E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
|
E.1.1.1 | Medical condition in easily understood language |
an autoimmune disease resulting in inflammation of the kidney, which can lead to destruction of the kidneys over time in about a third of the patients |
|
E.1.1.2 | Therapeutic area | Body processes [G] - Immune system processes [G12] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10021263 |
E.1.2 | Term | IgA nephropathy |
E.1.2 | System Organ Class | 10038359 - Renal and urinary disorders |
|
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the efficacy of a single treatment cycle of SM101 on the mean percent change in proteinuria from Baseline to Week 24 in subjects with IgAN |
|
E.2.2 | Secondary objectives of the trial |
1. To assess the safety and tolerability of SM101 in subjects with IgAN
2. To compare the relative efficacy and safety of 12 mg/kg and 24 mg/kg doses of SM101 in the treatment of IgAN
3. To assess the effect of SM101 on renal function, as determined by estimated glomerular filtration rate (eGFR)
4. To compare the effect of treatment with SM101 on the level of IgAN-specific biomarkers
5. To assess the pharmacokinetics (PK) of SM101 in subjects with IgAN |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Subject is 18 years of age or older at the time of Screening.
2. Subject may be of either gender and of any race or ethnicity.
3. Subject must have a biopsy-proven diagnosis of IgAN (obtained within 8 years
prior to Screening).
4. Subject’s blood pressure is ≤130/80 mmHg at Screening.
5. Subject is on maximally tolerated dose of an angiotensin-converting enzyme (ACE) inhibitor and/or angiotensin receptor blocker (ARB) for at least 3 month prior to Baseline visit.
6. Subject must present at Screening with current proteinuria levels between 1 g/24 h and 3.5 g/24 h.
7. Subject must present at Screening with eGFR [CKD-EPI] >40 mL/min/1.73m2.
8. If a female of childbearing potential, subject must have a negative pregnancy test at Screening, is not currently breastfeeding, and agrees to employ adequate birth control measures for the duration of the study. Male subjects with female partners of childbearing potential must agree to use adequate birth control measures for the duration of the study.
9. Subject is willing and able to comply with the requirements of this protocol and
agrees to sign an informed consent form prior to any study-related activities. |
|
E.4 | Principal exclusion criteria |
1. Subject has a history or current evidence of renal disease other than IgAN
2. Subjects with evidence of rapidly progressive disease (defined as a decline in
eGFR of ≥5 mL/min/1.73m2 in the preceding 6 months prior to Baseline)
3. Subject has IgAN with histologic evidence of advanced tubular atrophy and
interstitial fibrosis (eg, Oxford T2)
4. History or current evidence of other autoimmune disease (eg, SLE, inflammatory
bowel disease, rheumatoid arthritis)
5. History or current evidence of any chronic or uncontrolled medical condition (eg,
diabetes, severe hepatic or cardiovascular disease, alcohol or drug addiction)
which could, in the opinion of the Investigator, affect the subject’s safety and
ability to adhere to this protocol, or otherwise confound the results of the study
6. History or current evidence of a severe acute (ie, within 4 weeks prior to
Baseline) or chronic infection (eg, HIV, hepatitis B or C, tuberculosis, systemic
fungal infection [active or latent])
7. Use of systemic corticosteroids within 3 months prior to Baseline, or anticipated
use during the treatment period (Week 1 through Week 4). Note: Corticosteroids
administered by inhalation or intranasally, or limited topical use of low-potency
topical corticosteroids (ie, Class 6 and 7) are allowed throughout the study.
8. Known hypersensitivity or allergic reaction to any E. coli-derived recombinant
product, or to the IP or any of its excipients
9. Treatment with any immunomodulatory/immunosuppressive compound or
monoclonal antibody for any indication within 6 months (unless otherwise
stated) prior to Screening (eg, B cell-depleting agents [eg, rituximab,
epratuzumab] for ≥48 weeks; B-cell modifying agents [eg, belimumab, atacicept]
for ≥24 weeks; IV immunoglobulins for ≥12 weeks and all other
immunosuppressive treatments [eg, methotrexate, cyclophosphamide,
cyclosporine, tacrolimus, mycophenolate mofetil, azathioprine] for ≥12 weeks)
10. Clinically significant laboratory abnormalities prior to Baseline (eg, absolute
neutrophil count <1000 cells/μL; platelet count <100,000/μL; hemoglobin ≤10
g/dL; aspartate aminotransferase [AST], and alanine aminotransferase [ALT] ≥3
times the upper limit of normal)
11. History of any malignancy within past 5 years prior to Screening (except for
basal and squamous cell carcinomas of the skin, in situ cervical cancer, and
stable prostate cancer that does not require treatment)
12. History of tonsillectomy within 2 months prior to Screening
13. Subject has participated in another clinical study involving an IP or
investigational device within 30 days prior to Screening or is scheduled to
participate in another clinical study involving an IP or investigational device
during the course of this study
14. Subject is a family member or employee of the Investigator
15. A female subject who is pregnant or nursing at the time of Screening |
|
E.5 End points |
E.5.1 | Primary end point(s) |
To assess the efficacy of a single treatment cycle of SM101 on the mean percent change in proteinuria from Baseline to Week 24 in subjects with IgAN
1. Pooled high-dose SM101 and low-dose SM101 versus placebo
2. High-dose SM101 versus placebo
3. Low- dose SM101 versus placebo |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
1. Pooled high-dose SM101 and low-dose SM101 versus placebo (testing via 2x2
table by pooling high- and low-dose SM101 into single column, using placebo
as the second column).
2. High-dose SM101 versus placebo (testing via 2x2 table, using only SM101
high-dose and placebo)
3. Low- dose SM101 versus placebo (testing via 2x2 table, using only SM101
low-dose and placebo) |
|
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 | Yes |
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) | 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 | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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 | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 23 |
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 |
Canada |
Czech Republic |
Denmark |
Germany |
Hong Kong |
Sweden |
United Kingdom |
United States |
|
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
|
|
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 | 7 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 7 |
E.8.9.2 | In all countries concerned by the trial days | 0 |