E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Aplastic Anaemia, Myelodysplastic syndromes, Acute Myeloid Leukaemia undergoing immunosuppression therapy, high dose chemotherapy or reduced intensity stem cell transplantation |
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E.1.1.1 | Medical condition in easily understood language |
Fungal infection as a result of immunosuppressive therapy, chemotherapy or stem cell transplantation. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10038271 |
E.1.2 | Term | Refractory anaemia with excess blasts in transformation |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10059041 |
E.1.2 | Term | Allogeneic peripheral haematopoietic stem cell transplant |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10067862 |
E.1.2 | Term | Allogeneic stem cell transplantation |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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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 | 10038270 |
E.1.2 | Term | Refractory anaemia with an excess of blasts |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10010776 |
E.1.2 | Term | Constitutional aplastic anaemia |
E.1.2 | System Organ Class | 10005329 - Blood and lymphatic system disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10068063 |
E.1.2 | Term | Aplastic anaemia relapse |
E.1.2 | System Organ Class | 10005329 - Blood and lymphatic system disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10036699 |
E.1.2 | Term | Primary idiopathic aplastic anaemia |
E.1.2 | System Organ Class | 10005329 - Blood and lymphatic system disorders |
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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 | 10000880 |
E.1.2 | Term | Acute myeloid leukaemia |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 | 10001756 |
E.1.2 | Term | Allogenic bone marrow transplantation therapy |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10000884 |
E.1.2 | Term | Acute myeloid leukaemia NOS |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10032510 |
E.1.2 | Term | Other specified aplastic anaemias |
E.1.2 | System Organ Class | 10005329 - Blood and lymphatic system disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066355 |
E.1.2 | Term | Treatment related acute myeloid leukaemia |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10060355 |
E.1.2 | Term | Acute myeloid leukaemia in remission |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10028532 |
E.1.2 | Term | Myelodysplasia |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066764 |
E.1.2 | Term | Acute myeloid leukaemia progression |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 | 10002967 |
E.1.2 | Term | Aplastic anaemia |
E.1.2 | System Organ Class | 10005329 - Blood and lymphatic system 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 determine the cumulative incidence of invasive fungal disease (IFD) in patients given posaconazole tablet as primary prophylaxis at the start of admission for immunosuppressive therapy, chemotherapy or allogeneic RIC HSCT. |
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E.2.2 | Secondary objectives of the trial |
SECONDARY 1. To determine the cumulative incidence of IFD within treatment groups. 2. To measure trough plasma levels of posaconazole and correlate with the incidence of IFD 3. To determine the number of patients who received antifungal treatment 4. To determine if calcineurin inhibitors such as cyclosporine A or tacrolimus adversely affect the plasma posaconazole levels 5. To determine the clinical response to antifungal therapy 6. To determine the clinical performance of β-D-glucan, galactomannan, bi (methylthio)gliotoxin and PCR diagnostic tests 7. To assess the risk factors (e.g. baseline CT abnormalities, baseline ILR2 and MCP1 levels, GVHD, prolonged monocytopenia, poor performance status) for IFD
EXPLORATORY 1. To determine IFD incidence, number of patients on antifungal prophylaxis and treatment beyond week 24 of the study 2. To determine overall survival 3.To determine the pharmaco-economics of IFD diagnosis and treatment |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Adult > or = to 18 years 2. Patients with aplastic anaemia, MDS or AML undergoing: IST; or Intensive chemotherapy such as induction chemotherapy; or RIC allogeneic HSCT 3. Able to swallow and retain orally administered medication 4.Patients must agree to use and apply with effective contraception without interruption throughout the duration of study drug therapy |
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E.4 | Principal exclusion criteria |
1. Refusal or inability to consent 2. Autologous HSCT 3. Contraindicated medications 4. Current evidence of IFD diagnosis or treatment 5.Women who are pregnant or lactating |
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E.5 End points |
E.5.1 | Primary end point(s) |
Cumulative incidence of IFD in all treatment groups (aplastic anaemia with IST, chemotherapy only, RIC allograft) assessed over 24 weeks from Day 1 of study entry |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Between day 1 and week 24 |
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E.5.2 | Secondary end point(s) |
1.Cumulative incidence of IFD within treatment groups (aplastic anaemia with IST, chemotherapy only, RIC allograft) assessed over 24 weeks from Day 1 of study entry 2.Trough plasma levels of posaconazole correlated with the incidence of IFD assessed over 24 weeks from Day 1 of study entry 3.The number of patients who received antifungal treatment assessed over 24 weeks from Day 1 of study entry 4.Whether calcineurin inhibitors such as cyclosporine A or tacrolimus adversely affect plasma posaconazole levels assessed over 24 weeks from Day 1 of study entry 5.Clinical response to antifungal therapy assessed over 24 weeks from Day 1 of study entry 6.Clinical performance of GM, BDG, bmGT and PCR assessed over 24 weeks from Day 1 of study entry 7.The risk factors (baseline CT abnormalities, baseline IL2R and MCP1 levels, GVHD, prolonged monocytopenia, poor performance status) for IFD assessed over 24 weeks from Day 1 of study entry Exploratory Endpoints 1.IFD incidence, number of patients on antifungal prophylaxis and treatment from 24 weeks until 12 months 2.Overall survival at 6, 9 and 12 months 3.Pharmaco-economics of IFD diagnosis and treatment assessed over 12 months
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Secondary endpoints assessed between day 1 and week 24 Exploratory endpoints assessed at 12 months |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Yes |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | No |
E.6.4 | Safety | No |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
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 | Yes |
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.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
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 | 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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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 | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |