E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
The medical condition to be investigated is idiopathic non-histaminergic angioedema (InH-AAE). This disease is characterized by recurrent episodes with swelling of the subcutis and mucous membranes. Patient with InH-AAE have by defenition no wheals and are nonresponsive to anti-histamine therapy. |
Het te onderzoeken ziektebeeld is idiopatisch non-histaminerg verworven angio-oedeem (InH-AAE). Deze aandoening wordt gekenmerkt door recidiverende episodes met zwellingen in de subcutis en mucosa. InH-AAE patienten hebben per definitie geen urticaria en reageren niet op antihistaminica. |
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E.1.1.1 | Medical condition in easily understood language |
The medical condition to be investigated is idiopathic non-histaminergic angioedema (InH-AAE). This disease is characterized by recurrent episodes with swelling of the skin and mucous membranes. |
Het te onderzoeken ziektebeeld is idiopatisch non-histaminerg verworven angio-oedeem (InH-AAE). Deze aandoening wordt gekenmerkt door recidiverende episodes met zwellingen in de subcutis en mucosa. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
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 |
The primary objective of this exploratory study is to test if prophylactic treatment with conestat alfa decreases the frequency of angioedema attacks in patients with idiopathic non-histaminergic acquired angioedema. |
Het primaire doel van deze exploratieve studie is om te testen of profylactische behandeling met conestat alfa de aanvalsfrequentie van angio-oedeem by patiënten met idiopatisch non-histaminerg verworven angio-oedeem verminderd. |
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E.2.2 | Secondary objectives of the trial |
To test if prophylactic use of conestat alfa decreases disease activity in patients with InH-AAE.
To test if prophylactic use of conestat alfa improves the quality of life in patients with InH-AAE.
To establish the safety of prophylactic use of Conestat alfa in patients with InH-AAE.
To examine potential biomarkers for disease activity, response to treatment and predictive value for response to treatment.
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Het effect van profylactisch conestat alfa gebruik bij patiënten met InH-AAE op ziekte activiteit.
Het effect van profylactisch conestat alfa gebruik bij patiënten met InH-AAE op kwaliteit van leven.
Vaststellen van de veiligheid van profylactisch gebruik van conestat alfa bij patiënten met InH-AAE.
Onderzoek naar potentiele biomarkers voor ziekte activiteit, therapierespons, en predictie van therapierespons. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Age ≥ 18 years.
Diagnosis idiopathic non-histaminergic acquired angioedema (InH-AAE) were “non-histaminergic” is defined as following: insufficient effect of treatment with antihistamines up to 4 times the standard dose (step 2 in CSU-treatment regimen), defined as having breakthrough attacks.
Minimal mean attack rate of 2 per month during the past six months despite treatment; with at least one attack in the month prior to inclusion.
Normal C4 levels.
Written informed consent. |
Leeftijd ≥ 18 jaar
Diagnose idiopathic non-histaminerg verworven angio-oedema (InH-AAE) waarbij “non-histaminerg” alsvolgt is gedefinieerd: onvoldoende effect van behandeling met antihistaminica met maximaal 4 keer de standaard dosis (stap 2 in CSU-behandelingsprotocol), gedefinieerd als het voorkomen van doorbraak aanvallen.
Minimale aanvalsfrequentie van 2 per maand gedurende de afgelopen 6 maanden ondanks behandeling met anti-histaminica; met ten minste één angio-oedeem aanval in de maand voorafgaande aan studie-inclusie.
Normale C4 levels.
Getekend informed consent. |
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E.4 | Principal exclusion criteria |
Presence of recurrent wheals/ urticaria accompanying angioedema.
Diagnosis other than InH-AAE is deemed more likely.
ACE-inhibitor use in the past 6 months.
History suggesting allergy for rabbits or rabbit derived products (such as conestat alfa).
Currently trying to conceive, pregnancy and women giving breastfeeding.
Inability to comply with study and follow-up procedures.
Presence of clinically significant conditions that could interfere with the interpretation of the study results and or compromise the safety of the patients.
Participation in an investigational drug or device trial within the last 30 days prior to screening.
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Aanwezigheid van urticaria bij angio-oedeem.
Een andere diagnose dan InH-AAE is meer waarschijnlijk.
ACE-gebruik in de afgelopen 6 maanden.
Voorgeschiedenis suggestief voor konijnenallergie of allergie voor van konijnen verkregen producten (zoals conestat alfa).
Actieve zwangerschapswens, zwangerschap en momenteel borstvoeding gevend.
Onvermogen te kunnen voldoen aan de studieprocedures.
Aanwezigheid van klinisch significante aandoeningen die kunnen interfereren met de interpretatie van de studie en de veiligheid van de patiënt.
Deelname aan een klinische geneesmiddelenstudie of hulpmiddelen studie in de afgelopen dagen.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint of this study is the mean monthly attack frequency during the 8-week treatment period as reported by the patient on the AAS form.
This primary parameter will be compared with the patient reported mean monthly attack frequency over the past 6 months (primary outcome) and the mean monthly attack frequency during the 8-week observational period.
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Het primaire eindpunt van deze studie is de gemiddelde maandelijkse aanvalsfrequentie gedurende de 8-weekse behandelperiode zoals gerapporteerd op het AAS formulier.
Dit eindpunt zal worden vergeleken met de door de patiënt geraporteerde aanvalsfrequentie over de afgelopen 6 maanden (primary outcome), de gemiddelde maandelijkse aanvalsfrequentie tijdens de 8-weekse observatieperiode. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Daily by AAS & at initiation visit. |
Dagelijks met de AAS & tijdens de inclusie visit. |
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E.5.2 | Secondary end point(s) |
The mean monthly disease severity as measured by AAS28 or AAS7.
The quality of life measured by AE-QoL.
Changes in the UCT score.
Number of adverse and serious adverse events.
Levels of biomarkers. |
De gemiddelde maandelijkse ziekteactiviteit gemeten met de AAS28 of AAS7.
De kwaliteit van leven gemeten met de AE-QoL.
Veranderingen in de UCT scores. Changes in the UCT score.
Aantal adverse en serious adverse events.
Levels van biomarkers. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
AAS: daily
AE-QoL&UCT: montly
Adverse events: Montly during obervation and twice weekly during the 8-weeks of therapy.
Biomarkers: At the first visit (V1), last visit (V18) and during the treatment period at V2, V4, V9 and V17. |
AAS: dagelijks
AE-QoL&UCT: maandelijks
Adverse events: maandelijks tijdens observatie, tweewekelijks tijdens de behandelperiode.
Biomarkers: bij het eerste bezoek (V1), laatste bezoek(V18) en tijdens de behandelperiode bij V2, V4, V9 en V17. |
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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 | Yes |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | No |
E.6.5 | Efficacy | No |
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) | 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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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 | No |
E.8.2.3 | Other | No |
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 | No |
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 | 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 trial is defined by the last study visit of the last study subject.
The study (or funding for the study) can be terminated by Pharming or by the investigator as described in the trial agreement. |
Het einde van de trial wordt gedefinieerd als het laatste bezoek van de laatste deelnemer. |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |