E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Relapsing neuromyelitis optica |
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E.1.1.1 | Medical condition in easily understood language |
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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 | 16.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10029322 |
E.1.2 | Term | Neuromyelitis optica |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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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 |
Efficacy of eculizumab treatment as compared with placebo in relapsing NMO patients based on the time to first relapse and relapse risk reduction. |
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E.2.2 | Secondary objectives of the trial |
- Safety and tolerability of eculizumab compared with placebo
- Efficacy of eculizumab compared with placebo
- Describe the pharmacokinetics (PK) and pharmacodynamics (PD) of eculizumab
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Male or female patient ≥ 18 years old
- Diagnosis of NMO or NMO spectrum disorder
- NMO-IgG seropositive at screening visit
- Historical Relapse of at least 2 in last 6 months or 3 in the last 12 months with the most recent attack occurring ≥30 days and ≤90 days prior to Randomization
- EDSS score ≤7
- If patients enter the trial receiving an IST, they must be on the IST on which they had the most recent relapse and must remain at the same dose thoughout the trial
- Patients must be willing and able to give written informed consent |
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E.4 | Principal exclusion criteria |
- Use of rituximab or mitoxantrone within 3 months prior to randomization
- Use of IVIg within 3 weeks prior to screening
- Has received treatment with eculizumab at any time prior to enrolling in this study |
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E.5 End points |
E.5.1 | Primary end point(s) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Relapse evaluation visits:
- Within 24/48 hours after relapse
- Week +1 after relapse
- Week +4 after relapse
- Week +6 after relapse
Completion of the trial after 29 relapses in 29 distinct patients. |
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E.5.2 | Secondary end point(s) |
- Change from baseline in EDSS score at the End of Study Period
- Annualized relapse rate
- Change from baseline in EQ-5D at the End of the Study Period
- Change from baseline in modified Rankin Scale (mRS) score at the End of the Study Period
- Change from baseline in ambulatory function as measured by Hauser Ambulation Index at the End of the Study Period.
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
evaluation at:
- Screening visit
- Weeks 1, 4, 8, 12, 24, 36, 48, 60, 72, 84, 96, 104
- Relapse evaluation visits
- End of trial visit |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
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 | 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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 25 |
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 |
Australia |
Austria |
Belgium |
Brazil |
Canada |
Chile |
Finland |
France |
Germany |
Hong Kong |
Italy |
Japan |
Korea, Republic of |
Peru |
Russian Federation |
Saudi Arabia |
Singapore |
Spain |
Sweden |
Switzerland |
Taiwan |
Turkey |
United Arab Emirates |
United Kingdom |
United States |
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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
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Last patient last visit, expected to occur when one of the following conditions is met, whichever comes first:
- 20 relapse in 20 distinct patients are observed,
- The maximum number of relapses (29 relapses) is reached |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |