E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
House dust mite allergic rhinitis |
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E.1.1.1 | Medical condition in easily understood language |
Allergic rhinitis due to house dust mite |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10001725 |
E.1.2 | Term | Allergic rhinitis due to other allergen |
E.1.2 | System Organ Class | 100000004855 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of STG320 sublingual tablets at a daily dosage of 300 IR when administered for 12 months to adults and adolescents with HDM-associated allergic rhinitis. |
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E.2.2 | Secondary objectives of the trial |
- To assess the efficacy of STG320 sublingual tablets at dosage of 300 IR
- Rhinoconjunctivitis symptom evaluation and rescue medication use will also be evaluated during the 2-week secondary evalutation period
- To assess the effect of STG320 on other variables at the end of treatment (work productivity and activity impairment, immunological markers) |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Have house dust mite (HDM)-associated allergic rhinitis (AR) (with or without asthma) for at least 1 year based on the presence of:
• Symptoms for 4 or more consecutive weeks in the previous year and for at least 4 days per week during those weeks.
• Symptoms requiring regular intake of symptomatic treatment(s).
• Symptoms evaluated as “troublesome” by the patients or impairing their daily activities, leisure or sport, school or work or involving sleep disturbance.
2. Have given signed informed consent to participate, after having been informed of the nature and aims of the study, in accordance with local regulation and requirements.
3. Male or female outpatients 12 to 65 years of age.
4. Sensitized to D. pteronyssinus (D. pte) and/or D. farinae (D. far) defined as skin prick test wheal diameter at least 5 mm greater than the negative control and HDM-specific serum IgE ≥3.5 kU/L.
5. Willing to and capable of completing the e-diary, study questionnaires and scales. |
|
E.4 | Principal exclusion criteria |
1. A history of rhinitis, rhino-conjunctivitis or asthma to allergens other
than HDM, likely to result in rhinitis symptoms during the baseline and
primary evaluation periods.
Specifically, when the following are present:
• documented sensitization (positive Skin Prick Test or allergen specific
serum IgE >3.5kU/L) and history of clinically relevant symptoms to
allergen(s) other than HDM,
• anticipated exposure to such allergen(s) during the baseline and
primary evaluation periods.
For example, the following patients are to be excluded:
- patients sensitized to cat or dog allergens and regularly exposed to these animals
- patients sensitized to perennial allergens, such as aspergillus, cladosporium, alternaria, cockroach
- patients sensitized to seasonal allergens such as parietaria, ragweed or mugwort, if these allergens are endemic in the region during the baseline and primary evaluation periods.
2. Any diagnosed nasal (other than HDM allergic rhinitis) or oral disease that could interfere with the efficacy or safety assessments, such as nasal polyposis, recurrent chronic rhino-sinusitis (at least 2 isolated episodes per year in the 2 previous years, each episode lasting more than 8 weeks) or a history of chronic oral inflammation or current active oral inflammation from any etiology (e.g., oral lichen planus, oral ulceration or oral mycosis) and/or oral wounds.
3. Recent nasal surgery (i.e., within the previous 6 months).
4. Partially controlled or uncontrolled asthma defined in the Global Initiative for Asthma 2014 guidelines (GINA 2014) as the presence of daytime asthma symptoms more than twice/week or nocturnal symptoms/awakening or need for reliever/rescue treatment more than twice/week or FEV1 <80% of predicted or personal best value.
5. Asthma therapies consistent with GINA treatment Step 3, Step 4 and Step 5 i.e., the preferred controller medication consists of inhaled corticosteroid (ICS) combined with long-acting beta (β)-2 agonist (LABA) according to GINA classification 2014 (refer to Appendix II for the full details of other controller options).
6. Experienced a life-threatening asthma attack or an asthma exacerbation that resulted in Intensive Care Unit (ICU) hospitalization.
7. Requiring continuous treatment with systemic corticosteroids for any indication.
8. Requiring continuous treatment with β-blockers or with Monoamine Oxidase Inhibitors (MAOIs).
9. Received an immunosuppressive treatment within 3 months prior to screening.
10. Received allergen specific immunotherapy (AIT) by any route:
- for house dust mites: AIT for more than 1 month within the 5 years before screening
- for other allergen(s): ongoing or recently stopped (within 6 months) AIT.
11. Any history of anaphylaxis after previous allergen immunotherapy, exposure to allergen(s) or of unknown cause.
12. Any history of hypersensitivity to STG320 or its excipients or contraindication to the use of rescue medications
13. Female with positive urine pregnancy test or lactating or expecting to conceive within the duration of the study.
14. Sexually active female of child-bearing potential without medically accepted contraceptive method
15. Unable or unwilling to comply with the study protocol requirements, including those who anticipate significant changes in their daily environment in relation to HDM exposure or who are likely to travel for extended periods of time during the main efficacy assessment period.
16. Patients with past or current disease(s) which, as judged by the Investigator, may affect the patient’s participation in or the outcome of this study. These diseases include, but are not limited to, cardiovascular disease, malignancy, active tuberculosis, hepatic disease, renal disease, hematologic disease, neurologic or psychiatric disease, severe autoimmune disorder, immunodeficiency or immunologic disease and endocrine disease.
17. Patients with a history of eosinophilic esophagitis or with current severe or persistent gastroesophageal symptoms including dysphagia or chest pain.
18. Contraindications to allergen specific immunotherapy.
19. Patients with history of drug or alcohol abuse.
20. Participation in any clinical study within 30 days prior to the selection visit.
21. Possible dependency of the patient on sponsor or investigators/subinvestigators or study personnel. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Total Combined Score (TCS). The average TCS is calculated for each patient as the average of the non-missing daily TCSs.
The daily TCS (scale 0-15) is the sum of the patient’s daily Rhinitis Total Symptom Score (RTSS, scale 0-12) and daily Rescue Medication Score (RMS, scale 0-3). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
Rhinitis Total Symptom Score (RTSS)
Rescue Medication Score (RMS)
Adjusted Symptom Score (ASS, scale 0-12)
Combined Symptom and Medication Score (CSMS, scale 0-6)
Total Ocular Symptom Score (TOSS, scale 0-6)
Six Individual Rhinoconjunctivitis Symptom Scores (RSSs)
Rhinoconjunctivitis rescue medication usage
Visual Analogue Scale (VAS)
Proportion of Symptom-Controlled Days (PSCD)
Controlled patients (CP)
Overall Standardized Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ(S)≥12) scores
EQ-5D-5L Generic health-related quality of life questionnaire
Global Rating of Change Score (GRCS) |
|
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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
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 | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 11 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 125 |
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 |
Belgium |
Bulgaria |
Canada |
Czech Republic |
France |
Germany |
Israel |
Italy |
Poland |
Russian Federation |
Slovakia |
Spain |
United States |
|
E.8.7 | Trial has a data monitoring committee | No |
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
|
Last Visit of the Last Patient |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 9 |