E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Chronic kidney disease (CKD) stage 5 and on waiting list for renal transplantation |
Patienter med kronisk njursvikt som står på väntelistan för njurtransplantation |
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E.1.1.1 | Medical condition in easily understood language |
Patients with chronic kidney failure who requires dialysis and are on the waiting list for kidney transplantation |
Patienter med kronisk njursvikt som är beroende av dialys och står på väntelistan för njurtransplantation |
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E.1.1.2 | Therapeutic area | Not possible to specify |
MedDRA Classification |
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 find an IdeS dosing scheme which in the majority of the patients results in HLA antibody levels which are acceptable for transplantation. This will be measured as an MFI less than 1100 as measured in a single antigen bead (SAB) assay, within 24 hours from dosing
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Att hitta ett doseringsschema för IdeS som i merparten av patienterna resulterar i nivåer av HLA-antikroppar som är acceptabla för en transplantation. Detta kommer att definieras som ett MFI på 1100 eller mindre i en "single antigen bead (SAB) assay", inom 24 timmar efter dosering. |
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E.2.2 | Secondary objectives of the trial |
To determine the following in CKD patients: 1. Cytotoxic sera screen 2. FACS crossmatch test against available donor cells 3. The safety and tolerability of IdeS 4. The pharmacokinetic (PK) profile of IdeS 5. Pharmacodynamic (PD) profile of IdeS (cleavage of IgG) 6. The immunogenicity profile of IdeS
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Analys av följande i patienter med kronisk njursvikt: 1. Cytotoxisk serum screen 2. FACS korstest mot tillgängligadonatorceller 3. Säkerhet hos IdeS 4. PK-profil 5. PD-profil (klyvning av IgG) 6. TImmunogenicitet (ADA) |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Age 18 years or above
Diagnosed with CKD and in dialysis with identified antibodies against at least two HLA antigens of which at least one is 3000 MFI or more as measured by SAB assay on at least two occasions. |
18 år och äldre
Diagnostiserad med kronisk njursvikt och i dialys med antikroppar mot minst två olika HLA-antigen varav minst ett är på över 3000 MFIuppmätt med SAB-analys vid minst två tillfällen. |
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E.4 | Principal exclusion criteria |
1. Tested positive for IgE antibodies against IdeS 2. Any positive result on screening for serum hepatitis B surface antigen, hepatitis C antibody and human immunodeficiency virus (HIV) 3. Clinical signs of ongoing infectious disease. 4. Patients who have had their spleen removed 5.Severe other conditions requiring treatment and close monitoring, e.g. cardiac failure > NYHA (New York Heart Association) grade 3, unstable coronary disease or oxygen dependent COPD 6. Hypogammaglobulinemia defined as any values of P-total IgG less than 3 g/L 7.Patients with an ongoing relapse in an autoimmune disease. However, patients with diabetes or IgA-nephritis will not be excluded from the study 8.Patients who have undergone liver-, heart- or lungtransplantation 9. Patients that have received cell transplantation or cell therapy within 5 years. 10. Patients who have previously been treated with biological therapies based on antibodies within at least 5 T½ of the drug.
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1. Positiv test för anti-IdeS_antikroppar av IgE-typ 2. Positiv test för hepatit B eller C eller HIV 3.Symptom på pågående infektion 4. Patienter med borttagen mjälte 5. Annan allvarlig sjukdom, tex hjärtsvikt eller syrgasberoende COPD 6. Hypogammaglobulinemi 7. Patienter med relapserande autoimmun sjukdom. Patienter med diabetes eller igGA-nefrit kan dock inkluderas 8.Patienter som genomgått lever- hjärt- eller lungtransplantation 9. Patienter som genomgått celltransplantation eller cellterapi inom 5 år före inklusion 10. Patienter som genomgått behandling med biologiska läkemedel baserade på antikroppar inom 5 halveringstider för det läkemedlet |
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E.5 End points |
E.5.1 | Primary end point(s) |
Efficacy defined as the IdeS dosing scheme resulting in HLA antibody levels which are acceptable for transplantation, measured as an MFI of less than 1100 as measured in an SAB assay, within 24 hours from dosing |
Effekt definierad som det dosschema som resulterar i nivåer av HLA-antikroppar som är acceptabla vid en njurtransplantation, uppmätt som MFI på 1100 eller mindre i en SAB-analys, inom 24 timmar från dosering. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1, 2, and 24 hours, 64 days |
1, 2, 24 timmar, 64 dagar |
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E.5.2 | Secondary end point(s) |
Reduction of PRA levels in cytotoxic sera screen after IdeS treatment (efficacy) Result in FACS crossmatch test against available donor cells after IdeS treatment (efficacy) Safety parameters (Adverse events, clinical laboratory tests, vital signs and ECGs) Pharmacokinetic (PK) profile of IdeS Pharmacodynamic (PD) profile of IdeS (cleavage of IgG) • Immunogenicity of IdeS by measuring anti drug antibodies (ADA)
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Reduktion av PRA-nivåer i cytotoxisk screen efter behandling med IdeS Resultat i FACS-korstest mot tillgängliga donatorceller efter behandling med IdeS Säkerhetsparametrar (AEs, labtester, vital signs och EKG) PK-profil PD-profil Immunogenicitet (ADA) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Efficacy up to and including 24 hours after dosing PK up to and including 21 days PD up to and including 64 days ADA until day 365 |
Effekt till och med 24 timmar efter dos PK till och med dag 21 efter dos PD till och med dag 54 efter dos ADA till och med dag 365 efter dos |
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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 | Yes |
E.6.13.1 | Other scope of the trial description |
Immunogenicity |
Immunogenicitet |
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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) | 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
| 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 | 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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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 | |
E.8.9.1 | In the Member State concerned days | |