E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Hereditary hemorrhagic telangiectasia (HHT) |
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E.1.1.1 | Medical condition in easily understood language |
Osler–Weber–Rendu syndrome |
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E.1.1.2 | Therapeutic area | Diseases [C] - Congenital, Hereditary, and Neonatal Diseases and Abnormalities [C16] |
MedDRA Classification |
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 investigate the effectiveness of somatostatin analogues in decreasing the transfusion requirements in patients with HHT and GI bleeding who are refractory to endoscopic therapy. |
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E.2.2 | Secondary objectives of the trial |
Investigate the effectiveness of octreotide on: decreasing the endoscopic treatment frequency, increasing the quality of life, decreasing fatigue and epistaxis symptoms and cost-effectiveness. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Patients older than 18 years with written informed consent. - Diagnosis of HHT: either confirmed by genetic testing or the Curacao criteria (definite diagnosis). - Presence of IDA in combination with the presence endoscopic proven GI AVM manifestations / telangiectasias confirmed within the last 12 months (upper and/or lower endoscopy and/or capsule endoscopy). - Endoscopic refractory: at least 1 endoscopic APC / laser /other endoscopic treatment modality performed in the past 5 years. - Substantial transfusion dependency: at least 4 blood units and / or intravenous iron in the 6 months prior to study inclusion with a: o At least one serum ferritin below < 30 ug/l within the last 6 months requiring iron infusion above or equal to 1 g and/or o Hemoglobin below 5.6 mmol/l (9.0 g/dl) or are in need of transfusions due to anemia related symptoms within the last 6 months requiring blood transfusion above. |
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E.4 | Principal exclusion criteria |
- liver cirrhosis child-pugh C. - symptomatic cholecystolithiasis (possible side-effect octreotide). - pregnancy or nursing women or women have a pregnancy wish during the study period. |
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E.5 End points |
E.5.1 | Primary end point(s) |
‘successful response’, defined as a decrease of ≥50% in the amount of units intravenous iron and/or blood transfusions given |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
26 weeks prior to study inclusion and during the treatment study period (26 weeks). |
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E.5.2 | Secondary end point(s) |
The percentual or mean/median difference between the half year prior to inclusion and the treatment period of a half year between the treatment and observational arm in: - blood and intravenous iron requirements - PROM´s: quality of life (SF-36, EQ-5D), level of fatigue (multidimensional fatigue inventory (MFI)-20), epistaxis severity (ESS tool), and patient satisfaction - hemoglobin and ferritin levels - number of endoscopic treatments - cost-effectiveness (see economic evaluation) - Safety: All adverse events occurring during the study will be recorded in the patient's medical records. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
26 weeks prior to study inclusion and during the treatment study period (26 weeks). |
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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 | 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 | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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 | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
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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
| 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 | 6 |
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 | 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
|
The trial is ended when all patients have had their last trial visit. |
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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 | 2 |
E.8.9.2 | In all countries concerned by the trial months | 6 |