E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Familial Amyloid Polyneuropathy |
|
E.1.1.1 | Medical condition in easily understood language |
Familial Amyloid Polyneuropathy |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Congenital, Hereditary, and Neonatal Diseases and Abnormalities [C16] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10057949 |
E.1.2 | Term | Familial amyloid polyneuropathy |
E.1.2 | System Organ Class | 100000004850 |
|
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 evaluate the safety and tolerability of extended dosing with ISIS 420915 in patients with Familial Amyloid Polyneuropathy. |
|
E.2.2 | Secondary objectives of the trial |
To evaluate the efficacy of extended dosing with ISIS 420915 based on change from baseline and progression rate, if applicable, in the following measures:
• Modified Neuropathy Impairment Score +7 (mNIS+7)
• Norfolk Quality of Life-Diabetic Neuropathy (Norfolk QOL-DN) questionnaire:
o total score (all patients)
o symptoms domain score (Stage 1 patients)
o physical functioning/large fiber neuropathy domain score (Stage 2 patients)
• Modified body mass index (mBMI) and body mass index (BMI) • NIS, heat-pain sensory, touch-pressure sensory, nerve conduction, and heart rate to deep breathing tests (components of mNIS+7)
• Polyneuropathy disability score (PND score)
• To evaluate the pharmacodynamic (PD) effect of extended dosing with ISIS 420915 based on change from baseline in transthyretin (TTR) and retinol binding protein 4 (RBP4)
• Global longitudinal strain (GLS) by echocardiogram (ECHO)
To evaluate the plasma trough levels of ISIS 420915. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Completion of ISIS 420915-CS2 with the following as judged by the Investigator and Sponsor:
a. Satisfactory completion of dosing and end of treatment (EOT) efficacy assessments
b. No significant tolerability issues
c. Satisfactory compliance to the ISIS 420915-CS2 protocol requirements
2. Willingness to take vitamin A supplements
3. Satisfy one of the following:
a. Females: Non-pregnant and non-lactating; surgically sterile, postmenopausal, abstinent, or if engaged in sexual relations of childbearing potential, patient is using an acceptable contraceptive method (refer to Section 6.3.1) from the time of signing the informed consent form until at least 3 months after the last dose of ISIS 420915.
b. Males: Surgically sterile, abstinent, or if engaged in sexual relations with a female of childbearing potential, patient is utilizing an acceptable contraceptive method (refer to Section 6.3.1) during and for 3 months after the last dose of ISIS 420915.
4. Must have given written informed consent (signed and dated) and any authorization required by local law and be able to comply with all study requirements |
|
E.4 | Principal exclusion criteria |
Have any new condition or worsening of existing condition that in the opinion of the Investigator or Sponsor would make the patient unsuitable for enrollment, or could interfere with the patient participating in or completing the study. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Safety Endpoints
• Adverse events
• Vital signs and weight
• Physical examination
• Clinical laboratory tests
• ECG
• Use of concomitant medication
• Ophthalmology and ERG examinations |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Through the course of the study. |
|
E.5.2 | Secondary end point(s) |
Efficacy Endpoints
• Change in the mNIS+7 score and components from baseline to Week 78 and Week 156
• Change in the NIS score and components from baseline to Y5-W52 and Y4-W52
• Change in the Norfolk QOL-DN questionnaire scores from baseline to Week 78 and Week 156 and at the end of each subsequent treatment year (52nd week of each year)
• Change in the mBMI and BMI from baseline to Week 78 and Week 156
• Change in PND score from baseline to Week 78 and Week 156 and at the end of each subsequent treatment year (52nd week of each year)
• Changes in Global longitudinal strain (GLS) by echocardiogram (ECHO)from baseline to Week 78 and Week 156 and at the end of each subsequent treatment year (52nd week of each year) in the ISIS 420915-CS2 ECHO subgroup and in the Cardiomyopathy-ECHO (CM-ECHO) Set |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Week 78 and Week 156 and at Week 52 of each subsequent treatment year |
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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 | 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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
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 | 1 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 12 |
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 |
Brazil |
France |
Germany |
Italy |
Portugal |
Spain |
United Kingdom |
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 | 5 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 3 |