E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Acute Respiratory Tract Infection Due to Respiratory Syncytial Virus Infection |
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E.1.1.1 | Medical condition in easily understood language |
Acute Respiratory Tract Infection Due to Respiratory Syncytial Virus Infection |
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E.1.1.2 | Therapeutic area | Diseases [C] - Virus Diseases [C02] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066740 |
E.1.2 | Term | Acute respiratory tract infection |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061603 |
E.1.2 | Term | Respiratory syncytial virus infection |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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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 establish antiviral activity of JNJ-53718678 as measured by respiratory syncytial virus(RSV) viral load in nasal swab samples by a quantitative reverse transcription polymerase chain reaction (qRT-PCR) assay in children ≥28 days and ≤3 years of age with RSV disease. |
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E.2.2 | Secondary objectives of the trial |
To evaluate in children ≥28 days and ≤3 years of age with RSV disease: ● the dose-response relationship for antiviral activity of JNJ-53718678 ● the impact of JNJ-53718678 on the clinical course of RSV infection ● the safety and tolerability of JNJ-53718678 after repeated oral doses ● the pharmacokinetics (PK) of JNJ-53718678 after repeated oral doses ● medical resource utilization
For all secondary objectives, please refer to the protocol |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Title: A Substudy of 53718678RSV2002 to Explore the Feasibility and Applicability of the Use of a Biosensor to Evaluate Cardio-respiratory Parameters in Pediatric Subjects ≥28 Days and ≤3 Years of Age With Acute Respiratory Tract Infection Due to Respiratory Syncytial Virus Infection Date: 07-September-2018 Version: Amendment 1 |
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E.3 | Principal inclusion criteria |
Each potential subject must satisfy all of the following criteria to be enrolled in the study: 1. The subject is a boy or girl ≥28 days and ≤3 years at the time of consent. 2. Each subject’s legally acceptable representative (ie, parent(s)/legal guardian) must sign an informed consent form (ICF) indicating that he or she understands the purpose of and procedures required for the study, is willing for their child to participate in the study, is willing for their child to remain in the hospital until at least Day 2 (even if not clinically indicated; Cohort 1 only), and is willing/able to adhere to the lifestyle restrictions specified in the protocol and study procedures and assessments to be performed by the parent(s)/caregiver(s) as well as those by the investigator/site staff. Note: Prior to signing the main consent form for the study, subject’s legally acceptable representative may specifically allow for the collection and testing of nasal mid - turbinate swab by signing the pre-screening (diagnostic) ICF. This is not required if a positive RSV diagnostic result based on a local SOC sample collected within 48 hours prior to anticipated randomization is available and used for determining study eligibility. 3. The subject has been diagnosed with RSV infection using a preferably rapid polymerase chain reaction (PCR) or other molecular-based diagnostic assay (preferred) or a rapid-antigen-detection assay. Note: If a subject had a positive similar RSV diagnostic test from another study for which (s)he was otherwise ineligible or a SOC test within 24 hours prior to start of screening and meets all eligibility criteria for inclusion in this study, this diagnostic test result can be used for confirmation of eligibility. Randomization should occur within 24 hours after start of screening or within 48 hours after collection of the SOC sample used for local RSV diagnosis, whichever comes first. Note: If a rapid-antigen-detection assay is used as part of SOC or study specifically (with the main study ICF or with the diagnostic ICF having been signed), the remainder of the screening sample used for the RSV diagnostic testing should be sent to the central laboratory for additional virologic analyses, as applicable. 4. Criterion modified per Amendment 6: 4.1 The subject has an acute respiratory illness with at least 1 of the signs/symptoms listed in each of the following categories within 24 hours prior to start of screening and at screening, as evaluated by the investigator: • URTI: nasal congestion, rhinorrhea, pharyngitis, or otitis media; AND • LRTI: increased respiratory effort (as evidenced by subcostal, intercostal or tracheosternal retractions, grunting, head bobbing, nasal flaring or tachypnea), abnormal breathing sounds (wheezing, rales or rhonchi), cyanosis, apnea, or cough (cough or wheezing should be accompanied by at least one additional LRTI sign/symptom in order to be eligible); AND • Systemic/general: feeding difficulties, defined as <75% intake of normal food amounts; dehydration; fever; disturbed sleep or disturbed activity level (irritable/restless/agitated/less responsive). 5. The time of onset of RSV symptoms to the anticipated time of randomization must be ≤5 days. Onset of symptoms is defined as the time of the day (or part of the day if time of the day cannot be specified) the parent(s)/caregiver(s) became(s) aware of the first sign and/or symptom consistent with respiratory or systemic/general manifestation of symptoms of RSV infection. The time of symptom onset has to be assessed as accurately as possible. Note: Subjects with symptom onset ≤3 days before randomization must account for a minimum of 45% of all enrolled subjects in Cohorts 1 and 2 (ie, maximum 55% of subjects could be enrolled in the >3 days to ≤5 days stratum). |
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E.4 | Principal exclusion criteria |
Any potential subject who meets any of the following criteria will be excluded from participating in the study: 1. The subject is <3 months postnatal age at screening and was born prematurely (ie, <37 weeks and 0 days of gestation). 2. The subject weighs <2.4 kilogram (kg) or ≥16.8 kg 3. The subject had major surgery within the 28 days prior to randomization or planned major surgery through the course of the study. 4. The subject has major congenital anomalies or known cytogenetic or metabolic disorders other than the ones allowed above. Note: Isolated open ductus arteriosus and open foramen ovale are not exclusionary as these are not considered major anomalies. Subjects with congenital heart disease, cystic fibrosis, congenital diaphragmatic hernia, or Down Syndrome are allowed to participate. 5. The subject is considered by the investigator to be immunocompromised within the past 12 months, whether due to underlying medical condition (eg, malignancy or genetic disorder other than immunoglobulin A deficiency, or known human immunodeficiency virus [HIV] infection) or medical therapy (eg, immunomodulators other than corticosteroids for the treatment of comorbidities, chemotherapy, radiation, stem cell or solid organ transplant). 6. Criterion modified per Amendment 4: 6.1 The subject has other clinically significant abnormal ECG findings not consistent with the present risk factor for severe RSV disease (if applicable) in the study population, as judged by the investigator based on the machine read ECG results at screening. 7. Criterion modified per Amendment 4: 7.1 The subject has a QTcF interval >450 ms per the machine read (mean of triplicate) parameter result confirmed by repeat triplicate ECG recording during screening. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint is the RSV viral load area under the curve (AUC) from immediately prior to first dose of study drug through Day 5 derived from the RSV viral load as measured by a qRT-PCR assay in nasal swabs. |
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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) |
1. Virologic parameters derived from the RSV viral load as measured by a qRT-PCR assay in nasal swabs including: a) RSV viral load and change from baseline over time b) RSV viral load AUC from immediately prior to first dose of study drug (baseline) through Day 3, Day 8, and Day 14 c) time to undetectable RSV viral load d) proportion of subjects with undetectable RSV viral load at each timepoint throughout the study 2. Clinical course related endpoints - In hospitalized subjects and outpatients (these endpoints will be based on the Pediatric RSV Electronic Severity and Outcome Rating System [PRESORS] assessed throughout the study by parent(s)/caregiver(s) (parent[s]/caregiver[s] PRESORS) and by the investigator (clinician PRESORS) during scheduled visits): a) duration and severity of signs and symptoms of RSV disease b) change from baseline in parent(s)/caregiver(s) PRESORS scores (worsening or improvement) c) change from baseline in clinician PRESORS scores (worsening or improvement) d) time to resolution (ie, to none or mild) of RSV symptoms e) time to improvement based on general questions on overall health f) proportion of subjects with improvement or worsening of RSV disease based on general questions on overall health g) time to return to pre-RSV health as rated by the parent(s)/caregiver(s) In hospitalized subjects only: h) time to age-adjusted normal values for otherwise healthy and to pre-RSV infection status for subjects with (a) risk factor(s) for severe RSV disease, for heart rate, respiratory rate, and/or blood oxygen level (ie, without requirement of supplemental oxygen compared with pre-RSV infection status) i) time to discharge (from initial admission and from initiation of treatment) j) time to clinical stability, with clinical stability evaluated by the investigator (from initial admission and from initiation of treatment) 3. Safety and tolerability, as assessed by adverse events (AEs), clinical laboratory testing, electrocardiograms (ECGs), vital signs, throughout the study 4. PK parameters of JNJ-53718678, as determined by population PK (popPK) modeling 5. Medical resource utilization For all secondary endpoints, please refer to the protocol |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1a, 1c and 1d. Throughout the study 1b. Through Day (D)3, D8, and D14 2a to 2j and 3. Throughout the study 4. Cohort 1: D1 and D2. Cohort 2: D1 and D3 or D5 5 Throughout the study For all timepoints, please refer to the protocol |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Biomarker analyses, Pharmacokinetic/Pharmacodynamic Relationships, Medical Resource Utilization Analyses, Acceptability and Palatability |
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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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 71 |
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 |
Brazil |
Japan |
Korea, Democratic People's Republic of |
Malaysia |
Mexico |
Russian Federation |
South Africa |
Taiwan |
Thailand |
Turkey |
United States |
Belgium |
France |
Germany |
Hungary |
Italy |
Poland |
Sweden |
United Kingdom |
Bulgaria |
Spain |
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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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 19 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
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 | 19 |