E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Recessive dystrophic epidermolysis bullosa (RDEB) |
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E.1.1.1 | Medical condition in easily understood language |
Epidermolysis bullosa patients (butterfly children) have extremely fragile skin and innermost linings of the gastric and intestinal tract, leading to blisters, erosions and open wounds. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Skin and Connective Tissue Diseases [C17] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10014989 |
E.1.2 | Term | Epidermolysis bullosa |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
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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 |
The aim of this clinical trial is to investigate the efficacy (by monitoring overall improvement of EB symptoms measured by epidermolysis bullosa disease activity and scarring index [EBDASI] score and instrument for scoring clinical outcome of research for epidermolysis bullosa [iscorEB], wound healing assessed by photo documentation, and patients quality of life in EB [QOLEB] assessment) and safety (by monitoring adverse events [AEs]) of the IMP allo APZ2 EB administered intravenously to patients with EB in three applications (Day 0, Day 17 ±3, Day 35 ±3). |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male or female patients aged between ≥12 months and ≤55 years, Staggered design for patient enrollment: 1.) at least 3 adult patients ≥18 to ≤55 years (safety assessment 2 weeks after last treatment of third patient), 2.) at least 3 patients ≥12 to <18 years (safety assessment 2 weeks after first treatment of third patient), 3.) at least 3 patients ≥5 to <12 years (safety assessment 2 weeks after first treatment of third patient) and 4.) at least 3 patients ≥12 months to <5 years (safety assessment 2 weeks after first treatment of third patient); 2. Diagnosed with RDEB (combined diagnoses by genotype assessment [mutation analysis] and correlating phenotype assessment [wound assessment]), patients must have a negative immunofluorescence test result on salt-split skin against proteins of the basement membrane at Visit 1 (existing test results will be accepted); 3. Patient is eligible to participate in this clinical trial based on general health condition at the investigator’s discretion; 4. Patient/legal representative understands the nature of the procedure and are providing written informed consent prior to any clinical trial procedure; 5. Women of childbearing potential must have a negative urine pregnancy test at Visit 1; 6. Women of childbearing potential and their partner must be willing to use highly effective contraceptive methods during the course of the clinical trial. |
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E.4 | Principal exclusion criteria |
1. Tumor diseases or history of tumor disease; 2. Positive test result for human immunodeficiency virus 1 and/or 2 at Screening; 3. Any known allergies to components of the IMP; 4. Evidence of any other medical conditions (such as psychiatric illness or active infection) based on physical examination, or laboratory findings that may interfere with the planned treatment, affect the patient’s compliance, or place the patient at high risk of complications related to the treatment; at investigators discretion; 5. Inadequate pulmonary function with evidence of chronic obstructive or severe restrictive pulmonary disease; 6. Inadequate cardiac function with evidence of uncontrolled high blood pressure, congestive heart failure, angina pectoris, acute myocardial infarction within 6 months prior to treatment; 7. History of prior thrombosis or patients at risk for thrombosis 8. Clinically significant or unstable concurrent disease or other clinical contraindications to IMP application (based upon investigator’s judgment); 9. Patient/legal representative anticipated to be unwilling or unable to comply with the requirements of the protocol; 10. Pregnant or lactating women; 11. Current or previous (within 30 days of enrollment) treatment with another IMP, or participation and/or under follow-up in another clinical trial; 12. Previous participation in this clinical trial (except for screening failures due to an exclusion criterion); 13. Known abuse of alcohol, drugs, or medicinal products; 14. Employees of the sponsor, or employees or relatives of the investigator. |
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Efficacy endpoint: Overall improvement of EB symptoms after 12 weeks (measured by percentage change of a patient’s EBDASI score), or last available post-baseline measurement if the Week 12 measurement is missing (last observation carried forward [LOCF]). 2. Safety endpoint: Adverse events.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. Week 12, after first IMP application or timepoint of last observation carried forward. 2. During all patient visits except screening. |
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E.5.2 | Secondary end point(s) |
Secondary efficacy endpoints: 1. Overall improvement of EB symptoms after 12 weeks (measured by percentage change of a patient’s EBDASI score, without LOCF); 2. Overall improvement of EB symptoms after 12 weeks (measured by percentage change of patient’s iscorEB), or last available post-baseline measurement if the Week 12 measurement is missing (LOCF); 3. Overall improvement of EB symptoms after 12 weeks (measured by percentage change of patient’s iscorEB, without LOCF); 4. Overall improvement of EB symptoms at Day 17 (measured by percentage change of a patient’s EBDASI score and patient’s iscorEB); 5. Overall improvement of EB symptoms at Day 35 (measured by percentage change of a patient’s EBDASI score and patient’s iscorEB); 6. Inflammation (measured by panel of inflammation markers); 7. Pain assessment as per numerical rating scale (NRS); 8. Itch assessment as per NRS; 9. Assessment of QOLEB.
Secondary safety endpoint: 10. Physical examination and vital signs until Week 12; 11. Overall survival at month 12. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Week 12, after first IMP application; 2. Week 12, after first IMP application or timepoint of last observation carried forward; 3. Week 12, after first IMP application; 4. Day 17, after first IMP application; 5. Day 35, after first IMP application; 6. Day 0, 17 and 35 and week 12 after first IMP application; 7. Day 17 and 35 and week 12, after first IMP application; 8. Day 17 and 35 and week 12, after first IMP application; 9. Day 17 and 35 and week 12, after first IMP application; 10. Day 17, 35 and week 12 after first IMP application; 11. Month 12, after first IMP application; |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | 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) | Yes |
E.7.1.1 | First administration to humans | Yes |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Safety and efficacy in patients |
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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 | Yes |
E.8.1.7.1 | Other trial design description |
Patients are enrolled in a staggered fashion in 4 age cohorts |
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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
| 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 | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 7 |
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 |
Austria |
France |
Germany |
Italy |
United Kingdom |
United States |
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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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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 | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |