E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Sporadic Inclusion Body Myositis (sIBM) |
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E.1.1.1 | Medical condition in easily understood language |
progressive weakening of the muscles |
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E.1.1.2 | Therapeutic area | Body processes [G] - Metabolic Phenomena [G03] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10075052 |
E.1.2 | Term | Sporadic inclusion body myositis |
E.1.2 | System Organ Class | 100000004859 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of arimoclomol at a daily dosage of 1200 mg (400 mg t.i.d) compared to placebo in the treatment of sporadic IBM at 20 months.
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E.2.2 | Secondary objectives of the trial | |
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Meet any of the European Neuromuscular Centre Inclusion Body Myositis research diagnostic criteria 2011 categories for IBM.1 (as per Appendix 1 of the protocol)
2. Demonstrate being able to arise from a chair without support from another person or device
3. Able to ambulate at least 20 ft/6 meters with or without assistive device. Once arisen from the chair, participant may use any walking device, i.e. walker/frame, cane, crutches, or braces. They cannot be supported by another person and cannot use furniture or wall for support.
4. Age at onset of weakness > 45 years
5. Body weight of > 40 kgs
6. Able to give informed consent
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E.4 | Principal exclusion criteria |
1. History of any of the following excludes subject participation in the study: chronic infection particularly HIV or Hepatitis B or C; cancer other than basal cell cancer less than five years prior, or other chronic serious medical illnesses.
2. Presence of any of the following on routine blood screening: WBC < 3000; platelets < 100,000; hematocrit < 30%; BUN > 30 mg; creatinine > 1.5 x upper limit of normal; symptomatic liver disease with serum albumin < 30mg/dl
3. History of most recent creatine kinase >15x the upper limit of normal without any other explanation besides IBM.
4. History of non-compliance with other therapies.
5. Use of testosterone except for physiologic replacement doses in case of androgen deficiency. Participants must have documented proof of the androgen deficiency.
6. Coexistence of any other disease that would likely to affect outcome measures.
7. Drug or alcohol abuse within past three months. Patient has recent history (within 6 months before Screening) of chronic alcohol or drug abuse which may compromise the patient’s safety or ability to participate in study activities. Cannabis for IBM symptoms will be allowed (where legal).
8. Participation in a recent drug study in the last 30 days prior to the screening visit or use of biologic agents less than 6 months prior to the screening visit.
9. Women who are lactating or pregnant, or sexually active female subjects of child-bearing potential* intending to become pregnant or unwilling to use a highly effective method of contraception** during the trial through 1 month after the last dose of trial medication. Sexually active males with female partners of child-bearing potential* unwilling to use a condom with or without spermicide in addition to the birth control used by their partners during the trial until 3 months after the last dose of trial medication unless surgically sterile (vasectomy).
Non child-bearing potential is defined as post-menopausal (minimum of 12 months with no menses and follicle-stimulating hormone in the post-menopausal range) or sterilisation (hysterectomy, oophorectomy, or bilateral tubal ligation).
** Highly effective methods of contraception include combined (oestrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, or transdermal); progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, or implantable); intrauterine device; intrauterine hormone-releasing system; bilateral tubal occlusion; and vasectomised partner.
According to the recommendations from the Clinical Trial Facilitation Group (CTFG, 2014), sexual abstinence is considered a highly effective birth control method only if it is defined as refraining from heterosexual intercourse during the trial until 1 month after the last dose of trial medication (for female subjects of child-bearing potential) and for 3 months after the last dose of trial medication (for male subjects with female partners of child-bearing potential). The reliability of sexual abstinence needs to be evaluated by the investigator in relation to the duration of the clinical trial and the preferred and usual lifestyle of the subject.
10. Participants taking >7.5 mg prednisolone or equivalent or participants on intravenous immunoglobulin (IVIg) or other immunosuppressants within the last 3 months. Topical, nasal, and ocular corticosteroids are allowed unless they are being widely applied or the severity of the underlying condition makes them unsuitable in the Investigator’s opinion. Local steroid injections are allowed.
11. Clinically significant renal or hepatic disease, as indicated by clinical laboratory assessment (results ≥3 times the upper limit of normal [ULN] for alanine aminotransferase combined with bilirubin ≥2 times the ULN; symptomatic liver disease with serum albumin < 3 g/dL; or creatinine ≥1.5 times the ULN). Laboratory tests may be repeated once at screening. Reasons to repeat laboratory tests may include that the medication causing laboratory abnormality was suspended, any other suspected cause may no longer exist, or to rule out laboratory error.
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary efficacy endpoint is the change from baseline to Month 20 in the IBM Functional Rating Scale (IBMFRS) total score.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Efficacy endpoint will be checked at Visit at Month 20
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E.5.2 | Secondary end point(s) |
Secondary efficacy endpoints will include changes from baseline over months 12 to 20 in the following measures of strength and function:
• IBMFRS total score (12 months)
• 6 minute walk test with 2 minute distance captured
• Modified Timed Up and Go (mTUG)
• Muscle Strength Testing
o Manual Muscle Testing (MMT)
o Isometric Contraction Testing of bilateral quadriceps strength using the MicroFET
• Health Assessment Questionnaire (HAQ-DI)
• Grip strength using the Jamar device
• SF-36
• Falls and near falls
• Patient Global Impression of Severity (PGIS) and Patient Global Impression of Change (PGIC)
• Clinician Global Impression of Severity (CGIS) and Clinician Global Impression of Change (CGIC)
• Patient Global Impression of Severity (PGIS) and Patient Global Impression of Change (PGIC)
Safety endpoints:
• Adverse events (AEs);
• Hematology;
• Clinical chemistry;
• Vital signs;
• Columbia Suicide Severity Rating Scale (C SSRS) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Secondary endpoints will be checked as follows:
• IBMFRS total score: at every visit after the screening visit
• 6 minute walk test with 2 minute distance captured: at every clinical visit
• Modified Timed Up and Go (mTUG): at every clinical visit
• Muscle Strength Testing: at every clinical visit
• Health Assessment Questionnaire (HAQ-DI): at every clinical visit
• Grip strength using the Jamar device: at every clinical visit
• SF-36: at every clinical visit
• Falls and near falls: at every clinical visit
• PGIS and CGIS at all site visits,
• PGIC and CGIC at all post-baseline site visits (no PGI/CGI at Month1/Visit 3 or Month 2/Visit 4).
Safety endpoints will be checked at every visit |
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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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
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 CN1A Ab testing and biobanking for future analyses. |
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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) | 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 | 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 | 2 |
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 | 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 |
United Kingdom |
United States |
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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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Last visit of the last subject |
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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 | |
E.8.9.1 | In the Member State concerned days | |
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 | 11 |
E.8.9.2 | In all countries concerned by the trial days | 8 |