E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Skin and Connective Tissue Diseases [C17] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10047642 |
E.1.2 | Term | Vitiligo |
E.1.2 | System Organ Class | 10040785 - Skin and subcutaneous tissue disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of ruxolitinib cream in participants with vitiligo. |
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E.2.2 | Secondary objectives of the trial |
Key secondary:
To further assess the efficacy of ruxolitinib cream
Secondary:
To evaluate the safety and tolerability of ruxolitinib cream.
To evaluate the ruxolitinib PK in plasma after treatment of ruxolitinib cream. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Adolescents and adults aged ≥ 12 years.
2. Participants with a clinical diagnosis of non-segmental vitiligo with depigmented area including ≥ 0.5% BSA on the face, ≥ 0.5 F-VASI, ≥ 3% BSA on nonfacial areas, ≥ 3 T-VASI, and total body vitiligo area (facial and nonfacial) not exceeding 10% BSA.
3. Participants who agree to discontinue all agents used to treat vitiligo from screening through the final safety follow-up visit. Over-the-counter preparations deemed acceptable by the investigator and camouflage makeups are permitted.
4. Male and female participants must be willing to take appropriate contraceptive measures to avoid pregnancy or fathering a child for the duration of study participation with the exception of the following:
a. Females of non-childbearing potential (ie, or surgically sterile with a hysterectomy and/or bilateral oophorectomy OR postmenopausal, ≥ 12 months of amenorrhea without an alternative medical cause).
b. Prepubescent adolescents.
Note: Information about specific types of acceptable contraceptive measures and duration of contraceptive use are provided in the protocol.
5. For adult participant, ability to comprehend and willingness to sign an ICF, for adolescent participant written informed consent of the parent(s) or legal guardian and written assent from the adolescent participant.
Note: Adolescents, who during the course of the study become legal adults, will be asked for their consent to continue the study, and in the event of lack thereof, will be discontinued from further participation. |
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E.4 | Principal exclusion criteria |
1. Participants who have no pigmented hair within any of the vitiligo areas on the face.
2. Other forms of vitiligo (eg, segmental) or other differential diagnosis of vitiligo or other skin depigmentation disorders (eg, piebaldism, pityriasis alba, leprosy, postinflammatory hypopigmentation, progressive macule hypomelanosis, nevus anemicus, chemical leukoderma, and tinea versicolor).
3. Participants who have used depigmentation treatments (eg, monobenzone) for past treatment of vitiligo or other pigmented areas.
Note: Prior use of hydroquinone is not prohibited (as it is a bleaching agent, not a depigmentation treatment).
4. Participants with concurrent conditions and history of other diseases:
a. Any other skin disease that, in the opinion of the investigator, would interfere with the study medication application or study assessments.
b. Active acute bacterial, fungal, or viral skin infection (eg, herpes simplex, herpes zoster, chicken pox) within 1 week before baseline.
c. Conditions at baseline that would interfere with evaluation of vitiligo.
d. Any serious illness or medical, physical, or psychiatric condition(s) that, in the investigator's opinion, would interfere with full participation in the study, including administration of study drug and attending required study visits; pose a significant risk to the participant; or interfere with interpretation of study data.
Examples include but are not limited to the following:
− Clinically significant or uncontrolled cardiac disease, including unstable angina, acute myocardial infarction within 6 months from Day 1 of study drug administration, New York Heart Association Class III or IV congestive heart failure, and arrhythmia requiring therapy or uncontrolled hypertension (blood pressure > 150/90 mmHg) unless approved by the medical monitor/sponsor.
− History of thrombosis, including deep venous thrombosis and pulmonary embolism.
− Participants with concurrent malignant disease or a history of that in the 5 years preceding the baseline visit except for adequately treated nonmetastatic malignancies.
− Current and/or history of liver disease, including known hepatitis B or C, with hepatic or biliary abnormalities.
− History of alcoholism or drug addiction within 1 year before screening or current alcohol or drug use that, in the opinion of the investigator, will interfere with the participant's ability to comply with the administration schedule and study assessments.
− Participants who are committed to an institution by virtue of an order issued either by the judicial or the administrative authorities.
5. Participants using any of the following treatments within the indicated washout period before baseline:
a. 1 week: Topical drugs when used on the vitiligo areas, for example, corticosteroids, calcineurin, and phosphodiesterase type 4 inhibitors or retinoids.
b. 4 weeks:
− Melanocyte-stimulating agents (eg, afamelanotide).
− Immunomodulating systemic medications (eg, corticosteroids, methotrexate, cyclosporine).
− Any other systemic therapies that could increase the skin sensitivity to UV/visible light or impact skin pigmentation, for example, tetracyclines, metoxypsoralens.
− Received live vaccine.
Note: Live vaccine is prohibited during the course of the study and within 4 weeks after the EOT visit.
c. 8 weeks: Laser or any kind of phototherapy, including tanning bed or intentional UV exposure.
d. 5 half-lives or 12 weeks, whichever is longer: Biologic agents, investigational or experimental therapy or procedures for vitiligo. Investigational biologics should be discussed with the sponsor to determine whether a longer period of discontinuation is required.
6. Participants who have previously received JAK inhibitors, systemic or topical.
7. Participants with clinically significant abnormal laboratory values at screening:
a. Hemoglobin (< 10 g/dL).
b. Liver function tests:
− AST or ALT ≥ 2 × ULN.
− Alkaline phosphatase and/or bilirubin > 1.5 × ULN (isolated bilirubin > 1.5 × ULN is acceptable if bilirubin is fractionated and direct bilirubin < 35%).
c. Severe renal disease (with creatinine clearance < 30 ml/min) or renal disease requiring dialysis.
d. Clinically significant abnormal TSH or free T4 at screening as determined by the investigator.
e. Positive serology test results at screening for HIV antibody.
8. Body mass index < 17 or > 40 kg/m2.
9. Pregnant or lactating participants, or those considering pregnancy during the period of their study participation.
10. Participants who, in the opinion of the investigator, are unable or unlikely to comply with the administration schedule and study evaluations.
11. Employees of the sponsor or investigator or are otherwise dependents of them.
12. Participants with known allergy or reaction to any component of the study formulation |
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of participants achieving F-VASI75 at Week 24. |
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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) |
Key secondary:
• Percentage change from baseline in F-BSA at Week 24.
• Proportion of participants achieving F-VASI50 at Week 24.
• Proportion of participants achieving F-VASI75 at Week 52.
• Proportion of participants achieving F-VASI90 at Week 24.
• Proportion of participants achieving F-VASI90 at Week 52.
• Proportion of participants achieving T-VASI50 at Week 24.
• Proportion of participants achieving T-VASI50 at Week 52.
• Proportion of participants achieving T-VASI75 at Week 52.
• Proportion of participants achieving a VNS of “4 – A lot less noticeable” or “5 – No longer noticeable” at Week 24.
Secondary:
• The frequency, duration, and severity of AEs; physical examinations; vital signs; and laboratory data for hematology and serum chemistry.
• Proportion of participants achieving F-VASI25/50/75/90 during the treatment period (double-blind and treatment extension periods).
• Percentage change from baseline in F-VASI during the treatment period (double-blind and treatment extension periods).
• Percentage change from baseline in F-BSA during the treatment period (double-blind and treatment extension periods).
• Percentage change from baseline in T-VASI during the treatment period (double-blind and treatment extension periods).
• Percentage change from baseline in T-BSA during the treatment period (double-blind and treatment extension periods).
• Proportion of participants achieving T-VASI25/50/75/90 during the treatment period (double-blind and treatment extension periods).
• Proportion of participants in each category of VNS during the treatment period (double-blind and treatment extension periods).
• Population-based (trough) plasma concentrations of ruxolitinib at Weeks 4, 24 and 40. |
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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 | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
To determine the participants’ quality of life. |
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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 | 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 | 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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 32 |
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 |
Bulgaria |
Canada |
France |
Germany |
Italy |
Netherlands |
Poland |
Spain |
United Kingdom |
United States |
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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 | 2 |
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 |