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    Summary
    EudraCT Number:2016-002629-13
    Sponsor's Protocol Code Number:CY4033
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-01-20
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2016-002629-13
    A.3Full title of the trial
    A Phase 3, Open-Label Extension Study of Tirasemtiv for Patients with Amyotrophic Lateral Sclerosis (ALS) who Completed VITALITY-ALS (CY 4031)
    Studio di estensione di fase 3 in aperto di tirasemtiv per pazienti con sclerosi laterale amiotrofica (SLA) che hanno completato VITALITY-ALS (CY 4031)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    An Open-Label Extension Study for Patients Who Completed VITALITY-ALS (CY 4031)
    Studio di estensione di fase 3 in aperto per pazienti che hanno completato VITALITY-ALS (CY 4031)
    A.3.2Name or abbreviated title of the trial where available
    VIGOR-ALS
    VIGOR-ALS
    A.4.1Sponsor's protocol code numberCY4033
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02936635
    A.5.4Other Identifiers
    Name:-Number:-
    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 SponsorCYTOKINETICS, INC.
    B.1.3.4CountryUnited States
    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 supportCytokinetics, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCytokinetics, Inc.
    B.5.2Functional name of contact pointMedical Affairs
    B.5.3 Address:
    B.5.3.1Street Address280 East Grand Avenue
    B.5.3.2Town/ citySouth San Francisco, California
    B.5.3.3Post code94080
    B.5.3.4CountryUnited States
    B.5.4Telephone number001650 6242929
    B.5.5Fax number0
    B.5.6E-mailmedicalaffairs@cytokinetics.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 Yes
    D.2.5.1Orphan drug designation numberEU/3/12/970
    D.3 Description of the IMP
    D.3.1Product nameTirasemtiv
    D.3.2Product code CK-2017357
    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 INNTirasemtiv
    D.3.9.1CAS number 1005491-05-3
    D.3.9.2Current sponsor codeCK-2017357
    D.3.9.3Other descriptive name6-ethynyl-1-(pentan-3-yl)-1H-imidazo[4,5-b]pyrazin-2(3H)-one
    D.3.9.4EV Substance CodeSUB93455
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number125
    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
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Amyotrophic Lateral Sclerosis (ALS)
    Sclerosi Laterale Amiotrofica (SLA)
    E.1.1.1Medical condition in easily understood language
    Amyotrophic lateral sclerosis, or ALS, is a disease of the nerve cells in the brain and spinal cord that control voluntary muscle movement.
    Sclerosi laterale amiotrofica o SLA, che è una patologia delle cellule nervose del cervello e del midollo spinale che controllano il movimento volontario del muscolo.
    E.1.1.2Therapeutic area Diseases [C] - Nervous System Diseases [C10]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10002026
    E.1.2Term Amyotrophic lateral sclerosis
    E.1.2System Organ Class 10029205 - Nervous system disorders
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective is to assess the long-term safety and tolerability of tirasemtiv, in patients with ALS.
    L’obiettivo primario è di valutare la sicurezza e la tollerabilità a lungo termine di tirasemtiv nei pazienti con SLA.
    E.2.2Secondary objectives of the trial
    • To compare the clinical course of patients who completed treatment with tirasemtiv in CY 4031 with those who completed treatment with placebo in CY 4031 during continued treatment of both groups with tirasemtiv during CY 4033
    • To compare the clinical course of patients who completed treatment with tirasemtiv in CY 4031 during that study with their clinical course during continued treatment with tirasemtiv during CY 4033
    • To compare the clinical course of patients who completed treatment with placebo in CY 4031 during that study with their clinical course during treatment with tirasemtiv during CY 4033
    • Confrontare il decorso clinico dei pazienti che hanno completato il trattamento con tirasemtiv in CY 4031 con quello di coloro che hanno completato il trattamento con placebo in CY 4031 durante il proseguimento del trattamento con tirasemtiv di entrambi i gruppi nel corso di CY 4033
    • Confrontare il decorso clinico dei pazienti che hanno completato il trattamento con tirasemtiv in CY 4031 durante quello studio con il loro decorso clinico durante il proseguimento del trattamento con tirasemtiv nel corso di CY 4033
    • Confrontare il decorso clinico dei pazienti che hanno completato il trattamento con placebo in CY 4031 durante quello studio con il loro decorso clinico durante il trattamento con tirasemtiv nel corso di CY 4033.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Able to comprehend and willing to sign an Informed Consent Form (ICF). If verbal consent is given, a Legal Designee of the patient must sign the ICF form
    2. Completed participation on study drug and the Follow-Up Visit in the CY 4031 study
    3. Male patients, who have not had a vasectomy AND confirmed zero sperm count, must agree for the duration of their participation in the study to either:
    a. Use a condom during sexual intercourse with female partners who are of childbearing potential (i.e., following menarche until post-menopausal if not anatomically and physiologically incapable of becoming pregnant) AND to have female partners use a highly effective means of contraception (see below):
    OR
    b. Abstain from sexual intercourse during participation in the study.
    4. Female patients who are not post-menopausal (= 1 year) or sterilized, must:
    a. Not be breastfeeding
    b. Have a negative pregnancy test
    c. Have no intention to become pregnant during participation in the study,
    AND
    d. Practice sexual abstinence, defined as refraining from intercourse during the duration of the study OR if male partners are not vasectomized with a confirmed zero sperm count, require use of a condom AND use of a highly effective contraceptive measure, for the duration of the study such as:
    - Combined (estrogen and progestogen containing) oral, intravaginal, or transdermal hormonal contraception associated with inhibition of ovulation
    - Progestogen-only oral, injectable, or implantable hormonal contraception associated with inhibition of ovulation
    - Intrauterine device (IUD)
    - Intrauterine hormone-releasing system (IUS)
    - Bilateral tubal occlusion
    1. In grado di comprendere e disposto a firmare un modulo di consenso informato (informed consent form, ICF). Se viene fornito il consenso verbale, un rappresentante legale del paziente deve firmare il modulo ICF
    2. Ha completato la partecipazione con il farmaco in studio e la Visita di follow-up dello studio CY 4031
    3. I pazienti di sesso maschile, che non hanno avuto una vasectomia E una conta spermatica confermata pari a zero, devono accettare per la durata della loro partecipazione allo studio di:
    a. Utilizzare un preservativo durante i rapporti sessuali con compagne di sesso femminile in età fertile (ossia dal menarca fino alla post-menopausa se non anatomicamente e fisiologicamente incapaci di iniziare una gravidanza) E far usare alle compagne di sesso femminile un metodo contraccettivo altamente efficace (vedere di seguito)
    OPPURE
    b. Astenersi dai rapporti sessuali durante la partecipazione allo studio
    4. Le pazienti di sesso femminile che non sono in menopausa (=1 anno) o sterili, devono:
    a. Astenersi dall’allattare al seno
    b. Avere un test di gravidanza negativo
    c. Non avere alcuna intenzione di iniziare una gravidanza durante la partecipazione allo studio
    E
    d. Praticare l’astinenza sessuale, definita come l’astenersi dai rapporti sessuali nel corso della durata dello studio OPPURE, se i compagni di sesso maschile non hanno avuto una vasectomia con una conta spermatica confermata pari a zero, richiedere l’uso di un preservativo E utilizzare un metodo contraccettivo altamente efficace per l’intera durata dello studio, quale:
    - Contraccezione ormonale orale, intravaginale o transdermica combinata (a base di estrogeni e progestinici) associata all’inibizione dell’ovulazione
    - Contraccezione ormonale orale, iniettabile o impiantabile a base di soli progestinici associata all’inibizione dell’ovulazione
    - Dispositivo intrauterino (intrauterine device, IUD)
    - sistema di rilascio ormonale intrauterino (intrauterine system, IUS)
    - Occlusione bilaterale delle tube
    E.4Principal exclusion criteria
    1. Has a diaphragm pacing system (DPS) at study entry or anticipate DPS placement during the course of the study
    2. Has taken any investigational study drug (other than tirasemtiv) prior to dosing, within 30 days or five half-lives of the prior agent, whichever is greater
    3. Use of tizanidine and theophylline-containing medications during study participation
    4. Participation or planning to participate in another clinical trial involving stem cell therapy for the treatment of ALS or another investigational drug
    1. Ha un sistema di pacing diaframmatico (diaphragm pacing system, DPS) al momento dell’ingresso nello studio o prevede un impianto di DPS durante lo studio
    2. Ha assunto un farmaco in studio sperimentale (diverso da tirasemtiv) entro 30 giorni o cinque emivite dell’agente precedente, a seconda di quale periodo sia maggiore, prima della somministrazione
    3. Uso di farmaci contenenti tizanidina e teofillina durante la partecipazione allo studio
    4. Partecipazione o intenzione di partecipare a qualsiasi forma di terapia con cellule staminali per il trattamento della SLA o con altro farmaco sperimentale
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint is the incidence of adverse events (AEs) in the patient population.
    L'endpoint primario consiste nel rilevare l'incidenza degli eventi avversi (EA) nella popolazione di pazienti
    E.5.1.1Timepoint(s) of evaluation of this end point
    Entire duration of the study.
    Intera durata dello studio
    E.5.2Secondary end point(s)
    • Time to first use of assisted ventilation or death
    • Time to the first occurrence of respiratory insufficiency (defined as tracheostomy or the use of non-invasive ventilation for =22 hours per day for =10 consecutive days) or death
    • Time to death
    • Decline in percent predicted SVC from baseline
    • Decline in ALSFRS-R score from baseline
    • Slope of the change from baseline in percent predicted SVC
    • Slope of the change from baseline in ALSFRS-R
    • Tempo al primo utilizzo della ventilazione assistita o al decesso
    • Tempo alla prima insorgenza di insufficienza respiratoria (definita come tracheotomia oppure uso di ventilazione non invasiva (VNI) per =22 ore al giorno per =10 giorni consecutivi) o al decesso
    • Tempo al decesso
    • Riduzione della percentuale prevista di capacità vitale lenta (slow vital capacity, SVC) rispetto al basale
    • Riduzione nel punteggio della scala–rivista di valutazione funzionale della SLA (ALS functional rating scale–Revised, ALSFRS-R) rispetto al basale
    • Pendenza della variazione rispetto al basale della percentuale prevista di SVC
    • Pendenza della variazione rispetto al basale di ALSFRS-R
    E.5.2.1Timepoint(s) of evaluation of this end point
    The time to event endpoints will be assessed from the start of CY 4031 and from the start of CY 4033 to the end of CY 4033. The change from baseline endpoints will be assessed from the start of CY 4031 and from the start of CY 4033 to Week 24 and Week 48 of CY 4033. The slope of change endpoints will be assessed during the first 24 weeks and first 48 weeks of either CY 4031 or CY 4033.
    Gli endpoint relativi al tempo all’evento saranno valutati dall’inizio di CY 4031 e dall’inizio di CY 4033 fino alla fine di CY 4033. Gli endpoint relativi alla variazione rispetto al basale saranno valutati dall’inizio di CY 4031 e dall’inizio di CY 4033 fino alla Settimana 24 e alla Settimana 48 di CY 4033. Gli endpoint relativi alla pendenza della variazione saranno valutati durante le prime 24 settimane e le prime 48 settimane di CY 4031 o CY 4033.
    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 Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    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 No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    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 concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA21
    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 Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Canada
    United States
    Belgium
    France
    Germany
    Ireland
    Netherlands
    Portugal
    Spain
    United Kingdom
    E.8.7Trial 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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months0
    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: 250
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 100
    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 Yes
    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 No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state32
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 114
    F.4.2.2In the whole clinical trial 350
    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)
    None
    Nessuno
    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 Decision2017-02-23
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-03-28
    P. End of Trial
    P.End of Trial StatusCompleted
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