E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Thrombocytopenia in patients with Chronic Liver Disease (CLD) |
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E.1.1.1 | Medical condition in easily understood language |
Thrombocytopenia in patients with Chronic Liver Disease (CLD) |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10043554 |
E.1.2 | Term | Thrombocytopenia |
E.1.2 | System Organ Class | 10005329 - Blood and lymphatic system disorders |
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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 compare the efficacy of S-888711 with placebo for the treatment of thrombocytopenia in patients with CLD who are undergoing elective invasive procedures |
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E.2.2 | Secondary objectives of the trial |
•To assess the safety and tolerability of S-888711 treatment compared with placebo
•To assess the platelet response following treatment with S-888711 compared with placebo
•To assess the pharmacodynamics and pharmacokinetics of S-888711 |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Able to understand the study and comply with all the study procedures
2.Willing to provide written informed consent prior to Screening
3.Male or female
4.18 years of age or older at the time of signing informed consent
5.Platelet count < 50 × 10^9/L at baseline on Day 1 prior to randomisation
6.Undergoing an elective invasive procedure
7.In the opinion of the investigator, able to meet the requirements of the study
8.Male patients who are sterile or who agree to use an appropriate method of contraception (including use of a condom with spermicide) from screening to completion of the Post-treatment Period
9.Female patients who are not postmenopausal or surgically sterile need to agree to use highly effective contraception (including contraceptive implant, injectable contraceptive, combination hormonal contraceptive [including vaginal rings], intrauterine contraceptive device or vasectomised partner) from screening to completion of the Post-treatment Period. Barrier method with or without spermicide, double barrier contraception and oral contraceptive pill are in sufficient methods on their own. |
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E.4 | Principal exclusion criteria |
1.Any of the following diseases:
•haematopoietic tumour
•aplastic anaemia
•myelodysplastic syndrome
•myelofibrosis
•congenital thrombocytopenia
•drug induced thrombocytopenia
•generalised infection requiring treatment except for viral liver disease
•immune thrombocytopenia.
2.History of splenectomy.
3.History of liver transplantation.
4.Any of the following at Screening:
•hepatic encephalopathy uncontrolled by drugs
•ascites uncontrolled by drugs.
5.Portal vein tumour embolism.
6.Known to be positive for the human immunodeficiency virus.
7.Past or present thrombosis or prothrombotic condition (eg, cerebral infarction, myocardial infarction, angina pectoris, coronary artery stent placement, angioplasty, coronary artery bypass grafting, congestive heart failure [New York Heart Association {NYHA} Grade III/IV], arrhythmia known to increase the risk of thromboembolic events [eg, atrial fibrillation], pulmonary thromboembolism, deep vein thrombosis, or disseminated intravascular coagulation syndrome).
8.History or evidence of any of the following diseases:
•congenital thrombotic disease (eg, antithrombin deficiency, protein C deficiency, protein S deficiency, or coagulation factor [Factor V Leiden] mutation)
•acquired thrombotic disease (eg, antiphospholipid antibody syndrome, paroxysmal nocturnal haemoglobinuria, hyperhomocysteinaemia, or increased factor VIII)
•Budd Chiari syndrome.
9.Portal vein thrombosis based on ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) within 28 days prior to randomisation or a history of portal vein thrombosis.
10.Absence of hepatopetal blood flow in the main trunk of the portal vein as demonstrated by Doppler ultrasonography within 28 days prior to randomisation.
11.History or evidence of disease associated with a risk of bleeding (eg, coagulation factor deficiency or von Willebrand factor deficiency).
12.Bleeding score at randomisation ≥ Grade 2 according to the World Health Organization (WHO) Bleeding Scale.
13.Any of the following drugs or therapies within 90 days prior to randomisation:
•anticancer drugs
•interferon preparations
•radiation therapy
•exsanguination
•other TPO receptor agonist
•any investigational agent.
14.Any invasive procedure within 14 days prior to randomisation.
15.Blood transfusion within 14 days prior to randomisation.
16.Patients who have received S-888711 before.
17.Pregnant or lactating female.
18.Patients with known or suspected ongoing, active alcohol or substance abuse. Patients with a recent history who the investigator feels are able to comply with the study procedures and medications will be allowed to participate.
19.Considered ineligible by the investigator for any other reason. |
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E.5 End points |
E.5.1 | Primary end point(s) |
•Proportion of patients who require no platelet transfusion prior to the primary invasive procedure and no rescue therapy for bleeding from randomisation through 7 days after the primary elective procedure. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
On or after Day 8, but no more than 2 days prior to the elective invasive procedure. |
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E.5.2 | Secondary end point(s) |
•Proportion of patients who require no platelet transfusion during the study
•Proportion of responders: patients who achieve a platelet count of ≥ 50 × 109/L with an increase of ≥ 20 × 109/L from baseline at any time during the study
•Duration of the platelet count defined as the number of days during which the platelet count was maintained as ≥ 50 × 109/L
•Proportion of patients who require rescue therapy for bleeding at any time during the study
•Frequency of platelet transfusions
•The change from baseline in platelet count over time (time course of platelet count)
•Safety and tolerability
•Assessment of plasma concentrations of S-888711 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | 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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 61 |
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 |
Argentina |
Australia |
Austria |
Belgium |
Canada |
Czech Republic |
France |
Germany |
Hungary |
Israel |
Italy |
Korea, Republic of |
Poland |
Romania |
Russian Federation |
Spain |
Taiwan |
Thailand |
Turkey |
Ukraine |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 2 |
E.8.9.2 | In all countries concerned by the trial days | 0 |