E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Congenital, hereditary and neonatal diseases |
Enfermedades congénitas, hereditarias y neonatales |
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E.1.1.1 | Medical condition in easily understood language |
Congenital, hereditary and neonatal diseases |
Enfermedades congénitas, hereditarias y neonatales |
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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). |
Evaluar la seguridad y FC de eliglustat en pacientes pediátricos (≥6 to <18 años) |
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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). |
Evaluar la seguridad y FC de eliglustat en pacientes pediátricos (≥6 to <18 años) |
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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. |
- El paciente debe tener de 6 a <18 años en el momento de la firma del consentimiento informado. - Pacientes de ambos sexos con un diagnóstico clínico de EG1 o EG3 con deficiencia de actividad de la betaglucosidasa ácida documentada mediante un análisis enzimático y el genotipo del GBA. - Postmenarchal female patients must have a documented negative pregnancy test prior to enrollment and throughout the study. In addition, 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 (barrier method such as condom or diaphragm + spermicide or non-barrier method such as oral, injected, or implanted hormonal contraceptive with ethinylestradiol and norethindrone or similar active components). Para la Cohorte 1, los pacientes deben haber estado recibiendo un TSE (aprobado por al menos una autoridad reguladora) durante un mínimo de 24 meses con una dosis mensual equivalente a de 30 U/kg a 130 U/kg de Cerezyme® (imiglucerasa) con el tratamiento en curso en el momento de la inclusión y los pacientes deben presentar un OT preespecificado para la EG, definido por: a) Nivel de hemoglobina para las edades de 6 a <12 años: superior o igual 11,0 g/dl; para las edades de 12 a <18 años: superior i gual 11,0 g/dl en niñas y superior o igual 12,0 g/dl en niños, y b) Recuento de plaquetas superior o igual 100 000/mm3, y c) Volumen del bazo <10,0 múltiplos del valor normal (MN) y d) Volumen del hígado <1,5 MN, y e) Ausencia de enfermedad pulmonar relacionada con la EG y enfermedad ósea sintomática severa, tal y como se define a continuación para la Cohorte 2. Para la Cohorte 2, los pacientes deben haber estado recibiendo un TSE (aprobado por al menos una autoridad reguladora) durante un mínimo de 36 meses con una dosis equivalente a por lo menos 60 U/kg de imiglucerasa cada 2 semanas en el momento de la inclusión con el tratamiento en curso en el momento de la inclusión y la dosis estable durante al menos los 6 meses anteriores a la inclusión y los pacientes deben presentar manifestaciones clínicas severas de EG, que se define por la presencia de al menos uno de los siguientes: a) Enfermedad pulmonar relacionada con la EG como EPI. El diagnóstico de EPI debe estar confirmado por la presencia de densidades reticulonodulares en la radiografía de tórax. Y/O b) Enfermedad ósea sintomática caracterizada por fractura patológica, osteonecrosis, osteopenia/osteoporosis, o crisis ósea en los 12 meses previos a la inclusión. Y/O c) Trombocitopenia persistente (<80 000/mm3) relacionada con la EG. |
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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. |
- Terapia de reducción de sustrato para la EG durante los 6 meses anteriores a la inclusión. - Esplenectomía parcial o total si se ha realizado en los 2 años anteriores a la inclusión. - El paciente depende de transfusiones. Antecedentes de varices esofágicas o infarto de hígado. Enzimas hepáticas (alanina aminotransferasa [ALT], aspartato aminotransferasa [AST]) o bilirrubina total actualmente >2 veces el límite superior de la normalidad a menos que el paciente tenga un diagnóstico de síndrome de Gilbert. Defectos cardíacos congénitos, arteriopatía coronaria o insuficiencia cardíaca izquierda clínicamente significativas; arritmias o defecto de conducción clinicamente significativas como bloqueo auriculoventricular (AV) tipo 2 de segundo o tercer grado, bloqueo de rama completo, intervalo QTc prolongado o taquicardia ventricular (TV) sostenida. - El paciente tiene alguna enfermedad clínicamente significativa, además de la EG, incluida enfermedad cardiovascular, renal, hepática, gastrointestinal, pulmonar, neurológica, endocrina, metabólica (p. ej., hipopotasemia e hipomagnesemia) o psiquiátrica, un resultado positivo para el virus de la inmunodeficiencia humana (VIH), hepatitis B o hepatitis C, otras enfermedades (p. ej., obesidad mórbida o retraso severo del crecimiento), o enfermedades concomitantes graves que puedan descartar la participación en el estudio. - El paciente tiene otros síntomas neurológicos distintos de la apraxia oculomotora al entrar en el estudio. - El paciente ha recibido un producto en investigación en los 30 días previos a la inclusión. - Para la Cohorte 1 y 2, el paciente no puede recibir tratamiento con imiglucerasa debido a una hipersensibilidad conocida o no acepta recibir tratamiento con imiglucerasa cada 2 semanas. - El paciente tiene una intolerancia hereditaria conocida a la galactosa, deficiencia de lactasa de los lapones o malabsorción de glucosa o galactosa. |
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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 |
1- Concentración máxima (Cmax) de eliglustat en plasma. 2- Área debajo de la curva de concentración-tiempo de eliglustat en plasma (AUC) 3- Número de acontecimientos adversos en pacientes pediátricos |
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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 |
1- Concentración máxima (Cmax) de eliglustat en plasma: semanas 2, 13, 26 y 52 2- Área debajo de la curva de concentración-tiempo de eliglustat en plasma (AUC): semanas 2 y 52 3- Número de acontecimientos adversos en pacientes pediátricos: hasta la semana 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. |
1- Cambio absoluto desde el inicio para la hemoglobina (g / dL) (pacientes de la cohorte 1) 2- Cambio porcentual desde el inicio para el recuento de plaquetas (pacientes de la cohorte 1) 3- Cambio porcentual desde el inicio para el volumen del hígado (pacientes de la cohorte 1) 4- Cambio porcentual desde el inicio del estudio para el volumen del bazo (pacientes de la cohorte 1) 5- Proporción de pacientes con mejoría en la enfermedad pulmonar (pacientes de la cohorte 2) 6- Proporción de pacientes con mejoría en la enfermedad ósea (pacientes de la cohorte 2) 7- Proporción de pacientes con mejoría en la trombocitopenia (pacientes de la cohorte 2) 8- La calidad de vida relacionada con la salud se medirá con los cuestionarios Pediatric Quality of Life InventoryTM (PedsQLTM). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Baseline and Week 52 |
Basal hasta la semana 52 |
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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 |
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 | 11 |
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 |
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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LVLS |
Última visita del último paciente |
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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 | 4 |
E.8.9.1 | In the Member State concerned months | 11 |
E.8.9.1 | In the Member State concerned days | |
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 |