Clinical Trial Results:
A randomized, multicenter, double-blind, placebo-controlled, parallel group study of the 12 month effect of treatment with once daily triamcinolone acetonide (NASACORT® AQ Nasal Spray 110 μg) on the growth velocity of children, 3 to 9 years of age, with perennial allergic rhinitis (PAR)
Summary
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EudraCT number |
2014-004645-27 |
Trial protocol |
Outside EU/EEA |
Global end of trial date |
12 Oct 2011
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Results information
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Results version number |
v1(current) |
This version publication date |
01 Apr 2016
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First version publication date |
15 May 2015
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
XRG5029C_3503
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT00449072 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Sanofi U.S Services Inc.
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Sponsor organisation address |
55 Corporate Drive Bridgewater, New Jersey, United States, NJ 08807
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Public contact |
Trial Transparency Team, Sanofi Aventis Recherche & Developpement, Contact-US@sanofi.com
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Scientific contact |
Trial Transparency Team, Sanofi Aventis Recherche & Developpement, Contact-US@sanofi.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
Yes
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
10 Nov 2011
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
12 Oct 2011
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
The primary objective of the study was to characterize the difference in prepubescent growth velocity in children 3 to 9 years of age with perennial allergic rhinitis (PAR) treated with triamcinolone acetonide (TAA) nasal spray (NASACORT® AQ 110 μg treatment group) or placebo (NASACORT® AQ placebo group) for 12-months.
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Protection of trial subjects |
The study was conducted by investigators experienced in the treatment of pediatric subjects. The parent(s) or guardian(s) as well as the children were fully informed of all pertinent aspects of the clinical trial as well as the possibility to discontinue at any time. In addition to the consent form for the parent(s)/guardian(s), an assent form in child-appropriate language was provided and explained to the child. Repeated invasive procedures were minimized. The number of blood samples as well as the amount of blood drawn were adjusted according to age and weight. A topical anesthesia may have been used to minimize distress and discomfort.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
14 Mar 2007
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
United States: 299
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Worldwide total number of subjects |
299
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EEA total number of subjects |
0
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
299
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
0
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
The study was conducted between 14 March 2007 (first subject enrolled) and 12 October 2011 (last subject last visit) at 69 active centers located in the US. | |||||||||||||||||||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
299 subjects were randomized, 298 were treated. | |||||||||||||||||||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||||||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||||||||||||||||||||||||||||||||||||||
Roles blinded |
Subject, Investigator | |||||||||||||||||||||||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Placebo | |||||||||||||||||||||||||||||||||||||||||||||
Arm description |
3 to 9 year old subjects with PAR administered. - Placebo (once to demonstrate IP administration in the baseline/screening period). - Placebo in the double-blind treatment period. All subjects were provided Children's Claritin® Syrup as a rescue medication. | |||||||||||||||||||||||||||||||||||||||||||||
Arm type |
Placebo | |||||||||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Nasal spray
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Routes of administration |
Nasal use
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Dosage and administration details |
Placebo to TAA-AQ was administered once at the study site in each nostril during the baseline/screening period to demonstrate intranasal IP administration. Placebo to TAA-AQ was administered intranasally once daily in each nostril during the double-blind period.
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Investigational medicinal product name |
Claritin® Syrup
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Syrup
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Routes of administration |
Oral use
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Dosage and administration details |
Subjects were provided Children's Claritin® Syrup (5 mg of loratadine per 5 mL), as rescue medication for the relief of allergic rhinitis (AR) symptoms, and could be used throughout the study on an as needed basis according to the Food and Drug Administration-approved manufacturer's label.
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Arm title
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TAA-AQ | |||||||||||||||||||||||||||||||||||||||||||||
Arm description |
3 to 9 year old subjects with Perennial Allergic Rhinitis (PAR) administered. - Placebo in the baseline/screening period to demonstrate administration of IP with the nasal spray bottle. - Triamcinolone acetonide (TAA-AQ) in the double-blind treatment period. All subjects were provided Children's Claritin® Syrup as a rescue medication. | |||||||||||||||||||||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Nasal spray
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Routes of administration |
Nasal use
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Dosage and administration details |
Placebo to TAA-AQ was administered once at the study site in each nostril during the baseline/screening period to demonstrate intranasal IP administration.
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Investigational medicinal product name |
Triamcinolone acetonide aqueous (TAA-AQ) nasal spray (NASACORT AQ)
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Investigational medicinal product code |
XRG5029
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Other name |
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Pharmaceutical forms |
Nasal spray
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Routes of administration |
Nasal use
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Dosage and administration details |
110 μg TAA-AQ was administered once daily intranasally (1 spray delivering 55 μg of TAA-AQ in each nostril) during the double-blind treatment period.
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Investigational medicinal product name |
Claritin® Syrup
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Syrup
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Routes of administration |
Oral use
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Dosage and administration details |
Subjects were provided Children's Claritin® Syrup (5 mg of loratadine per 5 mL), as rescue medication for the relief of allergic rhinitis (AR) symptoms, and could be used throughout the study on an as needed basis according to the Food and Drug Administration-approved manufacturer's label.
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Baseline characteristics reporting groups
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Reporting group title |
Placebo
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Reporting group description |
3 to 9 year old subjects with PAR administered. - Placebo (once to demonstrate IP administration in the baseline/screening period). - Placebo in the double-blind treatment period. All subjects were provided Children's Claritin® Syrup as a rescue medication. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
TAA-AQ
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Reporting group description |
3 to 9 year old subjects with Perennial Allergic Rhinitis (PAR) administered. - Placebo in the baseline/screening period to demonstrate administration of IP with the nasal spray bottle. - Triamcinolone acetonide (TAA-AQ) in the double-blind treatment period. All subjects were provided Children's Claritin® Syrup as a rescue medication. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Placebo
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Reporting group description |
3 to 9 year old subjects with PAR administered. - Placebo (once to demonstrate IP administration in the baseline/screening period). - Placebo in the double-blind treatment period. All subjects were provided Children's Claritin® Syrup as a rescue medication. | ||
Reporting group title |
TAA-AQ
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Reporting group description |
3 to 9 year old subjects with Perennial Allergic Rhinitis (PAR) administered. - Placebo in the baseline/screening period to demonstrate administration of IP with the nasal spray bottle. - Triamcinolone acetonide (TAA-AQ) in the double-blind treatment period. All subjects were provided Children's Claritin® Syrup as a rescue medication. |
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End point title |
Growth Velocity | ||||||||||||
End point description |
Individual subject's growth velocity over double-blind treatment period was calculated using a linear regression of height over time. Height was measured on the same wall-mounted Harpenden stadiometer with the subject barefoot and in light clothing. The modified intent-to-treat (mITT) population included all intent-to-treat subjects who had at least 3 postrandomization visits with recorded height measurements during the double-blind treatment period, excluding those from Good Clinical Practice (GCP) noncompliant sites.
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End point type |
Primary
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End point timeframe |
Day 1 to end of treatment (Day 360)
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Statistical analysis title |
TAA-AQ vs Placebo | ||||||||||||
Statistical analysis description |
The treatment arm, age group (at Visit 1) and sex were fixed effects, and baseline growth velocity was a covariate in the ANCOVA model.
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Comparison groups |
Placebo v TAA-AQ
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Number of subjects included in analysis |
267
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||
P-value |
= 0.0096 | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Least squares mean difference | ||||||||||||
Point estimate |
-0.45
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-0.78 | ||||||||||||
upper limit |
-0.11 |
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End point title |
Change From Baseline in Instantaneous Total Nasal Symptom Score (TNSS) | ||||||||||||
End point description |
PAR symptoms nasal stuffiness, nasal discharge, sneezing, and nasal itching were scored upon arising in the morning according to the following 4point scale:
0 = symptom absent,
1 = mild (present but not annoying to self),
2 = moderate (annoying to self but not interfering with sleep or daily living),
3 = severe (interfered with daily living and/or sleep) TNSS was the sum of the individual symptom scores (ranging 0-3), and TNSS ranged from 0 (best outcome) to 12 (worst outcome). A negative value for change represents an improvement in symptoms. mITT population with scores available for TNSS: All randomized and treated subjects with at least 3 post-randomization height measurements during the double-blind treatment period with scores available for TNSS, excluding those from GCP noncompliant sites.
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End point type |
Secondary
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End point timeframe |
For 7 days prior to randomization (Baseline) and everyday for 7 days prior to Day 360 (end of treatment)
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Statistical analysis title |
TAA-AQ vs Placebo | ||||||||||||
Statistical analysis description |
The treatment arm, sex and age group were fixed effects, and baseline value was a covariate in the ANCOVA model.
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Comparison groups |
Placebo v TAA-AQ
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Number of subjects included in analysis |
206
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||
P-value |
= 0.7341 | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Least squares mean difference | ||||||||||||
Point estimate |
-0.12
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-0.83 | ||||||||||||
upper limit |
0.58 |
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End point title |
Change From Baseline in Four Individual Nasal Symptom Scores at the End of Treatment | ||||||||||||||||||||||||
End point description |
PAR symptoms - nasal stuffiness, nasal discharge, sneezing, and nasal itching were scored upon arising in the morning according to the following 4-point scale:
0 = symptom absent
1 = mild (present but not annoying to self)
2 = moderate (annoying to self but not interfering with sleep or daily living)
3 = severe (interfered with daily living and/or sleep)
Individual symptom scores ranged from 0 (best outcome) to 3 (worst outcome). A negative value for change represents an improvement in symptoms. mITT population with available nasal symptom scores: All randomized and treated participants with at least 3 post-randomization height measurements during the double-blind treatment period with available nasal symptom scores, excluding those from GCP noncompliant sites.
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End point type |
Secondary
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End point timeframe |
For 7 days prior to randomization (Baseline) and everyday for 7 days prior to Day 360 (end of treatment)
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Statistical analysis title |
Change in nasal stuffiness | ||||||||||||||||||||||||
Statistical analysis description |
The treatment arm, sex and age group were fixed effects, and baseline value was a covariate in the ANCOVA model.
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Comparison groups |
Placebo v TAA-AQ
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Number of subjects included in analysis |
267
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||||||||||||||
P-value |
= 0.1963 | ||||||||||||||||||||||||
Method |
ANCOVA | ||||||||||||||||||||||||
Parameter type |
Least squares mean difference | ||||||||||||||||||||||||
Point estimate |
-0.15
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Confidence interval |
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level |
95% | ||||||||||||||||||||||||
sides |
2-sided
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lower limit |
-0.37 | ||||||||||||||||||||||||
upper limit |
0.08 | ||||||||||||||||||||||||
Statistical analysis title |
Change in Nasal Discharge | ||||||||||||||||||||||||
Statistical analysis description |
The treatment arm, sex and age group were fixed effects, and baseline value was a covariate in the ANCOVA model.
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Comparison groups |
TAA-AQ v Placebo
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Number of subjects included in analysis |
267
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||||||||||||||
P-value |
= 0.7193 | ||||||||||||||||||||||||
Method |
ANCOVA | ||||||||||||||||||||||||
Parameter type |
Least squares mean difference | ||||||||||||||||||||||||
Point estimate |
-0.04
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Confidence interval |
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level |
95% | ||||||||||||||||||||||||
sides |
2-sided
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lower limit |
-0.24 | ||||||||||||||||||||||||
upper limit |
0.17 | ||||||||||||||||||||||||
Statistical analysis title |
Change in Sneezing | ||||||||||||||||||||||||
Statistical analysis description |
The treatment arm, sex and age group were fixed effects, and baseline value was a covariate in the ANCOVA model.
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Comparison groups |
Placebo v TAA-AQ
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Number of subjects included in analysis |
267
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||||||||||||||
P-value |
= 0.402 | ||||||||||||||||||||||||
Method |
ANCOVA | ||||||||||||||||||||||||
Parameter type |
Least squares mean difference | ||||||||||||||||||||||||
Point estimate |
0.09
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Confidence interval |
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level |
95% | ||||||||||||||||||||||||
sides |
2-sided
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lower limit |
-0.12 | ||||||||||||||||||||||||
upper limit |
0.29 | ||||||||||||||||||||||||
Statistical analysis title |
Change in Nasal Itching | ||||||||||||||||||||||||
Statistical analysis description |
The treatment arm, sex and age group were fixed effects, and baseline value was a covariate in the ANCOVA model.
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Comparison groups |
Placebo v TAA-AQ
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Number of subjects included in analysis |
267
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||||||||||||||
P-value |
= 0.8854 | ||||||||||||||||||||||||
Method |
ANCOVA | ||||||||||||||||||||||||
Parameter type |
Least squares mean difference | ||||||||||||||||||||||||
Point estimate |
-0.02
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Confidence interval |
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level |
95% | ||||||||||||||||||||||||
sides |
2-sided
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lower limit |
-0.23 | ||||||||||||||||||||||||
upper limit |
0.2 |
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End point title |
Global Efficacy as Assessed by the Subject (With the Help of a Parent/Guardian/Caregiver) During and at the End of the Double-blind Treatment Period | |||||||||||||||||||||
End point description |
Global efficacy was assessed by the subject (with the help of a parent/guardian/caregiver) using the following scale:
0 = no relief (symptoms unchanged or worse than before),
1 = slight relief (symptoms were present and only minimally improved)
2 = moderate relief (symptoms were present and could have been troublesome but were noticeably improved)
3 = marked relief (symptoms were greatly improved and although present were scarcely troublesome)
4 = complete relief (virtually no symptom present).
mITT population: All randomized and treated subjects with at least 3 post-randomization height measurements during the double-blind treatment period, excluding those from GCP noncompliant sites.
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End point type |
Secondary
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End point timeframe |
Day 120, Day 240 and Day 360
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Statistical analysis title |
Statistical Analysis for Day 120 | |||||||||||||||||||||
Statistical analysis description |
The treatment arm, assessment visit, their interaction, sex and age group were fixed effects, and assessment visit was a repeated factor.
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Comparison groups |
Placebo v TAA-AQ
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Number of subjects included in analysis |
267
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Analysis specification |
Pre-specified
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Analysis type |
superiority | |||||||||||||||||||||
P-value |
= 0.0951 | |||||||||||||||||||||
Method |
Mixed model for repeated measures | |||||||||||||||||||||
Confidence interval |
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Statistical analysis title |
Statistical analysis for Day 240 | |||||||||||||||||||||
Statistical analysis description |
The treatment arm, assessment visit, their interaction, sex and age group were fixed effects, and assessment visit was a repeated factor.
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Comparison groups |
Placebo v TAA-AQ
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Number of subjects included in analysis |
267
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority | |||||||||||||||||||||
P-value |
= 0.1247 | |||||||||||||||||||||
Method |
Mixed model for repeated measures | |||||||||||||||||||||
Confidence interval |
||||||||||||||||||||||
Statistical analysis title |
Statistical analysis for Day 360 | |||||||||||||||||||||
Statistical analysis description |
The treatment arm, assessment visit, their interaction, sex and age group were fixed effects, and assessment visit was a repeated factor.
|
|||||||||||||||||||||
Comparison groups |
Placebo v TAA-AQ
|
|||||||||||||||||||||
Number of subjects included in analysis |
267
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority | |||||||||||||||||||||
P-value |
= 0.0207 | |||||||||||||||||||||
Method |
Mixed model for repeated measures | |||||||||||||||||||||
Confidence interval |
|
||||||||||||||||||||||
End point title |
Global Efficacy as Assessed by the Investigator During and at the End of the Double-blind Treatment Period | |||||||||||||||||||||
End point description |
Global efficacy was assessed by the investigator using the following scale:
0 = no relief (symptoms unchanged or worse than before)
1 = slight relief (symptoms were present and only minimally improved)
2 = moderate relief (symptoms were present and could have been troublesome but were noticeably improved)
3 = marked relief (symptoms were greatly improved and although present were scarcely troublesome)
4 = complete relief (virtually no symptom present).
mITT population: All randomized and treated subjects with at least 3 post-randomization height measurements during the double-blind treatment period, excluding those from GCP noncompliant sites.
|
|||||||||||||||||||||
End point type |
Secondary
|
|||||||||||||||||||||
End point timeframe |
Day 120, Day 240 and Day 360
|
|||||||||||||||||||||
|
||||||||||||||||||||||
Statistical analysis title |
Statistical Analysis for Day 120 | |||||||||||||||||||||
Statistical analysis description |
The treatment arm, assessment visit, their interaction, sex and age group were fixed effects, and assessment visit was a repeated factor.
|
|||||||||||||||||||||
Comparison groups |
Placebo v TAA-AQ
|
|||||||||||||||||||||
Number of subjects included in analysis |
267
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority | |||||||||||||||||||||
P-value |
= 0.2445 | |||||||||||||||||||||
Method |
Mixed model for repeated measures | |||||||||||||||||||||
Confidence interval |
||||||||||||||||||||||
Statistical analysis title |
Statistical Analysis for Day 240 | |||||||||||||||||||||
Statistical analysis description |
The treatment arm, assessment visit, their interaction, sex and age group were fixed effects, and assessment visit was a repeated factor.
|
|||||||||||||||||||||
Comparison groups |
Placebo v TAA-AQ
|
|||||||||||||||||||||
Number of subjects included in analysis |
267
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority | |||||||||||||||||||||
P-value |
= 0.4488 | |||||||||||||||||||||
Method |
Mixed model for repeated measures | |||||||||||||||||||||
Confidence interval |
||||||||||||||||||||||
Statistical analysis title |
Statistical Analysis for Day 360 | |||||||||||||||||||||
Statistical analysis description |
The treatment arm, assessment visit, their interaction, sex and age group were fixed effects, and assessment visit was a repeated factor.
|
|||||||||||||||||||||
Comparison groups |
Placebo v TAA-AQ
|
|||||||||||||||||||||
Number of subjects included in analysis |
267
|
|||||||||||||||||||||
Analysis specification |
Pre-specified
|
|||||||||||||||||||||
Analysis type |
superiority | |||||||||||||||||||||
P-value |
= 0.0142 | |||||||||||||||||||||
Method |
Mixed model for repeated measures | |||||||||||||||||||||
Confidence interval |
|
|||||||||||||
End point title |
Percentage of Subjects Who Used the Rescue Medication During the Double-blind Phase of the Study | ||||||||||||
End point description |
Children's Claritin® syrup was provided as a rescue medication to control allergic rhinitis (AR) symptoms and could be used throughout the study on an as needed basis. Use of rescue medication was to be documented in the subject's diary. The percentage of subjects who used the rescue medication during each of the study periods is reported. mITT population: All randomized and treated subjects with at least 3 post-randomization height measurements during the double-blind treatment period, excluding those from GCP noncompliant sites.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline (4-6 months before Day 1), double-blind treatment period (Day 1 to Day 360) and follow-up (Day 361 to Day 420)
|
||||||||||||
|
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Percentage of Days Subjects Used the Rescue Medication During the Double-blind Treatment Phase of the Study | ||||||||||||
End point description |
Children's Claritin® syrup was provided as a rescue medication to control allergic rhinitis (AR) symptoms and could be used throughout the study on an as needed basis. Use of rescue medication was to be documented in the subject's diary. The percentage of days that subjects used the rescue medication during the double-blind treatment phase of the study. mITT population: All randomized and treated subjects with at least 3 post-randomization height measurements during the double-blind treatment period, excluding those from GCP noncompliant sites.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
double-blind treatment period (Day 1 to Day 360)
|
||||||||||||
|
|||||||||||||
No statistical analyses for this end point |
|
||||||||||||||||||||||
End point title |
24 Hour Urinary Free Cortisol Levels | |||||||||||||||||||||
End point description |
Urine cortisol levels was determined at screening, at the end of treatment, and at follow-up visit using routine laboratory testing. The normal range for urinary free cortisol for 3- to 9-year-olds was considered to be [1.4 - 21 μg/24 hours]. All randomized and treated subjects, excluding those from GCP noncompliant sites.
|
|||||||||||||||||||||
End point type |
Secondary
|
|||||||||||||||||||||
End point timeframe |
Baseline (2 to 6 weeks before Day 1), end of treatment (Day 360), and at follow-up (Day 420)
|
|||||||||||||||||||||
|
||||||||||||||||||||||
No statistical analyses for this end point |
|
||||||||||||||||||||||
End point title |
24 Hour Cortisol/Creatinine Ratio | |||||||||||||||||||||
End point description |
Urine cortisol and creatinine levels were determined at screening, at the end of treatment, and at follow-up visit using routine laboratory testing. The normal range for urinary free cortisol for 3- to 9-year-olds was considered to be [1.4 - 21 μg/24 hours]. No normal range is available for cortisol/creatinine ratio. All randomized and treated subjects, excluding those from GCP noncompliant sites.
|
|||||||||||||||||||||
End point type |
Secondary
|
|||||||||||||||||||||
End point timeframe |
Baseline (2 to 6 weeks before Day 1), end of treatment (Day 360), and at follow-up (Day 420)
|
|||||||||||||||||||||
|
||||||||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||
End point title |
Number of Subjects With Treatment-emergent Adverse Events (TEAE) | ||||||||||||||||||||||||
End point description |
Adverse events that developed, worsened, or became serious during the double-blind treatment period or within 7 days after the last dose of double-blind investigational product (IP) are defined as TEAEs.
A serious adverse event (SAE) was defined as any untoward medical occurrence that at any dose:
•Resulted in death
•Was life-threatening
•Required inpatient hospitalization or prolongation of existing hospitalization
•Resulted in persistent or significant disability/incapacity
•Was a congenital anomaly/birth defect
•Was a medically important event.
All randomized and treated subjects, excluding those from GCP noncompliant sites.
|
||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||
End point timeframe |
From Day 1 to 7 days following end of treatment (Day 360)
|
||||||||||||||||||||||||
|
|||||||||||||||||||||||||
No statistical analyses for this end point |
|
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Adverse events information
|
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Timeframe for reporting adverse events |
From treatment initiation to 7 days after the last dose of double-blind treatment (double blind treatment period)
|
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Adverse event reporting additional description |
Adverse events that developed, worsened, or became serious during the double-blind treatment period or within 7 days after the last dose of double-blind period, i.e. Treatment-emergent adverse events.
|
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Assessment type |
Non-systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
|
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Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
14.1
|
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Reporting groups
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Reporting group title |
TAA-AQ
|
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Reporting group description |
Placebo at screening and Triamcinolone acetonide administered in the treatment period. All subjects were provided Children's Claritin® Syrup as a rescue medication. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
|
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Reporting group description |
Placebo matched to triamcinolone acetonide at baseline and in the treatment period. All subjects were provided Children's Claritin® Syrup as a rescue medication. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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|
|||
Substantial protocol amendments (globally) |
|||
Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
||
05 Jul 2005 |
- Removal of the nasal spray aerosol type only.
- Removal Single-blind single-blind NASACORT AQ placebo, which was planned at baseline.
- Removal of stratification by age grouping.
- Removal of randomization procedure, including Interactive voice response system.
- Removal of statistical methods, including subset analyses.
- Removal of the NASACORT AQ HFA Nasal Aerosol reference materials. |
||
27 Sep 2005 |
- Limiting the inclusion age to 3 years of age and older.
- Clarifying why mild asthma is an inclusion criterion.
- Excluding children with a bone age which is different from chronological age by more than 1 year.
- Withholding intranasal corticosteroids and high potency topical corticosteroids for at least 6 weeks prior to baseline assessments.
- Performing an additional physical examination and Tanner staging at the final follow-up visit (Visit 11).
- Use of the 12-hour urinary free cortisol and not the urinary free cortisol corrected for creatinine to assess the effect of treatment on hypothalamic-pituitary-adrenal (HPA) axis.
- Repeating the PAR symptoms assessment at the end of treatment, in addition to the proposed 14-day assessment prior to randomization.
- Additional analyses to be included: A subset analysis excluding any subject who exhibits >Tanner Stage 2 characteristics at the end of treatment period; An analysis of the percent of children who are below a certain percentile of growth velocity (eg, 3 rd percentile) or percent of children whose percentile of height decreases during the treatment period; A subset analysis excluding children who receive systemic corticosteroids during the double-blind treatment period.
- A statistical analysis adjusting for the age factor in order to prevent variation between strata that could contribute to variation in the treatment effect.
- A linear regression model as it is a better method to estimate growth velocity since it takes into account all height measurements during the treatment period (vs change from baseline in height where it does not).
- Removal CLARITIN Reditabs as a rescue medication option. |
||
09 Jan 2006 |
Corrections in typographical errors and clarification of the timing of the dose. |
||
15 Sep 2006 |
- An administrative change in responsible medical expert and sponsor signatory.
- A change in the protocol title to extend the age range from 3-8 to 3-9 (9 year old males only).
- A correction in the study duration and dates.
- Re-wording of the Primary and Secondary Objectives; Inclusion and Exclusion Criteria; Concomitant Treatments section for greater clarity
- A change in the Study Design to remove the Single-Blind Run-In period and insert the use of demo placebo prior to randomization at Visit 3
- A change in Urinary Cortisol from 12 hour to 24 hour along with insertion of cortisol/creatinine ratio assessment in addition to urinary free cortisol; and insertion of normal ranges.
- A change in the Treatments section to add demo placebo and greater detail regarding the use of the rescue medication, Claritin Syrup.
- A change in study schedule at Visit 2 from -2 wks to -3 weeks to allow 1 week in which to complete the 24 urine collection and to ensure results are available to site prior to Visit 3, Randomization; also inserted early term visit procedures.
- The Period of Observation extended to the time the last 24 hour urine specimen is returned after the final visit (V11 or Early Term Visit).
- Inclusion of the revised NASACORT AQ package insert.
- Deletion of the Appendices for the US NCHS Growth charts for boys and girls-5th to 95th percentiles, as only the 3rd to 97th percentile growth charts were to be used. |
||
16 Jan 2007 |
- Correction in staff location and nonfunctional hyperlinks.
- Acceptance of an alternative bone image for bone assessment.
- Modification of the inclusion criterion for rhinitis symptom score.
- Demonstration of the placebo actuator earlier.
- Adjustment of rescue medication use per manufacturer’s instructions.
- Inclusion of a compliance measurement of partial dose administration.
