E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Nontuberculous Mycobacterial (NTM) Lung Infections caused by Mycobacterium avium complex (MAC) that are refractory to treatment |
Infezioni polmonari da micobatteri non tubercolari (MNT) causate da Mycobacterium avium complex (MAC), refrattarie al trattamento |
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E.1.1.1 | Medical condition in easily understood language |
Nontuberculous Mycobacterial (NTM) Lung Infections caused by Mycobacterium avium complex (MAC) that are refractory to treatment |
Infezioni polmonari da micobatteri non tubercolari (MNT) causate da Mycobacterium avium complex (MAC), refrattarie al trattamento |
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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 | 20.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10058806 |
E.1.2 | Term | Mycobacterium avium complex infection |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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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 evaluate long term safety and tolerability of LAI (590 mg) administered once daily (QD) for up to 12 months in subjects who were refractory to standard multi-drug treatment and failed to convert in Study INS-212 |
Valutare la sicurezza e la tollerabilit¿ a lungo termine di LAI (590 mg) somministrato una volta al giorno (QD) per un massimo di 12 mesi in soggetti refrattari al trattamento multifarmaco standard che non hanno ottenuto una conversione dell¿esame colturale nello studio INS-212 |
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E.2.2 | Secondary objectives of the trial |
Secondary Objectives 1. To evaluate the number of subjects achieving culture conversion (3 consecutive negative sputum cultures) by Month 6 2. To evaluate the number of subjects achieving culture conversion by Month 12/EOT (end of treatment) 3. To evaluate the time to culture conversion 4. To evaluate the change in the six-minute walk test (6MWT) distance at Month 6 and Month 12/EOT
Exploratory Objectives 1. To assess the proportion of subjects achieving culture conversion by Month 6 and 12/EOT 2. To assess subject-reported symptoms of NTM and change from Baseline in quality of life scores on the St George¿s Respiratory Questionnaire (SGRQ) and quality of life scores on the SGRQ ¿ Part 2 (Activities of Daily Living) at Month 6 and Month 12/EOT 3. To assess the change from Baseline in the EQ-5D-3L questionnaire subject-reported health outcomes at Month 6 and Month 12/EOT
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1.Valutare il numero di soggetti che ottengono una conversione dell¿esame colturale (3 colture dell¿espettorato negative consecutive) al Mese 6 2.Valutare il numero di soggetti che ottengono una conversione dell¿esame colturale al Mese 12/Fine trattamento (EOT) 3.Valutare il tempo alla conversione dell¿esame colturale 4.Valutare la variazione della distanza percorsa al test del cammino dei sei minuti (6MWT) al Mese 6 e al Mese 12/EOT
Obiettivi esploratori 1.Valutare la proporzione di soggetti che ottengono una conversione dell¿esame colturale al Mese 6 e 12/EOT 2.Valutare i sintomi riferiti dal soggetto di infezione da MNT e la variazione dal Basale nei punteggi di qualit¿ della vita al questionario respiratorio di St. George (SGRQ) e nei punteggi di qualit¿ della vita al SGRQ - Parte 2 (Attivit¿ della vita quotidiana) al Mese 6 e al Mese 12/EOT 3.Valutare la variazione dal Basale degli esiti sulla salute riferiti dal soggetto nel questionario europeo di qualit¿ della vita a 5 dime |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subjects are eligible to participate in the study if they meet all the following inclusion criteria:
1. have successfully completed the Month 6 and End of Treatment(EoT) visits in INS-212
2. have not achieved the INS-212 protocol definition of culture conversion (3 consecutive negative sputum cultures) by Month 6 in INS-212
OR
have experienced a relapse or recurrence (agar positive or more than 2 consecutive broth positive results after culture conversion has occurred) by Month 6 in INS-212
3. have demonstrated compliance with study medication in INS-212
4. willing to adhere to multi-drug treatment regimen during the course of the study
5. female of childbearing potential agrees to practice an acceptable method of birth control (e.g., abstinence, hormonal or barrier methods, partner sterilization, or intrauterine device (IUD))
6. provide written informed consent before performing any study related procedure
7. willing to have specimens stored
8. able to comply with study medication use, study visits, and study procedures as determined by the investigator
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I soggetti sono eleggibili per la partecipazione allo studio se soddisfano tutti i seguenti criteri di inclusione: 1.hanno completato con successo le visite del Mese 6 e EOT in INS-212 2.non hanno soddisfatto la definizione secondo il protocollo dell’INS-212 di conversione dell’esame colturale (3 colture dell’espettorato negative consecutive) al Mese 6 in INS-212 O hanno manifestato una recidiva o ricorrenza (risultato positivo in agar o più di 2 risultati positivi consecutivi in brodo dopo raggiungimento della conversione colturale) al Mese 6 in INS-212 3.hanno dimostrato di aderire al medicinale in studio in INS-212 4.sono disponibili ad aderire a un regime di trattamento multifarmaco nel corso dello studio 5.le donne potenzialmente fertili acconsentono ad adottare un metodo di contraccezione accettabile (ad esempio, astinenza, metodi ormonali o barriera, sterilizzazione del partner o dispositivo intrauterino [IUD]) 6.consenso informato scritto fornito prima dell’esecuzione di qualsiasi procedura correlata allo studio 7.consenso alla conservazione dei propri campioni 8.capacità di aderire all’uso del medicinale in studio, alle visite dello studio e alle procedure dello studio, secondo quanto stabilito dallo sperimentatore
