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    Summary
    EudraCT Number:2016-001653-40
    Sponsor's Protocol Code Number:64041575RSV2003
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2016-08-11
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2016-001653-40
    A.3Full title of the trial
    A Phase 2b, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Antiviral Activity, Clinical Outcomes, Safety, Tolerability, and Pharmacokinetics of Orally Administered ALS-008176 Regimens in Adult Subjects Hospitalized with Respiratory Syncytial Virus
    Estudio de fase 2b, aleatorizado, doble ciego y controlado con placebo para evaluar la actividad antiviral, los resultados clínicos, la seguridad, la tolerabilidad y la farmacocinética de regímenes administrados por vía oral del fármaco del estudio en pacientes adultos hospitalizados con infección por el virus respiratorio sincitial
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 2b study for adults hospitalized with Respiratory Syncytial Virus.
    Estudio fase 2b en pacientes adultos hospitalizados con infección por el virus respiratorio sincitial
    A.3.2Name or abbreviated title of the trial where available
    A Phase 2b study for adults with Respiratory Syncytial Virus.
    Estudio fase 2b en adultos infección por el virus respiratorio sincitial
    A.4.1Sponsor's protocol code number64041575RSV2003
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorJanssen-Cilag International NV
    B.1.3.4CountryBelgium
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportJanssen-Cilag International NV
    B.4.2CountryBelgium
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJanssen-Cilag, S.A.
    B.5.2Functional name of contact pointGlobal Clinical Operations
    B.5.3 Address:
    B.5.3.1Street AddressPº de las Doce Estrellas, 5-7
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28042
    B.5.3.4CountrySpain
    B.5.4Telephone number+34917228100
    B.5.5Fax number+34917228628
    B.5.6E-mailagonza45@its.jnj.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameALS-008176
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN_
    D.3.9.1CAS number 1445385-02-3
    D.3.9.2Current sponsor codeALS-008176
    D.3.9.3Other descriptive nameJNJ-64041575-AAA
    D.3.9.4EV Substance CodeSUB120906
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameALS-008176
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN_
    D.3.9.1CAS number 1445385-02-3
    D.3.9.2Current sponsor codeALS-008176
    D.3.9.3Other descriptive nameJNJ-64041575-AAA
    D.3.9.4EV Substance CodeSUB120906
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Respiratory Syncytial Virus Infection
    Infección por el virus respiratorio sincitial
    E.1.1.1Medical condition in easily understood language
    Viral Infection
    Infección por virus
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 19.0
    E.1.2Level PT
    E.1.2Classification code 10061603
    E.1.2Term Respiratory syncytial virus infection
    E.1.2System Organ Class 10021881 - Infections and infestations
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective is to determine in adults who are hospitalized with RSV infection the dose-response relationship of multiple regimens of ALS-008176 on antiviral activity based on nasal RSV shedding using quantitative real-time reverse transcriptase-polymerase chain reaction (qRT-PCR) assay.
    El objetivo principal es determinar en adultos que se encuentran hospitalizados con infección por el VRS la relación dosis-respuesta de diferentes regímenes de ALS-008176 en la actividad antiviral basada en la detección de VRS en secreciones nasales mediante un análisis de la reacción en cadena de la polimerasa-transcriptasa inversa cuantitativa en tiempo real (qRT-PCR).
    E.2.2Secondary objectives of the trial
    The secondary objectives are to determine in adults who are hospitalized with RSV infection:
    • The impact of ALS-008176 on the clinical course of RSV infection including:
    − Duration of hospital stay.
    − Duration of supplemental oxygen.
    − Evolution of Activities of Daily Living (ADL) as assessed by Katz ADL score.
    − Time to clinical stability.
    − Improvement on the ordinal scale.
    − Rate of mortality and complications.
    • The time to cessation of nasal RSV shedding.
    • The impact of ALS-008176 on the emergence of resistant strains of RSV.
    • The safety and tolerability of ALS-008176.
    • The pharmacokinetics (PK) of ALS-008112 and ALS-008144 (and other metabolites, if applicable) in plasma.
    • The relationship between the PK and pharmacodynamics (PD; antiviral activity, clinical symptoms, and selected safety parameters) after single (loading dose [LD]) and repeated oral dosing (maintenance dose [MD]) of ALS-008176.
    • El efecto de ALS-008176 en la evolución clínica de la infección por el VRS, incluido lo siguiente:
    Duración de la estancia hospitalaria.
    Duración de la necesidad de administración de oxígeno.
    Evolución de las actividades de la vida diaria (AVD) valoradas mediante el índice de Katz.
    Tiempo hasta la estabilidad clínica.
    Mejoría en la escala ordinal
    Tasa de mortalidad y complicaciones.
    • Tiempo hasta el cese de la detección del VRS en secreciones nasales.
    • Efecto de ALS-008176 en la aparición de cepas resistentes del VRS.
    • Seguridad y tolerabilidad de ALS-008176.
    • Farmacocinética (FC) de ALS-008112 y ALS-008144 (y otros metabolitos, según proceda) en plasma.
    • Relación entre la FC y la farmacodinamia (FD; actividad antiviral, síntomas clínicos y ciertos parámetros de seguridad) después de la administración por vía oral de dosis únicas (dosis de carga [DC]) y dosis repetidas (dosis de mantenimiento [DM]) de ALS-008176.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Each potential subject must satisfy all of the following criteria to be enrolled in the study:
    1. Men or women ≥50 years of age, defined at the time of randomization.
    2. Hospitalized (or in emergency room prior to hospitalization) at the time of randomization and unlikely to be discharged for the first 24 hours after randomization.
    3. Diagnosed with RSV infection based on polymerase chain reaction (PCR)-based assay due to the low viral loads in adults with or without co-infection with another respiratory pathogen (eg, influenza, human metapneumovirus, or bacteria).
    4. Has been, or will be, admitted to the hospital with an acute respiratory illness with signs and symptoms consistent with a viral infection (eg, fever, cough, nasal congestion, runny nose, sore throat, myalgia, lethargy, shortness of breath, or wheezing) with onset ≤5 days from the anticipated time of randomization.
    5. With the exception of the RSV disease, medically stable on the basis of medical history, physical examination, vital signs, and 12-lead ECG performed at screening. If there are abnormalities, they must be consistent with the underlying illness in the study population. This determination must be recorded in the subject’s source documents and initialled by the investigator.
    6. Medically stable on the basis of clinical laboratory tests performed at screening. If the results of the serum chemistry, haematology, or urinalysis are outside the normal reference ranges, the subject may be included only if the investigator judges the abnormalities or deviations from normal do not pose an unacceptable risk to the subject, are not clinically significant, or are appropriate and reasonable for the population under study. This determination must be recorded in the subject’s source documents and initialled by the investigator. A single repeat laboratory evaluation is allowed for eligibility determination.
    7. Must sign an ICF (or their legally acceptable representative must sign) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study.
    8. A woman must have a negative serum β-human chorionic gonadotropin at screening.
    9. Contraceptive use by women should be consistent with local regulations regarding the use of contraceptive methods for subjects participating in clinical studies.
    A woman must be of non-child bearing potential defined as either:
    • Postmenopausal: a postmenopausal state is defined as no menses for 12 months without an alternative medical cause and a serum follicle-stimulating hormone level in the postmenopausal range (>40 IU/L or mIU/mL), OR
    • Permanently sterile: permanent sterilization methods include hysterectomy, bilateral salpingectomy, bilateral tubal occlusion/ligation procedures (without reversal operation), and bilateral oophorectomy.
    10. Contraceptive use by men should be consistent with local regulations regarding the use of contraceptive methods for subjects participating in clinical studies.
    During the study and for a minimum of 1 spermatogenesis cycle (defined as approximately 90 days) after receiving the last dose of study drug, a man:
    • Who is sexually active with a woman of childbearing potential must agree to use a barrier method of contraception (e.g., condom with spermicidal foam/gel/film/cream/suppository)
    • Who is sexually active with a pregnant woman must use a condom
    • Must agree not to donate sperm
    11. Female partners of men must either be surgically sterilized, postmenopausal (amenorrhea for a minimum of 1 year) or, if of childbearing potential, must agree to use at least one of the following contraceptive methods during the study and for 90 days following the last dose of study drug: a non-hormonal intrauterine device with spermicide; contraceptive sponge with spermicide, diaphragm with spermicide, cervical cap with spermicide, or oral, implantable, transdermal, or injectable hormonal contraceptives.
    12. A woman must agree not to donate eggs (ova, oocytes) during the study and for at least 90 days after receiving the last dose of study drug.
    13. Willing and able to adhere to the prohibitions and restrictions specified in this protocol.
    1. Hombres o mujeres ≥ 50 años de edad, en el momento de la aleatorización.
    2.Pacientes hospitalizados en el momento de la aleatorización y con escasa probabilidad de recibir el alta hospitalaria en las primeras 24 horas siguientes a la aleatorización .
    3.Pacientes diagnosticados de infección por el VRS utilizando un método diagnóstico molecular basado en la PCR (Nota: cuando el centro no disponga de métodos basados en la PCR comercializados, se deberá consultar al promotor para obtener la aprobación del método que se utilizará) y con o sin coinfección de otro patógeno respiratorio (como gripe, metaneumovirus humano o bacterias)..
    4.Pacientes que hayan sido o vayan a ser admitidos por una enfermedad respiratoria aguda con signos y síntomas compatibles con una infección viral (p. ej., fiebre, tos, congestión nasal, moqueo, dolor de garganta, mialgia, letargia, dificultad para respirar o sibilancias) aparecidos ≤5 días antes de la fecha prevista de la aleatorización.
    5.Pacientes médicamente estables a tenor de la historia clínica, la exploración física, las constantes vitales y el ECG de 12 derivaciones realizados durante la selección. Las posibles anomalías deberán ser compatibles con la enfermedad subyacente en la población del estudio. Esta decisión deberá consignarse en los documentos originales del paciente con las iniciales del investigador.
    6.Pacientes médicamente estables a tenor de las pruebas de laboratorio realizadas en la selección. Si los resultados de bioquímica sérica, hematología y análisis de orina se encuentran fuera del intervalo de referencia normal, se podrá incluir al paciente únicamente si el investigador considera que las anomalías o desviaciones de la normalidad no representan un riesgo inaceptable para el paciente, no son clínicamente importantes o son apropiadas y razonables para la población estudiada. Esta decisión deberá consignarse en los documentos originales del paciente con las iniciales del investigador. Se permitirá repetir una sola vez las evaluaciones analíticas para la determinación de la elegibilidad
    7.Pacientes que hayan firmado (el paciente o su representante legal) un DCI en el que se declare que entienden el objetivo del estudio y los procedimientos que exige y que están dispuestos a participar en él
    8. Una mujer debe tener un suero negativo β hCG en el cribado.
    9. el uso de anticonceptivos en mujeres debe ser consistente con las regulacion local sobre el uso de métodos anticonceptivos para los sujetos que participan en estudios clínicos.
    La mujer no debe estar en edad de procrear lo que significa que:
    • posmenopáusica: un estado posmenopáusico se define como la no menstruación durante 12 meses sin una causa médica alternativa y una concentración sérica de folitropina de +40UI/L
    • permanente estéril: métodos de esterilización permanente incluyen la histerectomía, salpingectomía bilateral, procedimientos de oclusión/ligadura de trompas bilateral(Irreversible) y ooforectomía bilateral.
    10. el uso de anticonceptivos en hombres debe ser consistente con las regulacion local sobre el uso de métodos anticonceptivos para los sujetos que participan en estudios clínicos. En el estudio y durante un mínimo de 1 ciclo de espermatogénesis (definido como aproximadamente 90 días) después de recibir la última dosis del fármaco del estudio, los varones:
    • que sean sexualmente activos con mujeres en edad fértil deben comprometerse a utilizar un método anticonceptivo de barrera (p. ej., preservativo con espuma/gel/película/crema/supositorio espermicida).
    •que sean sexualmente activos con mujeres embarazadas deben usar un preservativo.
    •deben comprometerse a no donar semen
    11. 11. Las parejas femeninas de pacientes varones deben haberse sometido a esterilización quirúrgica, ser posmenopáusicas (amenorrea durante un mínimo de 1 año) o, si pueden tener hijos, comprometerse a utilizar al menos uno de los métodos anticonceptivos siguientes en los 90 días siguientes a la administración de la última dosis del fármaco del estudio: dispositivos intrauterinos no hormonal con espermicida; esponja anticonceptiva con espermicida, diafragma con espermicida, capuchón cervical con espermicida, o anticonceptivos hormonales orales, implantables, transdérmicos o inyectables
    12. Una mujer debe estar de acuerdo no donar óvulos (óvulos y ovocitos) durante el estudio y durante al menos 90 días después de recibir la última dosis del fármaco del estudio
    13.Pacientes dispuestos a respetar las prohibiciones y las restricciones especificadas en este protocolo y ser capaces de hacerlo
    E.4Principal exclusion criteria
    4.2. Exclusion Criteria
    Any potential subject who meets any of the following criteria will be excluded from participating in the study:
    1. Subjects who are not expected to survive for more than 48 hours.
    2. Subjects who have had major thoracic or abdominal surgery in the 6 weeks prior to randomization.
    3. Subjects who are considered by the investigator to be immunocompromised within the past 12 months, whether due to underlying medical condition (e.g., malignancy or genetic disorder) or medical therapy (e.g., medications, chemotherapy, radiation, stem cell or solid organ transplant).
    4. Subjects with a known history of human immunodeficiency virus (HIV) or chronic viral hepatitis.
    5. Subjects with ALT ≥3 times the upper limit of normal (ULN) AND bilirubin ≥2×ULN (direct >35%) OR ALT ≥5×ULN at screening.
    6. Subjects undergoing peritoneal dialysis, haemodialysis, or hemofiltration or with an estimated glomerular filtration rate (GFR, determined by Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] equation) of <30 mL/min.
    7. Known allergies, hypersensitivity, or intolerance to ALS-008176 or its excipients (refer to the IB).1
    8. Subjects who are anticipated to be treated or who are being treated with other agents with potential antiviral activity against RSV (e.g., ribavirin, intravenous immunoglobulin, palivizumab). Medications treating the sequelae of the RSV infection or any concurrent illness are permitted if not otherwise excluded (see Section 8).
    9. Subjects unwilling to undergo mid-turbinate nasal swab procedures or with any physical abnormality which limits the ability to collect regular nasal specimens.
    10. Subjects unable to take medications enterally or with a known gastrointestinal-related condition that is considered by the sponsor or investigator to be likely to interfere with study drug absorption.
    11. Women who are pregnant or breastfeeding.
    12. Men who plan to father a child while enrolled in this study or within 90 days after the last dose of study drug.
    13. Subjects taking any disallowed therapies as noted in Section 8 before the planned first dose of study drug.
    14. Subjects who received an investigational drug, an investigational vaccine, or used an invasive investigational medical device within 30 days or 5 half-lives (whichever is longer) before the planned first dose of study drug or is currently enrolled in an investigational study.
    15. Subjects with any condition for which, in the opinion of the investigator, participation would not be in the best interest of the subject (e.g., compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments.
    1. Pacientes con una expectativa de supervivencia inferior a 48 horas.
    2. Pacientes que se hayan sometido a cirugía mayor en las 6 semanas previas a la aleatorización.
    3. Pacientes que el investigador considere inmunodeprimidos en los últimos 12 meses, tanto si se debe a un proceso médico subyacente (p. ej., una neoplasia maligna o un trastorno genético) o al tratamiento médico (p. ej., medicación, quimioterapia o radioterapia, trasplante de células progenitoras o de órganos sólidos).
    NOTA: Se permite el empleo agudo de corticosteroides (inhalados o sistémicos) durante 7 días o menos; se permite el empleo crónico de corticosteroides (más de 28 días) para dosis de prednisona de 20 mg o menos (o el equivalente).
    4. Pacientes con antecedentes conocidos de infección por el virus de la inmunodeficiencia humana (VIH) o de hepatitis viral crónica.
    5. Pacientes con ALT ≥3 veces el límite superior de la normalidad (LSN) Y bilirrubina ≥2×LSN (directa >35%) O ALT ≥5×LSN en la selección.
    6. Pacientes sometidos a diálisis peritoneal, hemodiálisis o hemofiltración o con una filtración glomerular estimada (FGe, determinada con la ecuación de la Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI]) inferior a 30 ml/min.
    NOTA: El CIVD puede rebajar el límite excluyente de la FG a < 15 ml/min si alguno de los datos de FC emergentes disponibles en pacientes con FG ≥30 ml/min sugieren que previsiblemente las exposiciones al fármaco del estudio en presencia de insuficiencia renal intensa (esto es, FG ≥15 a <30 ml/min) seguirán dentro de un intervalo aceptable.
    En el caso de que el laboratorio local del centro no pueda realizar la determinación de CKD-EPI, se permitirá el uso de una metodología alternativa para determinar la FG, previa consulta y aprobación del promotor.
    7. Alergias, hipersensibilidad o intolerancia conocida al fármaco del estudio o a sus excipientes.
    8. Tratamiento de la enfermedad actual con fármacos dirigidos específicamente contra la propia infección por el VRS (p. ej., VRS, inmunoglobulina, ribavirina, palivizumab). Se permite el uso de medicamentos para tratar secuelas de la infección por el VRS o cualquier enfermedad concomitante, si no se prohíbe expresamente.
    9. Pacientes que no deseen someterse periódicamente a procedimientos de de obtención de una muestra de frotis nasal o que tengan alguna alteración física que limita la capacidad de extraer estas muestras con regularidad.
    10. Pacientes incapaces de tomar medicación por vía enteral (p. ej., por vía oral o mediante sonda nasogástrica o gastrostomía endoscópica percutánea) o con alguna enfermedad gastrointestinal confirmada que el promotor o el investigador considere que probablemente vaya a interferir con la absorción del fármaco del estudio.
    11. Mujeres embarazadas o lactantes.
    12. Varones que planeen engendrar un hijo durante su participación en este estudio o en los 90 días siguientes a la última dosis de la medicación del estudio.
    13. Pacientes que tomen tratamientos prohibidos antes de la primera dosis prevista del fármaco del estudio.
    14. Pacientes que hayan recibido un fármaco experimental (incluidas las vacunas experimentales) o utilizado un producto sanitario experimental invasivo en los 30 días o 5 semividas (lo que más largo sea) previos a la primera dosis programada del fármaco del estudio.
    15. Pacientes con algún trastorno por el que, en opinión del investigador, la participación en el estudio no sería lo mejor para el paciente (por ejemplo, comprometería su bienestar) o podría impedir, limitar o constituir un factor de confusión en las evaluaciones especificadas en el protocolo.
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint is RSV RNA viral load (measured by qRT-PCR in the mid-turbinate nasal swab specimens) area under the concentration-time curve (AUC) from immediately prior to first dose of study drug (baseline) until Day 7.
    NOTE: If the dosing duration is increased by the Independent Data Monitoring Committee (IDMC) to up to 10 days, the RSV RNA viral load AUC in subjects assigned to the longer dosing duration will be measured from baseline until 1 day (+2 days) after the last dose of study drug.
    El criterio de valoración principal es el área bajo la curva de la concentración-tiempo (AUC) de la carga viral de ARN del VRS (medida mediante qRT-PCR en muestras obtenidas con torunda del cornete nasal medio) desde justo antes de la administración de la primera dosis del fármaco del estudio (momento basal) hasta el día 7.
    NOTA: Si el Comité independiente de vigilancia de los datos (CIVD) decide prolongar el período de administración hasta 10 días, se medirá el AUC de la carga viral del ARN del VRS en pacientes asignados a ese período más largo de administración desde el momento basal hasta 1 días (+2 días) después de la última dosis del fármaco del estudio
    E.5.1.1Timepoint(s) of evaluation of this end point
    Immediately prior to first dose of study drug (baseline) until Day 7
    Inmediatamente antes de la primera dosis del fármaco del estudio (visita basal) hasta el Día 7
    E.5.2Secondary end point(s)
    The secondary endpoints are:
    • RSV clinical course endpoints:
    − Length of hospital stay from admission to discharge and from study treatment initiation to discharge.
    − Length of hospital stay from admission to readiness for discharge and from study treatment initiation to readiness for discharge, with readiness for discharge defined by the investigator.
    − Need for and duration of intensive care unit (ICU) stay.
    − Need for and duration of supplemental oxygen (regardless of method used).
    − Number of hours until peripheral capillary oxygen saturation (SpO2) ≥93% on room air among subjects who were not on supplemental oxygen prior to current hospitalization.
    − Respiratory rate, SpO2, and body temperature return to pre-RSV disease level.
    − Need for and duration of non-invasive ventilator support (eg, continuous positive airway pressure) and/or invasive ventilator support (eg, endotracheal-mechanical ventilation or mechanical ventilation via tracheostomy).
    − Time to return to pre-RSV functional status (Katz ADL score).
    − Need for hydration and feeding by intravenous catheter/nasogastric tube.
    − Time to clinical stability defined as the time at which the following criteria are all met:
    • normalization of blood oxygen level (return to baseline; by pulse oximetry) without requirement of supplemental oxygen beyond baseline level
    •normalization of oral feeding
    •normalization of respiratory rate
    •normalization of heart rate
    − Improvement on the ordinal scale.
    − All-cause mortality.
    • RSV RNA viral load as measured by qRT-PCR of the mid-turbinate nasal swab specimens which will be used to determine the following:
    − Viral load over time.
    − Peak viral load, time to peak viral load, rate of decline of viral load, and time to RSV RNA being undetectable.
    − Proportion of subjects with undetectable viral load at each time point.
    − RSV RNA viral load AUC from immediately prior to first dose of study drug (baseline) until Day 10 and until Day 14.
    • Sequence changes (postbaseline) in the RSV polymerase L-gene and other regions (only if no mutations are seen in the L-gene) of the RSV genome compared with baseline sequences.
    • Safety/tolerability including adverse events (AEs), physical examinations, vital signs, electrocardiograms (ECGs), and clinical laboratory results.
    • Population-derived PK parameters of ALS-008112 and ALS-008144 (and other metabolites, if applicable).
    • Criterios de valoración de la evolución clínica del VRS:
     Duración de la estancia hospitalaria desde el ingreso hasta el alta y desde el inicio del tratamiento del estudio hasta el alta.
     Duración de la estancia hospitalaria desde el ingreso hasta la preparación para el alta y desde el inicio del tratamiento del estudio hasta la preparación para el alta, definida ésta por el investigador.
     Necesidad y duración de la estancia en la unidad de cuidados intensivos (UCI).
     Necesidad y duración de la administración de oxígeno (independientemente del método utilizado).
     Número de horas transcurridas hasta la saturación de oxígeno capilar periférico (SpO2) ≥ 93 % en el aire ambiente en pacientes que no estaban recibiendo oxígeno antes de su hospitalización actual.
     Retorno de la frecuencia respiratoria, la SpO2 y la temperatura corporal a los valores previos a la infección por el VRS.
     Necesidad y duración del uso de respiración asistida no invasiva (p. ej., presión positiva continua de las vías respiratorias) o invasiva (p. ej., ventilación mecánica endotraqueal o ventilación mecánica mediante traqueostomía).
     Tiempo hasta recuperar el estado funcional previo a la infección por el VRS (índice de Katz para la valoración de las AVD).
     Necesidad de hidratación y alimentación mediante catéter intravenoso (IV) o sonda nasogástrica.
     Tiempo hasta la estabilidad clínica, definido como el momento en el que se cumplen todos los criterios siguientes:
    o normalización de la concentración sanguínea de oxígeno (retorno a la situación basal; mediante pulsioximetría) sin necesidad de administración de oxígeno por encima del nivel basal
    o normalización de la alimentación oral
    o normalización de la frecuencia respiratoria
    o normalización de la frecuencia cardiaca
     Mejoría en la escala ordinal
     Muerte por cualquier causa
    • Se utilizará la carga viral del ARN del VRS medida mediante qRT-PCR en muestras obtenidas con torunda del cornete nasal medio con el fin de determinar lo siguiente:
     Carga viral a lo largo del tiempo.
     Carga viral máxima, tiempo hasta la carga viral máxima, velocidad de disminución de la carga viral y tiempo hasta que el ARN del VRS se hace indetectable.
     Proporción de pacientes con carga viral no detectable en cada momento evaluado.
     AUC de la carga viral de ARN del VRS inmediatamente antes de la administración de la primera dosis de la medicación del estudio (momento basal) hasta el día 10 y hasta el día 14.
    • Cambios de secuencia (posbasales) en el gen L de la polimerasa del VRS y otras regiones (únicamente si no se observan mutaciones en el gen L) del genoma del VRS en comparación con las secuencias basales.
    • Datos de seguridad/tolerabilidad que incluyen acontecimientos adversos (AA), exploraciones físicas, constantes vitales, electrocardiogramas (ECG) y resultados de los análisis clínicos.
    • Parámetros de FC poblacional de ALS-008112 y ALS-008144 (y otros metabolitos, si procede)
    E.5.2.1Timepoint(s) of evaluation of this end point
    As described in the endpoints
    Según lo descrito en los criterios de valoración
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    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.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA46
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Australia
    Belgium
    Brazil
    Bulgaria
    Canada
    France
    Germany
    Hong Kong
    Japan
    Korea, Republic of
    Malaysia
    Mexico
    Netherlands
    Poland
    Singapore
    Spain
    Sweden
    Switzerland
    Taiwan
    United Kingdom
    United States
    E.8.7Trial 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
    Last Subject Last Visit
    Última visita del último paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months2
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months2
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 45
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 45
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    When the patient is unable to read and write to give the consent, a legally acceptable representative must consent in name of patient. ICF includes a section for the consent of the legal representative
    Cuando el paciente no sea capaz de leer o escribir, un representante legal, debe consentir en nombre del paciente. El consentimiento informado incluye una sección para el consentimiento del representante legal.
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state8
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 45
    F.4.2.2In the whole clinical trial 90
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Patients will not receive IP after they have completed the trial and will be expected to get standard of care.
    Los pacientes no recibirán el fármaco del estudio después de haber completado el ensayo, los pacientes recibirán el tratamiento habitual.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2016-10-22
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-09-13
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
    P.Date of the global end of the trial2018-10-16
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