E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
IDIOPATHIC PULMONARY FIBROSIS |
|
E.1.1.1 | Medical condition in easily understood language |
chronic, progressive disease that causes scarring (fibrosis) in lungs |
|
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 | LLT |
E.1.2 | Classification code | 10067761 |
E.1.2 | Term | Exacerbation of idiopathic pulmonary fibrosis |
E.1.2 | System Organ Class | 100000004855 |
|
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 |
To evaluate the effect of CC-90001, 200 mg and 400 mg, when orally administered (PO) once
daily (QD), compared with placebo, on percent of predicted forced vital capacity (FVC) after
24 weeks of treatment in subjects with IPF. |
|
E.2.2 | Secondary objectives of the trial |
To evaluate the effects of CC-90001, 200 mg and 400 mg PO QD, compared to placebo, after 24 weeks of treatment in subjects with IPF, on:
- FVC (milliliters [mL])
- Six-minute Walk Test (6MWT)
- Disease progression
- Heath-related quality of life: St. George’s Respiratory Questionnaire (SGRQ) and University of California San Diego-Shortness of Breath Questionnaire (UCSDSOBQ)
- Dose response
- Safety and tolerability |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Subject is male or female ≥ 40 years of age at the time of signing the
informed consent form (ICF)
2. Subject must understand and voluntarily sign an ICF prior to any
study-related assessments/procedures being conducted
3. Subject is willing and able to adhere to the study visit schedule and
other protocol requirements
4. Investigator has considered all available IPF treatment options with
the potential subject before consenting the subject for participation in
the study
5. Subject was diagnosed with IPF within 5 years of Screening.
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6. Diagnosis of IPF is supported by HRCT, as described in Table 3 and
Appendix G of the Protocol.
7. Extent of fibrotic changes (eg, honeycombing, reticular changes)
greater than the extent of emphysema on HRCT scan, as determined by
centralized review
8. No features supporting an alternative diagnosis on transbronchial
biopsy, bronchoalveolar lavage (BAL), or SLB, if performed prior to
Screening
9. Percent predicted forced vital capacity (% FVC) ≥ 45% and ≤ 95% at
Screening confirmed by centralized review
10. Change in FVC (measured in milliliters [mL]) between Screening and
Day 1 less than a 10% relative difference, calculated as: the absolute
value of 100% * (Screening FVC [mL] - Day 1 FVC [mL]) / Screening FVC
(mL)
11. Hemoglobin-corrected percent predicted diffusion capacity of the
lung for carbon monoxide (DLCO) ≥ 25% and ≤ 90% predicted at
Screening
12. Able to walk ≥ 150 meters during the 6-minute walk test (6MWT) at
Screening
13. Females of childbearing potential (FCBP) must:
a. Have two negative pregnancy tests as verified by the Investigator
prior to starting IP. She must agree to ongoing pregnancy testing during
the course of the study, and after end of study treatment. This applies
even if the subject practices true abstinence* from heterosexual contact.
b. Either commit to true abstinence* from heterosexual contact (which
must be reviewed on a monthly basis and source documented) or agree
to use two effective birth control methods (for example: birth control
pills, condoms, etc) at the same time, and be able to comply with,
effective contraception without interruption, 28 days prior to starting IP,
during the study therapy (including dose interruptions), and for 28 days
after discontinuation of IP
14. Male subjects must:
Practice true abstinence (which must be reviewed on a monthly basis)
or agree to use condoms not made out of natural [animal] membrane
during sexual contact with a pregnant female or a female of childbearing
potential while participating in the study, during dose interruptions and
for at least 28 days following IP discontinuation, even if he has
undergone a successful vasectomy. |
|
E.4 | Principal exclusion criteria |
1. Subject has any significant medical condition, laboratory abnormality,
or psychiatric illness that would prevent the subject from participating in
the study
2. Subject has any condition including the presence of laboratory
abnormalities, which places the subject at unacceptable risk if he/she
were to participate in the study
3. Subject has any condition that confounds the ability to interpret data
from the study
4. Significant clinical worsening of IPF between Screening and Baseline
(Visit 2), in the opinion of the Investigator
5. Subjects with any of the following laboratory criteria:
• White blood cell count (WBC) < 3500/mm3 (< 3.5 X 109/L) or >
14,000/mm3 (> 14 X 109/L)
• Platelet count < 120,000/μL (< 120 X 109/L)
• Serum creatinine > 1.5 mg/dL (> 132.6 μmol/L)
• Aspartate aminotransferase (AST/SGOT) > 1.5 X upper limit of normal
(ULN)
• Alanine aminotransferase (ALT/SGPT) > 1.5 X upper limit of normal
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(ULN)
• Total bilirubin > 2 mg/dL (> 34.2 μmol/L)
• Hemoglobin < 10 g/dL (< 100 g/L)
6. Subject with a QTcF > 450 msec
7. Any condition other than IPF that in the opinion of the Investigator is
likely to result in the death of the subject within the next year
8. Inability to obtain reproducible, high-quality pulmonary function tests.
9. Evidence of clinically relevant airways obstruction (ie, FEV1/FVC <
0.7) at Screening and/or significant respiratory disorder/pathology (eg,
pulmonary arterial hypertension requiring treatment, asthma,
tuberculosis, sarcoidosis, hypersensitivity pneumonitis, aspergillosis,
asbestosis, neoplastic disease, cystic fibrosis or other interstitial lung
disease) other than IPF
10. Subject is likely to have lung transplantation during the first 24
weeks of the study (being on transplantation list is acceptable for
participation)
11. Impairment (other than dyspnea) limiting the ability to comply with
study requirements (eg, pulmonary function tests, 6-minute walk test)
12. Subjects using any therapy targeted to treat IPF including, but not
limited to, pirfenidone, nintedanib, endothelium receptor antagonists
(eg, bosentan, ambrisentan), interferon gamma-1b, imatinib mesylate,
N-acetylcysteine, azathioprine, cyclophosphamide, methotrexate,
mycophenolate mofetil, and cyclosporine, oral steroids (eg, prednisone >
12.5 mg/day or equivalent) and oral anticoagulants within 4 weeks of
the Screening Visit. (Note: Oral anticoagulants for conditions other than
IPF are permitted. Subjects should not discontinue any of these
therapies for the sole purpose of participating in this study.)
13. Use of any cytokine modulator/biologic, such as etanercept,
adalimumab, efalizumab, infliximab, or rituximab within 12 weeks of
randomization
14. Use of an inhaled long-acting bronchodilator within 24 hours of the
Screening Visit or short-acting bronchodilator within 8 hours of the
Screening Visit
15. Use of drugs that are known to cause hepatotoxicity, such as, but not
limited to, acetaminophen (paracetamol) at dosages of > 3 grams/day
and niacin dosage of > 2 grams/day while on study or within 2 weeks of
first dose of IP
16. Use of any medications that are substrates of one or more of the
transporters P-gp, BCRP, OAT3, OATP1B1, OATP1B3, and OCT2 and have
a narrow therapeutic index (eg, digoxin, mycophenolate mofetil)
17. History of recent (within 6 months of Screening) deep vein
thrombosis (DVT) or pulmonary embolism (PE) and/or recurrent DVT or
recurrent PE
18. History of cardiac valve replacement requiring chronic
anticoagulation therapy
19. History of congenital and/or acquired immunodeficiencies (eg,
common variable immunodeficiency, human immunodeficiency virus
[HIV], etc)
20. History of hepatitis B and/or hepatitis C, including those considered
successfully treated/cured
21. Active or history of recurrent bacterial, viral, fungal, mycobacterial
or other infections (including, but not limited to, atypical mycobacterial
disease and herpes zoster), or any major episode of infection requiring
hospitalization or treatment with intravenous or oral antibiotics within 4
weeks of the Screening Visit and at any time during the Screening Phase,
up through the first dose of IP
22. History of latent or active TB, unless there is medical record
documentation of successful completion of a standard course of
treatment
23. Clinical diagnosis of any connective tissue disease, including, but not
limited to, scleroderma, polymyositis/dermatomyositis, systemic lupus
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erythematosus, and rheumatoid arthritis
24. History of end-stage renal disease requiring dialysis
25. History of severe hepatic impairment or end-stage liver disease
26. History of Gilbert's syndrome
27. History of alcohol or drug abuse within 6 months prior to Screening
Please refer to the Protocol for the full list of exclusion criteria |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Forced vital capacity (FVC) - Percentage point change in % predicted FVC |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
1. FVC - Absolute change and rate of decline in FVC (expressed in mL)
2. 6-minute Walk Test (6MWT) with Borg Scale:
- Change in the distance walked during the 6MWT as measured in meters (m)
- Change in dyspnea rating on Borg Scale
3. Disease progression:
- Death from respiratory failure, or
- Absolute decrease of ≥ 10% from baseline in % predicted FVC at two consecutive evaluations at a minimum of 4 weeks between evaluations, or
- Decrease from baseline of ≥ 50 meters in 6MWT distance (in the absence of a readily explainable cause, such as injury or trauma), or
- Unexplained worsening hypoxemia (an absolute decrease from baseline of 4% or more in SpO2).
4. Quality of life :
- Change from Baseline in total score and domains including cough on the Saint George’s Respiratory Questionnaire (SGRQ)
- Change from Baseline in the University of California San Diego Shortness of Breath Questionnaire (UCSD- SOBQ)
5. Safety and tolerability - Type, frequency, severity, and relationship of AEs, clinical laboratory tests including urine cytology, 12-lead ECG, vital signs, and physical examination |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. FVC - Baseline through Week 24
2. 6-minute Walk Test (6MWT) with Borg Scale:
- Baseline through Week 24;
- Baseline through Week 52;
- Week 24 through Week 52
3. Disease progression - Baseline through Week 24
4. Quality of life - Baseline through Week 24
5. Safety and tolerability - Signing of the informed consent form through Week 56 (4-week post-treatment observational follow-up) |
|
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 | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
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 | 3 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 21 |
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 |
Australia |
Brazil |
Canada |
Colombia |
France |
Germany |
Greece |
Romania |
Russian Federation |
Taiwan |
Turkey |
United Kingdom |
United States |
|
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
|
|
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 | 8 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 8 |