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E.4 | Principal exclusion criteria |
Subjects are not eligible to participate in the study if they meet any of the following criteria: 1. achieved culture conversion without relapse or recurrence in the INS-212 study by Month 6 2. early discontinuation (prior to Month 6 study visit) from INS-212 3. met any of the exclusion criteria of the INS-212 study, with the exception of ‘unable to perform the 6 Minute Walk Test (6MWT)’ or ‘receiving continuous oxygen therapy’ (if these occurred during the INS-212 study) 4. met any of the discontinuation criteria of the INS-212 study 5. positive pregnancy test or lactation. All women of child bearing potential will be tested. Women not of childbearing potential are defined as postmenopausal (i.e., amenorrheic for at least 1 year), or surgically or naturally sterile. 6. significant (as determined by the investigator) hearing loss, vestibular dysfunction, or neuromuscular weakness where the potential risk of aminoglycoside toxicity outweighs the potential benefit 7. aspartate aminotransferase or alanine aminotransferase = 3 times the upper limit of normal (ULN) and/or total bilirubin = 2 times the upper limit of normal (ULN) at their EOT study visit in INS-212 8. absolute neutrophil count =500/µL at their EOT study visit in INS-212 9. serum creatinine >2 times ULN at their EOT study visit in INS-212 10. current alcohol, medication or illicit drug abuse 11. any condition that, in the opinion of the Investigator, interferes with ability to safely complete the study or adhere to study requirements.
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I soggetti non sono eleggibili a partecipare allo studio se soddisfano uno qualsiasi dei seguenti criteri: 1.hanno ottenuto una conversione dell’esame colturale senza recidiva o ricorrenza nello studio INS-212 al Mese 6 2.interruzione anticipata (prima della visita dello studio del Mese 6) dello studio INS-212 3.hanno soddisfatto uno qualsiasi dei criteri di esclusione dello studio INS-212, ad eccezione di ‘impossibilità a effettuare il 6MWT’ o ‘sta ricevendo un’ossigenoterapia continuativa’ (se questi si sono manifestati durante lo studio INS-212) 4.hanno soddisfatto uno qualsiasi dei criteri di interruzione dello studio INS-212 5.test di gravidanza positivo o paziente in fase di allattamento. Tutte le donne potenzialmente fertili saranno sottoposte a test di gravidanza. Sono definite non potenzialmente fertili le donne in età postmenopausale (ovvero, con amenorrea da almeno 1 anno), oppure chirurgicamente o naturalmente sterili. 6.perdita dell’udito significativa (come stabilito dallo sperimentatore), disfunzione vestibolare o debolezza neuromuscolare, tali per cui il potenziale rischio di tossicità da aminoglicosidi ecceda il beneficio potenziale 7.livelli di aspartato aminotransferasi o alanina aminotransferasi = 3 volte il limite superiore della normalità (ULN) e/o bilirubina totale = 2 volte il limite superiore della normalità (ULN) alla visita dello studio EOT in INS-212 8.conta assoluta dei neutrofili =500/µL alla visita dello studio EOT in INS-212 9.creatinina sierica >2 volte l’ULN alla visita dello studio EOT in INS-212 10.attuale abuso di alcol, medicinali o sostanze illecite 11.qualsiasi condizione che, a giudizio dello sperimentatore, interferisca con la capacità di portare a termine lo studio in modo sicuro o di aderire ai requisiti dello studio
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the frequency of treatment-emergent adverse events (TEAEs), TEAEs leading to withdrawal from study, treatment-emergent serious adverse events (SAEs), AEs of special interest, clinically significant abnormal laboratory test results, and vital signs measurements. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
From baseline until end of study |
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E.5.2 | Secondary end point(s) |
1. Proportion of subjects achieving culture conversion (3 consecutive negative sputum cultures without relapse or recurrence) by Month 6
2. Proportion of subjects achieving culture conversion by Month 12/EOT
3. Time to culture conversion. The date of conversion is defined by the date of the first of at least 3 consecutive monthly culture specimens that are MAC negative.
4. The mean change from Baseline in 6MWT distance at Month 6 and Month 12/EOT
EXPLORATORY ENDPOINTS - EFFICACY
1. Proportion of subjects achieving culture conversion by Month 6 and 12/EOT
2. The mean change from Baseline at Month 6 and Month 12/EOT in the overall SGRQ and SGRQ ¿ Part 2 (Activities of Daily Living)
3. The mean change from Baseline at Month 6 and Month 12/EOT in the EQ 5D-3L
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
From baseline until end of study |
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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 | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | Yes |
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 | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 8 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 40 |
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 | Information not present in EudraCT |
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 |
Australia |
Austria |
Canada |
France |
Germany |
Israel |
Italy |
Japan |
Netherlands |
New Zealand |
Poland |
Spain |
Taiwan |
Thailand |
United Kingdom |
United States |
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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 | 10 |
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 | 10 |
E.8.9.2 | In all countries concerned by the trial days | 0 |