E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Persistent cough in Idiopathic Pulmonary Fibrosis (IPF) |
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E.1.1.1 | Medical condition in easily understood language |
Cough in IPF is often a debilitating symptom that adversely affects quality of life (QoL) and is usually refractory to medical therapy. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10070801 |
E.1.2 | Term | Persistent cough |
E.1.2 | System Organ Class | 100000004855 |
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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 |
Primary:
• To assess the efficacy of inhaled RVT-1601 in comparison with placebo following 12 weeks of treatment |
|
E.2.2 | Secondary objectives of the trial |
Secondary:
• To select the optimal dose of RVT-1601
• To assess the pharmacokinetic (PK) profile of RVT-1601
• To assess biomarker response to RVT-1601
• To assess the impact of RVT-1601 on IPF disease
• To assess the safety of RVT-1601 |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
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E.3 | Principal inclusion criteria |
Inclusion criteria:
1. Male or female subjects age 40 through 89 years, inclusive
2. Confirmed diagnosis of IPF with clinical features consistent with the
current clinical practice guidelines for IPF
3. Presence of persistent cough for at least 8 weeks that is primarily due
to IPF and not responsive to antitussive therapy
4. Daytime cough severity score of ≥40 mm on a 100-mm VAS at the
Screening Visit
5. 24-hour average cough count of at least 10 coughs per hour using an
objective cough-count monitor during Screening
6. Forced Vital Capacity (FVC) ≥ 45% predicted value within 4 weeks of
the Screening Visit
7. Life expectancy of at least 12 months
8. Willing and able to follow the study required visits and assessments
9. Willing and able to use the cough monitor for 24-hour periods at
select study visits
10. Willing and able to provide written informed consent prior to study-related
procedures
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E.4 | Principal exclusion criteria |
Exclusion criteria:
1. Current or recent history of clinically significant medical condition, laboratory abnormality, or illness that could place the subject at risk or compromise the quality of the study data as determined by the investigator
2. Significant coronary artery disease (i.e., myocardial infarction within 6 months or unstable angina within 1 month of the Screening Visit)
3. An upper or lower respiratory tract infection within 4 weeks of the Screening Visit
4. Acute exacerbation of IPF within 6 months of the Screening Visit (Collard et al., 2016)
5. Lung transplantation expected within 12 months
6. Requiring supplemental O2 ≥ 4 litres/min to maintain peripheral
arterial O2 saturation (SpO2) ≥ 88% at rest
7. History of malignancy likely to result in significant disability or likely
to require significant medical or surgical intervention within the next 2
years. This does not include minor surgical procedures for localized
cancer (e.g., basal cell carcinoma, squamous cell, prostate carcinoma or
cervical
carcinoma in situ)
8. Current smoker (i.e., use of tobacco products within the last 3
months)
9. Current or recent history of drug or alcohol abuse within 12 months of
the Screening Visit
10. Participation in any other investigational drug study within 4 weeks
of the Screening Visit or within 5 times the elimination half- life of an
investigational drug
11. Use of the following drugs for cough management within 4 weeks of
the Screening Visit: prednisone, opiates, baclofen, gabapentin,
pregabalin, thalidomide, amitriptyline, inhaled corticosteroids, or inhaled
bronchodilators
12. Use of ACE inhibitors or cromolyn sodium within 4 weeks of the
Screening Visit
13. Females who are pregnant or breastfeeding, or if of child-bearing
potential unwilling to practice acceptable means of birth control during
the study (e.g., abstinence, combination barrier and spermicide,
hormonal, or male partner sterilization)
14. History of hypersensitivity or intolerance to cromolyn sodium or its inactive ingredients |
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary endpoint:
• Change from baseline at the end of treatment in 24-hour average cough count |
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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) |
Secondary endpoints:
• Change from baseline at the end of treatment in cough severity as measured by VAS
• Change from baseline at the end of treatment in cough-specific QoL as measured by LCQ
• Proportion of responders with a minimum of 20% decrease from baseline at the end of
treatment in 24-hour average cough count
• Change from baseline at the end of treatment in daytime average cough count
• Change from baseline at the end of treatment in nighttime average cough count
• Change from baseline at the end of treatment in ILD-specific QoL as measured by K-BILD
• Change from baseline at the end of treatment in respiratory-related QoL as measured by SGRQ
• Change from baseline at the end of treatment in dyspnea score as measured by SOBQ
• Change from baseline at the end of treatment in 6MWT
• Change from baseline at the end of treatment in FVC
• Proportion of subjects with no decline (i.e., < 5% decline), 5% - 10% decline, and > 10%
decline in FVC % predicted at the end of treatment
• Change from baseline at the end of treatment in airway and lung volumes as measured by FRI
• Change from baseline at the end of treatment in average daily oxygen use
• Change from baseline at the end of treatment in exploratory biomarkers |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
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) | 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 | 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 | 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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 4 |
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 | 37 |
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 |
Australia |
Belgium |
Canada |
Czech Republic |
Germany |
Italy |
Netherlands |
New Zealand |
Turkey |
United Kingdom |
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
|
The end of the study will be determined by the last visit of the last
subject randomized. |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
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 | 2 |
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 |