E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Nephrotic syndrome relapse in children |
Recidief nefrotisch syndroom in kinderen |
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E.1.1.1 | Medical condition in easily understood language |
Nephrotic syndrome relapse in children |
Recidief nefrotisch syndroom in kinderen |
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E.1.1.2 | Therapeutic area | Not possible to specify |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10029172 |
E.1.2 | Term | Nephrotic syndrome with unspecified pathological lesion in kidney |
E.1.2 | System Organ Class | 10038359 - Renal and urinary disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10029164 |
E.1.2 | Term | Nephrotic syndrome |
E.1.2 | System Organ Class | 10038359 - Renal and urinary disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10029168 |
E.1.2 | Term | Nephrotic syndrome with lesion of minimal change glomerulonephritis |
E.1.2 | System Organ Class | 10038359 - Renal and urinary disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10042826 |
E.1.2 | Term | Syndrome nephrotic |
E.1.2 | System Organ Class | 10038359 - Renal and urinary disorders |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Primary Objective:
To study the effectiveness of a reduced steroid schedule for the treatment of a relapse in children with steroid sensitive nephrotic syndrome.
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E.2.2 | Secondary objectives of the trial |
Secondary Objective(s):
• To study the influence of maintenance immunosuppressive therapy on the effectiveness of a reduced steroid schedule for the treatment of a relapse in children with steroid sensitive nephrotic syndrome;
• To study the course of relapses in children with nephrotic syndrome under the standard treatment regimen;
• To study the influence of maintenance immunosuppressive therapy on the course of relapses in children with nephrotic syndrome under the standard treatment regimen.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Age over 1 and less than 18 years;
• Steroid sensitive nephrotic syndrome;
• At least 1 nephrotic syndrome relapse in the preceding 24 months that was treated with prednisolone;
• The last prednisolone use (at a dose over 10mg/m2 on alternate days) for the treatment of a previous episode was at least 4 weeks ago;
• Signed informed consent from the parent or legal assent and/or the patient, depending on the age of the patient.
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E.4 | Principal exclusion criteria |
• Steroid resistant nephrotic syndrome;
• Receiving, or within 3 months after receiving, cyclophosphamide or rituximab;
• Daily prednisolone maintenance therapy at any dose;
• Alternate day prednisolone maintenance therapy at a dose over 4 mg/m2;
• Documented or suspected significant non-compliance;
• Pregnancy;
• Stimulant drug use;
• Comorbidity;
- Kidney transplant patients
- Any disease that requires the variation in oral prednisolone to be at the discretion of the treating physician(s);
• Concomitant use of drugs that induce CYP3A4: carbamazepine, phenobarbital, phenytoin and/or rifampicin;
• Concomitant use of drugs that inhibit CYP3A4: ketaconazole, itraconazole, ritonavir, indinavir, macrolide antibiotics (erythromycin), diltiazem, verapamil.
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E.5 End points |
E.5.1 | Primary end point(s) |
Time to first relapse after study randomization (censored at 12 and 24 months) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
• Number of relapses after study randomization at 12 or 24 months
• Development of frequent relapsing nephrotic syndrome according to KDIGO criteria (four or more relapses in any 12-month period)
• Development of steroid dependent nephrotic syndrome according to KDIGO criteria (two consecutive relapses during corticosteroid therapy, or within 14 days of ceasing therapy)
• Cumulative dosage of prednisolone during study period (at 12 and 24 months)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | 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 | 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) | 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 | 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 | 2 |
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 | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 8 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The end of the trial is reached when the last patient has fulfilled the follow up of 24 months since the last day of the study medication. |
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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 | 4 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 4 |