- Restriction of wearing shoes, socks, or head cover during height and weight measurements and allow a subject to wear light clothing or gown during height and weight measurements
- Clarification that subject-reported daily diaries were to be dispensed at Visit 1 and collected, reviewed, and dispensed at Visits 2, 11, and early withdrawal
Clarification of when subjects might prematurely be withdrawn
- Administration of the first dose at the site
- Clarification that subjects who become toilet trained after Visit 2 and did not complete the Visit 2 urine collection would not participate in the 24-hour urine collection procedure
- Clarification that subjects who may have an abnormal cortisol at Visit 11 or an early withdrawal visit should either be continued for follow-
up or referred to another physician – with documentation in the case report form
- Permit the investigator or their designee to assess the validity of the 24-hour urine specimen
- Define overdose by the sponsor
- Permission of breaking of the blind by the investigator for expedited reporting or emergency medical treatment that would result in subject withdrawal. |
||
11 Sep 2008 |
- Changed Visit 10 study day from 365 ± 5 to 360 ± 5 days after Visit 3.
- Deletion of bone age Inclusion and Exclusion criteria at Visit 2.
- Removal of bone age assessment from the protocol.
- Addition of Inclusion criterion: subjects must be toilet-trained.
- Addition of exclusion criterion: abnormal 24-hour urinary free cortisol level.
- Clarification of Upper Respiratory Tract Infection, sinus infection, or nasal candidiasis.
- Clarification of inclusion criterion to specify “legal guardian” and to require subjects 7 years of age and older to provide a signed assent form.
- Changed the expected duration of the study from 44 months to 56 months, and the end of subject recruitment from 1st quarter 2009 to 1st quarter 2010.
- Provided instructions regarding the labeling of each bottle of the investigational product and instructions to subjects and caregivers.
- Provided compliance rate calculation and dosing adherence post-randomization.
- Deletion of exclusion criterion regarding concomitant use of nasal or oral antihistamine or decongestant or oral leukotriene modifier prior to Visit 3.
- Expanded visit window for screening (Visit 1) and baseline (Visit 2).
- Added permission to allow non-randomized subject to be re-screened and re-entered into the study.
- Clarification of sample size calculation.
- Broadening the definition of ITT population to include all subjects who received at least 1 dose of investigational product, regardless of their randomization status.
- Clarification of the End of Study follow-up period.
- Changed “Early Withdrawal” to “Early Termination”.
- Clarification that End of Study (Follow-up/post-treatment) Visit 11 procedures should be completed at 60 ± 5 days after Visit 10 or an Early Termination visit.
- Changed the 6-month visit date from 182 ± 5 days to 180 days ± 5 days and 12-month visit date from 365 ± 5 days to 360 ± 5 days.
- Changed language to clarify stratification by age and sex. |
||
01 Dec 2008 |
- Expansion the number of clinical sites (from 60 to 100).
- Clarification of systemic corticosteroid exclusion criterion: Treatment with systemic corticosteroids >2 courses received up to 1 year before Visit 1 was exclusionary. Up to 2 courses of systemic corticosteroids, each course not exceeding 14 days, up to 1 year before Visit 1 was allowed. |
||
23 Apr 2010 |
- Conduct the primary analysis in the mITT population.
- Conduct sensitivity analyses in the intent-to-treat (ITT) and per-protocol (PP) populations and other defined analysis sets.
- Define an mITT and PP population(s).
- Broaden the desired precision for growth velocity to a total width of 2*0.45 cm/year.
- Recalculate the sample size based on the desired precision .
- Identify unusual individual growth velocities and discuss their impact on the results of the overall analysis of growth velocity in the clinical study report.
- Perform statistical analyses that exclude questionable height measurements and include the percent of subjects who are below certain
percentiles of growth velocity.
- Perform descriptive statistics (comparison) on the growth velocities by sex and ethnicity.
- Summarize the number of subjects at each visit (from screening to follow-up) by investigational product treatment group.
- Conduct sensitivity analysis using the random-effects model accounting for repeated height measurements within subjects and for the difference in variance of the estimated individual growth slopes when the number of height measurements per subject varies across subjects |
||
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. | |||
Two study sites with significant GCP noncompliance were reported to the U.S. Food and Drug Administration (FDA) by the Sponsor. A total of 5 treated participants (1 placebo and 4 TAA-AQ) from these 2 study sites were excluded from the analysis. |