E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Maintenance of remission in eosinophilic esophagitis |
Mantenimiento de la remisión en la esofagitis eosinofílica |
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E.1.1.1 | Medical condition in easily understood language |
Chronic allergic/immune-mediated inflammatory disease of the gullet in its remission phase |
Enfermedad inflamatoria crónica alérgica/inmune del esófago en su fase de remisión |
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E.1.1.2 | Therapeutic area | Diseases [C] - Digestive System Diseases [C06] |
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 | 10064220 |
E.1.2 | Term | Eosinophilic esophagitis |
E.1.2 | System Organ Class | 100000004856 |
|
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To prove superiority compared to placebo of episodic treatment with 4 cycles of budesonide 0.5 mg orodispersible tablets twice daily (BID) for 4 weeks followed by 8 weeks placebo BID over a total of 48 weeks and/or of continuous 48-week treatment with budesonide 0.5 mg orodispersible tablets BID in adult and adolescent eosinophilic esophagitis (EoE) patients in maintaining clinico-histological remission. |
Demostrar la superioridad en comparación con el placebo del tratamiento ocasional con 4 ciclos de comprimidos bucodispersables de 0,5 mg de budesonida dos veces al día (2v/d) durante 4 semanas seguido de 8 semanas de placebo 2v/d durante un total de 48 semanas y/o de 48 semanas de tratamiento continuo con comprimidos bucodispersables de 0,5 mg de budesonida 2v/d en pacientes adultos y adolescentes con esofagitis eosinofílica (EEo) para mantener una remisión clínico-histológica |
|
E.2.2 | Secondary objectives of the trial |
Double-blind maintenance phase: • To further assess EoE-associated clinical, endoscopic and histological findings after 48 weeks treatment for maintenance of remission, • To study safety and tolerability as assessed by adverse events and laboratory parameters, • To assess patients’ quality of life. |
Fase de mantenimiento con doble ciego: • Evaluar más a fondo los hallazgos clínicos, endoscópicos e histológicos asociados con la EEo después de 48 semanas de tratamiento para el mantenimiento de una remisión, • Estudiar la seguridad y la tolerabilidad mediante la evaluación de los acontecimientos adversos y los parámetros analíticos, • Evaluar la calidad de vida de los pacientes. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Signed informed consent, • Male or female patients, 16 to 75 years of age, • Confirmed clinico-histological diagnosis of EoE according to established diagnostic criteria, • Clinico-histological remission of EoE, • Negative pregnancy test in females of childbearing potential at baseline visit |
• Consentimiento informado firmado, • Pacientes masculinos o femeninos, de 16 a 75 años de edad, • Diagnóstico clínico-histológico confirmado de EEo según los criterios diagnósticos establecidos, • Remisión clínico-histológica de EEo, • Prueba de embarazo negativa en mujeres en edad fértil en la visita de seleccíón. |
|
E.4 | Principal exclusion criteria |
• Gastroesophageal reflux disease (GERD), • Achalasia, scleroderma esophagus, or systemic sclerosis, • Clinically evident causes for esophageal eosinophilia other than EoE, • Any concomitant esophageal disease and relevant active gastrointestinal disease, • Abnormal laboratory values, presence of or suspected relevant concomitant disease(s), that could affect study-specific assessments and/or their evaluation, or might compromise patient's safety and/or compliance (e.g. severe cardiovascular, renal, endocrine, psychiatric diseases/disorders, relevant infectious diseases associated with clinical signs, liver cirrhosis, portal hypertension, or uncontrolled cardiovascular disease, diabetes mellitus, osteoporosis, active peptic ulcer disease, glaucoma, cataract, • History of cancer, recent upper gastrointestinal bleeding, esophageal surgery, esophageal dilation procedures or need for an immediate endoscopic intervention due to a stricture • Diagnosis of chickenpox, herpes zoster, or measles within the last 3 months prior to baseline, • Treatment with medication, that could compromise/influence the effects of the study treatment, assessment of the endpoints and/or patients' safety, during or within too narrow timeframe of the clinical trial (e.g. systemic or oral glucocorticosteroids, immunosuppressants, CYP3A4 inhibitors, live vaccination, treatment with proton pump inhibitors, consumption of grapefruit) • Existing or intended pregnancy or breast-feeding. |
• Enfermedad por reflujo gastroesofágico (ERGE), • Acalasia, esclerodermia esofágica o esclerosis sistémica, • Causas clínicamente evidentes de eosinofilia esofágica distintas de la EEo, • Cualquier enfermedad esofágica concomitante y enfermedad gastrointestinal activa relevante, • Valores de laboratorio anormales, presencia o sospecha de enfermedad(es) concomitante(s) relevante(s), que pueda(n) afectar a las valoraciones específicas del estudio y/o a su evaluación, o que puedan comprometer la seguridad y/o el cumplimiento del paciente (por ejemplo, enfermedades/trastornos cardiovasculares, renales, endocrinos, psiquiátricos graves, enfermedades infecciosas relevantes asociadas a signos clínicos, cirrosis hepática, hipertensión portal, o enfermedad cardioascular no controlada, diabetes mellitus, osteoporosis, úlcera péptica activa, glaucoma, cataratas) • Antecedentes de cáncer, hemorragia gastrointestinal superior reciente, cirugía esofágica, procedimientos de dilatación esofágica o necesidad de una intervención endoscópica inmediata debido a una estenosis, • Diagnóstico de varicela, herpes zóster o sarampión en los últimos 3 meses antes del inicio, • Tratamiento con medicación que pueda comprometer/influir en los efectos del tratamiento del estudio, en la evaluación de los criterios de valoración y/o en la seguridad de los pacientes, durante o dentro de un plazo demasiado estrecho del ensayo clínico (por ejemplo, glucocorticosteroides sistémicos u orales, inmunosupresores, inhibidores del CYP3A4, vacunación viva, tratamiento con inhibidores de la bomba de protones, consumo de pomelo), • Embarazo o lactancia existente o previsto. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of patients free of treatment failure after a 48 weeks DB treatment phase |
Proporción de pacientes sin fracaso del tratamiento después de una fase de tratamiento DC de 48 semanas |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
after 48 weeks of double-blind phase |
Después de 48 semanas de la fase doble ciego |
|
E.5.2 | Secondary end point(s) |
• Proportion of patients with histological relapse at DB week 48 • Proportion of patients with clinical relapse, or who have experienced a food impaction, which needed endoscopic intervention during the DB treatment phase • Proportion of patients in clinico-histological remission at DB week 48 |
• Proporción de pacientes con recidiva histológica en la semana 48 de DC • Proporción de pacientes con una recidiva clínica, o que hayan sufrido una impactación de alimentos que haya necesitado una intervención endoscópica durante la fase de tratamiento de DC • Proporción de pacientes en remisión clínico-histológica en la semana 48 de DC |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
after 48 weeks of double-blind phase |
Después de 48 semanas de la fase doble ciego |
|
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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
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 | 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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
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 | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Abierto: posibles fases de 6 semanas para la inducción o reinducción de la remisión |
Open-label: possible 6-week phases for induction or re-induction of remission |
|
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 | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 22 |
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 |
Germany |
Italy |
Spain |
Switzerland |
|
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
|
Last Patient Last Visit |
Ultima visita último paciente |
|
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 | 6 |
E.8.9.1 | In the Member State concerned days | 15 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 0 |