E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Anterior Uveitis in subjects with Axial Spondyloarthritis (axSpA) and a history of AU. |
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E.1.1.1 | Medical condition in easily understood language |
Anterior Uveitis is an inflammation of the middle layer of the eye. Axial Spondyloarthritis is a chronic inflammatory disease predominantly affecting the axial skeleton (sacroiliac joints and spine). |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | SOC |
E.1.2 | Classification code | 10028395 |
E.1.2 | Term | Musculoskeletal and connective tissue disorders |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue 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 demonstrate the effect of Certolizumab Pegol (CZP) treatment on the reduction of Anterior Uveitis (AU) flares in subjects with active Axial Spondyloarthritis (axSpA) and a documented history of AU |
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E.2.2 | Secondary objectives of the trial |
- To assess the effect of Certolizumab Pegol (CZP) treatment on the reduction of Anterior Uveitis (AU) flares in subjects with active Axial Spondyloarthritis (axSpA) having at least 1 documented history of AU within 12 months prior to Baseline
- To assess the effect of Certolizumab Pegol (CZP) treatment on axSpA disease activity |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1) Subjects must have a documented diagnosis of adult-onset axial Spondyloarthritis (axSpA) with at least 3 months' symptom duration and meet the Assessment of SpondyloArthritis International Society (ASAS) criteria
2) Subjects must have active disease at Screening as defined by
- Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score >=4
- Spinal pain >= 4 on a 0 to 10 Numerical Rating Scale (NRS; from BASDAI item 2)
- Nonradiographic (Nr)-axSpA subjects must either have C-reactive protein (CRP) > upper limit of normal (ULN) and /or current evidence of sacroiliitis on magnetic resonance imaging (MRI) (no confirmation by central reading) as defined by ASAS criteria
- Ankylosing spondylitis (AS) subjects must have evidence of sacroiliitis on x-ray meeting the modified New York (mNY) classification criteria according to the Investigator
3) Subjects must have a documented history of Anterior Uveitis (AU) diagnosed by an ophthalmologist and have at least 2 AU flares in the past, of which at least 1 AU flare was in the last 12 months prior to Baseline |
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E.4 | Principal exclusion criteria |
- Other inflammatory arthritis
- Secondary, noninflammatory condition that, in the Investigator's opinion, is symptomatic enough to interfere with evaluation of the effect of study drug on the subject's primary diagnosis of axial spondyloarthritis (axSpA)
- Any history of uveitis except for Anterior Uveitis (AU) associated with axSpA
- Any condition or complicating factor that may interfere with the AU assessment
- Retisert® or Iluvien® (glucocorticosteroid implant) within 3 years prior to the Baseline Visit or has had complications related to the device
- Subject has had Retisert or Iluvien (glucocorticosteroid implant) removed within 90 days prior to the Baseline Visit
- Intraocular or periocular corticosteroids within 90 days prior to the Baseline visit
- Ozurdex® (dexamethasone implant) within 6 months prior to the Baseline Visit
- Cyclophosphamide within 30 days prior to the Baseline Visit
- Intravitreal methotrexate (MTX) within 90 days prior to the Baseline Visit
- Intravitreal anti-vascular endothelial growth factor (VEGF) therapy |
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E.5 End points |
E.5.1 | Primary end point(s) |
Number of distinct episodes of anterior uveitis (AU) flares during the Treatment Period |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
During the Treatment Period up to 96 weeks |
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E.5.2 | Secondary end point(s) |
1. Number of Anterior Uveitis (AU) flares per 100 patient-years in subjects with active axial Spondyloarthritis (axSpA) and a history of AU at Week 48
2. Number of Anterior Uveitis (AU) flares per 100 patient-years in subjects with active axial
Spondyloarthritis (axSpA) and a history of AU at Week 96
3. Number of Anterior Uveitis (AU) flares per 100 patient-years in subjects with active axial
Spondyloarthritis (axSpA) and at least 1 AU episode within 12 months prior Baseline at Week 48
4. Number of Anterior Uveitis (AU) flares per 100 patient-years in subjects with active axial
Spondyloarthritis (axSpA) and at least 1 AU episode within 12 months prior Baseline at Week 96
5. Change from Baseline in Ankylosing Spondylitis Disease Activity Score (ASDAS) at Week 48
6. Change from Baseline in Ankylosing Spondylitis Disease Activity Score (ASDAS) at Week 96
7. Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at Week 48
8. Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at Week 96
9. Percentage of subjects with Axial Spondyloarthritis International Society 20 % response criteria (ASAS20) at Week 48
10. Percentage of subjects with Axial Spondyloarthritis International Society 20 % response criteria (ASAS20) at Week 96
11. Percentage of subjects with Axial Spondyloarthritis International Society 40 % response criteria (ASAS40) at Week 48
12. Percentage of subjects with Axial Spondyloarthritis International Society 40 % response criteria (ASAS40) at Week 96
13. Percentage of subjects with Axial Spondyloarthritis International Society (ASAS) 5/6 response at Week 48
14. Percentage of subjects with Axial Spondyloarthritis International Society (ASAS) 5/6 response at Week 96
15. Percentage of subjects with Axial Spondyloarthritis International Society (ASAS) partial remission (PR) response at Week 48
16. Percentage of subjects with Axial Spondyloarthritis International Society (ASAS) partial remission (PR) response at Week 96
17. Change from Baseline in tender joint count (44 joint count) at Week 48
18. Change from Baseline in tender joint count (44 joint count) at Week 96
19. Change from Baseline in swollen joint count (44 joint count) at Week 48
20. Change from Baseline in swollen joint count (44 joint count) at Week 96
21. Change From Baseline in Physician's Global Assessment of Disease Activity (PhGADA) at Week 48
22. Change From Baseline in Physician's Global Assessment of Disease Activity (PhGADA) at Week 96
23. Change From Baseline in Patient's Global Assessment of Disease Activity (PtGADA) at Week 48
24. Change From Baseline in Patient's Global Assessment of Disease Activity (PtGADA) at Week 96
25. Change from Baseline in total spinal pain at Week 48 assessed by Numerical Rating Scale (NRS)
26. Change from Baseline in total spinal pain at Week 96 assessed by Numerical Rating Scale (NRS)
27. Change from Baseline to Week 48 in the Bath Ankylosing Spondylitis Functional Index (BASFI)
28. Change from Baseline to Week 96 in the Bath Ankylosing Spondylitis Functional Index (BASFI)
29. Change from Baseline to Week 48 in Inflammation assessed by the mean of the Bath Ankylosing Spondylitis Disease Activity Index
(BASDAI) questions 5 and 6 concerning morning stiffness and duration
30. Change from Baseline to Week 96 in Inflammation assessed by the mean of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) questions 5 and 6 concerning morning stiffness and duration
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1, 3: During the Treatment Period up to 48 weeks
2, 4: During the Treatment Period up to 96 weeks
5, 7, 17, 19, 21, 23, 25, 27, 29: From Baseline to Week 48
6, 8, 18, 20, 22, 24, 26, 28, 30: From Baseline to Week 96
9, 11, 13, 15: Week 48
10, 12, 14, 16: Week 96 |
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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 | Yes |
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 | 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) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
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) | No |
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 | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 32 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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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Last Subject Last Visit (LSLV)
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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 | 3 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |