at specific time points (after inhalations 5, 8, 11 and 14)
    3) Percentage of subjects whose influenza signs have completely resolved at specific time points (after inhalations 5, 8, 11 and 14)
    4) Composite symptom score changes over time (AUC)
    5) Change in viral load before inhalation 8
    6) Percentage of subjects with >2-log drop in viral load prior to 8th dose
    7) Descriptive statistics regarding adverse events and treatment discontinuations
    8) Descriptive statistics of influenza related and all-cause mortality at follow-up visit 3
    1) Tiempo hasta el alivio se define como el tiempo en horas desde la primera inhalación de LASAG hasta la resolución de por lo menos 4 de los 5 signos clínicos descriptos precedentemente en los criterios de resolución definidos y que se mantengan durante por lo menos 24±2 horas sin uso de medicación para el alivio de los síntomas (es decir, acetaminofeno).
    E.5.2.1Timepoint(s) of evaluation of this end point
    1) Time from start of treatment to alleviation of at least 4 of 5 clinical influenza signs maintained for at least 24±2 hours without use of symptomatic relief medicines (i.e. acetaminophen)
    2) Percentage of subjects whose influenza symptoms and signs have completely resolved at specific time points (after inhalations 5, 8, 11 and 14)
    3) Composite symptom score changes over time (AUC)
    4) Change in viral load before inhalation 8
    5) Percentage of subjects with >2-log drop in viral load prior to 8th dose
    6) Descriptive statistics regarding AEs and treatment discontinuations
    7) Descriptive statistics of influenza related and all-cause mortality at follow-up visit 3
    1) Tiempo desde el inicio del tratamiento hasta el alivio de por lo menos 4 de 5 signos clínicos de la gripe que se mantenga durante por lo menos 24±2 horas y sin uso de medicación para el alivio de los síntomas.
    2) % de sujetos con resolución completa de síntomas y signos (después de las inhalaciones 5, 8, 11 y 14)
    3) Cambios en el puntaje combinado de síntomas en el tiempo (AUC)
    4) Cambio en la carga viral antes de la inhalación 8
    5) Porcentaje de sujetos con una reducción >2 log en la carga viral antes de la 8va dosis
    6) Estadística descriptiva con respecto a eventos adversos y discontinuaciones del tratamiento
    7) Estadística descriptiva de la mortalidad por gripe y por todas las causas en la visita de seguimiento 3
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    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.8.4.1Number of sites anticipated in Member State concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA38
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Chile
    Czech Republic
    Germany
    Hungary
    Poland
    Slovakia
    Spain
    Ukraine
    E.8.7Trial 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
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years1
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 100
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 100
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state20
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 100
    F.4.2.2In the whole clinical trial 200
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    After end of study all patients will be further treated according to the standard of care procedures of the involved hospitals if still necessary in the Investigator?s opinion.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2013-10-28
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2013-10-14
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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