E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Hereditary Transthyretin-mediated Amyloidosis (hATTR amyloidosis) |
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E.1.1.1 | Medical condition in easily understood language |
hATTR is a hereditary disease caused by protein aggregates in the heart and the nervous system. It leads to heart dysfunction, damages to the nerves, and gastrointestinal and bladder dysfunctions. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Congenital, Hereditary, and Neonatal Diseases and Abnormalities [C16] |
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 | 10007509 |
E.1.2 | Term | Cardiac amyloidosis |
E.1.2 | System Organ Class | 10007541 - Cardiac disorders |
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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 | 10019889 |
E.1.2 | Term | Hereditary neuropathic amyloidosis |
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 |
To evaluate the TTR reduction of patisiran-LNP in hATTR amyloidosis patients with disease progression after OLT |
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E.2.2 | Secondary objectives of the trial |
- To evaluate the effect of patisiran-LNP on neuropathy
- To evaluate the effect of patisiran-LNP on patient reported outcomes including QoL, activities of daily living and autonomic neuropathy symptoms
- To characterize the effect on nutritional status |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-18 years of age or older
-Received an orthotopic liver transplant for treatment of hATTR amyloidosis at least 1 year prior
-Increase in polyneuropathy disability post-liver transplant as measured by polyneuropathy disability (PND) score.
-Karnofsky performance status of ≥70%
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E.4 | Principal exclusion criteria |
-Currently taking tafamidis, doxycycline, diflunisal, or tauroursodeoxycholic acid
-Liver allograft rejection episodes or abnormal LFTs suggestive of possible allograft rejection in the past 6 months
-Abnormal liver function tests
-Known leptomeningeal amyloidosis
-New York Heart Association (NYHA) classification of >2
-PND score IV (wheelchair bound or bedridden)
- Prior organ transplant other than liver transplant
-Hospitalization for congestive heart failure or arrhythmia in the past 3 months |
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E.5 End points |
E.5.1 | Primary end point(s) |
Percent change from baseline in serum TTR levels |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
-Change from baseline in Neuropathy Impairment Score (NIS)
-Change from baseline in quality of life and disability as assessed by Norfolk Quality of Life (QoL-DN), Rasch-built Overall Disability Scale (R-ODS), and Autonomic Symptoms Questionnaire (COMPASS 31)
-Change from baseline in modified Body Mass Index (mBMI) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
12 months (this is applicable to all 3 of the secondary end points) |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
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 | 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 | No |
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.8.2.4 | Number of treatment arms in the trial | 1 |
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 | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 10 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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 | 1 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 10 |