E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
cerebellar gait disorder, cerebellar ataxia, sensorimotor adaption and ocular motor disorders, postural sway, dysarthria |
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E.1.1.1 | Medical condition in easily understood language |
Imbalance, dizziness, vertigo, fall incidence, fatigue, speech disorder |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10008025 |
E.1.2 | Term | Cerebellar ataxia |
E.1.2 | System Organ Class | 10029205 - Nervous system 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 |
Primary objective:
1) To demonstrate the effectiveness of sustained released 4-aminopyridine regarding the reduction of the gait variability (improvement of gait) at maximum walking speed compared to placebo.
2) To demonstrate the effectiveness of sustained released 4-aminopyridine regarding the increase of individual preferred walking speed compared to placebo.
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E.2.2 | Secondary objectives of the trial |
Secondary objective:
1) Comparison of the gait variability at maximum walking speed at the end of the 12-week treatment phase under sustained released 4-aminopyridine or placebo (long term effect).
2) Analysis of the difference in the (relative) change of the individual preferred walking speed at the end of the 12-week treatment phase versus pre-treatment (baseline) under sustained released 4-aminopyridine or placebo (long term effect).
3) Quantitative description or comparison of the changes in various ataxia-, mobility- and QoL-scores within the two treatment groups compared to baseline value (after 14 days, 12 weeks, or follow-up visit).
4) Comparison of the number of falls under sustained released 4-aminopyridine or placebo.
5) Study the frequency of (S)AEs under sustained released 4-aminopyridine compared to placebo.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subjects will only be included in the study if they meet all of the following criteria:
1. Patients male or female, aged between 18 and 80 years
2. Clinical evaluated diagnosis of cerebellar ataxia with at least 2 points in the scale for the assessment and rating of ataxia (SARA)
3. Written informed consent of the subject
4. Subjects, with the ability to follow study instructions and likely to attend and complete all required visits (Compliance). |
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E.4 | Principal exclusion criteria |
Subjects will not be included in the study if any of the following criteria applies:
1. Weight of 40 kg or less
2. Pregnancy or breast-feeding
3. Concurrend treatment with inhibitors of organic cation transporter 2 (OCT2), e.g. cimetidine
4. Cardiovascular diseases e.g. recent heart attack (within the last 3 months), cardiac arrhythmia (QTc interval > 500 ms, atrial fibrillation, AV block grade ≥ II), unstable angina pectoris (chest tightness due to impaired blood flow to the heart), severe heart failure (NYHA class IV)
5. Recently occurred stroke (within the last 3 months)
6. Epileptic seizure currently or in the past
7. Severe arterial hypertension (grade III according to the guidelines of the German society of cardiology, 2008)
8. Liver insufficiency (e.g. cirrhosis of the liver)
9. Asthma (severity ≥ grade III)
10. Milde or severe renal failure (Creatinine Clearance ≤ 80ml/min)
11. Unadjusted thyroid dysfunction
12. Acute gastric and intestinal ulcer
13. Other acute, serious illness of the subject
14. Subject is unable to understand the nature, scope, significance and consequences of this clinical trial.
15. Subject is unable to comply with the study design
16. Previous participation in this clinical trial or simultaneous participation in another clinical trial or participation in any clinical trial involving an investigational medicinal product within 30 days prior to written informed consent for this clinical trial
Note to Exclusion Criterion 10. Mild or severe renal failure (Creatinine Clearance ≤ 80ml/min):
If Creatinine Clearance at Screening Visit is > 80ml/min a 24 hour urin sample will be taken (collection start at day of Screening Visit) for re-assessment of Creatinine Clearance. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary end point:
1) Logarithmized gait variability at maximum walking speed (CVmax [%])
2) Logarithmized individual preferred walking speed (G_pref)
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
14 days after beginnig of a 12-week treatment phase (Visit 2 and Visit 5) |
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E.5.2 | Secondary end point(s) |
Secondary end point:
1) Logarithmized gait variability at maximum walking speed
2) Change of the logarithmized individual preferred walking speed [m/sec]
3) Number of falls analysed via a standarized fall diary
4) Changes in ataxia-score (SCAFI) and in mobility- and QoL-scores (FES, ABC, BDI-II, EQ-5D-5L, FSS)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Regarding end points 1 & 2:
At the end of each 12-week treatment phase (Visit 3 and Visit 6) and after an additional 1-month follow-up period.
Regarding end points 3:
Messured during each 12-week treatment phase and after an additional 1-month follow-up period.
Regarding end points 4:
14 days after beginning of each treatment phase (Visit 2 and Visit 5) or rather at the end of each 12-week treatment phase (Visit 3 and Visit 6) and after an additional 1-month follow-up period.
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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 | Yes |
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 | No |
E.8.1.6 | Cross over | Yes |
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
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
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 | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |