E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
ocular dryness (Dry Eye Disease - DED) |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Eye Diseases [C11] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10013778 |
E.1.2 | Term | Dry eyes |
E.1.2 | System Organ Class | 100000004853 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10013777 |
E.1.2 | Term | Dry eye syndrome |
E.1.2 | System Organ Class | 100000004853 |
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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 |
The primary objectives of this study are to:
1. Evaluate the ocular tolerance and overall ocular safety of PADciclo (0.06% and 0.03%) in dry eye patients.
2. Evaluate the efficacy of PADciclo (0.06% and/or 0.03%) compared to current BSC administered once daily for 6 months in improving CFS in dry eye patients using a responder approach analysis. |
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E.2.2 | Secondary objectives of the trial |
The key secondary study objective is to:
1. Evaluate the efficacy of PADciclo (0.06% and 0.03%) to current BSC administered once daily for 6 months in improving corneal fluorescein staining and global ocular discomfort score (VAS) in dry eye patients using a composite responder approach analysis.
Additional secondary study objectives are to:
1. Evaluate the efficacy of PADciclo (0.06% and/or 0.03%) compared to PADciclo vehicle administered once daily for 6 months in improving CFS in dry eye patients using a responder approach analysis.
2. Evaluate the efficacy of PADciclo (0.06% and 0.03%) to PADciclo vehicle administered once daily for 6 months in improving corneal fluorescein staining and global ocular discomfort score (VAS) in dry eye patients using a composite responder approach analysis.
3. Compare efficacy of PADciclo 0.03% and PADciclo 0.06%.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Patients are at least 18 years of age
2. Patients with at least a 3 month documented history of moderate to severe DED persisting despite conventional management (which may include artificial tear drops, gels, ointments and/or punctual occlusion), and defined as the following:
a. Corneal fluorescein staining (CFS) = 3 or 4 (modified Oxford scale, scale 0 – 5)
AND
b. Global ocular discomfort score of ≥ 30mm using a 100 mm VAS. Patients will assess burning/stinging, foreign body sensation, eye dryness and pain and the mean score will be calculated: (where "0" means no symptom and "100" means the worst that have ever experienced).
3. Patients must provide written informed consent
4. Patients must be willing and able to undergo and return for scheduled study-related examinations.
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E.4 | Principal exclusion criteria |
Patients presenting with any of the following will not be included in the study:
1. History of the disease for less than 3 months (symptoms stabilized)
2. Best corrected distance visual acuity (BCDVA) score ≥ +1.0 LogMAR (≤ 35 ETDRS letters, ≤ 20/200 Snellen or ≤ 0.1) in each eye
3. Within the 3 months before the screening visit, history of ocular trauma, infection (viral, bacterial, fungal), inflammation not associated with dry eye
Other exclusion criteria are defined in the protocol (they are referring to the ocular history, the medical history and the contraindications to treatment).
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary safety variable is the incidence and severity of ocular and systemic adverse events throughout the study.
The primary efficacy variable is CFS response in the worse eye at Month 6, defined as at least a 2-grade improvement from baseline, as assessed with the modified Oxford scale.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Primary safety variable
Timepoint: Baseline and Months 1, 3, 6 and 9
Primary efficacy variable
Timepoint: at Month 6 |
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E.5.2 | Secondary end point(s) |
Secondary safety and tolerability variables:
• BCVA assessed in both eyes
• Slit lamp examination performed in both eyes
• IOP recorded for both eyes
• Vital signs (blood pressure and heart rate)
• Ciclosporin concentration in plasma
Key secondary efficacy variable
• Composite response endpoint (defined in the protocol and based on an improvement from baseline in CFS and VAS)
Other secondary efficacy variables are defined in the protocol (eg. CFS assessment at different timepoints, VAS response, Shirmer test, TBUT...).
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Secondary safety and tolerability variables:
Timepoint: Baseline and Months 1, 3, 6 and 9 for all variables except ciclosporin concentration which will be assessed at baseline and Month 6.
Key secondary efficacy variable
Timepoint: Month 6 |
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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 | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | Yes |
E.8.2.3.1 | Comparator description |
Hydromoor (lubricant drops) |
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E.8.2.4 | Number of treatment arms in the trial | 4 |
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 | 1 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 26 |
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 |
Austria |
Denmark |
Netherlands |
Norway |
Portugal |
Spain |
Switzerland |
United Kingdom |
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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
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |