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    Clinical Trial Results:
    A Phase 2a, Randomized, Double-Blind, Placebo Controlled, Parallel-Group Study to Evaluate the Efficacy and Safety of AMG 714 in Adult Patients with Type II Refractory Celiac Disease, an In Situ Small Bowel T Cell Lymphoma.

    Summary
    EudraCT number
    2015-004063-36
    Trial protocol
    FI   NL   ES  
    Global end of trial date
    02 May 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    10 May 2018
    First version publication date
    10 May 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CELIM-RCD-002
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02633020
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Amgen, Inc.
    Sponsor organisation address
    One Amgen Center Drive, Thousand Oaks, United States, 91320
    Public contact
    IHQ Medical Info-Clinical Trials, Amgen (EUROPE) GmbH, MedInfoInternational@amgen.com
    Scientific contact
    IHQ Medical Info-Clinical Trials, Amgen (EUROPE) GmbH, MedInfoInternational@amgen.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    02 May 2017
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    02 May 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study was to assess the efficacy of AMG 714 in treating refractory celiac disease Type II (RCD-II), an in situ small bowel T-cell lymphoma, in adult patients.
    Protection of trial subjects
    This trial was conducted in accordance with the ethical principles of Good Clinical Practice, according to the ICH Harmonized Tripartite Guideline, and in accordance with the Declaration of Helsinki. The study protocol, informed consent form (ICF), any recruitment materials, and relevant supporting information were submitted to the human research ethics committee, independent ethics committee (IEC), or institutional review board (IRB) by the Investigator or sponsor-appointed designee. Investigator or designee had to have obtained the written approval of the ethics committee (EC) or IRB before initiating any subject-related study activity at a study site. All subjects provided written informed consent before undergoing any study-related procedures, including screening procedures.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    13 Apr 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 12
    Country: Number of subjects enrolled
    Spain: 2
    Country: Number of subjects enrolled
    Finland: 1
    Country: Number of subjects enrolled
    France: 11
    Country: Number of subjects enrolled
    United States: 2
    Worldwide total number of subjects
    28
    EEA total number of subjects
    26
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    14
    From 65 to 84 years
    14
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    This study was conducted at 6 sites in 5 countries, France, Netherlands, Finland, Spain, and the United States.

    Pre-assignment
    Screening details
    After signing informed consent, subjects were screened for the study. Subjects who met the study entry criteria were randomized at a 2:1 ratio to receive either 8 mg/kg AMG 714 or placebo. Randomization and initial dosing of the first 10 subjects were staggered to allow observation for any possible unanticipated side effects.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    AMG 714
    Arm description
    Subjects were administered 8 mg/kg AMG 714 via intravenous infusion on day 0, day 7 and every 2 weeks thereafter through week 10.
    Arm type
    Experimental

    Investigational medicinal product name
    AMG 714
    Investigational medicinal product code
    AMG 714
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Administered via a 120-minute IV infusion for a total of 7 times over 10 weeks.

    Arm title
    Placebo
    Arm description
    Subjects were administered placebo via intravenous infusion on day 0, day 7 and every 2 weeks thereafter through week 10.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Administered via a 120-minute IV infusion for a total of 7 times over 10 weeks.

    Number of subjects in period 1
    AMG 714 Placebo
    Started
    19
    9
    Completed
    18
    9
    Not completed
    1
    0
         Adverse event, non-fatal
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    AMG 714
    Reporting group description
    Subjects were administered 8 mg/kg AMG 714 via intravenous infusion on day 0, day 7 and every 2 weeks thereafter through week 10.

    Reporting group title
    Placebo
    Reporting group description
    Subjects were administered placebo via intravenous infusion on day 0, day 7 and every 2 weeks thereafter through week 10.

    Reporting group values
    AMG 714 Placebo Total
    Number of subjects
    19 9 28
    Age categorical
    Units: Subjects
        18 - 64 years
    12 2 14
        65 - 84 years
    7 7 14
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    63.0 ± 10.2 68.4 ± 10.9 -
    Gender categorical
    Units: Subjects
        Female
    8 6 14
        Male
    11 3 14
    Race
    Units: Subjects
        White
    19 9 28
    Ethnicity
    Units: Subjects
        Hispanic/Latino
    0 2 2
        Not Hispanic/Latino
    19 7 26

    End points

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    End points reporting groups
    Reporting group title
    AMG 714
    Reporting group description
    Subjects were administered 8 mg/kg AMG 714 via intravenous infusion on day 0, day 7 and every 2 weeks thereafter through week 10.

    Reporting group title
    Placebo
    Reporting group description
    Subjects were administered placebo via intravenous infusion on day 0, day 7 and every 2 weeks thereafter through week 10.

    Primary: Percent Change from Baseline in the Percentage of Aberrant Intestinal Intraepithelial Lymphocytes Versus Total IELs

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    End point title
    Percent Change from Baseline in the Percentage of Aberrant Intestinal Intraepithelial Lymphocytes Versus Total IELs
    End point description
    The primary endpoint in this study was the reduction in the percentage of aberrant intestinal intraepithelial lymphocytes (IELs) with respect to total IELs, as assessed by flow cytometry (Immunological Response 1). Aberrant IELs were defined by flow cytometry as surface CD3-negative, intra-cellular CD3-positive IELs (sCD3-, icCD3+). The analysis was conducted using the per protocol (PP) population which included subjects who received study treatment and provided evaluable data for efficacy analysis, excluded non-evaluable subjects and subjects with major protocol deviations. Subjects with atypical RCD-II (a different phenotype of the aberrant IELs compared to the classic phenotype) were further excluded from the PP population for the analyses of Immunological Response 1.
    End point type
    Primary
    End point timeframe
    Baseline and Week 12
    End point values
    AMG 714 Placebo
    Number of subjects analysed
    14
    8
    Units: percent change
        least squares mean (standard error)
    2.45 ± 8.83
    7.30 ± 11.70
    Statistical analysis title
    Primary Analysis
    Comparison groups
    AMG 714 v Placebo
    Number of subjects included in analysis
    22
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.7451 [1]
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -4.85
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    -30.26
         upper limit
    20.56
    Variability estimate
    Standard error of the mean
    Dispersion value
    14.7
    Notes
    [1] - The primary endpoint was analyzed using analysis of covariance (ANCOVA), where the baseline % aberrant IELs vs total IELs was included as a covariate and treatment group as a fixed effect in the statistical model.

    Secondary: Percent Change from Baseline in the Percentage of Aberrant Intestinal Intraepithelial Lymphocytes Versus Intestinal Epithelial Cells

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    End point title
    Percent Change from Baseline in the Percentage of Aberrant Intestinal Intraepithelial Lymphocytes Versus Intestinal Epithelial Cells
    End point description
    Reduction in the percentage of aberrant intestinal IELs with respect to intestinal epithelial cells (Immunological Response 2) is a composite endpoint calculated by multiplying the percent of aberrant IEL versus total IELs (per flow cytometry) by the percent of total IEL versus intestinal epithelial cells as assessed by IHC. The analysis was conducted using the per protocol (PP) population which included subjects who received study treatment and provided evaluable data for efficacy analysis, excluded non-evaluable subjects and subjects with major protocol deviations. Subjects with atypical RCD-II (a different phenotype of the aberrant IELs compared to the classic phenotype) were further excluded from the PP population for the analyses of Immunological Response 2.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    AMG 714 Placebo
    Number of subjects analysed
    14
    8
    Units: Percent change
        least squares mean (standard error)
    11.66 ± 15.79
    49.88 ± 21.33
    Statistical analysis title
    Primary Analysis
    Comparison groups
    Placebo v AMG 714
    Number of subjects included in analysis
    22
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.1803 [2]
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -38.22
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -95.73
         upper limit
    19.29
    Variability estimate
    Standard error of the mean
    Dispersion value
    27.48
    Notes
    [2] - Analyzed using analysis of covariance (ANCOVA), where the baseline % aberrant IELs vs intestinal epithelial cells was included as a covariate and treatment group as a fixed effect in the statistical model.

    Secondary: Percent Change From Baseline in Villous Height to Crypt Depth Ratio

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    End point title
    Percent Change From Baseline in Villous Height to Crypt Depth Ratio
    End point description
    Small bowel biopsies were performed at baseline and week 12; histological assessments were performed by a blinded central pathologist. The analysis was conducted in the per protocol population.
    End point type
    Secondary
    End point timeframe
    Baseline and week 12
    End point values
    AMG 714 Placebo
    Number of subjects analysed
    17
    9
    Units: percent change
        least squares mean (standard error)
    26.44 ± 14.06
    15.77 ± 19.36
    Statistical analysis title
    Analysis of Change from Baseline in VH:CD Ratio
    Comparison groups
    AMG 714 v Placebo
    Number of subjects included in analysis
    26
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.6607 [3]
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    10.67
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -38.97
         upper limit
    60.31
    Variability estimate
    Standard error of the mean
    Dispersion value
    24
    Notes
    [3] - Analysed using analysis of covariance (ANCOVA), where the baseline VH:CD ratio was included as a covariate and treatment group as a fixed effect in the statistical model.

    Secondary: Percentage of Participants with Improvement in Marsh Score at Week 12

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    End point title
    Percentage of Participants with Improvement in Marsh Score at Week 12
    End point description
    The Marsh classification system describes the stages of damage in the small intestine as seen under a microscope, with possible values of 0, 1, 2, 3a, 3b, or 3c. A score of 0 (best score) indicates that the intestinal lining is normal and celiac disease highly unlikely, a score of 3c (worst score) indicates increased intra-epithelial lymphocytes, increased crypt hyperplasia and complete villi atrophy. Improvement is defined as a decrease in score from baseline. The analysis was conducted in the PP population.
    End point type
    Secondary
    End point timeframe
    Baseline and week 12
    End point values
    AMG 714 Placebo
    Number of subjects analysed
    17
    9
    Units: percentageof participants
        number (not applicable)
    35.3
    33.3
    Statistical analysis title
    Analysis of Improvement in Marsh Score
    Comparison groups
    AMG 714 v Placebo
    Number of subjects included in analysis
    26
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.9204
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.09
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.2
         upper limit
    6.01

    Secondary: Percent Change from Baseline in Total Intraepithelial Lymphocyte Count at Week 12

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    End point title
    Percent Change from Baseline in Total Intraepithelial Lymphocyte Count at Week 12
    End point description
    Small bowel biopsies were performed at baseline and week 12; histological assessments were performed by a blinded central pathologist. The total IEL count is the density of IELs vs intestinal epithelial cells measured by immunochemistry. The analysis was conducted in the PP population.
    End point type
    Secondary
    End point timeframe
    Baseline and week 12
    End point values
    AMG 714 Placebo
    Number of subjects analysed
    17
    9
    Units: percent change
        least squares mean (standard error)
    26.84 ± 17.90
    39.57 ± 24.95
    Statistical analysis title
    Analysis of Change from Baseline in Total IELs
    Comparison groups
    AMG 714 v Placebo
    Number of subjects included in analysis
    26
    Analysis specification
    Pre-specified
    Analysis type
    superiority [4]
    P-value
    = 0.6885
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -12.73
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -77.57
         upper limit
    52.12
    Variability estimate
    Standard error of the mean
    Dispersion value
    31.34
    Notes
    [4] - Analysis of covariance (ANCOVA), where the baseline total IEL counts was included as a covariate and treatment group as a fixed effect in the statistical model.

    Secondary: Number of Weekly Bowel Movements at Baseline and Week 12

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    End point title
    Number of Weekly Bowel Movements at Baseline and Week 12
    End point description
    Subjects were asked to record every bowel movement during the study using an electronic diary. If no bowel movements were experienced by the subject on any given day, the subject was required to document this in the diary. The analysis was conducted in the intent-to-treat population which consisted of all randomized subjects who had received at least one dose of the study drug.
    End point type
    Secondary
    End point timeframe
    Baseline and week 12
    End point values
    AMG 714 Placebo
    Number of subjects analysed
    19
    9
    Units: bowel movements
    arithmetic mean (standard deviation)
        Baseline (n = 19, 8)
    10.3 ± 5.21
    7.4 ± 4.03
        Week 12 (n = 18, 9)
    11.3 ± 5.72
    8.3 ± 3.39
    Statistical analysis title
    Analysis of Total Weekly Bowel Movements
    Comparison groups
    AMG 714 v Placebo
    Number of subjects included in analysis
    28
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.4469 [5]
    Method
    Generalized Linear Mixed Model
    Parameter type
    LS Mean Ratio
    Point estimate
    1.17
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.77
         upper limit
    1.8
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.24
    Notes
    [5] - Generalized linear mixed models with subject as a random effect and treatment group, time (week) and their interaction as fixed effects.

    Secondary: Percentage of Participants with Diarrhoea at Baseline and Week 12

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    End point title
    Percentage of Participants with Diarrhoea at Baseline and Week 12
    End point description
    The Bristol Stool Form Scale (BSFS) is a pictorial aid to help subjects identify the shape and consistency of their bowel movements. Subjects were asked to complete this form daily using an electronic diary at the time of each bowel movement. The BSFS categorizes bowel movements into 7 types, from Type 1 (separate hard lumps, like nuts; hard to pass) to Type 7 (watery, no solid pieces, entirely liquid). Diarrhoea was defined at least one BSFS score >= 6 for the given week. The analysis was conducted in the intent-to-treat population.
    End point type
    Secondary
    End point timeframe
    Baseline and week 12
    End point values
    AMG 714 Placebo
    Number of subjects analysed
    19
    9
    Units: percentage of participants
    number (not applicable)
        Baseline
    52.6
    22.2
        Week 12
    36.8
    44.4
    No statistical analyses for this end point

    Secondary: Change from Baseline in Total Weekly Gastrointestinal Symptom

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    End point title
    Change from Baseline in Total Weekly Gastrointestinal Symptom
    End point description
    The GSRS is a 15-question 7-scale questionnaire used to assess 5 dimensions of gastrointestinal syndromes: diarrhea, indigestion, constipation, abdominal pain and reflux. Questions are scored between 1 (no discomfort at all) and 7 (very severe discomfort). The total GSRS score is calculated as the sum of the scores of all 15 questions, and ranges from 15 (no discomfort at all) to 105 (very severe discomfort in all 5 dimensions of gastrointestinal syndromes). The analysis was conducted in the intent-to-treat population.
    End point type
    Secondary
    End point timeframe
    Baseline and week 12
    End point values
    AMG 714 Placebo
    Number of subjects analysed
    18
    8
    Units: units on a scale
        least squares mean (standard error)
    -0.14 ± 0.13
    0.20 ± 0.19
    Statistical analysis title
    Analysis of Change From Baseline in Weekly GSRS
    Comparison groups
    AMG 714 v Placebo
    Number of subjects included in analysis
    26
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.4832 [6]
    Method
    Linear mixed effects repeated measures
    Parameter type
    LS Mean Difference
    Point estimate
    -0.14
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.53
         upper limit
    0.26
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.19
    Notes
    [6] - Linear mixed effects repeated measures model (MMRM) with the baseline value, treatment group, time point and a time point-by-treatment group interaction term as fixed effects

    Secondary: Change from Baseline in Total Celiac Disease GSRS (CeD-GSRS) Score at

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    End point title
    Change from Baseline in Total Celiac Disease GSRS (CeD-GSRS) Score at
    End point description
    The CeD-GSRS score is derived from a subset of questions from GSRS questionnaire (questions 1, 4-9, 11, 12 and 14), which are each assessed on a scale of 1 (no discomfort at all) to 7 (very severe discomfort). The total CeD-GSRS score ranges from 10 (no discomfort at all) to 70 (very severe discomfort in all celiac syndromes). The analysis was conducted in the intent-to-treat population.
    End point type
    Secondary
    End point timeframe
    Baseline and week 12
    End point values
    AMG 714 Placebo
    Number of subjects analysed
    18
    8
    Units: units on a scale
        least squares mean (standard error)
    -0.14 ± 0.16
    0.17 ± 0.24
    Statistical analysis title
    Analysis of Change From Baseline in CeD-GSRS
    Comparison groups
    AMG 714 v Placebo
    Number of subjects included in analysis
    26
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.5561 [7]
    Method
    Linear mixed effects repeated measures
    Parameter type
    LS Mean Difference
    Point estimate
    -0.14
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.64
         upper limit
    0.35
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.24
    Notes
    [7] - Linear mixed effects repeated measures model (MMRM) with the baseline value, treatment group, time point and a time point-by-treatment group interaction term as fixed effects

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first dose of study drug until week 16
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.1
    Reporting groups
    Reporting group title
    AMG 714
    Reporting group description
    Subjects were administered 8 mg/kg AMG 714 via intravenous infusion on day 0, day 7 and every 2 weeks thereafter through week 10.

    Reporting group title
    Placebo
    Reporting group description
    Subjects were administered placebo via intravenous infusion on day 0, day 7 and every 2 weeks thereafter through week 10.

    Serious adverse events
    AMG 714 Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    5 / 19 (26.32%)
    1 / 9 (11.11%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    Nervous system disorders
    Balance disorder
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebellar syndrome
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peroneal nerve palsy
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Hepatitis
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Pneumococcal infection
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tuberculosis
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    AMG 714 Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    16 / 19 (84.21%)
    8 / 9 (88.89%)
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    2 / 19 (10.53%)
    1 / 9 (11.11%)
         occurrences all number
    5
    3
    Fatigue
         subjects affected / exposed
    2 / 19 (10.53%)
    0 / 9 (0.00%)
         occurrences all number
    3
    0
    Pyrexia
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    2
    0
    Cough
         subjects affected / exposed
    2 / 19 (10.53%)
    0 / 9 (0.00%)
         occurrences all number
    3
    0
    Dyspnoea exertional
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Psychiatric disorders
    Depressed mood
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Disorientation
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Sleep disorder
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Investigations
    Alanine aminotransferase abnormal
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Bacterial test
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Blood albumin decreased
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Blood urine present
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Eosinophil count abnormal
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Eosinophil count increased
         subjects affected / exposed
    3 / 19 (15.79%)
    0 / 9 (0.00%)
         occurrences all number
    3
    0
    Helicobacter test positive
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Neutrophil count decreased
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Prostatic specific antigen increased
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Protein total decreased
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    0 / 19 (0.00%)
    3 / 9 (33.33%)
         occurrences all number
    0
    4
    Dizziness postural
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Headache
         subjects affected / exposed
    3 / 19 (15.79%)
    0 / 9 (0.00%)
         occurrences all number
    5
    0
    Tremor
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Paraesthesia
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    2
    0
    Blood and lymphatic system disorders
    Eosinophilia
         subjects affected / exposed
    2 / 19 (10.53%)
    0 / 9 (0.00%)
         occurrences all number
    2
    0
    Anaemia
         subjects affected / exposed
    2 / 19 (10.53%)
    0 / 9 (0.00%)
         occurrences all number
    2
    0
    Eye disorders
    Erythema of eyelid
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Eye swelling
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Visual impairment
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    3
    0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 19 (5.26%)
    1 / 9 (11.11%)
         occurrences all number
    1
    1
    Diarrhoea
         subjects affected / exposed
    3 / 19 (15.79%)
    1 / 9 (11.11%)
         occurrences all number
    3
    1
    Duodenal ulcer
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Dyspepsia
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Gastric ulcer
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Lip dry
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Lip exfoliation
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Mouth ulceration
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Nausea
         subjects affected / exposed
    2 / 19 (10.53%)
    0 / 9 (0.00%)
         occurrences all number
    3
    0
    Vomiting
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    Actinic keratosis
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Eczema
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Rash
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Rosacea
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Skin plaque
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Bacteraemia
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Bronchitis viral
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Conjunctivitis
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Nasopharyngitis
         subjects affected / exposed
    8 / 19 (42.11%)
    1 / 9 (11.11%)
         occurrences all number
    10
    1
    Oral herpes
         subjects affected / exposed
    0 / 19 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    Pharyngitis
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Respiratory tract infection
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Urinary tract infection
         subjects affected / exposed
    2 / 19 (10.53%)
    1 / 9 (11.11%)
         occurrences all number
    2
    1
    Sinusitis
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0
    Metabolism and nutrition disorders
    Iron deficiency
         subjects affected / exposed
    1 / 19 (5.26%)
    0 / 9 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    06 Nov 2015
    The following major changes and clarifications were made in the sections specified: 1. Addition of contact information for protocol vendors and responsible staff. 2. Clarification for selected inclusion/exclusion criteria of 6 months of GFD and IEL cut-off. 3. Addition of subject visits with a dietitian at Visits 1, 4, 6, and 8. Addition of the sample questions related to this consultation. 4. Addition of PK assessment at Visit 6. 5. Revision to Inclusion Criterion #4 to include the following clarification “and after exclusion of other potential causes of symptomatic non-response (eg, microscopic colitis, bacterial overgrowth, lactose intolerance, exocrine pancreatic insufficiency, hyperthyroidism, etc.) and intestinal histological abnormality (autoimmune enteropathy, giardiasis, immunodeficiency, collagenous sprue, Whipple’s disease, etc.).” 6. Revision to Exclusion Criterion #5 to provide additional examples of exclusionary history of immune suppression. 7. Revision of the Physician Global Assessment to include a Rating of Change assessment. The rating of change assessment was to be administered at Visits 1, 2, 3, 4, 6, 8, and 9. 8. Addition of a Patient Global Assessment and Rating of Change. The PtGA alone was to be administered at Visit 1. The PtGA and Patient Rating of Change were to be administered at Visits 2, 3, 4, 6, 8, and 9. 9. Addition of SAE telephone contact numbers. 10. Revision of SAE email contact number. 11. Addition of sample Investigational Product labels. 12. Addition of IHC assessments (exploratory endpoint). 13. Clarification that AEs and SAEs occurring in possible subjects traveling to study sites from countries other than study countries were to be assessed and managed in the same fashion as those appearing in subjects from study countries.
    01 Feb 2016
    The following changes and clarifications were made in the sections specified: 1. Addition of Investigational New Drug Application (IND) number. 2. Update of contact information for protocol vendors and responsible staff. 3. Minor corrections to Schedule of Study Procedures: a. Addition of superscript to PK sample collection at Visit 6 (Week 8) to indicate that the sample for PK analysis at this visit should be collected before dosing starts. b. Clarification that the Visit 8 endoscopy and biopsy could be collected 7 days before or after Visit 8. 4. Addition of rules to stagger the randomization and initial dosing of the first ten subjects. 5. Correct provision of iVYLISA GIP test kit and instructions for home collection from Visit 1 to Visit 2. 6. Removal of mandatory hood use for preparation of clinical supplies, as long as preparation was performed using aseptic techniques, under sterile conditions. 7. Corrections to the list of Laboratory Parameters to match Schedule of Events: a. Clarification that “mRNA/DNA” at Screening and Visit 8 (Week 12) means “Biopsy mRNA” and “Biopsy DNA for TcR clonality.” b. Addition of “PK” at Visit 7 (Week 10). c. Addition of “Biopsy flow-cytometry” at Visit 8 (Week 12/Day 84) or Early Termination Visit.
    11 Jul 2016
    The following changes and clarifications were made in the sections specified: 1. To reduce burden on patients: a. The rules for collection of stool samples were revised to allow a more flexible window of ±3 days and to allow any place of collection, not only the patient’s home. b. The time of collection of the blood cell pellet was changed to allow collection at any time during study. 2. It was clarified throughout the protocol that the DSMB would review unblinded data, including during the interim analysis. 3. Clarification that simultaneous concomitant therapy with topical and systemic steroids was permissible at or below the maximum doses indicated in the protocol. 4. Clarification that, after thawing, the product could be stored for up to 72 hours at 5 ± 3°C, and no longer than 12 hours at room temperature. After preparation (once injected in the IV bag), the study drug had to be used immediately and could only be kept at room temperature for a maximum of 12 hours including the 2 hours of the IV administration. These instructions were in line with the study manual and were correctly followed by the sites. 5. Clarification of the instructions to prepare the IV bag by withdrawing the volume of the thawed investigational product needed for the weight of the patient (8 mg per kg, calculating the volume needed given the concentration of investigational product of 100 mg/ml) and injecting this volume directly into a 100 mL 5% dextrose IV bag using the injection port at the base of the bag. These instructions were in line with the study manual and have been correctly followed by the sites. 6. Clarification of the patient populations for analysis and the statistical analysis method for the Marsh score. The definitions and method were consistent with the SAP and were used at completion of the study.

    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.
    None reported
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