E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
the traumatic chronic spinal cord injury condition |
lésion traumatique chronique de la moelle épinière |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Musculoskeletal Diseases [C05] |
MedDRA Classification |
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 determine a daily dose of Riluzole that improves spasticity in patients with chronic SCI |
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E.2.2 | Secondary objectives of the trial |
To demonstrate, in a phase 2b trial, the efficacy of Riluzole to improve spasticity vs placebo, in patients with chronic SCI. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Chronic traumatic SCI defined as: a.At least a 12-month history of i. C4-T12 traumatic SCI ii. Complete and incomplete ( AIS A,B,C,D) iii. With Spasticity (5>MAS>1 on at least adductor muscles and/or triceps surae muscles and NRS ≥ 4) 2.Male or Female 3.Aged 18 to 65 years at the time of screening 4.Judged by site investigator to be able to comply with evaluations at baseline and throughout the study 5.Last injection of BTX-A in striated muscle more than 3 months ago and patients must have returned to their level of spasticity before BTX-A injection 6.Last intrathecal (IT) injection of baclofen or per os administration of any myorelaxant should be more than 14 days ago (Step 1) 7.The dose of myorelaxant or Baclofen should be stable for ≥ 30 days prior to screening and kept at stable daily dose until the end of the protocol (Step 2). 8.Stable on all other chronic medications for ≥ 30 days prior to screening, including analgesics 9.Stable on rehabilitation (methods and frequency) for ≥ 15 days prior to screening 10Written informed consent provided by subject |
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E.4 | Principal exclusion criteria |
1.Spinal cord injury of less than 12 months, 2.Associated Brain lesion that might be the cause of spasticity, 3.MAS≤1 or =5 on at least adductor muscles and/or triceps surae muscles or NRS < 4 4.Presence of urinary infection, fever, pressure ulcer or other spasticity-aggravating factors. 5.Presence of other significant neurological or mental disorder or other illness, which would preclude accurate evaluation, 6.Recent history (less than 1 year) of chemical substance dependency or significant psychosocial disturbance, 7.Insufficient fluency in local language to complete neuropsychological, global and spasticity assessments 8.Active liver disease or clinical jaundice 9.Active malignancy or history of invasive malignancy within the last five years 10.Neutropenia, liver enzymes (ALT/SGPT or AST/SGOT) 2 times the upper limit of normal (ULN) at screening visit, baseline elevations of several liver function tests (especially elevated bilirubin). 11.AIDS or AIDS-related complex, 12.The systolic blood pressure measurement is > 190 or < 85 mm Hg and/or the diastolic blood pressure measurement is > 105 or < 50 mm Hg at screening. 13.The ECG is abnormal at screening and judged to be clinically significant by the site investigator. Particular attention will be given to any sign suggesting conduction disorders. 14.Treatment with any investigational drugs or device within 60 days of screening 15.Any myorelaxant medication including IT baclofen, taken by the subject in the last 14 days prior to screening (step 1) 16.Not stable under IT baclofen or per os myorelaxant medication for at least 30 days prior screening (step 2) 17.Not stable on all other chronic medications for ≥ 30 days prior to screening, including analgesics 18.Injection of BTX-A in striated muscle less than 3 months ago 19.Subject is currently using, and will continue to use for the next 14 days any of the following medications which are classified as Inhibitors of CYP 1A2 (e.g. diclofenac, diazepam, nicergoline, clomipramine, imipramine, fluvoxamine, phenacetin, theophylline, amitriptyline and quinolones) or Inducers of CYP 1A2 (e.g. rifampicin and omeprazole) 20.Ongoing pregnancy or lactation. Women with childbearing potential not using any form of efficacious contraception. 21.Known hypersensitivity to Riluzole
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E.5 End points |
E.5.1 | Primary end point(s) |
is defined as the improvement of Modified Ashworth Score better than 1 point, or 11 points Numerical Rating Scale (0-10 NRS) spasticity score better than 20% between Week 0 and Week 2. |
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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) |
Safety : side effects Pharmacokinetics (PK) Electrophysiology Efficacy Pain Bladder dysfunctiont |
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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 | No |
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) | Yes |
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 | No |
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 | 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 | 7 |
E.8.5 | The trial involves multiple Member States | No |
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 | 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 | 6 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |