Clinical Trial Results:
A Phase 3, Multi-centre, Randomised, Double-Blind, Placebo Controlled Study of the Efficacy and Safety of SD-101 Cream in Patients with Epidermolysis Bullosa
Summary
|
|
EudraCT number |
2014-002288-14 |
Trial protocol |
AT NL GB IT DE PL ES LT BE |
Global end of trial date |
05 Jul 2017
|
Results information
|
|
Results version number |
v1(current) |
This version publication date |
12 Jul 2018
|
First version publication date |
12 Jul 2018
|
Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
|
|||
Trial identification
|
|||
Sponsor protocol code |
SD-005
|
||
Additional study identifiers
|
|||
ISRCTN number |
- | ||
US NCT number |
NCT02384460 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
|
|||
Sponsor organisation name |
Scioderm, Inc., An Amicus Therapeutics Company
|
||
Sponsor organisation address |
1 Cedar Brook Drive, Cranbury, United States, NJ 08512
|
||
Public contact |
Patient Advocacy, Amicus Therapeutics, Inc, clinicaltrials@amicusrx.com
|
||
Scientific contact |
Patient Advocacy, Amicus Therapeutics, Inc, clinicaltrials@amicusrx.com
|
||
Paediatric regulatory details
|
|||
Is trial part of an agreed paediatric investigation plan (PIP) |
Yes
|
||
EMA paediatric investigation plan number(s) |
EMEA-001590-PIP01-13 | ||
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 |
05 Jul 2017
|
||
Is this the analysis of the primary completion data? |
Yes
|
||
Primary completion date |
05 Jul 2017
|
||
Global end of trial reached? |
Yes
|
||
Global end of trial date |
05 Jul 2017
|
||
Was the trial ended prematurely? |
No
|
||
General information about the trial
|
|||
Main objective of the trial |
The primary objective was to compare the efficacy and safety of SD-101-6.0 versus SD-101-0.0 (placebo) in subjects with simplex, recessive dystrophic, or junctional non-Herlitz epidermolysis bullosa (EB).
|
||
Protection of trial subjects |
This study was designed and monitored in accordance with sponsor procedures, which comply with the ethical principles of Good Clinical Practice, as required by the major regulatory authorities and in accordance with the Declaration of Helsinki and its updates.
|
||
Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
11 Mar 2015
|
||
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: 3
|
||
Country: Number of subjects enrolled |
Poland: 8
|
||
Country: Number of subjects enrolled |
Spain: 12
|
||
Country: Number of subjects enrolled |
United Kingdom: 5
|
||
Country: Number of subjects enrolled |
Austria: 1
|
||
Country: Number of subjects enrolled |
France: 19
|
||
Country: Number of subjects enrolled |
Germany: 16
|
||
Country: Number of subjects enrolled |
Italy: 8
|
||
Country: Number of subjects enrolled |
Lithuania: 4
|
||
Country: Number of subjects enrolled |
Australia: 11
|
||
Country: Number of subjects enrolled |
United States: 60
|
||
Country: Number of subjects enrolled |
Serbia: 16
|
||
Country: Number of subjects enrolled |
Israel: 6
|
||
Worldwide total number of subjects |
169
|
||
EEA total number of subjects |
76
|
||
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) |
11
|
||
Children (2-11 years) |
84
|
||
Adolescents (12-17 years) |
31
|
||
Adults (18-64 years) |
42
|
||
From 65 to 84 years |
1
|
||
85 years and over |
0
|
|
|||||||||||||||||||||||||||||||
Recruitment
|
|||||||||||||||||||||||||||||||
Recruitment details |
Of 210 subjects screened for this study, 169 subjects were randomly assigned, on a 1:1 basis, to treatment with SD-101-6.0 or placebo at 31 study centres in 13 countries. The first subject was enrolled on 11 March 2015 and the last subject completed the study on 05 July 2017. | ||||||||||||||||||||||||||||||
Pre-assignment
|
|||||||||||||||||||||||||||||||
Screening details |
Subjects had to be 1 month of age or older with a diagnosis of simplex, recessive dystrophic, or junctional non-Herlitz EB and a target wound with a surface area of 10 to 50 cm^2 in size and at least 21 days old to be considered for participation in the study. Subjects who did not meet all inclusion/exclusion criteria were eligible for rescreening. | ||||||||||||||||||||||||||||||
Period 1
|
|||||||||||||||||||||||||||||||
Period 1 title |
Overall Study (overall period)
|
||||||||||||||||||||||||||||||
Is this the baseline period? |
Yes | ||||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
|
||||||||||||||||||||||||||||||
Blinding used |
Double blind | ||||||||||||||||||||||||||||||
Roles blinded |
Subject, Investigator, Monitor, Carer, Assessor | ||||||||||||||||||||||||||||||
Blinding implementation details |
All study centre personnel, subjects, and the sponsor were blinded to study drug assignment. Tubes of study drug were identical and SD-101-6.0 and SD-101-0.0 (placebo) were indistinguishable with regard to appearance, smell, and sensation.
|
||||||||||||||||||||||||||||||
Arms
|
|||||||||||||||||||||||||||||||
Are arms mutually exclusive |
Yes
|
||||||||||||||||||||||||||||||
Arm title
|
SD-101-6.0 | ||||||||||||||||||||||||||||||
Arm description |
Subjects applied SD-101-6.0 cream once a day for a period of 90 days. The first study drug treatment was applied at the study centre after randomisation and completion of baseline assessments. Efficacy measurements and safety assessments were carried out at study visits at Week 2 and Months 1, 2 and 3. | ||||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
SD-101-6.0
|
||||||||||||||||||||||||||||||
Investigational medicinal product code |
|||||||||||||||||||||||||||||||
Other name |
Allantoin 6% concentration, Zorblisa
|
||||||||||||||||||||||||||||||
Pharmaceutical forms |
Cream
|
||||||||||||||||||||||||||||||
Routes of administration |
Topical use
|
||||||||||||||||||||||||||||||
Dosage and administration details |
SD-101 is a white, crystalline powder that is formulated within an odourless, soft, white cream base. SD-101-6.0 cream contains allantoin, a diureide glyoxlylic acid, at a concentration of 6% and other excipients. Subjects applied the cream topically, once a day to the entire body.
|
||||||||||||||||||||||||||||||
Arm title
|
Placebo | ||||||||||||||||||||||||||||||
Arm description |
Subjects applied SD-101-0.0 (placebo) cream once a day for a period of 90 days. The first study drug treatment was applied at the study centre after randomisation and completion of baseline assessments. Efficacy measurements and safety assessments were carried out at study visits at Week 2 and Months 1, 2 and 3. | ||||||||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
SD-101-0.0
|
||||||||||||||||||||||||||||||
Investigational medicinal product code |
Placebo
|
||||||||||||||||||||||||||||||
Other name |
|||||||||||||||||||||||||||||||
Pharmaceutical forms |
Cream
|
||||||||||||||||||||||||||||||
Routes of administration |
Topical use
|
||||||||||||||||||||||||||||||
Dosage and administration details |
SD-101 is a white, crystalline powder that is formulated within an odourless, soft, white cream base. SD-101-0.0 (placebo) cream contains no allantoin, but otherwise contains the same excipients as SD-101-6.0. Subjects applied the cream topically, once a day to the entire body.
|
||||||||||||||||||||||||||||||
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Baseline characteristics reporting groups
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
SD-101-6.0
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects applied SD-101-6.0 cream once a day for a period of 90 days. The first study drug treatment was applied at the study centre after randomisation and completion of baseline assessments. Efficacy measurements and safety assessments were carried out at study visits at Week 2 and Months 1, 2 and 3. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects applied SD-101-0.0 (placebo) cream once a day for a period of 90 days. The first study drug treatment was applied at the study centre after randomisation and completion of baseline assessments. Efficacy measurements and safety assessments were carried out at study visits at Week 2 and Months 1, 2 and 3. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
End points reporting groups
|
|||
Reporting group title |
SD-101-6.0
|
||
Reporting group description |
Subjects applied SD-101-6.0 cream once a day for a period of 90 days. The first study drug treatment was applied at the study centre after randomisation and completion of baseline assessments. Efficacy measurements and safety assessments were carried out at study visits at Week 2 and Months 1, 2 and 3. | ||
Reporting group title |
Placebo
|
||
Reporting group description |
Subjects applied SD-101-0.0 (placebo) cream once a day for a period of 90 days. The first study drug treatment was applied at the study centre after randomisation and completion of baseline assessments. Efficacy measurements and safety assessments were carried out at study visits at Week 2 and Months 1, 2 and 3. |
|
|||||||||||||
End point title |
Time to Complete Target Wound Closure Within 3 Months. | ||||||||||||
End point description |
Target wounds were monitored at each study visit for complete closure, defined as skin re-epithelialisation without drainage. Time to target wound closure was measured from the date of the first administration of the study drug to the date of target wound closure. Subjects were censored if they did not have a response within 3 months, or withdrew earlier before the confirmation of their target wound closing.
This primary end point displays the mean time to complete target wound closure, analysed using a Kaplan-Meier approach. Analysis was performed on subjects from the intent-to-treat (ITT) population with post-baseline wound closure data and whose target wound had closed within 3 months.
|
||||||||||||
End point type |
Primary
|
||||||||||||
End point timeframe |
From baseline to Month 3 visit
|
||||||||||||
|
|||||||||||||
Notes [1] - Number of subjects analysed were those whose target wound had closed within 3 months. [2] - Number of subjects analysed were those whose target wound had closed within 3 months. |
|||||||||||||
Statistical analysis title |
Cox Model Analysis | ||||||||||||
Statistical analysis description |
Cox proportional hazards model compares treatment groups with baseline target wound size, target wound age and EB type as covariates.
|
||||||||||||
Comparison groups |
SD-101-6.0 v Placebo
|
||||||||||||
Number of subjects included in analysis |
84
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other | ||||||||||||
P-value |
= 0.985 [3] | ||||||||||||
Method |
Cox Model | ||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||
Point estimate |
1.004
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.651 | ||||||||||||
upper limit |
1.549 | ||||||||||||
Notes [3] - p-value is from Type 3 tests to present as overall p-value for each term in the model. |
|
|||||||||||||
End point title |
Percentage of Subjects Experiencing Complete Closure of The Target Wound Within 3 Months | ||||||||||||
End point description |
Target wounds were monitored at each study visit for complete closure, defined as skin re-epithelialisation without drainage. Subjects were considered responders if they experienced complete wound closure at the Week 2 or Months 1, 2, or 3 visits. If a target wound was documented to have closed at a given visit, it was considered closed at all subsequent visits.
This primary end point displays the percentage of subjects from the ITT population who had complete target wound closure by the end of the study period (i.e. 3 months). Analysis was performed on subjects with post-baseline wound closure data.
|
||||||||||||
End point type |
Primary
|
||||||||||||
End point timeframe |
From baseline to Month 3 visit
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Logistic Regression Analysis | ||||||||||||
Statistical analysis description |
Comparison between treatment groups of complete closure of target wound within 3 months was performed using logisitic regression modelling with multiple imputation.
|
||||||||||||
Comparison groups |
SD-101-6.0 v Placebo
|
||||||||||||
Number of subjects included in analysis |
163
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other [4] | ||||||||||||
P-value |
= 0.39 [5] | ||||||||||||
Method |
Regression, Logistic | ||||||||||||
Parameter type |
Odds ratio (OR) | ||||||||||||
Point estimate |
0.733
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.365 | ||||||||||||
upper limit |
1.474 | ||||||||||||
Notes [4] - Multiple imputation is implemented by two steps. First step using Markov Chain Monte Carlo (MCMC) to get monotonic missing data pattern. In second step, a logistic regression model is used, with the following covariates included in the imputation model: treatment, EB type, baseline target wound size, target wound age, and non-missing data from earlier time points. The seed number is 010005 and the number of imputations is 5. [5] - p-value is from Type 3 tests to present as overall p-value for each term in the model |
|
|||||||||||||||||||
End point title |
Percentage of Subjects Experiencing Complete Closure of The Target Wound at Month 1 and Month 2 Visits | ||||||||||||||||||
End point description |
Target wounds were monitored at each study visit for complete closure, defined as skin re-epithelialisation without drainage. The percentage of subjects who completed target wound closure at the Month 1 and Month 2 study visits is displayed. If a target wound was documented to have closed at a given visit, it was considered closed at all subsequent visits. Analysis was performed on subjects from the ITT population with post-baseline wound closure data.
|
||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||
End point timeframe |
From baseline to Month 1 and Month 2 visits
|
||||||||||||||||||
|
|||||||||||||||||||
Statistical analysis title |
Logistic Regression Analysis at Month 1 | ||||||||||||||||||
Statistical analysis description |
Comparison between treatment groups of complete closure of target wound within 1 month was performed using logisitic regression modelling with multiple imputation.
|
||||||||||||||||||
Comparison groups |
SD-101-6.0 v Placebo
|
||||||||||||||||||
Number of subjects included in analysis |
163
|
||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||
Analysis type |
other [6] | ||||||||||||||||||
P-value |
= 0.212 [7] | ||||||||||||||||||
Method |
Regression, Logistic | ||||||||||||||||||
Parameter type |
Odds ratio (OR) | ||||||||||||||||||
Point estimate |
1.633
|
||||||||||||||||||
Confidence interval |
|||||||||||||||||||
level |
95% | ||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||
lower limit |
0.758 | ||||||||||||||||||
upper limit |
3.517 | ||||||||||||||||||
Notes [6] - Multiple imputation is implemented by two steps. First step using MCMC to get monotonic missing data pattern. In second step, a logistic regression model is used, with the following covariates included in the imputation model: treatment, EB type, baseline target wound size, target wound age, and non-missing data from earlier time points. The seed number is 010005 and the number of imputations is 5. [7] - p-value is from Type 3 tests to present as overall p-value for each term in the model |
|||||||||||||||||||
Statistical analysis title |
Logistic Regression Analysis at Month 2 | ||||||||||||||||||
Statistical analysis description |
Comparison between treatment groups of complete closure of target wound within 2 months was performed using logisitic regression modelling with multiple imputation.
|
||||||||||||||||||
Comparison groups |
SD-101-6.0 v Placebo
|
||||||||||||||||||
Number of subjects included in analysis |
163
|
||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||
Analysis type |
other [8] | ||||||||||||||||||
P-value |
= 0.802 [9] | ||||||||||||||||||
Method |
Regression, Logistic | ||||||||||||||||||
Parameter type |
Odds ratio (OR) | ||||||||||||||||||
Point estimate |
0.891
|
||||||||||||||||||
Confidence interval |
|||||||||||||||||||
level |
95% | ||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||
lower limit |
0.436 | ||||||||||||||||||
upper limit |
1.821 | ||||||||||||||||||
Notes [8] - Multiple imputation is implemented by two steps. First step using MCMC to get monotonic missing data pattern. In second step, a logistic regression model is used, with the following covariates included in the imputation model: treatment, EB type, baseline target wound size, target wound age, and non-missing data from earlier time points. The seed number is 010005 and the number of imputations is 5. [9] - p-value is from Type 3 tests to present as overall p-value for each term in the model |
|
|||||||||||||
End point title |
Change from Baseline in Body Surface Area Index (BSAI) of Lesional Skin at Month 3 Visit | ||||||||||||
End point description |
Lesional skin was defined as areas that contained any of the following: blisters, erosions, ulcerations, scabbing, bullae, or eschars, as well as areas that were weeping, sloughing, oozing, crusted, or denuded. BSAI was calculated as a percentage, ranging from 0% to 100%, of affected body surface area, recorded for each defined body region (ie, head/neck, upper limbs, trunk [includes groin], and lower limbs), multiplied by the weighting factor, then summed for all body regions. Analysis was performed on the ITT population.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From baseline to Month 3 visit
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Mixed Model Repeated Measures (MMRM) Analysis | ||||||||||||
Statistical analysis description |
The MMRM approach (using restricted maximum likelihood [REML] estimation) is used on each multiply-imputed data set. The model includes treatment, baseline BSAI of lesional skin, EB type, visit, and visit-treatment interaction as the fixed effects.
|
||||||||||||
Comparison groups |
SD-101-6.0 v Placebo
|
||||||||||||
Number of subjects included in analysis |
153
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other [10] | ||||||||||||
P-value |
= 0.706 [11] | ||||||||||||
Method |
Mixed models analysis | ||||||||||||
Parameter type |
Least squares (LS) mean difference | ||||||||||||
Point estimate |
0.682
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-2.873 | ||||||||||||
upper limit |
4.238 | ||||||||||||
Notes [10] - Multiple imputation is used by two steps. First step using MCMC to get monotonic missing data pattern. In second step, a linear regression model is used, with the following covariates included in the imputation model: treatment, EB type, baseline BSAI of lesional skin, and non-missing data from earlier time points. The seed number is 010005 and the number of imputations is 5. [11] - The p-value is calculated based on the hypothesis testing for the difference of LS-means between treatment and placebo. |
|
|||||||||||||
End point title |
Change from Baseline in BSAI of Total Body Wound Burden at Month 3 Visit | ||||||||||||
End point description |
Total body wound burden was calculated using BSAI. A wound was defined as an open area on the skin (ie, epidermal covering disrupted). BSAI was calculated as a percentage, ranging from 0% to 100%, of affected body surface area, recorded for each defined body region (ie, head/neck, upper limbs, lower limbs,trunk [includes groin], and multiplied by the weighting factor, then summed for all body regions. Analysis was performed on the ITT population.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From baseline to Month 3 visit
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
MMRM Analysis | ||||||||||||
Statistical analysis description |
The MMRM approach (using REML estimation) is used on each multiply-imputed data set. The model includes treatment, baseline BSAI of lesional skin, EB type, visit, and visit-treatment interaction as the fixed effects.
|
||||||||||||
Comparison groups |
SD-101-6.0 v Placebo
|
||||||||||||
Number of subjects included in analysis |
154
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other [12] | ||||||||||||
P-value |
= 0.9 [13] | ||||||||||||
Method |
Mixed models analysis | ||||||||||||
Parameter type |
LS mean difference | ||||||||||||
Point estimate |
-0.128
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-2.116 | ||||||||||||
upper limit |
1.861 | ||||||||||||
Notes [12] - Multiple imputation is used by two steps. First step using MCMC to get monotonic missing data pattern. In second step, a linear regression model is used, with the following covariates included in the imputation model: treatment, EB type, baseline BSAI of lesional skin, and non-missing data from earlier time points. The seed number is 010005 and the number of imputations is 5. [13] - The p-value is calculated based on the hypothesis testing for the difference of LS-means between treatment and placebo. |
|
|||||||||||||
End point title |
Change from Baseline in Itching Score at Day 7 | ||||||||||||
End point description |
Itching was assessed using the 5 point Itch Man Pruritus Assessment Tool. For subjects up to 5 years of age itching was assessed using caretaker’s response and subjects 6 years of age and older self-reported their itching assessments based on the following scores: 0=Comfortable, no itch, 1=itches a little, does not interfere with activity, 2=itches more, sometimes interferes with activity, 3=itches a lot, difficult to be still, concentrate, 4=itches most terribly, impossible to sit still or concentrate. Itching scores were categorised into three groups based on improvement: Improved or No Itching, Not Improved, and Missing. An itching score reduction from baseline greater than or equal to 1 point on the scale was classed as improved. Analysis was performed on the ITT population.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From baseline to Day 7
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Logistic Regression Analysis | ||||||||||||
Statistical analysis description |
The proportion of subjects experiencing improvement in itching versus non-improvement (including missing) was compared between the two treatment groups for Day 7 using the logistic regression model with baseline itching score, and EB type as covariates.
|
||||||||||||
Comparison groups |
SD-101-6.0 v Placebo
|
||||||||||||
Number of subjects included in analysis |
156
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other | ||||||||||||
P-value |
= 0.262 [14] | ||||||||||||
Method |
Regression, Logistic | ||||||||||||
Parameter type |
Odds ratio (OR) | ||||||||||||
Point estimate |
1.445
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.759 | ||||||||||||
upper limit |
2.752 | ||||||||||||
Notes [14] - p-value is from Type 3 Tests to present as overall p-value for each term in the model. |
|
|||||||||||||
End point title |
Change from Baseline in Pain Score at Day 7 | ||||||||||||
End point description |
Change in pain assessed at Day 7, compared to baseline was measured using the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioural Scale for subjects 1 month to 3 years of age. Each of the five FLACC categories is scored from 0-2, which results in a total score between 0 and 10 with 0=Relaxed and comfortable, 1-3=Mild discomfort, 4-6=Moderate pain and 7-10=Severe discomfort/pain. For Subjects 4 years of age and older the “Wong Faces Pain Scale” was used. This scale shows a series of faces ranging from a happy face at 0 which represents "no hurt" to a crying face at 10 which represents "hurts worst".
