E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Duchenne muscular dystrophy |
|
E.1.1.1 | Medical condition in easily understood language |
|
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.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the safety, tolerability and efficacy of two different doses of intravenous (IV) PRO044 and one dose of subcutaneous (SC) PRO044 in subjects with DMD after 48 weeks treatment. |
|
E.2.2 | Secondary objectives of the trial |
•To assess the safety, tolerability and efficacy of two different doses of intravenous (IV) PRO044 and one dose of subcutaneous (SC) PRO044 in subjects with DMD over time.
•To assess the pharmacokinetic profile of two different dosages and different routes of administration of PRO044 in subjects with DMD.
|
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Subjects previously treated with PRO044.
2.Continued use of glucocorticoids for a minimum of 60 days prior to study entry with a reasonable expectation that the subject will remain on steroids for the duration of the study. Changes to the dose regimen or cessation of glucocorticoids will be at the discretion of the Principle Investigator (PI) in consultation with the subject/parent and the Medical Monitor. If the subject is not on steroids, involvement in the study needs to be discussed with the medical monitor
|
|
E.4 | Principal exclusion criteria |
1. Current, or history of, liver or renal disease.
2. Acute illness within 4 weeks prior to the first dose of PRO044 (Week 1) which may interfere with the measurements.
3. Severe cardiac myopathy which in the opinion of the Investigator prohibits participation in this study
4. Need for daytime mechanical ventilation.
5. Screening aPTT above the upper limit of normal (ULN).
6. Screening platelet count below the lower limit of normal (LLN).
7. Use of anticoagulants, antithrombotics or antiplatelet agents.
8. Use of any investigational product within 6 months prior to the start of Screening for the study.
9. Current or history of drug and/or alcohol abuse.
|
|
E.5 End points |
E.5.1 | Primary end point(s) |
Safety Parameters:
•Adverse events
•Tolerability
•Physical examination
•Vital signs (temperature, blood pressure, pulse rate, respiration rate)
•Laboratory assessments including:
-Routine biochemistry and hematology
-Urinalysis (routine parameters plus alpha1-microglobulin, microscopy) and 24-hour urine (additionally including protein electrophoresis, urine cystatin C, KIM 1)
-Coagulation parameters (aPTT, PT [INR], fibrinogen)
-Complement C3 (including split fragments C3a, SC5b and Bb))
-Pro-inflammatory markers haptoglobulin, MCP 1
-Anti-dystrophin antibodies
-Anti-PRO044 antibodies
•ECG
•Echocardiography
•Renal ultrasound.
Efficacy parameters:
•Muscle Function
-6 Minute Walk Distance (6MWD)
-North Star Ambulatory Assessment
-Timed tests (10-meter walk/run, rising from floor, stair climb)
-DMD Functional Outcomes Questionnaire (DMD-FOS) –for ambulant subjects only
-Egen Klassification - for non-ambulant subjects.
•Muscle strength
-Pulmonary Function (Spirometry)
-Handheld myometry.
•Exploratory:
-Performance Upper Limb (PUL).
-Patient Reported Outcome measure (PROM).
|
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
Pharmacokinetic parameters:
•t ½
•AUC: 0-24h, 0-∞ (where applicable)
•Cmax
•tmax
•CL (for IV subjects) or CL/F (for SC subjects)
•PRO044 concentrations in muscle tissue.
Pharmacodynamic parameters:
•Presence of dystrophin expression after treatment (muscle biopsy)
•Nuclear Magnetic Resonance imaging (MRI and MRS) in some subjects in study centers with appropriate imaging capabilities and training.
•Exploratory biomarkers (e.g., MMP 9, miRNA 1, miRNA-133). |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
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 | Yes |
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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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 | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 4 |
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 | 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 | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |