E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Hemophilia A or B |
Emofilia A o B. |
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E.1.1.1 | Medical condition in easily understood language |
Hemophilia A or B |
Emofilia A o B. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066439 |
E.1.2 | Term | Hemophilia |
E.1.2 | System Organ Class | 100000004850 |
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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 confirm appropriate dose levels of fitusiran when administered to male pediatric participants (ages 1 to <12 years of age) with severe hemophilia A or B |
Confermare i livelli di dose appropriati di fitusiran quando viene somministrato ai partecipanti pediatrici di sesso maschile (età compresa tra 1 e <12 anni) con emofilia A o B grave |
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E.2.2 | Secondary objectives of the trial |
- To characterize the safety and tolerability
- To characterize the pharmacokinetics (PK)
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Caratterizzare la sicurezza e la tollerabilità Caratterizzare la farmacocinetica (PK) |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Male, aged 1 to <12 years at the time of enrollment. - Severe hemophilia A or B (Factor VIII (FVIII) <1% or Factor IX (FIX) </=2%) - Participants must have inhibitory antibodies to FVIII or FIX and must meet one of the following Nijmegen-modified Bethesda assay results criteria: - Inhibitor titer of >/=0.6 BU/mL at screening, OR - Inhibitor titer of <0.6 BU/mL at screening with medical record evidence of 2 consecutive titers >/=0.6 BU/mL, OR - Inhibitor titer of <0.6 BU/mL at screening with medical record evidence of anamnestic response. - Adequate peripheral venous access, as determined by the Investigator, to allow the blood draws required by the study protocol. - Weight requirements at the time of enrollment: 8 to <45 kg - Willing and able to comply with the study requirements and to provide signed written informed consent obtained from parent(s)/legal guardian (hereinafter the “parent”) and written or oral assent obtained from participant, per local and national requirements. |
- Maschio, età compresa tra 1 e <12 anni al momento dell'arruolamento - Emofilia grave di tipo A o B (Fattore VIII (FVIII) <1% o Fattore IX (FIX) </=2%) - I partecipanti devono avere anticorpi inibitori a FVIII o FIX e devono soddisfare uno dei seguenti criteri, basati sui risultati del test di Nijmegen-modificato Bethesda: - Titolo dell'inibitore >/= 0,6 BU / mL allo screening, O - Titolo dell'inibitore <0,6 BU / ml allo screening con evidenza medica documentata di 2 titoli consecutivi >/=0,6 BU / mL, O - Titolo dell'inibitore <0,6 BU / ml allo screening con evidenza medica documentata di una risposta anamnestica. - Adeguato accesso venoso periferico, in base al giudizio dello Sperimentatore, per consentire i prelievi di sangue richiesti dal protocollo di studio - Requisiti di peso al momento dell'arruolamento: da 8 a <45 kg - Pazienti che abbiano la volontà e siano in grado di rispettare i requisiti dello studio e di fornire il consenso informato scritto firmato ottenuto dal/dai genitore/i / tutore legale (di seguito "genitore") e l'assenso scritto o orale ottenuto dal partecipante, in accordo ai requisiti locali e nazionali. |
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E.4 | Principal exclusion criteria |
- Known co-existing bleeding disorders other than hemophilia A or B
- Antithrombin (AT) activity <60% at Screening
- Co-existing thrombophilic disorder
- Clinically significant liver disease
- Active Hepatitis C virus infection
- Acute or chronic Hepatitis B virus infection
- Acute Hepatitis A or hepatitis E infection
- HIV positive with a CD4 count of <400 cells/µL
- History of arterial or venous thromboembolism, unrelated to an indwelling venous access
- Inadequate renal function
- History of multiple drug allergies or history of allergic reaction to an oligonucleotide or N-Acetylgalactosamine (GalNAc)
- Subjects with central or peripheral indwelling catheters, with history of venous access complications leading to hospitalization and/or systemic anticoagulation therapy.
- History of intolerance to subcutaneous (SC) injection(s)
- Any other conditions or comorbidities that would make the patient unsuitable for enrollment or could interfere with participation in or completion of the study, per Investigator judgment |
- Patologie emorragiche coesistenti note, diverse dall'emofilia A o B - Attività Antitrombina (AT) <60% allo screening - Disturbo trombofilico coesistente - Presenza di malattia epatica clinicamente significativa - Positività anticorpale al virus dell'epatite C - Presenza di infezione da epatite B acuta o cronica - Presenza di epatite acuta A o Epatite E - Positività nota al virus dell'HIV con conta CD4 < 400 cellule/µL - Storia pregressa di tromboembolismo arterioso o venoso, non correlato ad un accesso venoso - Disturbi renali - Storia di più allergie ai farmaci o storia di reazione allergica a oligonucleotide o N-Acetilgalattosamina (GalNAc) - Soggetti con catetere centrale o periferico, con una storia di complicazioni all’accesso venoso che hanno portato a ospedalizzazione e/o terapia anticoagulante sistemica - Storia di intolleranza alle iniezioni sottocute (SC) - Qualsiasi condizione o comorbidità che secondo il parere dello Sperimentatore, renderebbe il paziente non idoneo all'arruolamento o che potrebbe interferire con la compliance allo studio o con il completamento del periodo di trattamento dello studio. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Lowering of plasma antithrombin (AT) activity level; Lowering of plasma antithrombin (AT) activity level from Day 1 pre-fitusiran dose to Day 85 |
Riduzione del livello dell’attività dell’antitrombina (AT) plasmatica; Riduzione del livello dell’attività dell’antitrombina (AT) plasmatica dal Giorno 1, prima della somministrazione di fitusiran, fino al Giorno 85. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Day 1 to Day 85 |
Dal giorno 1 al giorno 85 |
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E.5.2 | Secondary end point(s) |
1 - Number of participants reported with adverse events; Number of participants reported with treatment-emergent adverse events (TEAEs)
2 - Pharmacokinetics (PK): Maximum plasma concentration (Cmax); Plasma samples will be collected for measurement of plasma concentrations of fitusiran such as Cmax.
3 - Pharmacokinetics (PK): Time to reach maximum plasma concentration (Tmax); To evaluate time to reach Cmax
4 - Pharmacokinetics (PK): Ctrough; To evaluate concentration observed just before investigational medicinal product (IMP) administration during repeated dosing (Ctrough) |
1- Numero di pazienti che hanno riportato eventi avversi; Numero di partecipanti che hanno riportato eventi avversi emergenti durante il trattamento (TEAEs) 2- Farmacocinetica (PK): concentrazione plasmatica massima (Cmax); campioni plasmatici saranno raccolti per la misurazione della concentrazione plasmatica di fitusiran come Cmax. 3- Farmacocinetica (PK): tempo per raggiungere la concentrazione plasmatica massima (Tmax); valutare il tempo per raggiungere la Cmax 4- Farmacocinetica (PK): C through; valutare la concentrazione osservata subito prima della somministrazione a dosi ripetute del trattamento di studio (IMP) (Ctrought) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1 : 160 weeks
2, 3, 4 : Day 1, Day 29, Day 57 |
1: 160 settimane 2,.3,4: giorno 1, giorno 29, giorno 57 |
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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 | Yes |
E.6.3 | Therapy | Yes |
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 | 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) | 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 | No |
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
| 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 | 5 |
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 | Information not present in EudraCT |
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 |
Canada |
Italy |
Spain |
United States |
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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
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |