E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Paediatric Subjects with Asthma |
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E.1.1.1 | Medical condition in easily understood language |
Paediatric Subjects with Asthma |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10003553 |
E.1.2 | Term | Asthma |
E.1.2 | System Organ Class | 10038738 - Respiratory, thoracic and mediastinal 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 evaluate the magnitude of effect (with a level of precision) of inhaled FF 50 mcg versus inhaled placebo OD on growth velocity in prepubertal children over one year of treatment |
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E.2.2 | Secondary objectives of the trial |
To assess the safety of inhaled FF 50 mcg OD |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male or female subjects.
2. Age:
a. Males between 5 and <9 years old
b. Females between 5 and <8 years old
3. Subjects must be pre-pubertal (Tanner Stage 1).
4. Height centile between 3% and 97% based on US CDC charts.
5. Subjects with body weight and body mass index that is between 3rd and 97th centile based on the US CDC charts (provided in the Study Reference Manual [SRM]).
6. A documented history of symptoms consistent with a diagnosis of asthma for at least 6 months prior to Visit 1.
7. A pre-bronchodilatory FEV1 at Visit 1 (Screening) of ≥60%. There should be no SABA use within 4 hours of this measurement. NOTE: Only subjects who are unable to perform the FEV1 manoeuvre at their Visit 1 can, at the discretion of the investigator, attend the clinic to perform the manoeuvre once more on another day before Visit 2. This repeat FEV1 manoeuvre must be acceptable (as defined in the SRM) and must meet the FEV1 inclusion limits to be eligible for the study.
8. Able to replace their current SABA treatment with study supplied rescue albuterol/salbutamol provided at Visit 1 for use as needed for the duration of the study.
9. A cACT score of >19.
10. Patients should have required at least one course of corticosteroid for their asthma (inhaled or oral) in the past year.
There must be no ICS use within 6 weeks of Visit 1 (Screening).
There must be no oral corticosteroids use within 12 weeks of Visit 1 (Screening)
11. Using one or more of the following asthma therapies prior to entry into the study:
Short acting beta-agonist (SABA) inhaler alone (e.g. salbutamol) on an as needed basis and/or
Regular non-ICS controller medications for asthma (e.g. cromones or leukotriene receptor antagonists).
12. Written informed consent from at least one parent/care giver (legal guardian) and accompanying informed assent from the subject (where the subject is able to provide assent) prior to admission to the study.
If applicable, subject must be able and willing to give assent to take part in the study according to local requirement. The study investigator is accountable for determining a child's capacity to assent for participation in a research study, taking into consideration any standards set by the responsible IEC.
Subject and their legal guardian(s) understand that they must comply with study medication administration regimens and study assessments including recording of symptom scores and rescue albuterol/salbutamol use, attending all study visits, and being accessible by telephone. |
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E.4 | Principal exclusion criteria |
1. Growth Criteria:
a. Any previous or current condition that affects growth, including sleep disorders, endocrine disorders, skeletal dysplasia, Turner and Noonan syndromes, Marfan, Beckwith–Wiedeman and Sotos syndromes, Klinefelter’s syndrome, coeliac disease, inflammatory bowel diseases and renal failure or any significant abnormality or medical condition that is identified at the screening medical assessment (including serious psychological disorder) that is likely to interfere with the conduct of the study.
b. Subjects with premature adrenarche (further details will be provided in the SRM).
c. A child who is unable to stand, or who finds standing difficult due to illness or physical disabilities should be excluded.
2. Disease Criteria:
a. Subjects with a history of asthma exacerbation requiring the use of systemic corticosteroids (tablets, suspension, or injection) for at least 3 days or use of a depot corticosteroid injection within 3 months or those requiring hospitalisation for asthma (within 6 months) prior to screening.
b. Culture-documented or suspected bacterial or viral infection of the upper or lower respiratory tract, sinus or middle ear that is not resolved within 4 weeks of Visit 1 and led to a change in asthma management or, in the opinion of the Investigator, is expected to affect the subject’s asthma status or the subject’s ability to participate in the study.
c. Clinical visual evidence of candidiasis at Visit 1 (Screening).
d. Any significant abnormality or medical condition identified at the screening medical assessment that in the Investigator’s opinion, preclude entry into the study due to risk to the subject or that may interfere with the outcome of the study.
3. General:
a. Prior use of any medication or treatment that might affect growth including, but not limited to: amphetamines, anticonvulsants, biphosphonates, calcitonin, erythropoietin, growth hormone, methylphenidate, phosphate binders, antithyroid drugs (e.g., Methimazole) or thyroid hormone.
4. Use of any of the prohibited medications listed in Section 6.10.2.
5. Hypersensitivity: Known hypersensitivity to corticosteroids, leukotrienes, or any excipients in the ELLIPTA inhaler and study tablets.
6. Milk Protein Allergy: History of severe milk protein allergy.
7. The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current
study: 30 days, 5 half-lives or twice the duration of the biological effect of the
investigational product (whichever is longer).
8. Exposure to more than 4 investigational medicinal products within 12 months prior to the first dosing day.
9. Children who are an immediate family member of the participating Investigator, sub-Investigator, study coordinator, or employee of the participating Investigator.
10. The Parent or Guardian has a history of known or suspected psychiatric disease, intellectual deficiency, substance abuse or other condition (e.g. inability to read, comprehend or write) which may affect:
validity of consent to participate in the study
adequate supervision of the subject during the study
compliance of subject with study medication and study procedures
(e.g.completion of daily diary, attending scheduled clinic visits)
subject safety and well-being
11. Children in care: Children who are wards of the government or state are not eligible for participation in this study. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Growth Velocity (cm/yr) over the doubleblind treatment period, as determined by stadiometry
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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) |
Proportion of subjects below the 3rd percentile of growth velocity
Change in growth velocity quartiles from baseline to endpoint
Growth velocity over the first 12 weeks of double-blind treatment period
Height standard deviation scores (SDS) at each visit
Incidence of adverse events
Incidence of asthma exacerbations |
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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 | No |
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 | Yes |
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 | Yes |
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
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 15 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Argentina |
Poland |
Romania |
Russian Federation |
South Africa |
United States |
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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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The end of the study is defined as the last subject’s last visit. |
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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 | 9 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
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 |