E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) |
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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] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
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 |
The primary objective is to evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on recurrent exacerbations as measured by EXACT (EXAcerbation of Chronic pulmonary disease Tool) in subjects with COPD following a recent exacerbation.
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E.2.2 | Secondary objectives of the trial |
To evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on: • The COPD Assessment Tool (CAT) score • Pulmonary function (including but not limited to forced expiratory volume in 1 second [FEV1]) • The frequency and severity of adverse events (AEs) and changes in, physical examination, vital signs, ophthalmic examination, laboratory tests, weight, electrocardiogram (ECG), and concomitant medications • The pharmacokinetics (PK) of AQX-1125 in plasma |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Provide written informed consent and be willing and able to comply with all aspects of the study requirements 2. Male or female aged ≥40 years at screening 3. History of COPD for at least 18 months prior to screening, characterised by excessive sputum production 4. Chronic productive cough for at least 3 months in each of the 2 years prior to screening (if other causes of productive cough have been excluded) and/or an exacerbation of COPD with predominantly bronchitic symptoms at enrolment 5. At least 2 documented exacerbations during the last 18 months prior to screening. If the subject has experienced exacerbations during the last 18 months that were self-treated at home and subsequently documented by a physician, this can be documented at Visit 1 6. Presentation of a diagnosed acute exacerbation of COPD, or have recently (within 3 days) been discharged from hospital due to an acute exacerbation of COPD 7. Ability to perform pulmonary function testing and with documented fixed airway obstruction determined by an FEV1 /forced vital capacity (FVC) ratio (post-bronchodilator) of <0.70 and a predicted FEV1 value of 30%-80% of normal within the 6 months prior to or at Visit 1. 8. Former smoker or current smoker, both with a smoking history of at least 10 pack years 9. Female subjects should be of non-child bearing potential. They should be one year or more post-menopause, previously surgically sterilised, or have had a hysterectomy. From the screening visit until 1 month after last dose of investigational medicinal product (IMP), male subjects must agree to use condoms with any sexual intercourse with women of child bearing potential and have partners who use adequate methods of contraception (e.g. sterilisation, hormone implants, hormone injections, some intrauterine devices, or combination birth control pills). If male subjects have had a confirmed vasectomy use of condoms is not required. |
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E.4 | Principal exclusion criteria |
1. Diagnosis of other relevant lung disease (e.g. asthma, cystic fibrosis [CF] or significant non-CF bronchiectasis) 2. Known alpha-1-antitrypsin deficiency 3. Treatment with roflumilast or theophylline within 1 month prior to screening 4. History of alcohol or drug abuse in the past 3 years prior to screening 5. Participation in another clinical research study within 90 days prior to screening 6. Lobar pneumonia, with current positive chest X-ray (CXR) or within the 3 months prior to screening including the presence of any new radiological infiltrate on CXR within the previous two weeks 7. Have any other conditions, disease or circumstances which, in the opinion of the Investigator, could compromise safety of the subject or confound the interpretation of the study results. This will include a relevant documented medical history of clinically significant irregularities in kidney function, liver function or blood counts; or malignant or premalignant irregularities of the urinary bladder. 8. Serious and/or life-threatening co-existing conditions that would merit acute hospitalisation, aside from the acute exacerbation event These include, but are not limited to, acute myocardial infarction, acute renal failure, acute pancreatitis, thromboembolic disease, and diabetic ketoacidosis 9. Hospitalisation for more than 7 days for current acute exacerbation, or the requirement for intubation during hospitalisation 10. For outpatients, prior medical history indicating that previous exacerbations required >3 weeks to stabilise 11. Known intolerance to micro-crystalline cellulose (Avicel® PH-102) |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint of this study is the difference in the “area above the curve” (AAC) for the daily EXACT score from baseline to Week 12 between subjects treated with AQX-1125 and subjects treated with placebo. |
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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) |
• The difference in number of COPD exacerbations and time to first COPD exacerbation between subjects treated with AQX-1125 or placebo • The difference in change from baseline in CAT score between subjects treated with AQX-1125 or placebo • The difference in change from baseline in pulmonary function (FEV1, expressed in litres and as percent predicted normal) between subjects treated with AQX 1125 and subjects treated with placebo • The difference in number and frequency of AEs, physical examination, ECG, ophthalmology examination, and concomitant medications and changes from baseline for clinical laboratory assessments and vital signs between subjects treated with AQX 1125 and subjects treated with placebo • Trough AQX-1125 concentrations in plasma |
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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 | 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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 40 |
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 |
New Zealand |
United States |
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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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Last visit of the last patient remaining in the study |
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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 | 0 |
E.8.9.1 | In the Member State concerned months | 14 |
E.8.9.1 | In the Member State concerned days | 12 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 17 |
E.8.9.2 | In all countries concerned by the trial days | 19 |