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Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
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  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43865   clinical trials with a EudraCT protocol, of which   7286   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
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    Summary
    EudraCT Number:2017-003190-34
    Sponsor's Protocol Code Number:ACE-536-MDS-002
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-01-25
    Trial 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 number2017-003190-34
    A.3Full title of the trial
    A Phase 3, Open -label, Randomized Study to Compare the Efficacy and Safety of Luspatercept (ACE-536) versus Epoetin alfa for the Treatment of Anemia due to IPSS-R Very Low, Low or Intermediate Risk Myelodysplastic Syndromes (MDS) in ESA Naïve Subjects who require Red Blood Cell Transfusions.
    Studio di Fase 3, in aperto, randomizzato per confrontare l'efficacia e la sicurezza di Luspatercept (ACE-536) rispetto a Epoetina alfa per il trattamento dell'anemia dovuta a sindromi mielodisplastiche (MDS) a rischio molto basso, basso o intermedio secondo IPSS-R in soggetti naïve a ESA che necessitano di trasfusioni di globuli rossi.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 3 study to see the benefit and safety of Luspatercept in comparison with Epoetin Alfa to treat anaemia due to very low, low or intermediate risk Myelodysplastic Syndromes (MDS) in people who have not taken erythropoiesis-stimulating agents (ESA's) before and who require red blood cell transfusions.
    Studio di Fase 3 per verificare i benefici e la sicurezza di Luspatercept rispetto a Epoetina alfa per il trattamento dell'anemia dovuta a sindromi mielodisplastiche (MDS) a rischio molto basso, basso o intermedio in soggetti che non hanno mai assunto agenti stimolanti l'eritropoiesi (ESA) e che richiedono trasfusioni di globuli rossi.
    A.3.2Name or abbreviated title of the trial where available
    The Commands Trial
    La sperimentazione Commands
    A.4.1Sponsor's protocol code numberACE-536-MDS-002
    A.5.1ISRCTN (International Standard Randomised Controlled Trial) NumberISRCTN00000000
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT00000000
    A.5.3WHO Universal Trial Reference Number (UTRN)U0000-0000-0000
    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 SponsorCELGENE CORPORATION
    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 supportCelgene Corporation
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPPD
    B.5.2Functional name of contact pointPPD Project Manager
    B.5.3 Address:
    B.5.3.1Street Addressvia San Bovio, 3
    B.5.3.2Town/ citySan Felice Segrate, Milan
    B.5.3.3Post code20090
    B.5.3.4CountryItaly
    B.5.4Telephone number00390282951230
    B.5.5Fax number0039023271659
    B.5.6E-mailSimone.Pizzimenti@ppdi.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/3/14/1331
    D.3 Description of the IMP
    D.3.1Product nameLuspatercept
    D.3.2Product code [ACE-536]
    D.3.4Pharmaceutical form Lyophilisate for solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 1373715-00-4
    D.3.9.2Current sponsor codeACE-536
    D.3.9.4EV Substance CodeSUB189400
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number37500
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 2
    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/3/14/1331
    D.3 Description of the IMP
    D.3.1Product nameLuspatercept
    D.3.2Product code [ACE-536]
    D.3.4Pharmaceutical form Lyophilisate for solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNLuspatercept
    D.3.9.1CAS number 1373715-00-4
    D.3.9.2Current sponsor codeACE-536
    D.3.9.3Other descriptive nameLuspatercept
    D.3.9.4EV Substance CodeSUB189400
    D.3.10 Strength
    D.3.10.1Concentration unit µg/kg microgram(s)/kilogram
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number87500
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 3
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name Eprex
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag Ltd
    D.2.1.2Country which granted the Marketing AuthorisationBelgium
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameEpoietina Alfa
    D.3.2Product code [Epoietina Alfa]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEpoietina Alfa
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU international unit(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 4
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name Eprex
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag Ltd
    D.2.1.2Country which granted the Marketing AuthorisationBelgium
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameEpoietina Alfa
    D.3.2Product code [Epoietina Alfa]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor codeEPOETINA ALFA
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU international unit(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 5
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name Eprex
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag Ltd
    D.2.1.2Country which granted the Marketing AuthorisationBelgium
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameEpoietina Alfa
    D.3.2Product code Epoietina Alfa
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor codeEPOETINA ALFA
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU international unit(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 6
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name Eprex
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag Ltd
    D.2.1.2Country which granted the Marketing AuthorisationBelgium
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameEpoietina Alfa
    D.3.2Product code Epoietina Alfa
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor codeEPOETINA ALFA
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU international unit(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 7
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name Eprex
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag Ltd
    D.2.1.2Country which granted the Marketing AuthorisationBelgium
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameEpoietina Alfa
    D.3.2Product code Epoietina Alfa
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor codeEPOETINA ALFA
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU international unit(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 8
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name Eprex
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag Ltd
    D.2.1.2Country which granted the Marketing AuthorisationBelgium
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameEpoietina Alfa
    D.3.2Product code Epoietina Alfa
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor codeEPOETINA ALFA
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU international unit(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 9
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name ERYPO® FS
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameERYPO® FS
    D.3.2Product code [32077.02.00 - Janssen-Cilag GmbH - Germany]
    D.3.4Pharmaceutical form Powder and solvent for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor codeEPOETINA ALFA
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU/ml international unit(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 10
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name ERYPO® FS
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameERYPO® FS
    D.3.2Product code [32077.02.00 - Janssen-Cilag GmbH - Germany]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNepoetina alfa
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU/ml international unit(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 11
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name ERYPO
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameERYPO® FS
    D.3.2Product code [32077.02.00 - Janssen-Cilag GmbH - Germany]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor codeNA
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU/ml international unit(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 12
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name ERYPO® FS
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameERYPO® FS
    D.3.2Product code [32077.02.00 - Janssen-Cilag GmbH - Germany]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU/ml international unit(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 13
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name ERYPO® FS
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameERYPO® FS
    D.3.2Product code [32077.02.00 - Janssen-Cilag GmbH - Germany]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU/ml international unit(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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.IMP: 14
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name ERYPO® FS
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameERYPO® FS
    D.3.2Product code [32077.02.00 - Janssen-Cilag GmbH - Germany]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEPOETINA ALFA
    D.3.9.1CAS number 113427-24-0
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB06575MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU/ml international unit(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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
    Myelodysplastic syndrome (MDS)
    Sindrome Mielodisplastica
    E.1.1.1Medical condition in easily understood language
    Umbrella term for disorders of the bone marrow, leading to a reduced number of red blood cells.
    Termine generico per i disturbi del midollo osseo, che portano ad una riduzione del numero di globuli rossi.

    E.1.1.2Therapeutic area Diseases [C] - Blood and lymphatic diseases [C15]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10068361
    E.1.2Term MDS
    E.1.2System Organ Class 100000004864
    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 of the study is to evaluate the efficacy of luspatercept compared with epoetin alfa for the treatment of anemia due to IPSS-R very low, low, or intermediate risk MDS in ESA naïve subjects who require RBC transfusions.
    L'obiettivo primario dello studio è valutare l’efficacia di luspatercept rispetto a epoetina alfa per il trattamento dell'anemia dovuta a MDS a rischio molto basso, basso o intermedio secondo IPSS-R in soggetti naïve agli ESA che richiedono trasfusioni di RBC.
    E.2.2Secondary objectives of the trial
    • To assess the safety and efficacy of luspatercept compared to epoetin alfa
    • To assess health-related quality of life (HRQoL) and anemia outcome measures (ie, the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire [EORTC QLQ-C30] and the Functional Assessment of Cancer Therapy - Anemia (FACT-An) questionnaire for subjects treated with luspatercept compared to epoetin alfa
    • To evaluate population pharmacokinetics and exposure-response relationships for luspatercept in MDS subjects
    • Valutare la sicurezza e l'efficacia di luspatercept rispetto a epoetina alfa
    • Valutare la qualità di vita correlata allo stato di salute (HRQoL) e le misure di esito dell'anemia (ovvero, il questionario sulla qualità di vita redatto dall'Organizzazione europea per la ricerca e il trattamento del cancro [EORTC QLQ-C30] e il questionario di valutazione funzionale della terapia antitumorale - anemia [FACT-An]) per i soggetti trattati con luspatercept rispetto a epoetina alfa
    • Valutare la farmacocinetica della popolazione e le correlazioni esposizione-risposta per luspatercept in soggetti con MDS
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Subject is = 18 years of age 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. Subject has a documented diagnosis of MDS according to WHO 2016 classification that meets IPSS R classification of very low, low, or intermediate risk disease, and < 5% blasts in bone marrow.
