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    Clinical Trial Results:
    Assessment of Anatomical and Functional Outcomes in Patients Treated with Ocriplasmin for Vitreomacular Traction/Symptomatic Vitreomacular Adhesion (VMT/sVMA)

    Summary
    EudraCT number
    2013-005464-25
    Trial protocol
    HU   GB   DE   IT   ES   NL   PT   BE   PL   FR  
    Global end of trial date
    02 Sep 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    30 Aug 2016
    First version publication date
    30 Aug 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    M-13-056
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02035748
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Alcon, A Novartis Division
    Sponsor organisation address
    6201 S. Freeway, Fort Worth, Texas, United States, 76134
    Public contact
    EMEA Medical Affairs Lead, Pharma, Alcon, A Novartis Division, +1 888-451-3937, alcon.medinfo@alcon.com
    Scientific contact
    EMEA Medical Affairs Lead, Pharma, Alcon, A Novartis Division, +1 888-451-3937, alcon.medinfo@alcon.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    02 Sep 2015
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    02 Sep 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The purpose of this study is to observe the anatomical and functional outcomes of ocriplasmin (JETREA®) over a 6-month follow-up period. After receiving a single intravitreal injection as per country's product label (Day 0), subjects were followed for a 6-month period (Day 180).
    Protection of trial subjects
    This study was performed in compliance with the ethical principles of the Declaration of Helsinki and Good Clinical Practice (GCP), including the archiving of essential documents.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    21 Apr 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 35
    Country: Number of subjects enrolled
    Poland: 30
    Country: Number of subjects enrolled
    Portugal: 9
    Country: Number of subjects enrolled
    Spain: 34
    Country: Number of subjects enrolled
    United Kingdom: 60
    Country: Number of subjects enrolled
    Belgium: 40
    Country: Number of subjects enrolled
    France: 99
    Country: Number of subjects enrolled
    Germany: 33
    Country: Number of subjects enrolled
    Hungary: 23
    Country: Number of subjects enrolled
    Italy: 38
    Country: Number of subjects enrolled
    Canada: 67
    Worldwide total number of subjects
    468
    EEA total number of subjects
    401
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    81
    From 65 to 84 years
    364
    85 years and over
    23

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects were recruited from 87 study centers located in Europe and Canada (10 Italy, 5 Netherlands, 4 Poland, 4 Portugal, 12 Spain, 15 United Kingdom, 3 Belgium, 12 France, 9 Germany, 5 Hungary, and 8 Canada).

    Pre-assignment
    Screening details
    Of the 628 enrolled, 160 subjects were exited prior to initiation of treatment. This reporting group includes all treated subjects (468).

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Ocriplasmin
    Arm description
    Ocriplasmin 0.125 mg in a 0.1 mL volume administered as a single dose by intravitreal injection
    Arm type
    Experimental

    Investigational medicinal product name
    Ocriplasmin
    Investigational medicinal product code
    Other name
    JETREA
    Pharmaceutical forms
    Concentrate for solution for injection
    Routes of administration
    Intravitreal use
    Dosage and administration details
    0.5 mg/0.2 mL solution for injection

    Number of subjects in period 1
    Ocriplasmin
    Started
    468
    Full Analysis Set
    466
    Completed
    448
    Not completed
    20
         Physician decision
    3
         Adverse event, non-fatal
    5
         Death
    3
         Lost to follow-up
    2
         Progressive disease
    1
         Withdrawal by subject
    6

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall study
    Reporting group description
    Ocriplasmin 0.125 mg in a 0.1 mL volume administered as a single dose by intravitreal injection

    Reporting group values
    Overall study Total
    Number of subjects
    468 468
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    71.7 ( 8.3 ) -
    Gender categorical
    Units: Subjects
        Female
    345 345
        Male
    123 123

    End points

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    End points reporting groups
    Reporting group title
    Ocriplasmin
    Reporting group description
    Ocriplasmin 0.125 mg in a 0.1 mL volume administered as a single dose by intravitreal injection

    Primary: Proportion of Subjects With Nonsurgical Resolution of Focal Vitreomacular Traction (VMT/VMA) at Day 28, as Determined by Central Reading Center (CRC) Spectral Domain Optical Coherence Tomography (SD-OCT) Evaluation

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    End point title
    Proportion of Subjects With Nonsurgical Resolution of Focal Vitreomacular Traction (VMT/VMA) at Day 28, as Determined by Central Reading Center (CRC) Spectral Domain Optical Coherence Tomography (SD-OCT) Evaluation [1]
    End point description
    Vitreous separation was assessed by SD-OCT using scores ranging from 1 (vitreous attached from macula to ON; separated elsewhere cannot determine foveal) to 12 (unable to determine state of separation). Nonsurgical resolution was defined as a change from baseline score of 5/6/8 to 7/9/10 at Day 28. The assessment of resolution of VMT/sVMA was based upon the anatomical resolution of VMA only, i.e. no resolution of the related symptoms was considered. Thus, the term VMA is used interchangeably with VMT/sVMA. Proportion of subjects is presented as a percentage, with percentage based on the number of subjects who have VMT/sVMA at baseline and SD-OCT value at Day 28. One eye (study eye) contributed to the analysis. Subjects treated with IP with at least one post-treatment SD-OCT measurement (FAS). Missing data imputed using the last observation carried forward (LOCF) method. Subjects with vitrectomy after VMT/sVMA resolution were considered 'no resolution' after timepoint of vitrectomy.
    End point type
    Primary
    End point timeframe
    Baseline, Day 28
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was performed
    End point values
    Ocriplasmin
    Number of subjects analysed
    466
    Units: percentage of subjects
        number (not applicable)
    47.4
    No statistical analyses for this end point

    Secondary: Nonsurgical Change From Baseline in Best-corrected Visual Acuity (BCVA) at Distance

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    End point title
    Nonsurgical Change From Baseline in Best-corrected Visual Acuity (BCVA) at Distance
    End point description
    BCVA (with spectacles or other visual corrective devices) was assessed using Early Treatment Diabetic Retinopathy Study (ETDRS) testing at 4 meters. The charts contain 14 rows of letters. BCVA was calculated as the number of letters read correctly and improvement defined as an increase (gain) in letters read from the baseline assessment. One eye (study eye) contributed to the analysis. Full Analysis Set. Missing data imputed using LOCF. BCVA values after a vitrectomy were imputed with the last non-missing value prior to the vitrectomy.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 0), Day 28, Day 90, Day 180
    End point values
    Ocriplasmin
    Number of subjects analysed
    448
    Units: letters
    arithmetic mean (standard deviation)
        Change from baseline at Day 28
    1.7 ( 6.7 )
        Change from baseline at Day 90
    3 ( 7.07 )
        Change from baseline at Day 180
    3.5 ( 7.77 )
    No statistical analyses for this end point

    Secondary: Proportion of Subjects With Nonsurgical Closure of Macular Hole (MH), if Present at Baseline

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    End point title
    Proportion of Subjects With Nonsurgical Closure of Macular Hole (MH), if Present at Baseline
    End point description
    The closure of macular hole (a full thickness defect of the retinal tissure involving the anatomical fovea) is defined as a flattened and reattached hole rim along the whole circumference of macular hole. Closure was determined by SD-OCT evaluation and the percentage of subjects tabulated. Proportion of subjects is presented as a percentage, with percentage based on the number of subjects who had macular hole at baseline and OCT value at each specific visit. One eye (study eye) contributed to the analysis. Full Analysis Set. Missing data imputed using LOCF. Subjects who had vitrectomy after MH closure were considered as 'no MH closure' after the timepoint of vitrectomy.
    End point type
    Secondary
    End point timeframe
    Day 28, Day 90, Day 180
    End point values
    Ocriplasmin
    Number of subjects analysed
    86
    Units: percentage of subjects
    number (not applicable)
        Day 28
    39.5
        Day 90
    40.7
        Day 180
    41.9
    No statistical analyses for this end point

    Secondary: Proportion of Subjects With Nonsurgical Resolution of VMT/sVMA

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    End point title
    Proportion of Subjects With Nonsurgical Resolution of VMT/sVMA
    End point description
    Vitreous separation was assessed by SD-OCT using scores ranging from 1 (vitreous attached from macula to ON; separated elsewhere cannot determine foveal) to 12 (unable to determine state of separation). Nonsurgical resolution was defined as a change from baseline score of 5/6/8 to 7/9/10 at Day 90 and Day 180. The assessment of resolution of VMT/sVMA was based upon the anatomical resolution of VMA only, i.e. no resolution of the related symptoms was considered. Thus, the term VMA is used interchangeably with VMT/sVMA. Proportion of subjects is presented as a percentage, with percentage based on the number of subjects who have VMT/sVMA at baseline and SD-OCT value at Day 90/Day 180. One eye (study eye) contributed to the analysis. Full Analysis Set. Missing data imputed using LOCF. Subjects who had vitrectomy after VMT/sVMA resolution were considered as 'no resolution' after the timepoint of vitrectomy.
    End point type
    Secondary
    End point timeframe
    Baseline, Day 90, Day 180
    End point values
    Ocriplasmin
    Number of subjects analysed
    466
    Units: percentage of subjects
    number (not applicable)
        Day 90
    47.9
        Day 180
    49.4
    No statistical analyses for this end point

    Secondary: Proportion of Subjects Experiencing Pars Plana Vitrectomy (PPV) at Day 180

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    End point title
    Proportion of Subjects Experiencing Pars Plana Vitrectomy (PPV) at Day 180
    End point description
    Pars plana vitrectomy (the surgical removal of vitreous gel from the eye) was captured in Concomitant Ocular Procedures. Proportion of subjects is reported as a percentage. One eye (study eye) contributed to the analysis. Full Analysis Set
    End point type
    Secondary
    End point timeframe
    Day 180
    End point values
    Ocriplasmin
    Number of subjects analysed
    466
    Units: percentage of subjects
        number (not applicable)
    12
    No statistical analyses for this end point

    Secondary: Mean Nonsurgical Change From Baseline in Central Foveal Thickness (CFT)

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    End point title
    Mean Nonsurgical Change From Baseline in Central Foveal Thickness (CFT)
    End point description
    Nonsurgical change in central foveal thickness (CFT values after a vitrectomy were imputed with the last non-missing value prior to the vitrectomy) was determined by subtracting the measurements in subretinal fluid and retinal pigment epithelium (RPE) elevations and/or SHRM (subretinal hyper-reflective material such as choroidal neovascularization (CNV)) from the value in total retinal measurement. A lower CFT indicates improvement. One eye (study eye) contributed to the analysis. Full Analysis Set. Missing data is imputed using LOCF. CFT values after a vitrectomy were imputed with the last non-missing value prior to the vitrectomy.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 0), Day 28, Day 180
    End point values
    Ocriplasmin
    Number of subjects analysed
    466
    Units: micrometers
    arithmetic mean (standard deviation)
        Baseline (Day 0), n=466
    276.1 ( 166.4 )
        Change from baseline at Day 28, n=465
    -43.2 ( 113.47 )
        Change from baseline at Day 180, n=466
    -45.4 ( 131.84 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events (AEs) were collected for the duration of a subject's participation in the study (up to 7 months). Ocular AEs are presented for both study eye and non-study eye combined. AEs are reported as treatment-emergent.
    Adverse event reporting additional description
    An AE was defined as any untoward medical occurrence in a subject regardless of the causal relationship to the study medication. AEs could be volunteered or solicited by the Investigator or study personnel.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.0
    Reporting groups
    Reporting group title
    Ocriplasmin
    Reporting group description
    All subjects exposed to the investigational product

    Serious adverse events
    Ocriplasmin
    Total subjects affected by serious adverse events
         subjects affected / exposed
    46 / 468 (9.83%)
         number of deaths (all causes)
    4
         number of deaths resulting from adverse events
    0
    Investigations
    Colonoscopy
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Breast cancer
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Breast cancer metastatic
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Oesophageal carcinoma
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bronchial carcinoma
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Cardiac failure
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Left ventricular failure
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Arrhythmia
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Cardioversion
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ear operation
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Heart valve replacement
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hip arthroplasty
         subjects affected / exposed
    2 / 468 (0.43%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hip surgery
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lithotripsy
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Renal stone removal
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Shoulder operation
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vitrectomy
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebrovascular accident
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Disturbance in attention
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Oedema peripheral
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Ciliary zonular dehiscence
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Macular hole
         subjects affected / exposed
    8 / 468 (1.71%)
         occurrences causally related to treatment / all
    4 / 8
         deaths causally related to treatment / all
    0 / 0
    Retinal detachment
         subjects affected / exposed
    4 / 468 (0.85%)
         occurrences causally related to treatment / all
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    Visual acuity reduced
         subjects affected / exposed
    5 / 468 (1.07%)
         occurrences causally related to treatment / all
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    Vitreous adhesions
         subjects affected / exposed
    2 / 468 (0.43%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    2 / 468 (0.43%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Rectal prolapse
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pickwickian syndrome
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Nephrolithiasis
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Bacterial sepsis
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 468 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Ocriplasmin
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    247 / 468 (52.78%)
    Eye disorders
    Colour blindness acquired
         subjects affected / exposed
    26 / 468 (5.56%)
         occurrences all number
    26
    Eye pain
         subjects affected / exposed
    40 / 468 (8.55%)
         occurrences all number
    41
    Macular oedema
         subjects affected / exposed
    52 / 468 (11.11%)
         occurrences all number
    53
    Photophobia
         subjects affected / exposed
    24 / 468 (5.13%)
         occurrences all number
    27
    Photopsia
         subjects affected / exposed
    104 / 468 (22.22%)
         occurrences all number
    114
    Vision blurred
         subjects affected / exposed
    54 / 468 (11.54%)
         occurrences all number
    62
    Visual acuity reduced
         subjects affected / exposed
    127 / 468 (27.14%)
         occurrences all number
    138
    Vitreous floaters
         subjects affected / exposed
    78 / 468 (16.67%)
         occurrences all number
    93

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    04 Mar 2014
    The purpose of this amendment was to include additional exclusion criteria to ensure that patients for whom treatment was not recommended were not enrolled in this study.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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