Pain scores were categorised into three groups based on improvement: Improved or No Pain, Not Improved, and Missing. A pain score reduction from baseline greater than or equal to 2 points on the scale was classed as improved. Analysis was performed on the ITT population.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From baseline to Day 7
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Logistic Regression Analysis | ||||||||||||
Statistical analysis description |
The proportion of subjects experiencing improvement in pain versus non-improvement (including missing) was compared between the two treatment groups for Day 7 using the logistic regression model with baseline pain score, and EB type as covariates.
|
||||||||||||
Comparison groups |
SD-101-6.0 v Placebo
|
||||||||||||
Number of subjects included in analysis |
157
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other | ||||||||||||
P-value |
= 0.098 [15] | ||||||||||||
Method |
Regression, Logistic | ||||||||||||
Parameter type |
Odds ratio (OR) | ||||||||||||
Point estimate |
0.596
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.323 | ||||||||||||
upper limit |
1.1 | ||||||||||||
Notes [15] - p-value is from Type 3 Tests to present as overall p-value for each term in the model. |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse events information
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Timeframe for reporting adverse events |
From baseline up to 3 months.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse event reporting additional description |
Adverse events (AE) were defined as treatment emergent (TEAEs) if the AE occurred on or after the first date of application of study drug.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
19.1
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting groups
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
SD-101-6.0
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects applied SD-101-6.0 cream once a day for a period of 90 days. The first study drug treatment was applied at the study centre after randomisation and completion of baseline assessments. Efficacy measurements and safety assessments were carried out at study visits at Week 2 and Months 1, 2 and 3. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects applied SD-101-0.0 (placebo) cream once a day for a period of 90 days. The first study drug treatment was applied at the study centre after randomisation and completion of baseline assessments. Efficacy measurements and safety assessments were carried out at study visits at Week 2 and Months 1, 2 and 3. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Frequency threshold for reporting non-serious adverse events: 2% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
Substantial protocol amendments (globally) |
|||
Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
||
12 Nov 2014 |
• The primary efficacy endpoint was clarified to be complete closure of the target wound within 2 months.
• Median time to complete target wound closure was added as a secondary efficacy endpoint.
• Some secondary efficacy endpoints were re-categorised.
• Sample size was increased from 90 subjects to 130 subjects and the number of study centres was increased from 10 to 15.
• The option to enter Study SD-006, extension study, was added.
• The minimum target lesion size specified was increased from 5 cm^2 to 10 cm^2 based on results from Study SD-003.
• Investigator responsibilities for reporting Serious AEs was added at the request of a European regulatory agency.
•A statement indicating that a draft statistical analysis plan (SAP) would be completed before randomisation of the first subject was added, as requested by Food and Drugs Administration (FDA).
• Regulatory requirements were broadened to include those that are applicable outside the United States, at the request of European regulatory agencies.
|
||
19 Sep 2016 |
• The single primary endpoint (i.e, complete target wound closure within 2 months) was revised to be 2 co-primary efficacy endpoints: the time to complete target wound closure within 3 months and the proportion of subjects experiencing complete target wound closure within 3 months.
• Estimation of total body wound burden was re-categorised from an exploratory efficacy endpoint to be a secondary efficacy endpoint.
• Secondary efficacy endpoints were added to capture the proportion of subjects experiencing complete target wound closure within 2 months and 1 month.
• Exploratory efficacy endpoints were added to capture percentage change from baseline in total body wound burden and lesional skin based on BSAI at additional time points.
• Enrollment was changed from approximately 130 subjects to up to 150 subjects to allow for 2 potential interim analyses after ~90 and ~125 subjects were enrolled.
• Statistical methods were modified to support the evaluation of co-primary and secondary endpoints in a step-down procedure while controlling the type I error rate and addressing multiplicity. |
||
10 Mar 2017 |
• Co-primary efficacy endpoints were renamed as 2 primary efficacy endpoints for consistency with the SAP in response to comments from FDA. Secondary efficacy endpoints were renamed as key secondary efficacy endpoints, and exploratory endpoints were renamed as other secondary efficacy endpoints.
• Other secondary efficacy endpoints were re-ordered to reflect the SAP and change in target wound characteristics was added as another secondary efficacy endpoint.
• The interim analyses were omitted because enrollment increased and it was no longer considered necessary. |
||
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 |