E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Ankylosing Spondylitis |
Espondilitis Anquilosante |
|
E.1.1.1 | Medical condition in easily understood language |
Ankylosing Spondylitis is a form of arthritis that primarily affects the spine. |
La Espondilitis Anquilosante es una forma de artritis que afecta principalmente a la columna vertebral. |
|
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 | 19.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10002556 |
E.1.2 | Term | Ankylosing spondylitis |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue disorders |
|
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 |
Assess the dose-response based on the efficacy of bimekizumab |
Evaluar la relación dosis-respuesta basándose en la eficacia de bimekizumab |
|
E.2.2 | Secondary objectives of the trial |
- assess the efficacy of the individual dose regimens of bimekizumab compared to placebo - assess the safety and tolerability of bimekizumab - assess the pharmacokinetics (PK) of bimekizumab - assess the pharmacodynamics (PD) of bimekizumab - assess the immunogenicity of bimekizumab - assess the exposure: response relationship of bimekizumab as it relates to efficacy and safety |
-Evaluar la eficacia de cada una de las pautas posológicas de bimekizumab en comparación con placebo. -Evaluar la seguridad y tolerabilidad de bimekizumab. -Evaluar la FC de bimekizumab. -Evaluar la FD de bimekizumab. -Evaluar la inmunogenicidad de bimekizumab. -Evaluar la relación exposición-respuesta a bimekizumab a efectos de la eficacia y la seguridad. |
|
E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
A substudy will be initiated to asses genomic, genetic/epigenetic and proteomic variables. In a subpopulation MRIs will be taken for radiographic changes. |
Se empezará un subestudio para evaluar las variables genómicas,genéticas/epigenéticas y proteómicas. en una subpoblación se harán RMs para evaluar cambios radiográficos. |
|
E.3 | Principal inclusion criteria |
- Subject has active AS, determined by documented radiologic evidence fulfilling the Modified New York criteria for AS including symptoms for >=3 months and age of onset <45 years - Subject has moderate to severe active disease as defined by each of the following: --BASDAI score >=4 --Spinal pain >=4 on a 0 to 10 NRS (from BASDAI item 2) - Subjects must have at least 1 of the following: -- inadequate response to nonsteroidal anti-inflammatory drug (NSAID) therapy -- intolerance to administration of at least 1 NSAID -- contraindication(s) to NSAID therapy - Subjects who are regularly taking NSAIDs/COX-2 inhibitors as part of their AS therapy are required to be on a stable dose for at least 14 days before Baseline - Subjects taking corticosteroids must be on an average daily dose of <=10mg/day prednisone or equivalent for at least 14 days before Baseline and should remain on a stable dose up to Week 16 - Subjects taking MTX (<=25mg/week) are allowed to continue their medication if started at least 12 weeks prior to Baseline, with a stable dose for at least 8 weeks before randomization - Subjects taking sulfasalazine (up to 3grams/day) or hydroxychloroquine (up to 400mg per day total) are allowed to continue their medication if started at least 12 weeks prior to Baseline, with a stable dose for at least 8 weeks before randomization - Subjects may be TNF inhibitor-naïve or may have received 1 prior TNF inhibitor. Subjects who have been on a TNF inhibitor previously must have: --experienced an inadequate response to previous treatment given for at least 3 months -- been intolerant to administration (eg, had a side effect/AE that led to discontinuation) -- lost access to TNF inhibitor for other reasons |
-EA activa, determinada por signos radiológicos documentados (radiografía) que cumplen los criterios modificados de Nueva York para la EA (1984), incluyendo la presencia de síntomas durante un período ≥3 meses y una edad al inicio de la enfermedad <45 años. -Enfermedad de actividad moderada a intensa, definida por cada una de las siguientes características: -Puntuación BASDAI ≥4. -Dolor en la columna vertebral ≥4 en la EVN del 0 al 10 (del ítem 2 en el índice BASDAI). -Presentar, como mínimo, 1 de las siguientes: -Respuesta insuficiente al tratamiento con AINE. -Intolerancia a la administración de al menos 1 AINE. -Contraindicación para el tratamiento con AINE. -Los pacientes que estén utilizando regularmente AINE/inhibidores de la COX-2 como parte de su tratamiento para la EA deben haber recibido una dosis estable durante un mínimo de 14 días antes de la visita basal -Los pacientes que estén utilizando corticoesteroides deben haber recibido una dosis diaria promedio de prednisona ≤10 mg/día oequivalente durante un mínimo de 14 días antes de la visita basal y seguir recibiendo una dosis estable hasta la semana 16. -Los pacientes que estén recibiendo MTX (≤25 mg/semana) pueden seguir haciéndolo, si la administración comenzó al menos 12 semanas antes de la visita basal y han estado recibiendo una dosis estable durante un mínimo de 8 semanas antes de la aleatorización. -Los pacientes que estén tomando sulfasalazina (máximo 3 mg/día) o hidroxicloroquina (máximo 400 mg/día en total) pueden seguir haciéndolo, si la administración comenzó al menos 12 semanas antes de la visita basal y han estado recibiendo una dosis estable durante un mínimo de 8 semanas antes de la aleatorización. -Pueden no haber recibido tratamiento previo con inhibidores del TNF o haber recibido previamente 1 inhibidor del TNF. Los pacientes que hayan recibido previamente un inhibidor del TNF deben: -haber tenido una respuesta insuficiente al tratamiento previo administrado durante al menos 3 meses, -ser intolerantes a la administración (p. ej., haber tenido un efecto secundario o AA que provocara la interrupción), -haber dejado de acceder al tratamiento inhibidor del TNF por otros motivos. |
