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    Summary
    EudraCT Number:2018-003099-10
    Sponsor's Protocol Code Number:DCR-PHXC-301
    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:2021-06-17
    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 number2018-003099-10
    A.3Full title of the trial
    An Open-Label Roll-Over Study to Evaluate the Long-Term Safety and Efficacy of DCR PHXC Solution for Injection (subcutaneous use) in Patients with Primary Hyperoxaluria
    Studio roll over in aperto per valutare la sicurezza e l’efficacia a lungo termine di DCR-PHXC in soluzione per iniezione (uso sottocutaneo) in pazienti con iperossaluria primaria
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study for patients with Primary Hyperoxaluria to evaluate the Long-Term Safety and Efficacy of DCR-PHXC Solution for Injection
    Studio per pazienti con iperossaluria primaria per valutare la sicurezza ed efficacia a lungo termine di DCR-PHXC soluzione per iniezione
    A.3.2Name or abbreviated title of the trial where available
    PHYOX-3
    PHYOX-3
    A.4.1Sponsor's protocol code numberDCR-PHXC-301
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04042402
    A.5.3WHO Universal Trial Reference Number (UTRN)U1111-1224-7484
    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 SponsorDicerna Pharmaceuticals Inc.
    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 supportDicerna Pharmaceuticals Inc
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationDicerna Pharmaceuticals Inc
    B.5.2Functional name of contact pointRalf Rosskamp
    B.5.3 Address:
    B.5.3.1Street Address33 Hayden Ave.
    B.5.3.2Town/ cityLexington
    B.5.3.3Post codeMA 02421
    B.5.3.4CountryUnited States
    B.5.4Telephone number0016176126275
    B.5.6E-mailrrosskamp@dicerna.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/3/18/2052
    D.3 Description of the IMP
    D.3.1Product nameNedosiran
    D.3.2Product code [DCR-PHXC]
    D.3.4Pharmaceutical form 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 INNDCR-L1360
    D.3.9.2Current sponsor codeDCR-PHXC
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number170
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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 No
    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
    Primary Hyperoxaluria
    Iperossaluria primaria
    E.1.1.1Medical condition in easily understood language
    Primary hyperoxaluria is where the liver overproduces oxalate. As a result calcium-oxalate crystals form in the urinary system and lead to stones and impaired kidney function.
    Nell'iperossaluria primaria il fegato produce eccesso di ossalato.Nel sistema urinario si formano cristalli di ossalato di calcio e portano formaz di calcoli
    renali e compromissione funzionalit renale
    E.1.1.2Therapeutic area Diseases [C] - Nutritional and Metabolic Diseases [C18]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level PT
    E.1.2Classification code 10020703
    E.1.2Term Hyperoxaluria
    E.1.2System Organ Class 10038359 - Renal and urinary disorders
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the effect of DCR PHXC on estimated glomerular filtration rate (eGFR)

    [For 6-to-11-year-old participants who were not previously enrolled in a study of DCR-PHXC, an interim analysis will assess the efficacy of DCR PHXC in reducing urinary oxalate (Uox) burden in patients with primary hyperoxaluria (PH) types 1 and 2]
    Valutare l’effetto di DCR-PHXC sulla stima della velocità di filtrazione glomerulare (eGFR)

    [Per i partecipanti di età tra i 6 e 11 anni che non sono stati precedentemente arruolati in uno studio DCR-PHXC, un’analisi intermedia valuterà l’efficacia di DCR-PHXC nel ridurre il carico di ossalato urinario (Uox) in pazienti con iperossaluria primaria (PH) tipo 1 e 2]
    E.2.2Secondary objectives of the trial
    Key Secondary:
    To evaluate the safety and tolerability of DCR PHXC when administered monthly to patients with primary hyperoxaluria (PH)
    Secondary:
    1. To identify the proportion of participants with normalized or nearnormalized Uox
    2. To assess the effect of DCR-PHXC on stone events in patients with PH
    3. To assess the effect of DCR-PHXC on stone burden in patients with PH
    4. To evaluate the incidence of chronic kidney disease (CKD) and endstage renal disease (ESRD) in participants with PH
    5. To evaluate the effect of DCR-PHXC on Quality of Life (QoL)
    assessments in patients with PH
    6. To assess the efficacy of DCR PHXC in reducing Uox burden in patients with PH

    Exploratory objectives:
    1.To characterize the PK of DCR-PHXC in patients with PH
    Secondari principali:
    Valutare la sicurezza e la tollerabilità di DCR PHXC somministrato mensilmente a pazienti con PH

    Secondari:
    1.Determinare la percentuale di partecipanti con valori Uox normalizzati o quasi normalizzati delle 24 ore
    2.Valutare l’effetto di DCR-PHXC sugli eventi di litiasi in pazienti con PH
    3.Valutare l’effetto di DCR-PHXC sul carico litiasico in pazienti con PH
    4.Valutare l’incidenza della nefropatia cronica (CKD) e della nefropatia allo stadio terminale (ESRD) nei partecipanti con PH
    5.Valutare l’effetto di DCR-PHXC sulla qualità della vita (QoL) in pazienti con PH
    6.Valutare l’efficacia di DCRPHXC nel ridurre il carico di Uox nei pazienti con PH

    Obiettivi esplorativi:
    1. Caratterizzare la PK di DCR PHXC in pazienti con PH
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    ROLL-OVER PARTICIPANTS AND THEIR PEDIATRIC SIBLINGS
    Age
    1. Participant must be at least 6 years of age, at the time of signing the informed consent/assent.

    Type of Participant and Disease Characteristics
    2. Documented diagnosis of PH, confirmed by genotyping (historically available genotype information is acceptable for study eligibility)
    3. Participant successfully completed a Dicerna Pharmaceuticals, Inc. study of DCR-PHXC.
    a. For participants rolling over from Study DCR-PHXC-101, a minimum 12 weeks must have elapsed from dosing in DCR-PHXC-101 and 24-hour Uox excretion must have returned to =80% of study DCR-PHXC-101 baseline.
    4. Estimated GFR at screening = 30 mL/min normalized to 1.73 m2 BSA calculated using the Modification of Diet in Renal Disease (MDRD) formula in participants aged > 16 years, or the formula by Schwartz in participants aged 6 to 16 years (Levey et al., 1999; Schwartz et al., 2009; National Kidney Foundation, 2002).

    Sex
    5. Male or female
    Male participants:
    A male participant with a female partner of childbearing potential must agree to use contraception, as detailed in Section 10.4.2, during the treatment period and for at least 12 weeks after the last dose of study intervention and refrain from donating sperm during this period.
    Female participants:
    A female participant is eligible to participate if she is not pregnant (see Section 10.4.1), not breastfeeding, and at least one of the following conditions applies:
    Not a woman of childbearing potential (WOCBP) as defined in Section 10.4.1
    OR
    A WOCBP who agrees to follow the contraceptive guidance in Section 10.4.2 during the treatment period and for at least 12 weeks after the last dose of study intervention.
    Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.