    5. Subject has an endogenous serum erythropoietin (sEPO) level of <
    500 U/L.
    6. Subject requires RBC transfusions, as documented by the following criteria:
    • Average transfusion requirement of 2 - 6 units/8 weeks of pRBCs confirmed for a minimum of 8 weeks immediately preceding randomization.
    Hemoglobin levels at the time of or within 7 days prior to administration of a RBC transfusion must have been = 9.0 g/dL with symptoms of anemia (or = 7 g/dL in the absence of symptoms) in order for the transfusion to be counted towards meeting eligibility criteria. Red blood cell transfusions administered when Hgb levels were > 9.0 g/dL (or > 7 g/dL in the absence of symptoms) and/or RBC transfusions
    administered for elective surgery, infections or bleeding events will not qualify as a required transfusion for the purpose of meeting eligibility criteria or stratification.
    The hemoglobin level after the last RBC transfusion prior to randomization must be < 11.0 g/dL (centrally or locally analyzed).
    7. Subject has Eastern Cooperative Oncology Group (ECOG) score of 0, 1, or 2.
    8. Females of childbearing potential (FCBP), defined as a sexually mature woman who:
    1) has not undergone a hysterectomy or bilateral oophorectomy or 2) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (ie, has had menses at any time in the preceding 24 consecutive months), must:
    •Have two negative pregnancy tests as verified by the investigator prior to starting study therapy (unless the screening pregnancy test was done within 72 hours of W1D1). She must agree to ongoing pregnancy testing during the course of the study, and after end of study treatment.
    •If sexually active, agree to use, and be able to comply with, highly effective contraception without interruption, 5 weeks prior to starting investigational product, during the study therapy (including dose interruptions), and for 12 weeks after discontinuation of study therapy.
    9. Male subjects must:
    •Practice true abstinence (which must be reviewed prior to each IP administration or on a monthly basis [eg, in the event of dose delays]) or agree to use a condom (latex or non-latex, but 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 12 weeks following investigational product discontinuation, even if he has undergone a successful vasectomy.
    1. Il soggetto ha = 18 anni al momento della sottoscrizione del modulo di consenso informato (ICF).
    2. Il soggetto deve comprendere e firmare volontariamente un ICF prima che sia effettuata qualsiasi valutazione/procedura correlata allo studio.
    3. Il soggetto intende ed è in grado di attenersi al programma di visite dello studio e agli altri requisiti del protocollo.
    4. Il soggetto presenta una diagnosi documentata di MDS secondo la classificazione 2016 dell'OMS che soddisfa la classificazione IPSS R di malattia a rischio molto basso, basso o intermedio e < 5% di blasti nel midollo osseo.
    5. Il soggetto ha un livello di eritropoietina endogena nel siero (sEPO) <500 U/l.
    6. Il soggetto richiede trasfusioni di RBC, come documentato dai seguenti criteri:
    • Necessità media di trasfusioni pari a 2-6 unità/8 settimane di pRBC confermate per un minimo di 8 settimane immediatamente prima della randomizzazione.
    I livelli di emoglobina al momento della somministrazione di una trasfusione di RBC o nei 7 giorni precedenti devono essere = 9,0 g/dl con sintomi di anemia (o = 7 g/dl in assenza di sintomi) affinché la trasfusione sia conteggiata per il rispetto dei criteri di eleggibilità. Le trasfusioni di globuli rossi somministrate con livelli di Hgb > 9,0 g/dl (o > 7 g/dl in assenza di sintomi) e/o le trasfusioni di RBC
    somministrate per la chirurgia elettiva, le infezioni o gli eventi di sanguinamento non saranno considerate come trasfusione richiesta ai fini del rispetto dei criteri di eleggibilità o della stratificazione.
    Il livello di emoglobina dopo l'ultima trasfusione di RBC prima della randomizzazione deve essere < 11,0 g/dl (analizzato a livello centrale o locale).
    7. Il soggetto presenta un punteggio ECOG (Eastern Cooperative Oncology Group) di 0, 1 o 2.
    8. Le donne in età fertile (FCBP), definite come una donna sessualmente matura che:
    1) non è stata sottoposta a isterectomia o a ooforectomia bilaterale oppure 2) non si trova in stato di post-menopausa naturale (l'amenorrea dovuta a terapia per il cancro non esclude la potenziale fertilità) da almeno 24 mesi consecutivi (ovvero ha avuto cicli mestruali in un momento qualsiasi dei precedenti 24 mesi consecutivi), devono:
    •Presentare due test di gravidanza negativi come verificato dallo sperimentatore prima dell'inizio della terapia in studio (salvo che il test di gravidanza allo screening sia stato eseguito nelle 72 ore precedenti il S1G1). La donna deve accettare di sottoporsi a test di gravidanza continuativi nel corso dello studio e dopo la conclusione del trattamento in studio.
    •Se sessualmente attive, accettare di usare ed essere in grado di attenersi a un metodo di contraccezione altamente efficace senza interruzioni, 5 settimane prima dell'inizio della somministrazione del prodotto sperimentale, durante la terapia in studio (comprese le interruzioni della somministrazione della dose) e per 12 settimane dopo l'interruzione della terapia in studio.
    9. I soggetti di sesso maschile devono:
    •Praticare astinenza completa (che deve essere riesaminata prima di ogni somministrazione di IP o a cadenza mensile [ad es., nel caso di ritardi di somministrazione della dose]) o accettare di utilizzare il preservativo (di lattice o materiale diverso dal lattice, ma non costituito da membrana naturale [animale]) durante i rapporti sessuali con una donna in gravidanza o con una donna in età fertile nel corso della partecipazione allo studio, durante le interruzioni della somministrazione della dose e per almeno 12 settimane dopo l'interruzione del trattamento con il prodotto sperimentale, anche in caso di intervento efficace di vasectomia.
    E.4Principal exclusion criteria
    1.Subject with the any of the following prior treatments:
    •Erythropoiesis-stimulating agents (ESAs)
    •Granulocyte colony-stimulating factor (G-CSF), granulocyte- macrophage colony-stimulating factor (GM-CSF), unless given for treatment of febrile neutropenia
    •Disease modifying agents (eg, immune-modulatory drug [IMiDs such as lenalidomide]
    Except if the subject received = 1 week of treatment with a disease modifying agent = 8 weeks from randomization, at the investigator's discretion.
    •Hypomethylating agents
    Subjects may be randomized at the investigator's discretion contingent that the subject received no more than 2 doses of HMA. The last dose must be = 8 weeks from the date of randomization.
    •Luspatercept (ACE-536) or sotatercept (ACE-011)
    •Immunosuppressive therapy for MDS
    •Hematopoietic cell transplant
    2.Subject with MDS associated with del(5q) cytogenetic abnormality or
    MDS unclassifiable (MDS-U) according to WHO 2016 classification.
    3.Subject with myelodysplastic/myeloproliferative neoplasms (MDS/MPN) according to WHO 2016 classification (ie, Chronic myelomonocytic leukemia (CMML), Atypical chronic myeloid leukemia (aCML), BCR-ABL12, Juvenile myelomonocytic leukemia (JMML), MDS/MPN with ring sideroblasts and thrombocytosis (MDS/MPN-RS-T), MDS/MPN unclassifiable.
    4.Subject with secondary MDS, ie, MDS that is known to have arisen as the result of chemical injury or treatment with chemotherapy and/or radiation for other diseases.
    5.Subject with known clinically significant anemia due to iron, vitamin B12, or folate deficiencies, or autoimmune or hereditary hemolytic anemia, or hypothyroidism, or any type of known clinically significant bleeding or sequestration. Subject with drug induced anemia (eg, mycophenolate).
    •Iron deficiency to be determined by serum ferritin < 100 µg/L and additional testing if clinically indicated (eg, calculated transferrin saturation [iron/total iron binding capacity = 20%] or bone marrow aspirate stain for iron).
    6.Subject with known history of diagnosis of AML.
    7.Subject receiving any of the following treatment within 8 weeks prior to randomization:
    •Anticancer cytotoxic chemotherapeutic agent or treatment
    •Systemic corticosteroid, except for subjects on a stable or decreasing dose for = 1 week prior to randomization for medical conditions other than MDS
    •Iron-chelating agents, except for subjects on a stable or decreasing dose for at least 8 weeks prior to randomization
    •Other RBC hematopoietic growth factors (eg, Interleukin-3)
    •Androgens, unless to treat hypogonadism
    •Hydroxyurea
    •Oral retinoids (except for topical retinoids)
    •Arsenic trioxide
    •Interferon and interleukins
    •Investigational drug or device, or approved therapy for investigational use (if 5 times the half-life of the previous investigational drug exceeds
    8 weeks, then the time of exclusion should be extended up to 5 times the half-life of the investigational drug)
    8.Subject with uncontrolled hypertension, defined as repeated elevations of systolic blood pressure (SBP) of = 150 mmHg and/or diastolic blood pressure (DBP) = 100 mmHg despite adequate treatment.
    9.Subject with any of the following laboratory abnormalities:
    •Absolute neutrophil count (ANC) < 500/µL (0.5 x 10^9/L)
    •Platelet count < 50,000/µL (50 x 10^9/L)
    •Estimated glomerular filtration rate (eGFR) < 40 mL/min/1.73 m2 (via the 4-variable modification of diet in renal disease [MDRD] formula)
    •Serum aspartate aminotransferase/serum glutamic oxaloacetic transaminase (AST/SGOT) or alanine aminotransferase/serum glutamic pyruvic transaminase (ALT/SGPT) = 3.0 x upper limit of normal (ULN)
    •Total bilirubin = 2.0 x ULN.
    Higher levels are acceptable if these can be attributed to active red blood cell precursor destruction within the bone marrow (ie, ineffective erythropoiesis) or in the presence of known history of Gilbert Syndrome.

    Further exclusion criteria are noted in the Protocol.
    1.Soggetto con uno dei seguenti trattamenti precedenti:
    •Agenti stimolanti l'eritropoiesi (ESA)
    •Fattore stimolante le colonie granulocitarie (G-CSF), fattore stimolante le colonie granulocitarie-macrofagiche (GM-CSF), salvo se somministrati per il trattamento della neutropenia febbrile
    •Agenti modificanti la malattia (ad es., farmaco immunomodulante [IMiD come lenalidomide]
    Eccetto se il soggetto ha ricevuto = 1 settimana di trattamento con un agente modificante la malattia = 8 settimane dalla randomizzazione, a discrezione dello sperimentatore.
    •Agenti ipometilanti
    I soggetti potranno essere randomizzati a discrezione dello sperimentatore a condizione che il soggetto abbia ricevuto non più di 2 dosi di HMA. L’ultima dose deve essere stata somministrata = 8 settimane prima della data di randomizzazione.
    •Luspatercept (ACE-536) o sotatercept (ACE-011)
    •Terapia immunosoppressiva per MDS
    •Trapianto di cellule ematopoietiche
    2.Soggetto con MDS associata ad anomalia citogenetica del(5q) o
    MDS non classificabile (MDS-U) secondo la classificazione 2016 dell'OMS.
    3.Soggetto con sindrome mielodisplastica/neoplasia mieloproliferativa (MDS/MPN) secondo la classificazione 2016 dell'OMS (ovvero, leucemia mielomonocitica cronica (CMML), leucemia mieloide cronica atipica (aCML), BCR-ABL12, leucemia mielomonocitica giovanile (JMML), MDS/MPN con sideroblasti ad anello e trombocitosi (MDS/MPN-RS-T), MDS/MPN non classificabile.
    4.Soggetto con MDS secondaria, ad es. MDS notoriamente causata da lesione chimica o trattamento con chemioterapia e/o radiazioni per altre malattie.
    5.Soggetto con anemia nota clinicamente significativa dovuta a carenza di ferro, vitamina B12 o folato oppure anemia emolitica autoimmune o ereditaria o ipotiroidismo o qualsiasi tipo di sanguinamento o sequestro noto clinicamente significativo. Soggetto con anemia indotta da farmaci (ad es. micofenolato).
    •La carenza di ferro deve essere determinata in base a ferritina sierica < 100 µg/l e test aggiuntivi se clinicamente indicato (ad es., saturazione della transferrina calcolata [capacità ferro legante totale/ferro = 20%] o aspirato di midollo osseo con colorazione per il ferro).
    6.Soggetto con anamnesi nota di diagnosi di leucemia mieloide acuta.
    7.Soggetto che ha ricevuto uno qualsiasi dei seguenti trattamenti nelle 8 settimane precedenti la randomizzazione:
    •Agente o trattamento chemioterapico citotossico antitumorale
    •Corticosteroidi sistemici, tranne per soggetti con dosaggio stabile o in diminuzione da = 1 settimana prima della randomizzazione per condizioni mediche diverse da MDS
    •Agenti ferro-chelanti, tranne per soggetti con dosaggio stabile o decrescente da almeno 8 settimane prima della randomizzazione
    •Altri fattori di crescita ematopoietica RBC (ad es. Interleuchina-3)
    •Androgeni, se non per trattare ipogonadismo
    •Idrossiurea
    •Retinoidi per via orale (fatta eccezione per i retinoidi topici)
    •Ossido arsenioso
    •Interferone e interleuchine
    •Farmaco o dispositivo sperimentale o terapia approvata per uso sperimentale (se 5 volte l'emivita del farmaco sperimentale precedente è più di
    8 settimane, allora il tempo di esclusione deve essere esteso fino a 5 volte l'emivita del farmaco sperimentale)
    8.Soggetto con ipertensione non controllata, definita come ripetuti aumenti della pressione arteriosa sistolica (SBP) = 150 mmHg e/o pressione diastolica (DBP) = 100 mmHg nonostante trattamento adeguato.
    9.Soggetto che presenta una delle seguenti anomalie nei valori di laboratorio:
    •Conta assoluta dei neutrofili (ANC) <500/µl (0,5 x 10^9/l)
    •Conta piastrinica <50.000/µl (50 x 10^9/l)
    •Velocità di filtrazione glomerulare stimata (eGFR) < 40 ml/minuto/1,73 m2 (utilizzando la formula di modifica della dieta nella malattia renale [Modification of Diet in Renal Disease, MDRD] a 4 variabili)

    Ulteriori Criteri di esclusione si trovano nel protocollo
    E.5 End points
    E.5.1Primary end point(s)
    Proportion of subjects who are RBC transfusion free over the first 24 weeks from randomization

    Percentuale di soggetti che non ricevono trasfusioni di RBC nel corso delle prime 24 settimane dalla randomizzazione
    E.5.1.1Timepoint(s) of evaluation of this end point
    Randomization through week 24
    Randomizzazione fino alla settimana 24
    E.5.2Secondary end point(s)
    1. Proportion of subjects achieving HI-E over any consecutive 56-day period.
    2. Proportion of subjects achieving = 1.5 g/dL mean increase in hemoglobin over the first 24 weeks from randomization compared to baseline in the absence of RBC transfusions.
    3. Proportion of subjects achieving HI-E over any consecutive 56-day period.
    4. Proportion of subjects achieving = 1.5 g/dL mean increase in hemoglobin over any consecutive 24-week period compared to baseline in the absence of RBC transfusions.
    5. Time from first dose to first onset of achieving = 1.5 g/dL increase in hemoglobin over any consecutive 56-day period in the absence of RBC transfusions.
    6. Maximum duration of achieving = 1.5 g/dL increase in hemoglobin for subjects who achieve mean hemoglobin increase = 56 days in the absence of RBC transfusions.
    7. Maximum duration of RBC transfusion independence for subjects who achieve RBC TI = 24 weeks.
    8. Proportion of subjects who are RBC transfusion free over a consecutive 84-day period.
    9. Maximum duration of RBC transfusion independence for subjects who achieve RBC TI = 84 days.
    10. Time from randomization to first onset of transfusion independence
    = 84 days.
    11. Time from randomization to first transfusion on treatment.
    12. Total number of RBC units transfused on treatment.
    13. Mean change in total pRBC units transfused over a rolling 8-week period.
    14. Proportion of subjects who are RBC transfusion independent during
    Weeks 4-24.
    15. Proportion of subjects who are RBC transfusion free for a consecutive 24-week period in the first 48 weeks from Randomization.
    16. Evaluation of EORTC QLQ-C30 score and FACT-An.
    17. Type, frequency, severity of AEs and relationship of AEs to luspatercept/epoetin alfa.
    18. A Population PK model that describes the PK exposure data of luspatercept and associated variability. Exposure-response relationship
    for selected endpoints of efficacy and safety.
    19. Frequency of antidrug antibodies and effects on efficacy, or safety, or
    PK.
    20. Number and percentage of subjects progressing to AML; time to AML
    progression.
    21. Time from date of randomization to death due to any cause.
    22. Evaluation of biomarkers such as TGF-ß superfamily members (eg, GDF11) and other molecules that may potentially impact luspatercept efficacy, predict response or relapse, help to better understand MOA and/or provide further prognostic classification of MDS subtypes. Molecular markers (eg, SF3B1) include evaluation of MDS-associated gene mutations and their impact on drug efficacy, clinical response or relapse, disease progression, drug MOA and prognostication of MDS.
    23. Evaluation of healthcare resource use (eg, hospitalization)
    associated with investigational product (IP) during study.
    24. Description of QUALMS-P and Treatment Satisfaction.
    1. Percentuale di soggetti che raggiungono HI-E nell'arco di qualsiasi periodo di 56 giorni consecutivi.
    2. Percentuale di soggetti che raggiungono un aumento medio dell'emoglobina = 1,5 g/dl nel corso delle prime 24 sett. dalla randomizzazione rispetto alla baseline in assenza di trasfusioni di RBC.
    3. Percentuale di soggetti che raggiungono HI-E nell'arco di qualsiasi periodo di 56 gg consecutivi.
    4. Percentuale di soggetti che raggiungono un aumento medio dell'emoglobina = 1,5 g/dl nell’arco di qualsiasi periodo di 24 sett. consecutive rispetto alla baseline in assenza di trasfusioni di RBC.
    5. Tempo dalla somministrazione della prima dose alla prima insorgenza del raggiungimento dell’aumento medio dell’emoglobina = 1,5 g/dl nell’arco di qualsiasi periodo di 56 gg consecutivi in assenza di trasfusioni di RBC.
    6. Durata massima del raggiungimento di un aumento dell'emoglobina = 1,5 g/dl per i soggetti che raggiungono un aumento medio dell’emoglobina in = 56 gg in assenza di trasfusioni di RBC.
    7. Durata massima dell’indipendenza da trasfusioni di RBC per i soggetti che raggiungono RBC-TI in = 24 sett.
    8. Percentuale di soggetti che non ricevono trasfusioni di RBC nell’arco di un periodo di 84 gg consecutivi.
    9. Durata massima dell’indipendenza da trasfusioni di RBC per i soggetti che raggiungono RBC-TI in = 84 gg.
    10. Tempo dalla randomizzazione alla prima insorgenza dell’indipendenza da trasfusioni
    in = 84 gg.
    11. Tempo dalla randomizzazione alla prima trasfusione durante il trattamento.
    12. Numero totale di unità di RBC trasfuse durante il trattamento.
    13. Variazione media nelle unità di pRBC totali trasfuse nel corso di un periodo di 8 sett. di tipo rolling.
    14. Percentuale di soggetti indipendenti da trasfusioni di RBC durante le Settimane 4-24.
    15. Percentuale di soggetti che non ricevono trasfusioni di RBC per un periodo di 24 sett consecutive nelle prime 48 sett dalla randomizzazione.
    16. Valutazione del punteggio dell'EORTC QLQ-C30 e FACT-An.
    17. Tipo, frequenza, gravità degli AE e correlazione degli AE con luspatercept/epoetina alfa.
    18. Un modello PK di popolazione che descrive i dati di esposizione PK di luspatercept e la variabilità associata. Rapporto esposizione-risposta
    per selezionati endpoint di efficacia e sicurezza.
    19. Frequenza degli anticorpi antifarmaco ed effetti su efficacia, sicurezza o PK.
    20. Numero e percentuale di soggetti con progressione a AML; tempo trascorso prima della
    progressione a AML.
    21. Tempo trascorso tra la data di randomizzazione e il decesso per qualsiasi motivo.
    22. Valutazione dei biomarcatori, quali ad esempio i membri della superfamiglia TGF-ß (ad es. GDF11) e altre molecole che possono potenzialmente influenzare l’efficacia di luspatercept, predire la risposta o una recidiva, essere utili per comprendere meglio il meccanismo d’azione (MOA) e/o fornire un'ulteriore classificazione prognostica dei sottotipi di MDS. I marcatori molecolari (ad es.ricoveri ospedalieri associati al prodotto speriment
    E.5.2.1Timepoint(s) of evaluation of this end point
    1, 2, 5, 8, 10, 12, 13: Randomization through week 24
    3, 4, 5, 13, 15: Randomization thought week 48
    6, 7, 9, 11: Randomization through End of Treatment
    14: week 4 through week 24
    17: Screening though 42 days post last dose; randomization thorough week 48
    18, 19: Randomization through 1-year post first dose
    20, 21: randomization though at least 3 year post last dose
    22, 23: Baseline through end of treatment
    16, 24: Screening through end of treatment
    1, 2, 5, 8, 10, 12, 13: Randomizzazione fino alla Settimana 24
    3, 4, 5, 13, 15: Randomizzazione fino alla Settimana 48
    6, 7, 9, 11: Randomizzazione fino alla Fine del trattamento
    14: dalla Settimana 4 fino alla Settimana 24
    17: dallo Screening fino a 42 giorni dopo l’ultima dose; randomizzazione fino alla settimana 48
    18, 19: Randomizzazione per 1 anno dopo la prima dose
    20, 21: randomizzazione per almeno 3 anni dopo l’ultima dose
    22, 23: dalla baseline fino alla Fine del trattamento
    16, 24: dallo Screening fino alla fine del trattamento
    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 Yes
    E.6.13.1Other scope of the trial description
    Biomarkers
    Biomarcatori
    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 Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    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) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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 concerned10
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA111
    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
    Australia
    Canada
    Japan
    Russian Federation
    Taiwan
    Turkey
    Ukraine
    United States
    Austria
    Belgium
    Czechia
    France
    Germany
    Italy
    Lithuania
    Netherlands
    Poland
    Portugal
    Spain
    Sweden
    Switzerland
    United Kingdom
    E.8.7Trial 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
    Either the date of the last visit of the last subject to complete the post- treatement follow-up, or the date of receipt of the last data point from the last subject that is required for primary, secondary and/or exploratory analysis, as prespecified in the protocol, whichever is the later date.
    Data dell'ultima visita dell'ultimo soggetto che conclude il follow-up post-trattamento o data di ricezione dell'ultimo dato dall'ultimo soggetto, elemento necessario per un'analisi primaria, secondaria e/o esplorativa, come preliminarmente specificato nel protocollo, a seconda di quale delle due date sia posteriore.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years8
    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 years8
    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: 103
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 247
    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 state60
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 255
    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)
    Subjects who have received at least one dose of IP should undergo EOT and 42d Follow-up evaluations for 8wks after last dose of IP or the EOT Visit, whichever occurs later.Subjects will be followed every 12wks for the first 3yrs from the date of last dose of IP or from the date of the EOT Visit(whichever is later)& every 6mths thereafter for monitoring & overall survival for min 5yrs from the date of last dose of IP unless the subject withdraws from the study.
    I soggetti che hanno ricevuto almeno una dose di IP faranno le valutaz. di EOT e di FUP a 42 giorni per 8 sett. dopo l’ultima dose di IP o la Visita EOT, a seconda dell’evento che si verifica più tardi. Saranno seguiti ogni 12 settim. per 3 anni dall’ultima dose IP o della Visita EOT (a seconda dell’evento che si verifica più tardi) e ogni 6 mesi successivam. per il monitoraggio e la sopravvivenza complessiva per min. 5 anni da data ultima dose IP, tranne se il soggetto si ritiri dallo studio.
    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 Decision2018-10-04
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-07-18
    P. End of Trial
    P.End of Trial StatusOngoing
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