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    Clinical Trial Results:
    Phase II study of first line treatment of Chronic Graft versus Host Disease with Arsenic Trioxide

    Summary
    EudraCT number
    2016-002358-18
    Trial protocol
    FR  
    Global end of trial date
    22 Jun 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Dec 2021
    First version publication date
    13 Dec 2021
    Other versions
    Summary report(s)
    GvHD-ATO Study Synopsis (extract from the CSR Version 1.0 – 29JUN21)

    Trial information

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    Trial identification
    Sponsor protocol code
    GMED16-001
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02966301
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    MEDSENIC
    Sponsor organisation address
    204 avenue de Colmar, Strasbourg, France, 67100
    Public contact
    François RIEGER, MEDSENIC, 33 671733159, fr@medsenic.org
    Scientific contact
    François RIEGER, MEDSENIC, 33 671733159, fr@medsenic.org
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    29 Jun 2021
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    22 Jun 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    22 Jun 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To improve the response rate (complete and partial remission) at 6 months after diagnosis of chronic graft versus host disease (GvHD) and treatment with arsenic trioxide (ATO) in combination with prednisone with or without ciclosporine as first line treatment
    Protection of trial subjects
    Each patient has been followed during the whole study with regular visits of follow up and SAE have been declared to the pharmacovigilance entity. Assessment of quality of live at each evaluation visit (Inclusion, W6, W14, M6, M9 and M12). In addition, a meeting of the IDMC of the study has been organized every year during the study (4 meetings) in order to review the safety data. Conclusions of these meetings have been included into the DSUR adressed to the national competent authorities.
    Background therapy
    No background therapy.
    Evidence for comparator
    Not applicable
    Actual start date of recruitment
    30 Nov 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 22
    Worldwide total number of subjects
    22
    EEA total number of subjects
    22
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    15
    From 65 to 84 years
    7
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Recruitment period from the 30/NOV/2016 (Toulouse-site 05) to the 03/JUN/2019 (Caen-site 06) in FRANCE. Last subject Last Visit : 22/JUN/2020.

    Pre-assignment
    Screening details
    Site 1 : 6 screened / 6 Included / 5 treated Site 2: 2 screened / 2 Included / 2 treated Site 3: 1 screened / 1 Included / 1 treated Site 5: 6 screened / 4 Included / 4 treated Site 6: 9 screened / 9 Included / 9 treated Site 8: 2 screened / 0 Included Site 9: 1 screened / 0 Included Site 10: 2 screened / 0 Included

    Period 1
    Period 1 title
    Baseline period
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    N/A

    Arms
    Arm title
    Arsenic Trioxide
    Arm description
    One group of treatment : 0.15mg/kg/d of arsenic trioxide
    Arm type
    Experimental

    Investigational medicinal product name
    Arsenic Trioxide
    Investigational medicinal product code
    Other name
    Trisenox,Arscimed
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    As soon as the diagnosis of chronic GvHD requiring systemic immunosuppressive therapy was confirmed, patients were included. They received corticosteroids at 1 mg/kg/day and Ciclosporine A (if relevant).

    Number of subjects in period 1 [1]
    Arsenic Trioxide
    Started
    21
    Completed
    21
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: On the 22 enrolled patients, 1 patient has not been treated due to rellapse of the leukemia immediately after enrollement. As a consequence, the "started" number of patients used in the baseline is 21, which is consistent with the Safety population.
    Period 2
    Period 2 title
    M6 period
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    N/A

    Arms
    Arm title
    Arsenic Trioxide
    Arm description
    One group of treatment : 0.15mg/kg/d of arsenic trioxide
    Arm type
    Experimental

    Investigational medicinal product name
    Arsenic Trioxide
    Investigational medicinal product code
    Other name
    Trisenox,Arscimed
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    As soon as the diagnosis of chronic GvHD requiring systemic immunosuppressive therapy was confirmed, patients received in addition to Ciclosporine A (if relevant) and corticosteroids 1 mg/kg/day, ATO 0.15 mg/kg/day over a 4 weeks period (one cycle). The treatment plan was indicative for one cycle (=11 infusions) within 10 days of starting Prednisone 1mg/kg/day. Patients in partial response after the 1st cycle of ATO were eligible to receive a second cycle of ATO as consolidation therapy. A delay of 8 weeks to a maximum of 11 weeks was to be observed between the two cycles of ATO therapy.

    Number of subjects in period 2
    Arsenic Trioxide
    Started
    21
    Completed
    20
    Not completed
    1
         Adverse event, non-fatal
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Baseline period
    Reporting group description
    -

    Reporting group values
    Baseline period Total
    Number of subjects
    21 21
    Age categorical
    Subjects are Adult patients (≥18 years)
    Units: Subjects
        Adults (≥18 years)
    21 21
    Gender categorical
    Male and female subjects
    Units: Subjects
        Male & Female
    21 21
    Subject analysis sets

    Subject analysis set title
    Full Analysis Set (FAS)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All patients who entered the study, completed their first cycle of ATO and for whom the response at Week 6 after diagnosis of chronic GvHD has been evaluated.

    Subject analysis set title
    Safety Analysis (SA)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All patients included in the study for whom there is any evidence that they received at least one ATO infusion

    Subject analysis set title
    Per Protocol (PP)
    Subject analysis set type
    Per protocol
    Subject analysis set description
    All patients who were in the FAS and did not have a major protocol deviation.

    Subject analysis sets values
    Full Analysis Set (FAS) Safety Analysis (SA) Per Protocol (PP)
    Number of subjects
    20
    21
    17
    Age categorical
    Subjects are Adult patients (≥18 years)
    Units: Subjects
        Adults (≥18 years)
    20
    21
    17
    Age continuous
    Units:
        
    ( )
    ( )
    ( )
    Gender categorical
    Male and female subjects
    Units: Subjects
        Male & Female
    20
    21
    17

    End points

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    End points reporting groups
    Reporting group title
    Arsenic Trioxide
    Reporting group description
    One group of treatment : 0.15mg/kg/d of arsenic trioxide
    Reporting group title
    Arsenic Trioxide
    Reporting group description
    One group of treatment : 0.15mg/kg/d of arsenic trioxide

    Subject analysis set title
    Full Analysis Set (FAS)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All patients who entered the study, completed their first cycle of ATO and for whom the response at Week 6 after diagnosis of chronic GvHD has been evaluated.

    Subject analysis set title
    Safety Analysis (SA)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All patients included in the study for whom there is any evidence that they received at least one ATO infusion

    Subject analysis set title
    Per Protocol (PP)
    Subject analysis set type
    Per protocol
    Subject analysis set description
    All patients who were in the FAS and did not have a major protocol deviation.

    Primary: Efficacy success

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    End point title
    Efficacy success [1]
    End point description
    Efficacy success was defined as the response (complete remission (CR) and partial remission (PR)) at 6 months after the first ATO infusion, with no secondary systemic therapy at any time.
    End point type
    Primary
    End point timeframe
    Month 6 after the first ATO infusion
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: One arm study, only percentage, no comparison.
    End point values
    Arsenic Trioxide Full Analysis Set (FAS) Per Protocol (PP)
    Number of subjects analysed
    20
    20
    17
    Units: Number of subjects
        Complete Remission (CR) and Partial Remission (PR)
    15
    15
    14
    No statistical analyses for this end point

    Secondary: Failure free survival

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    End point title
    Failure free survival
    End point description
    Treatment failure were defined by: - Initiation of a new systemic treatment for chronic GvHD; - Recurrent or progressive malignancy; - Death
    End point type
    Secondary
    End point timeframe
    Failure-free survival (FFS) was estimated at M6 and M12
    End point values
    Full Analysis Set (FAS)
    Number of subjects analysed
    20
    Units: Percentage
    arithmetic mean (confidence interval 95%)
        M6
    90 (65.6 to 97.4)
        M12
    65 (40.3 to 81.5)
    No statistical analyses for this end point

    Secondary: Non-relapse mortality (NRM)

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    End point title
    Non-relapse mortality (NRM)
    End point description
    Non-relapse mortality (NRM) of infectious and non-infectious origin
    End point type
    Secondary
    End point timeframe
    M6 and M12
    End point values
    Full Analysis Set (FAS)
    Number of subjects analysed
    20
    Units: Percentage
    arithmetic mean (confidence interval 95%)
        M6
    100 (100 to 100)
        M12
    5 (0.3 to 21.1)
    No statistical analyses for this end point

    Secondary: Overall survival (OS)

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    End point title
    Overall survival (OS)
    End point description
    overall survival (OS)
    End point type
    Secondary
    End point timeframe
    M6 and M12
    End point values
    Full Analysis Set (FAS)
    Number of subjects analysed
    20
    Units: Percentage
    arithmetic mean (confidence interval 95%)
        M6
    100 (100 to 100)
        M12
    95 (69.5 to 99.3)
    No statistical analyses for this end point

    Secondary: Sparing of corticotherapy

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    End point title
    Sparing of corticotherapy
    End point description
    patients from long-term use of corticosteroids (and their long-term side effects)
    End point type
    Secondary
    End point timeframe
    Dose from baseline, M6, and M12 (mg/kg per day)
    End point values
    Full Analysis Set (FAS)
    Number of subjects analysed
    20
    Units: dosage form
    arithmetic mean (standard error)
        Baseline
    0.92 ( 0.21 )
        M6
    0.22 ( 0.29 )
        M12
    0.08 ( 0.13 )
    Attachments
    Sparing corticosteroids
    No statistical analyses for this end point

    Secondary: Tolerability and safety

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    End point title
    Tolerability and safety
    End point description
    tolerability and safety of ATO in combination with Prednisone, with or without Ciclosporine, in patients with chronic GvHD after allo-SCT.
    End point type
    Secondary
    End point timeframe
    During the whole study
    End point values
    Arsenic Trioxide Safety Analysis (SA)
    Number of subjects analysed
    21
    21
    Units: AE & SAE number
        AE
    197
    197
        SAE
    22
    22
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    During the whole study.
    Adverse event reporting additional description
    197 AEs were reported in 21 patients, among which 22 in 9 patients were serious (SAEs). 14 AEs in 7 patients could not be excluded from being related to treatment. Among them, 2 were serious (2 hepatotoxicities) of which 1 led to patient withdrawal. 2 SAEs (one septic shock and one encephalopathy) both not related to the study product.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.1
    Reporting groups
    Reporting group title
    Safety population
    Reporting group description
    -

    Serious adverse events
    Safety population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    9 / 21 (42.86%)
         number of deaths (all causes)
    2
         number of deaths resulting from adverse events
    2
    Nervous system disorders
    Encephalopathy
    Additional description: Fatal encephalopathy started on Nov 15th, 2018 and led to patient’s death on Dec 28th, 2018, before this patient could perform M12 visit. Investigator considered that there was not related to the IMP.
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Epilepsy
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Pancytopenia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Oedema peripheral
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hepatitis acute
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Lung disorder
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory distress
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection viral
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Septic shock
    Additional description: The patient was hospitalized several times in 2017 for pneumopathy and pneumonia. On October the patient was hospitalized for septic shock. Investigator considered that the SAE is not related to the study product.
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Urinary tract infection
         subjects affected / exposed
    3 / 21 (14.29%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Genital herpes
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oropharyngeal candidiasis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Escherichia pyelonephritis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Safety population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    21 / 21 (100.00%)
    Vascular disorders
    Hyperaemia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    2
    Hypertension
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Thrombosis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Venous thrombosis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    3 / 21 (14.29%)
         occurrences all number
    3
    Chest pain
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Cyst
    Additional description: Related AE
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Face oedema
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Influenza like illness
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Medical device pain
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Mucosal inflammation
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Oedema peripheral
    Additional description: 1 related AE
         subjects affected / exposed
    7 / 21 (33.33%)
         occurrences all number
    8
    Pain
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Pyrexia
         subjects affected / exposed
    5 / 21 (23.81%)
         occurrences all number
    7
    Immune system disorders
    Drug hypersensitivity
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Hypogammaglobulinaemia
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Reproductive system and breast disorders
    Vulvovaginal dryness
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Vulvovaginal erythema
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    9 / 21 (42.86%)
         occurrences all number
    10
    Dyspnoea
         subjects affected / exposed
    3 / 21 (14.29%)
         occurrences all number
    3
    Epistaxis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Lung disorder
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Nasal congestion
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Obstructive airways disorder
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Pleural effusion
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Pulmonary mass
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Rales
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Respiratory distress
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Irritability
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Sleep disorder
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Investigations
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Cardiac murmur
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    CD4 lymphocytes decreased
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    2
    Electrocardiogram QT prolonged
    Additional description: Related AE
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Lumbar vertebral fracture
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Scar
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Atrial fibrillation
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Dysgeusia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Headache
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Paraesthesia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Peroneal nerve palsy
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Seizure
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anaemia
    Additional description: 1 related AE
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Thrombocytopenia
    Additional description: 1 related AE
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Eye disorders
    Dry eye
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Keratitis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Ocular discomfort
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    2
    Vision blurred
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Visual acuity reduced
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal pain
    Additional description: One AE related
         subjects affected / exposed
    3 / 21 (14.29%)
         occurrences all number
    4
    Abdominal pain upper
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Diarrhoea
    Additional description: 2 related AE
         subjects affected / exposed
    8 / 21 (38.10%)
         occurrences all number
    10
    Dysphagia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Haemorrhoids
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Mouth haemorrhage
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Nausea
    Additional description: One AE related
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Odynophagia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Rectal haemorrhage
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Vomiting
    Additional description: Related AE
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Hepatobiliary disorders
    Hepatocellular injury
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    4
    Skin and subcutaneous tissue disorders
    Dermatitis exfoliative generalised
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Eczema
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Erythema
         subjects affected / exposed
    3 / 21 (14.29%)
         occurrences all number
    3
    Ingrowing nail
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Lichenification
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Nail bed bleeding
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Endocrine disorders
    Cushing's syndrome
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Back pain
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    3
    Muscle spasms
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Myalgia
    Additional description: Related AE
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Campylobacter infection
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Conjunctivitis
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Cytomegalovirus infection
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    3
    Device related infection
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Epstein-Barr virus infection
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Escherichia urinary tract infection
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Fungal infection
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Genital herpes
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Genital infection fungal
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Klebsiella infection
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Oral herpes
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Pneumonia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Pseudomonal bacteraemia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Respiratory syncytial virus infection
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Rhinovirus infection
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Staphylococcal infection
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Staphylococcal sepsis
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Urinary tract infection
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    7
    Viral infection
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Vulvovaginal mycotic infection
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Fluid retention
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Hyperkalaemia
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Hypocalcaemia
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1
    Hypokalaemia
    Additional description: 1 related AE
         subjects affected / exposed
    4 / 21 (19.05%)
         occurrences all number
    5
    Hypomagnesaemia
         subjects affected / exposed
    2 / 21 (9.52%)
         occurrences all number
    2
    Malnutrition
         subjects affected / exposed
    1 / 21 (4.76%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    30 May 2017
    Protocol V4.0 Updating of the list of investigators. Modification of exclusion criteria for fitting with the clinical condition of patients with cGvHD. Precisions regarding the modalities of administration of ATO and associated treatments. Modifications of the study planning. Precisions regarding the conditioning of ATO. Precisions regarding the safety management. Extension of the inclusion period.
    06 Oct 2017
    Protocol V5.0 Replacement of the study treatment TRISENOX® (TEVA) by ARSCIMED® (Pierre Fabre) for newly included subjects.
    06 Mar 2018
    Protocol V.6.0 Extension of the inclusion period. Suppression of one exclusion criteria “GvHD occurring following donor lymphocytes infusion (DLI)”, in order to adapt the protocol at the current hospital practice, as the DLI is more and more used as a preventive treatment for recurrence of initial leukemia. Updating of the Sponsor’s mailing address. Updating of the list of investigators.
    18 Dec 2018
    Protocol V7.0 Extension of the inclusion period. Updating of the list of investigators. Modification of the section dealing data protection with GDPR law compliance.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Not applicable
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