E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Congenital, hereditary and neonatal diseases |
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E.1.1.1 | Medical condition in easily understood language |
Congenital, hereditary and neonatal diseases |
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E.1.1.2 | Therapeutic area | Diseases [C] - Congenital, Hereditary, and Neonatal Diseases and Abnormalities [C16] |
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 | 10075697 |
E.1.2 | Term | Gaucher's disease type I |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
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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 | 10075699 |
E.1.2 | Term | Gaucher's disease type III |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
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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 |
Evaluate the safety and pharmacokinetics of eliglustat in pediatric patients (≥6 to <18 years old). |
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E.2.2 | Secondary objectives of the trial |
Evaluate the efficacy of eliglustat and quality of life in pediatric patients (≥6 to <18 years old). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-The patient is 6 to <18 years old at the time of informed consent.
-Male and female patients with a clinical diagnosis of Gaucher disease (GD) type 1 or type 3 with documented deficiency of acid beta-glucosidase activity by enzyme assay and glucocerebrosidase (GBA) genotype.
-Postmenarchal female patients must have a documented negative pregnancy test prior to enrollment and throughout the study. Patients must be willing to practice true abstinence in line with their preferred and usual lifestyle, or use a medically accepted form of contraception throughout the study.
Cohort 1 (Eliglustat monotherapy):
-Patients must have been receiving an enzyme replacement therapy (ERT) for a minimum of 24 months at a monthly dose equivalent to 30 U/kg to 130 U/kg of Cerezyme® (imiglucerase) with treatment ongoing at the time of enrollment. Patients must be at pre-specified treatment goals, as defined by:
-Hemoglobin level for ages 6 to <12 years: ≥11.0 g/dL; for ages 12 to <18 years: ≥11.0 g/dL for females and ≥12.0 g/dL for males;
-Platelet count ≥100,000/mm3;
-Spleen volume <10.0 multiples of normal (MN);
-Liver volume <1.5 MN;
-Absence of GD related pulmonary disease, and severe bone disease, as defined below for Cohort 2.
Cohort 2 (Eliglustat plus imiglucerase):
-Patients must have been receiving an ERT for a minimum of 36 months at a dose equivalent to at least 60 U/kg of imiglucerase every 2 weeks at the time of enrollment with treatment ongoing at the time of enrollment and the dose stable for at least the 6 months preceding enrollment. Patients must have severe clinical manifestations of GD, as defined by the presence of at least of the
following:
-GD related pulmonary disease such as interstitial lung disease (ILD). The diagnosis of ILD must be confirmed by the presence of reticulonodular densities on chest X-ray.
AND/OR
-Symptomatic bone disease characterized by pathological fracture, osteonecrosis,
osteopenia/osteoporosis, or bone crisis occurring in the 12 months prior to enrollment.
AND/OR
-Persistent thrombocytopenia (<80,000/mm3) related to GD. |
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E.4 | Principal exclusion criteria |
-Substrate reduction therapy for GD within 6 months prior to enrollment
-Partial or total splenectomy if performed within 2 years prior to enrollment
-The patient is transfusion dependent, a history of esophageal varices or liver infarction, elevated liver enzymes, significant congenital cardiac defect, coronary artery disease or left sided heart failure; clinically significant arrhythmias or conduction defect such as Type 2 second degree or third degree atrioventricular (AV) block, complete bundle branch block, prolonged QTc interval, or sustained ventricular tachycardia (VT).
-The patient has any clinically significant disease other than GD.
-The patient has neurological symptoms other than oculomotor apraxia at study entry.
-The patient has received an investigational product within 30 days prior to enrollment.
-The patient is unable to receive treatment with imiglucerase due to a known hypersensitivity or is unwilling to receive imiglucerase treatment every 2 weeks.
-The patient has a known hereditary galactose intolerance, Lapp lactase deficiency or glucose galactose malabsorption, or is a CYP2D6 ultra-rapid metabolizer or indeterminate metabolizer. |
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E.5 End points |
E.5.1 | Primary end point(s) |
1- Maximum concentration (Cmax) of eliglustat in plasma.
2- Area under the plasma eliglustat concentration-time curve (AUC)
3- Number of adverse events in pediatric patients |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1- Maximum concentration (Cmax) of eliglustat in plasma : Weeks 2, 13, 26 and 52
2- Area under the plasma eliglustat concentration-time curve (AUC) : Weeks 2 and 52
3- Number of adverse events in pediatric patients : Up to Week 104 |
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E.5.2 | Secondary end point(s) |
1- Absolute change from baseline for hemoglobin (g/dL) (Cohort 1 patients)
2- Percent change from baseline for platelet count (Cohort 1 patients)
3- Percent change from baseline for liver volume (Cohort 1 patients)
4- Percent change from baseline for spleen volume (Cohort 1 patients)
5- Proportion of patients with improvement in pulmonary disease (Cohort 2 patients)
6- Proportion of patients with improvement in bone disease (Cohort 2 patients)
7- Proportion of patients with improvement in thrombocytopenia (Cohort 2 patients)
8- Health-related quality of life will be measured by the Pediatric Quality of Life InventoryTM (PedsQLTM) questionnaires. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | No |
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) | 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 | No |
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) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
Will this trial be conducted at a single site globally?
| No |
E.8.4 | Will this trial be conducted at multiple sites globally? | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | Specify the countries outside of the EEA in which trial sites are planned |
Argentina |
Canada |
Egypt |
France |
Italy |
Netherlands |
Russian Federation |
Spain |
Sweden |
Turkey |
United Kingdom |
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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.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 11 |