E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Juvenile Primary Fibromyalgia Syndrome |
|
E.1.1.1 | Medical condition in easily understood language |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of duloxetine 30/60 mg once daily
(QD) compared with placebo on the reduction of average pain severity as measured by the Brief Pain Inventory (BPI) |
|
E.2.2 | Secondary objectives of the trial |
To evaluate the efficacy of duloxetine 30/60 mg QD in the treatment of adolescents with
JPFS during a 13-week, double-blind treatment phase, based on the improvement of the
following measures:
o Brief Pain Inventory (BPI) Modified Short Form: Adolescent Version severity
(worst pain, least pain, pain right now) and interference.
o Response to treatment, as defined by a 30% and 50% reduction in the BPI average
pain severity.
o Pediatric Pain Questionnaire (PPQ) pain right now, worst pain and average pain
items.
o Clinical Global Impression of Severity for Overall Illness (CGI-S: Overall
Illness) scale.
o Clinical Global Impression of Severity for Mental Illness (CGI-S: Mental Illness)
scale.
o Functional Disability Inventory - child version scale (FDI-child).
o Functional Disability Inventory - parent version scale (FDI-parent).
o Children's Depression Inventory (CDI).
o Multidimensional Anxiety Scale for Children (MASC). |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
•Meet criteria for primary JPFS
•Have a score of greater than or equal to 4 on Brief Pain Inventory (BPI) average pain severity (Item 3) during screening
•Female participants must have a negative serum pregnancy test during screening
•Participant's parent/legal representative and participant judged to be reliable to keep all appointments for clinical tests and procedures
•Participant's parent/legal representative and participant must have a degree of understanding such that they can communicate intelligently
•Participants must be capable of swallowing investigational product whole
•Participants must have venous access sufficient to allow blood sampling and be compliant with blood draws
|
|
E.4 | Principal exclusion criteria |
•Currently enrolled in, or discontinued within the last 30 days from, a clinical trial involving an investigational drug or device or off-label use of a drug or device or concurrently enrolled in any other type of medical research
•Previously completed or withdrawn after randomization from a study investigating duloxetine
•Known hypersensitivity to duloxetine or any of the inactive ingredients, or have frequent or severe allergic reactions to multiple medications
•Treated with duloxetine within the last 6 months. Will not likely benefit from duloxetine treatment, in the opinion of the investigator or have had prior nonresponse or inadequate tolerance to duloxetine
•Pain symptoms related to traumatic injury, past surgery, structural bone or joint disease or regional pain syndrome that will interfere with interpretation of outcome measures
•Currently have evidence of rheumatologic disorder or have a current diagnosis of rheumatoid arthritis, inflammatory arthritis, or infectious arthritis, or an autoimmune disease (for example, systemic lupus erythematosus)
•Have a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I condition, currently or within the past year, except major depressive disorder (MDD) and/or generalized anxiety disorder (GAD), adjustment disorder or specific phobias with primary investigator approval
•Have a current secondary DSM-IV Axis I condition of attention-deficit/hyperactivity disorder that requires pharmacologic treatment
•Lifetime DSM-IV Axis I diagnosis of psychosis, bipolar disorder, or schizoaffective disorder
•DSM-IV Axis II disorder which would interfere with protocol compliance
•History of substance abuse or dependence within the 6 months
•Positive urine drug screen for any substances of abuse or excluded medication
•Family history of 1 or more first-degree relatives with diagnosed bipolar I disorder
•Significant suicide attempt within 1 year of screening or are currently at suicidal risk in the opinion of the investigator
•Weight less than 20 kilogram (kg) at screening
•History of seizure disorder (other than febrile seizures)
•Taking any excluded medications that cannot be discontinued at screening
•Fluoxetine within 30 days prior to completion of screening
•Monoamine oxidase inhibitor (MAOI) within 14 days of screening; or the potential need to use an MAOI during the study or within 5 days of discontinuation of investigational product
•Abnormal thyroid-stimulating hormone (TSH) concentrations
•Uncontrolled narrow-angle glaucoma
•Acute liver injury (such as hepatitis) or severe cirrhosis (Child-Pugh Class C)
•Serious or unstable medical illness
•Female participants who are either pregnant, nursing or have recently given birth |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Change from baseline to 13 week endpoint in Brief Pain Inventory (BPI) modified short form-adolescent version 24 hour average pain severity item |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
1.Change from baseline to 13 week endpoint in Brief Pain Inventory (BPI) modified short form-adolescent version severity and interference items
2.Maintenance effect in acute phase responders on the Brief Pain Inventory (BPI) modified short form-adolescent version 24 hour average pain severity item
3.Proportion of patients with greater than or equal to 30% and 50% reduction in BPI 24 hour average pain severity score at 13 weeks
4.Change from baseline in Pediatric Pain Questionnaire (PPQ) item scores
5.Change from baseline in Clinical Global Impression (CGI) Severity: overall score and mental illness score
6.Change from baseline in Functional Disability Inventory (FDI) child scale and rent scale
7.Change from baseline in Children's Depression Inventory (CDI)
8.Change from baseline in Multidimensional Anxiety Scale for Children (MASC |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Baseline, 13 weeks ; Baseline (extension phase), 39 weeks |
|
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 | No |
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) | 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 | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
Will this trial be conducted at a single site globally?
| No |
E.8.4 | Will this trial be conducted at multiple sites globally? | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.2 | Trial being conducted completely outside of the EEA | Yes |
E.8.6.3 | Specify the countries outside of the EEA in which trial sites are planned |
Argentina |
India |
United States |
|
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
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.2 | In all countries concerned by the trial years | 6 |