E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Nonsense mutation dystrophinopathy |
|
E.1.1.1 | Medical condition in easily understood language |
Duchenne and Becker muscular dystrophy |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Musculoskeletal Diseases [C05] |
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 | 10013801 |
E.1.2 | Term | Duchenne muscular dystrophy |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
|
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 | 10059117 |
E.1.2 | Term | Becker's muscular dystrophy |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
|
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 determine the ability of ataluren to slow disease progression as assessed by ambulatory decline (decrease in 6MWD) in patients with nonsense mutation dystrophinopathy. |
|
E.2.2 | Secondary objectives of the trial |
To determine the effect of ataluren on: - Ambulation - Proximal muscle function - Physical function - Patient and/or parent reported activities of daily living and disease symptoms - Parent-reported HRQL - Safety parameters - Compliance - Exposure of ataluren in plasma |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Evidence of signed and dated informed consent/assent document(s) indicating that the subject (and/or his parent/legal guardian) has been informed of all pertinent aspects of the trial 2. Male sex 3. Age ≥7 and ≤16 years. 4. Phenotypic evidence of dystrophinopathy based on the onset of characteristic clinical symptoms or signs (eg, proximal muscle weakness, waddling gait, and Gowers’ maneuver) by 6 years of age, an elevated serum CK, and ongoing difficulty with ambulation. 5. Documentation of the presence of a nonsense point mutation in the dystrophin gene as determined by gene sequencing from a laboratory certified by College of American Pathologists (CAP), Clinical Laboratory Improvement Act/Amendment (CLIA), or an equivalent organization. 6. Documentation that a blood sample has been drawn for confirmation of the presence of a nonsense mutation in the dystrophin gene. 7. Use of systemic corticosteroids (prednisone, prednisolone, or deflazacort) for a minimum of 6 months immediately prior to start of study treatment, with no significant change in dosage or dosing regimen (not related to body weight change) for a minimum of 3 months immediately prior to start of study treatment and a reasonable expectation that dosage and dosing regimen will not change significantly for the duration of the study. 8. Valid Screening 6MWD ≥150 meters. Valid Screening 6MWD must be ≤80% of predicted for age and height [Geiger 2007]. 9.Results of the 2 Baseline 6MWD results must be determined as valid and results of the Day 2 Baseline 6MWD must be within 20% of the Day 1 Baseline 6MWD. 10. Baseline 6MWD (mean valid Day 1 and Day 2 values) must be no more than a 20% change from the valid Screening 6MWD. 11. Confirmed screening laboratory values within the central laboratory ranges specified in in the protocol. 12. In subjects who are sexually active, willingness to abstain from sexual intercourse or employ a barrier or medical method of contraception during the study drug administration and 6-week follow-up period. 13. Willingness and ability to comply with scheduled visits, drug administration plan, study procedures, laboratory tests, and study restrictions. |
|
E.4 | Principal exclusion criteria |
1. Treatment with systemic aminoglycoside antibiotics within 3 months prior to start of study treatment. 2. Initiation of systemic corticosteroid therapy within 6 months prior to start of study treatment. 3. Change in systemic corticosteroid therapy (eg, change in type of drug, dose modification not related to body weight change, schedule modification, interruption, or reinitiation) within 3 months prior to start of study treatment. 4. Any change (initiation, change in type of drug, dose modification, schedule modification, interruption, discontinuation, or reinitiation) in prophylaxis/treatment for congestive heart failure (CHF) within 3 months prior to start of study treatment. 5. Ongoing use of coumarin-based anticoagulants (eg. warfarin), phenytoin, tolbutamide, or paclitaxel. 6. Prior therapy with ataluren. 7. Known hypersensitivity to any of the ingredients or excipients of the study drug [eg. refined polydextrose, polyethylene glycol 3350, poloxamer 407, mannitol 25C, crospovidone XL10, hydroxyethyl cellulose, colloidal silica, magnesium stearate] 8. Exposure to another investigational drug within 3 months prior to start of study treatment. 9. History of major surgical procedure within 6 weeks prior to start of study treatment 10. Ongoing immunosuppressive therapy (other than corticosteroids) 11. Ongoing participation in any clinical trial (except for studies specifically approved by PTC Therapeutics) 12. Expectation of major surgical procedure (eg, scoliosis surgery) during the 12-month treatment period of the study. 13. Requirement for daytime ventilator assistance. 14. Uncontrolled clinical symptoms and signs of CHF (American College of Cardiology/American Heart Association Stage C or Stage D) [Hunt 2001] 15. Prior or ongoing medical condition (eg, concomitant illness, psychiatric condition, behavioral disorder, alcoholism, drug abuse), medical history, physical findings (eg. lower limb injury that may affect 6MWT performance), ECG findings, or laboratory abnormality that, in the investigator’s opinion, could adversely affect the safety of the subject, makes it unlikely that the course of treatment or follow-up would be completed, or could impair the assessment of study results. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Screening visit and every 8 weeks |
|
E.5.2 | Secondary end point(s) |
1. Time to 10% persistent worsening in 6MWD 2. Proportion of patients with ≥10% worsening in 6MWD at Week 48 3. Change in %-predicted 6MWD 4. Change in timed function tests (time to walk/run 10 meters and time to climb/descend 4 stairs) 5. Change in physical function as measured by the NSAA 6. Change in patient and/or parent/caregiver reports of activities of daily living as measured by a standardized survey administered by site personnel 7. Change in PODCI Transfers/Basic Mobility and Sports/Physical Functioning scores 8. Safety profile characterized by type, frequency, severity, timing, and relationship to study drug of any adverse events, or of abnormalities of laboratory tests, vital signs, physical examinations, or ECGs 9. Study drug compliance as assessed by quantification of unused study drug 10. Plasma concentration as assessed by a validated bioanalytical method |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
1, 3, 4, 5, 6, 7: Screening visit and every 8 weeks 2. Week 48 8. Adverse events: every 8 weeks until end of treatment, then 6 weeks post-treatment Laboratory tests and vital signs: Screening, every 8 weeks until end of treatment, then 6 weeks post-treatment Physical examinations: Screening, week 1, week 24, week 48 and 6 weeks post-treatment ECGs: Screening, week 48 and 6 weeks post-treatment 9, 10: Every 8 weeks from week 8 |
|
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 | Yes |
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 | 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 | 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 | 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 | 23 |
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 |
Australia |
Brazil |
Canada |
Chile |
Israel |
Korea, Republic of |
Switzerland |
Turkey |
United States |
|
E.8.7 | Trial has a data monitoring committee | Yes |
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
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 17 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
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 | 17 |