|
E.4 | Principal exclusion criteria |
- Subjects with a total ankylosis of the spine, or a diagnosis of any other inflammatory arthritis eg,rheumatoid arhritis (RA), sarcoidosis, systemic lupus erythematosus, or reactive arthritis - Subjects with any current sign or symptom that may indicate an active infection (except for the common cold) - Subjects with a history of chronic or recurrent infections, or a serious or life-threatening infection within the 6 months prior to the Baseline Visit - Subjects receiving any live vaccination within the 8 weeks prior to Baseline - Subjects with known tubercolosis (TB) infection, at high risk of acquiring TB infection, with latent TB infection or current or history of nontuberculous mycobacteria (NTMB) infection - Subjects with concurrent malignancy or a history of malignancy during the past 5 years will be excluded, with following exceptions that may be indlucded: a) <= 3 excised or ablated basal cell carcinomas of the skin b) One squamous cell carcinoma of the skin (stage T1 maximum) successfully excised, or ablated only (other treatments, ie, chemotherapy, do not apply), with no signs of recurrence or metastases for more than 2 years prior to Screening c) Actinic keratosis (-es) d) Squamous cell carcinoma-in-situ of the skin successfully excised, or ablated, more than 6 months prior to Screening |
-Anquilosis total de la columna vertebral, o diagnóstico de cualquier otra artritis inflamatoria, p. ej., AR, sarcoidosis, lupus eritematoso sistémico o artritis reactiva. -Cualquier signo o síntoma en curso, indicativo de una infección activa (excepto resfriado común) -Antecedentes de infecciones crónicas o recurrentes, o infección grave o potencialmente mortal en los 6 meses anteriores a la visita basal -Recepción de alguna vacuna elaborada con microorganismos vivos (incluidas las vacunas atenuadas) en las 8 semanas previas a la visita basal -TB diagnosticada, riesgo alto de contraer TB, TB latente (TBL)* oinfección pasada o presente por MBNT. -Neoplasia maligna concurrente o antecedentes de neoplasia maligna (incluido carcinoma cervicouterino in situ resecado quirúrgicamente) durante los últimos 5 años, con las siguientes excepciones: a) Cifra ≤3 de carcinomas basocelulares de la piel eliminados por extirpación o ablación. b) Un carcinoma de la piel espinocelular (estadio T1 máximo) con extirpación o ablación satisfactoria solamente (otros tratamientos, es decir, la quimioterapia, no son aplicables), sin signos de recurrencia ni metástasis durante más de 2 años antes de la selección c) Queratosis actínica. d) Carcinoma espinocelular in situ de la piel con extirpación o ablación satisfactoria más de 6 meses antes de la selección. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Subjects with Axial Spondyloarthritis International Society 40 % response criteria (ASAS40) at Week 12 |
Pacientes con uno 40 % de Criterio de Respuesta de la Sociedad Internacional para la Evaluación de las Espondiloartritis (Axial Spondyloarthritis International Society) (ASAS40) en la Semana 12 |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
- Change from Baseline in Ankylosing Spondylitis Disease Activity Score - C-Reactive Protein (ASDAS [CRP]) at Week 12 - Subjects with Axial Spondyloarthritis International Society 20 % response criteria (ASAS20) at Week 12 - Subjects with Axial Spondyloarthritis International Society (ASAS) 5/6 response at Week 12 - Change from Baseline to Week 12 in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) - Change from Baseline to Week 12 in the Bath Ankylosing Spondylitis Functional Index (BASFI) |
-Cambio desde el valor basal en la puntuación de actividad de la enfermedad ASDAS (Ankylosing Spondylitis Disease Activity Score) utilizando la PCR como reactivo de fase aguda (ASDAS-PCR) en la semana 12. -Pacientes con Respuesta ASAS20 en la semana 12. -Pacientes con Respuesta ASAS5/6 en la semana 12. -Cambio desde el valor basal en el índice de actividad de la enfermedad BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) en la semana 12. -Cambio desde el valor basal en el índice de actividad de la enfermedad BASFI (Bath Ankylosing Spondylitis Functional Index) en la semana 12. |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Baseline Week 12 |
Basal Semana 12 |
|
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 | No |
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 | Yes |
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 | 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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 5 |
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 | 6 |
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 |
Bulgaria |
Canada |
Czech Republic |
Germany |
Hungary |
Poland |
Romania |
Russian Federation |
Spain |
Ukraine |
United States |
|
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
|
|
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 | 7 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 7 |
E.8.9.2 | In all countries concerned by the trial days | 0 |