    Informed Consent/Assent
    6. Participant (and/or participant’s parent or legal guardian if participant is a minor [defined as patient < 18 years of age, or younger than the age of majority, according to local regulations]) is capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
    a. Adolescents (12 to < 18 years of age, or older than 12 years but younger than the age of majority, according to local regulations) must be able to provide written assent for participation.
    b. For children younger than 12 years of age, assent will be based on local regulations.
    PARTECIP ROLL-OVER e FRATELLI PEDIAT
    1.Almeno 6 aa, alla firma del consenso/assenso
    2.Diagnosi docum PH, confermata da genotipiz
    3.partecip o fratello completato con successo studio di Dicerna su DCR-PHXC.
    a.partecipanti al passaggio da uno studio multidose su DCR-PHXC,l'arruolam deve avvenire tra 25-75 gg da ultima dose farmaco in studio.Per minimiz gap nella sommin DCR-PHXC ogni sforzo deve essere fatto per arruolare pz non appena tutte valutaz del precedente studio sono state completate.Si deve specifi se al pz è stato richiesto di ripetere raccolta urine delle 24h della EOS per violaz criteri completezza
    b.Fratelli devono i)avere <18 aa ii)avere criteri di elegibilità(inclusa genotipiz), iii)avere 2 valori Uox 24h >=0.7mmol(normalizzato a 1,73 m2 BSA)allo screning,IV)avere meno del 20% variazione tra i 2valori di escrez di creatinina urinaria nelle 24h ottenuti durante periodo screening.Soggetti che non raggiungono <20%variazione possono andare incontro ad un secondo giro di raccolta urine. 7gg calendario possono essere aggiunti alla finestra di screening per partecip che devono completare secondo giro di raccolta urine.pz che dovessereo fallire di nuovo nel raggiungere la variazione entro il 20%,saranno esclusi
    4.GFR stimato allo screening > o = 30 ml/min normaliz a 1,73 m2 BSA calcolato utilizzando l'equazi CKD-EPI per partecipanti di età>=18aa, o l'equaz multivariata del 2012 di Schwartz nei partecip di età tra 6-16 aa.In Giappone verrà usata l'equaz di Uemura et.al per partecip tra 6 e 17aa e l'equaz di Matsuo et al. per partecip età >=18 aa. Per partecipanti al passaggio da studio multidose di 6 mesi con DCR-PHXC, eGFR della Visita Giorno150 o 180(EOS) verrà usato per screening
    5. Maschio o femminaPartecipante maschio con una partner femmina in età fertile deve accettare di utilizzare la contraccezione, come descritto nella Sez 10.4.2, durante il periodo trattamento e per almeno 12 settimane dopo l'ultima dose di intervento dello studio e di astenersi dal donare sperma durante questo periodo.Partecipanti femmine può partecipare se non incinta(ved. Sez 10.4.1),non allatta seno e si applica almeno 1delle seguenti condizioni:Non è una donna in età fertile(WOCBP)(sez 10.4.1)OE' una WOCBP che accetta di seguire la guida ai contraccettivi nella Sez10.4.2 durante periodo di trattamento e per almeno 12 settimane dopo l'ultima dose di intervento nello studio.
    L'uso di anticoncezionali da parte di uomini o donne dovrebbe essere coerente con le normative locali relative ai metodi contraccettivi per coloro che partecipano a studi clinici.
    6. partecipante in grado di dare il consenso informato firmato,che include conformità con requisiti e restriz elencati nell'ICF e protocollo.
    a. adolescenti devono essere in grado di fornire un assenso scritto per la partecipazione.
    b. Per i bambini di età inferiore ai 12 anni, l'assenso sarà basato su normative locali.
    BAMBINI 6-11 NON PRECEDENTEMENTE ARRUOLATI in STUDI DCR-PHXC
    1.Età: 6-11 anni alla firma del consenso/assenso
    2.Diagnosi docum di PH1 o PH2, confermata da genotipiz (accettabile info genotipo già disponibile)
    3.UOX secrezione 24-ore >=0.7mmol(normal a 1,73 m2 BSA) in entrambe le raccolte del periodo screening
    4.meno del 20% variazione tra i 2 valori di escrez di creatinina urin nelle 24h ottenuti durante periodo screening.Soggetti che non raggiungono <20%variaz possono andare incontro ad un secondo giro di raccolta urine.7gg possono essere aggiunti alla finestra si screening per partecipanti che devono completare il secondo giro di raccolta urine.I pz che dovessereo fallire di nuovo nel raggiungere la variaz entro il 20%,saranno esclusi
    5.GFR stimato allo screening >o= 30 ml/min normaliz a 1,73 m2 BSA calcolato utilizzando formula multivariata Schwartz
    6.Non può essere arruolato in studio doppio cieco su DCR-PHXC a causa tempistiche arruolamento
    7.Maschio o femmina
    8 genitore o tutore in grado di dare il consenso informato firmatoa. l'assenso basato su normative locali.
    E.4Principal exclusion criteria
    ROLL-OVER PARTICIPANTS&PED SIBLINGS
    1.Prior renal or hepatic transpl;or planned transpl within study period
    2.Currently receiving dialysis
    3.Documented evidence of clinical manifestations of systemic oxalosis
    4.Routine or chronic use of more than 3gr of acetaminophen/paracetamol daily
    5.Use of an RNAi drug (other than DCR-PHXC)within last 6months
    6.History of 1 or more of the following reactions to an oligonucleotide-based therapy: a. severe thrombocytopenia (platelet count =100,000/µL)b.hepatotoxicity, defined as(ALT or AST >3×the ULN) and (total bilirubin >2×ULN or INR>1.5)c.severe flu-like symptoms leading to discontinuation of therapy d. localized skin reaction from the injection (graded severe) leading to discontinuation of therapy e. coagulopathy/clinically significant prolongation of clotting time
    7.Particip receiving pyridoxine (vitB6)must have been at a stable dose for at least 4weeks prior to Day1 and must be willing to remain on the same stable dose throughout the study
    8.Participation in any clinical study in which they received an IMP)other than DCR-PHXC within 4months before Screening. a.For IMPs(other than DCR-PHXC)with the potential to reduce urine
    and/or plasma oxalate concentrations, these concentrations must have returned to historical baseline levels prior to Screening
    9.Plasma oxalate > 30µmol/LNote:For participants rolling over from a 6-month multidose study of
    DCR-PHXC,plasma oxalate value from either Day150 or Day180(EOS) visit may be used for screening
    10.Known hypersensitivity to DCR-PHXC or any of its ingredients
    11.Inability or unwillingness to comply with study procedures
    6-11-YRs-OLD CHILDREN NOT PREVIOUSLY ENROLLED IN A STUDY OF DCR-PHXC
    1.Prior renal or hepatic transpl; or planned transpl within study period
    2.Currently receiving dialysis or anticipating requirements for dyalisis during study period
    3.Documented evidence of clinical manifestations of systemic oxalosis
    4.Presence of any condition or comorbidities that would interfere with study compliance
    or data interpretation or potentially impact study participant safety including, but not restricted to:a.severe intercurrent illness b. known causes of active liver disease/injury or transaminase elevation b.known causes of active liver disease/injury or transaminase elevation c.history of serious mental illness that includes, but not limited to,schizophrenia,bipolar disorder, or severe depression requiring hospitaliz or pharmacol intervention d.clinically relevant history or presence of cardiovas, respir,gastrointes,hematolog,lymphatic,neurolog,musculoskel,genitourin,immunologi diseases,including dermatolog,or connective tissue diseases or disorders
    5.Routine or chronic use of more than 3gr of acetaminophen/paracetamol daily
    6.Use of an RNAi drug within the last 6 months
    7.History of one or more of the following reactions to an oligonucleotide-based therapy:a.severe thrombocytopenia (platelet count = 100,000/µL)b.hepatotoxicity, defined as ALT or AST > 3 × ULN and total bilirubin >2×ULN or INR >1.5
    c.severe flu-like symptoms leading to discontinuation of therapy d.localized skin reaction from the injection (graded severe) leading to discontinuation of therapy e.coagulopathy/clinically significant prolongation of clotting time
    8.Particip receiving pyridoxine must have been at a stable dose for at least 4 weeks prior to Day 1 and must be willing to remain on the same stable dose throughout the study.
    9.Participation in any clinical study in which they received an IMP within4 months before Screening
    a. for IMPs with the potential to reduce urine and/or plasma oxalate concentrations, these concentrations must have returned to historical baseline levels prior to Screening
    10.Plasma oxalate >30µmol/L
    11.Liver function test abnormalities: ALT and/or AST >1.5 × ULN for age and gender
    12.Known hypersensitivity to DCR-PHXC,or any of its ingredients
    13.Inability or unwillingness to comply with study procedures
    PARTECIPANTI ROLL-OVER e LORO FRATELLI PEDIATRICI
    1.Trap renale o epatico o pianificato entro periodo studio
    2.Dialisi
    3.Prova documentata delle manifestazioni cliniche di ossalosi sistemica
    4.Uso di routine o cronico di >3 gr acetaminofene/paracetamolo/giorno
    5.Uso di un farmaco RNAi (diverso da DCR-PHXC)negli ultimi 6 mesi
    6.Storia di una o + seguenti reazioni a una terapia a base di oligonucleotidi: trombocitopenia grave (conta piastrinica minore o = 100.000 / µl),epatotossicità, definita come (ALT o AST maggiore di 3 × il limite superiore della norma [ULN]) e (bilirubina tot >2 ×ULN o INR >1.5),gravi sintomi simil-influenzali che portano all'interruzione della terapia,reazione cutanea localizzata dall'iniezione (gravemente classificata) che porta all'interruzione della terapia,coagulopatia/prolungamento clinicamente significativo del tempo di coagulazione
    7.Partecip ricevono piridossina (vitB6) devono aver assunto una dose stabile per almeno 4settimane prima del primo giorno e devono essere disposti a rimanere sulla stessa dose stabile durante studio
    8.Partecipaz a qualsiasi studio clinico in cui abbiano ricevuto un medicinale sperimentale (medicinale sperimentale [IMP], diverso da DCR-PHXC) entro 4 mesi prima Screening.
    9.Oxalato plasmatico >30µmol/L. Per partecipanti che passano da studio multidose 6medi il valore del G150 o180 può essere usato allo screenin
    10.Ipersensibilità nota a DCR-PHXC
    11.Incapacità o riluttanza a rispettare le procedure studio

    BAMBINI 6-11 AA non ARRUOLATI IN PRECEDENTE STUDIO DCR-PHXC
    1.Trap renale o epatico o pianificato entro periodo studio
    2.Dialisi o richiesta di dialisi nota
    3.Prova documentata delle manifestazioni cliniche di ossalosi sistemica
    4.Presenza di condizione o comorbidità che interferirebbe con conformità allo studio o interpretaz dati o impatto potenziale su sicurezza partecipanti, compresi, ma non limitato a:
    a.grave malattia intercorrente b.cause note di malattia/danno epatico attivo o elevazione transaminasi c.storia di gravi malattie mentali che include, ma non si limita alla schizofrenia, disturbo bipolare, depressione grave che richiede ospedalizzazione o intervento farmacologico.
    d. storia clinicamente rilevante o presenza di patologie cardiovascolari, respiratorie, gastrointestinali, ematologiche, linfatiche, neurologiche, muscoloscheletriche, genitourinarie, immunologiche, dermatologiche comprendenti rash, grave eczema o dermatite, o malattie o disturbi del tessuto connettivo.
    5.Uso di routine o cronico di oltre 3gr acetaminofene/paracetamolo/giorno
    6.Uso di farmaco RNAi (diverso da DCR-PHXC) negli ultimi 6 mesi
    7.Storia di 1 o più seguenti reazioni a una terapia a base di oligonucleotidi: a. trombocitopenia grave (conta piastrinica minore o = 100.000/µl) b. epatotossicità, definita come ALT oAST>di 3 ×limite superiore della norma [ULN]) e (bilirubina tot >2×ULN o INR>1.5 c. gravi sintomi simil-influenzali che portano a interruzione terapia d. reazione cutanea localizzata dall'iniezione (gravemente classificata) che porta all'interruzione della terapia e. coagulopatia/prolungamento clinicamente significativo del tempo di coagulazione
    8.Partecip che ricevono piridossina devono aver assunto dose stabile per almeno 4settimane prima del primo giorno e devono essere disposti a rimanere sulla stessa dose stabile durante lo studio.
    9.Partecipaz a qualsiasi studio clinico in cui abbiano ricevuto un IMP, diverso da DCR-PHXC entro 4 mesi prima dello Screening a.Per IMP con il potenziale di ridurre concentrazioni di urina e/o di ossalato plasmatico,queste concentrazioni devono essere ritornate ai livelli storici di riferimento prima dello Screening.
    10.Oxalato plasmatico >30µmol/L.
    11.Funzion renale anomala: ALT e/o AST >1.5 xULN per età e sesso
    12.Ipersensibilità nota a DCR-PHXC
    13.Incapacità o riluttanza a rispettare le procedure di studio
    E.5 End points
    E.5.1Primary end point(s)
    The annual rate of decline in eGFR.
    [AUC from Day 90 to Day 180, based on percent change from Baseline in
    24-hour Uox]
    Tasso di riduzione annuale dell’eGFR


    [AUC dal Giorno 90 al Giorno 180, basata sulla variazione percentuale rispetto al basale del valore Uox delle 24 ore]
    E.5.1.1Timepoint(s) of evaluation of this end point
    Ongoing evaluation of all medical assessments and patient’s quality of life questionnaires. Continuous risk-benefit assessments will be conducted by the Sponsor and the Medical Monitor of the CRO.
    Valutazione continua di tutte le valutazioni mediche e dei questionari sulla qualità di vita del paziente. Continue valutazioni del rischio-beneficio
    verranno condotte dallo sponsor e dal medical monitor della CRO
    E.5.2Secondary end point(s)
    Key Secondary:
    The incidence and severity of treatment-emergent adverse events (TEAE) and serious adverse events (SAE)
    Change from Baseline in 12-lead electrocardiogram (ECG), physical examination findings, vital signs, and clinical laboratory tests (hematology, chemistry, coagulation parameters, and urinalysis)

    Secondary:
    1. The proportion of participants with a 24 hour Uox level (< 0.46 mmol/24 hours or = 0.46 - < 0.60 mmol/24 hours [adjusted per 1.73 m2 body surface area (BSA) in participants aged < 18 years]) at quarterly intervals throughout the study
    2. Change from Baseline in the number of stone events over a 12-month period, annually in Year 1, Year 2, etc.
    3. Change from Baseline in the stone burden at Year 1, Year 2, etc.
    4. The number of participants with severe CKD (GFR = 15 29 mL/min) or ESRD (GFR <15 mL/min); adjusted per 1.73 m2 BSA in participants aged < 18 years
    5. Change from Baseline in the Short Form (36) Health Survey (SF-36®), Wisconsin Stone Quality of Life Questionnaire (WISQOL), and EQ-5D-5L in adults; and in the Pediatric Quality of Life Inventory (PedsQL) in children
    6. Area under the curve (AUC) of 24-hour Uox from Day 90 to Day 180, based on percent change from Baseline. This endpoint will only be assessed in participants previously randomized to placebo in a multidose study of DCR-PHXC

    Exploratory:
    1. Population and individual pharmacokinetic (PK) parameters for DCR PHXC, including clearance (CL) and volume of distribution (V) estimates along with secondary parameters of area under the curve (AUC), maximum observed concentration (Cmax), minimum observed
    concentration (Cmin), time to maximum concentration (Tmax), and terminal elimination half-life (t1/2)
    Secondari Principali:
    Incidenza e gravità degli eventi avversi emergenti dal trattamento (EAET) e degli eventi avversi gravi (EAG)
    Variazioni rispetto al basale di elettrocardiogramma (ECG) a 12 derivazioni, risultati dell’esame obiettivo, segni vitali ed esami di laboratorio clinici (ematologia, chimica clinica, parametri della coagulazione e analisi delle urine)

    Secondari:
    1.La percentuale di partecipanti con livello di Uox nell’arco di 24 ore (inferiore a 0,46 mmol/24 ore o = 0,46 - < 0,60 mmol/24 ore [corretto per 1,73 m2 di superficie corporea (BSA) nei partecipanti di età < 18 anni]) a intervalli trimestrali per tutta la durata dello studio
    2.Variazione rispetto al basale del numero di eventi di litiasi su un periodo di 12 mesi, valutata annualmente per Anno 1, Anno 2, ecc.
    3.Variazione rispetto al basale del carico litiasico per Anno 1, Anno 2, ecc.
    4.Il numero di partecipanti con CKD grave (GFR = 15 29 mL/min) o ESRD (GFR <15 mL/min); aggiustato per 1,73 m2 della BSA nei partecipanti di età < 18 anni
    5.Variazione rispetto al basale nella versione breve (36) del questionario sullo stato di salute (SF-36) e nell’EQ-5D-5L™ per gli adulti; nel questionario sulla qualità della vita pediatrica (PedsQL™) per i bambini
    6.Area sotto la curva standardizzata (AUC) del valore Uox delle 24 ore, dal Giorno 90 al Giorno 180, in base alla variazione percentuale rispetto al basale. Questo endpoint sarà valutato solo nei partecipanti precedentemente randomizzati al placebo in uno studio multidose di DCR-PHXC

    Esplorativi:
    1.Parametri farmacocinetici (PK) di popolazione e individuali per DCR PHXC, comprese stime di clearance (CL) e volume di distribuzione (V), insieme ai parametri secondari di AUC, concentrazione massima osservata (Cmax), concentrazione minima osservata (Cmin), tempo di raggiungimento della concentrazione massima (Tmax) ed emivita di eliminazione terminale (t1/2)
    E.5.2.1Timepoint(s) of evaluation of this end point
    Ongoing evaluation of all medical assessments and patient’s quality of life questionnaires. Continuous risk-benefit assessments will be conducted by the Sponsor and the Medical Monitor of the CRO.
    Valutazione continua di tutte le valutazioni mediche e dei questionari sulla qualità di vita del paziente. Continue valutazioni del rischio-beneficio verranno condotte dallo sponsor e dal medical monitor della CRO
    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 No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    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 No
    E.8.1.1Randomised No
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    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) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    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 concerned2
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA30
    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
    Israel
    Japan
    Lebanon
    New Zealand
    United States
    France
    Germany
    Italy
    Netherlands
    Poland
    Romania
    Spain
    United Kingdom
    E.8.7Trial 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
    A participant is considered to have completed the study if he or she has completed all phases of the study including the last visit or the last scheduled procedure shown in the Schedule of Activities (SoA), Section 1.3 in the protocol.
    Per partecipante che abbia completato lo studio si intende un partecipante che abbia completato tutte le fasi dello studio, inclusa l'ultima visita o l'ultima procedura programmata presente nello Schema delle Attività, Sezione 1.3 del Protocollo
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    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 years3
    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 Yes
    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) Yes
    F.1.1.5.1Number of subjects for this age range: 10
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 10
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 28
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 2
    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 state4
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 32
    F.4.2.2In the whole clinical trial 50
    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)
    All participants will receive open-label DCR-PHXC until commercial approval of DCR-PHXC in the participant’s country or the program is terminated by Sponsor.
    Tutti i partecipanti riceveranno DCR-PHXC in aperto fino all'approvazione commerciale di DCR-PHXC nel proprio paese o finché il programma verrà terminato dallo Sponsor.
    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 Decision2019-06-26
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-09-18
    P. End of Trial
    P.End of Trial StatusOngoing
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