E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Post-herpetic neuralgia (PHN) is a painful condition that can occur after shingles (herpes zoster) in the area where the rash occurred |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10036376 |
E.1.2 | Term | Post herpetic neuralgia |
E.1.2 | System Organ Class | 10029205 - Nervous 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 characterize dose response, and evaluate safety and efficacy of three different doses of EMA401 compared to placebo in patients with post-herpetic neuralgia (PHN) |
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E.2.2 | Secondary objectives of the trial |
• To compare efficacy of EMA401 vs placebo in 24-hour average pain intensity score, using an 11 point Numeric Rating Scale (NRS) by testing the superiority of at least one active dose of EMA401 vs. placebo
• To evaluate efficacy, as measured by the Brief Pain Inventory-Short Form (BPI-SF) interference total score
• To evaluate efficacy, as measured by the weekly mean of the 24-hour worst pain intensity score, using an 11-point NRS
• To evaluate efficacy, on the Patient Global Impression of Change (PGIC)
• To evaluate proportion of patients achieving a ≥ 30% and a ≥ 50% reduction in weekly mean 24-hour average pain intensity score using the NRS (i.e., responder rates)
• To evaluate effect on the Insomnia Severity Index (ISI)
• To evaluate effect on the Neuropathic Pain Symptom Inventory (NPSI)
• To evaluate safety and tolerability in PHN patients
• To evaluate pharmacokinetics of EMA401 and exposure-response (decrease in pain intensity) relationship for EMA401 |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• At the time of Screening, have documented diagnosis of PHN (ICD-10 code B02.29), defined as pain in the region of the rash persisting for more than 6 months after onset of herpes zoster rash.
• Be assessed as suffering from moderate to severe neuropathic pain across the Screening epoch (NRS ≥ 4).
• Patients must have documented past and/or ongoing inadequate treatment response (having insufficient pain relief with treatment or inability to tolerate) to at least 2 different prescribed therapies\Analgesics commonly used to treat and considered effective for the treatment of PHN.
• Patients must be willing to complete daily eDiary.
Other protocol-defined inclusion criteria may apply. |
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E.4 | Principal exclusion criteria |
• Electrocardiogram (ECG) abnormalities indicating significant risk of safety for patients participating in the study.
• Major depressive episode within 6 months prior to Screening and/or a history of diagnosed recurrent major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) diagnostic criteria.
• Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant unless they are using highly effective methods of contraception during dosing and for 3 days after stopping study medication.
• Have evidence of significant renal insufficiency or pre-existing liver condition.
• Have platelets ≤ 100 x 10^9/L, or neutrophil count < 1.2 x 10^9/L (or equivalent), hemoglobin ≤ 100 g/L for women or hemoglobin ≤ 110 g/L for men.
• Patients who have a known diagnosis of diabetes and are stable on medication with a hemoglobin A1c > 8%. Those who do not have a known diagnosis of diabetes with a hemoglobin A1c > 7%.
Other protocol-defined exclusion criteria may apply. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Dose-response in change in weekly mean of the 24-hour average pain score, using an 11-point Numeric Rating Scale (NRS), from Baseline to Week 12 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
• Change in weekly mean 24-hour average pain score (using the 11 point Numerical Rating Scale) from Baseline to Week 12
• Change in Brief Pain Inventory-Short Form interference total score from Baseline to Week 12
• Change in weekly mean of the 24-hour worst pain score, using an 11-point NRS, from Baseline to Week 12
• Patient Global Impression of Change at Week 12
• Proportion of patients meeting responder criteria from Baseline to Week 12
• Change in Insomnia Severity Index from Baseline to Week 12
• Change in Neuropathic Pain Symptom Inventory from Baseline to Week 12
• Number and severity of treatment emergent adverse events and the frequency of adverse events leading to discontinuation. Number of serious adverse events.
• Pharmacokinetics of EMA401 and exposure-response (decrease in pain intensity) relationship for EMA401 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
For full details, please refer to the schedule of assessments table in the protocol. |
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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 | Yes |
E.6.10 | Pharmacogenetic | Yes |
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 | 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 | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 60 |
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 |
Belgium |
Canada |
Czech Republic |
Denmark |
France |
Germany |
Hungary |
Italy |
Japan |
Norway |
Poland |
Portugal |
Slovakia |
Spain |
Sweden |
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 | 8 |
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 | 8 |