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    Summary
    EudraCT Number:2019-002989-12
    Sponsor's Protocol Code Number:IMR-BTL-201
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2020-10-21
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2019-002989-12
    A.3Full title of the trial
    A Phase 2 Study to Evaluate the Safety and Tolerability of IMR-687 in Subjects with Beta Thalassemia
    Studio di fase 2 volto a valutare la sicurezza e la tollerabilità di IMR-687 in soggetti affetti da beta talassemia
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Clinical study to review how safe and how well tolerated IMR-687 is in subjects with Beta Thalassemia
    Studio clinico per verificare la sicurezza e la tollerabilità di IMR-687 in soggetti con beta talassemia
    A.3.2Name or abbreviated title of the trial where available
    not applicable
    non disponibile
    A.4.1Sponsor's protocol code numberIMR-BTL-201
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04411082
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorIMARA Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportIMARA, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationIMARA, Inc.
    B.5.2Functional name of contact pointKevin B. Johnson
    B.5.3 Address:
    B.5.3.1Street Address116 Huntington avenue 6th floor
    B.5.3.2Town/ cityBoston
    B.5.3.3Post codeMA 02116
    B.5.3.4CountryUnited States
    B.5.4Telephone number+16172062027
    B.5.5Fax number+16173074491
    B.5.6E-mailKjohnson@imaratx.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameIMR-687
    D.3.2Product code [IMR-687 200 mg]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIMR-687
    D.3.9.2Current sponsor codeIMR-687
    D.3.9.4EV Substance CodeSUB190944
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameIMR-687
    D.3.2Product code [IMR-687 100 mg]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIMR-687
    D.3.9.2Current sponsor codeIMR-687
    D.3.9.4EV Substance CodeSUB190944
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameIMR-687
    D.3.2Product code [IMR-687 150 mg]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIMR-687
    D.3.9.2Current sponsor codeIMR-687
    D.3.9.4EV Substance CodeSUB190944
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    ß-thalassemia
    Beta talassemia
    E.1.1.1Medical condition in easily understood language
    ß-thalassemia
    Beta talassemia
    E.1.1.2Therapeutic area Diseases [C] - Blood and lymphatic diseases [C15]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10054660
    E.1.2Term Thalassemia beta
    E.1.2System Organ Class 100000004850
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective of this study in both Population 1 (TDT - transfusion-dependent) and Population 2 (NTDT - non-transfusion-dependent) is to assess the safety and tolerability of IMR-687 in adult subjects with ß-thalassemia.
    L’obiettivo primario di questo studio sia nella Popolazione 1 (TDT - trasfusione dipendente) che nella Popolazione 2 (NTDT - non trasfusione dipendente) è valutare la sicurezza e la tollerabilità di IMR-687 in soggetti adulti affetti da ß talassemia.
    E.2.2Secondary objectives of the trial
    The secondary objectives in Population 1 (TDT) subjects are:
    • To evaluate the effect of IMR-687 versus placebo on reduction in red blood cell (RBC) transfusion burden.
    • To evaluate the change in transfusional iron load rate of IMR-687 versus placebo.
    • To characterize the pharmacokinetic (PK) profile of IMR-687.

    The secondary objectives in Population 2 (NTDT) subjects are:
    • To evaluate the effect of IMR-687 versus placebo on fetal hemoglobin (HbF).
    • To evaluate the effect of IMR-687 versus placebo on anemia.
    • To characterize the PK profile of IMR-687.

    Please refer to the protocol for the Exploratory objectives.
    Gli obiettivi secondari nella Popolazione 1 (TDT) sono:
    • Valutare l’effetto di IMR-687 rispetto al placebo sulla riduzione del carico trasfusionale di globuli rossi (red blood cell, RBC).
    • Valutare la variazione nel tasso di carico di ferro trasfusionale di IMR-687 rispetto al placebo.
    • Caratterizzare il profilo farmacocinetico (PK) di IMR-687.

    Gli obiettivi secondari nella Popolazione 2 (NTDT) sono:
    • Valutare l’effetto di IMR-687 rispetto al placebo sull’emoglobina fetale (HbF).
    • Valutare l’effetto di IMR-687 rispetto al placebo sull’anemia.
    • Caratterizzare il profilo PK di IMR-687.

    Per gli obiettivi esplorativi si prega di far riferimento al protocollo.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Subjects must meet all of the following inclusion criteria to be eligible for the study:
    1. Subjects must understand and voluntarily provide informed consent and sign an informed consent form (ICF) prior to any study-related assessments/procedures being conducted. Although RBC transfusions and associated hemoglobine (Hb) laboratory measurements 12 weeks prior to the Screening visit are not study related, the ICF will specifically request subject consent to collect these data.
    2. Subjects must be >=18 to <=65 years of age at the time of signing the ICF.
    3. Subjects must have documented diagnosis of ß-thalassemia or HbE/ß-thalassemia. Concomitant single alpha gene deletion, duplication, or triplication is allowed.
    4. For TDT subjects only: Subjects must be regularly transfused, defined as >3 to 10 RBC units in the 12 weeks prior to screening and no transfusion-free period for >=35 days during that period.
    For NTDT subjects only: Subjects must be transfusion independent, defined as 0 to <=3 units of RBCs received during the 12-week period prior to randomization, must not be on a regular transfusion program, must be RBC transfusion-free for at least => 4 weeks prior to randomization, and must not be scheduled to start a regular hematopoietic stem cell transplantation within 9 months.
    5. Subjects must have documentation of dates of transfusions and the number of all RBC units within the 12 weeks prior to Screening.
    6. Subjects must be willing and able to complete all study assessments and procedures, and to communicate effectively with the investigator and site staff.
    7. Subjects must have Eastern Cooperative Oncology Group (ECOG) performance score of 0 to 1 (Appendix 1 of the protocol).
    8. Female subjects must not be pregnant, not be breast feeding, and be highly unlikely to become pregnant. Male subjects must be unlikely to impregnate a partner. Detailed information is available in the protocol.
    9. Subjects receiving hydroxyurea must have received it continuously for at least 6 months prior to signing the ICF, and must have been on a stable dose for at least 3 months prior to signing the ICF, with no anticipated need for dose adjustments during the study including the screening period, in the opinion of the investigator.
    10. For NTDT subjects only: Subjects must have mean baseline Hb <=10.0 g/dL, based on a minimum of 2 measurements >=1 week apart within 4 weeks prior to randomization; Hb values within 21 days post-transfusion will be excluded.
    Per essere idonei a partecipare a questo studio, i soggetti devono soddisfare tutti i seguenti criteri di inclusione:
    1. I soggetti devono comprendere e fornire volontariamente il consenso informato e firmare un modulo di consenso informato (ICF) prima che sia condotta qualsiasi valutazione-procedura correlata allo studio. Sebbene le trasfusioni di RBC e le relative misurazioni di laboratorio dei livelli di Hb nelle 12 settimane precedenti la visita di screening non siano correlate allo studio, l’ICF richiede specificamente che il soggetto acconsenta alla raccolta di questi dati.
    2. I soggetti devono avere un’età >=18 e <= 65 anni al momento della firma dell’ICF.
    3. I soggetti devono avere una diagnosi documentata di ß-talassemia o HbE/ß-talassemia. Sono consentite delezioni, duplicazioni o triplicazioni singole concomitanti nel gene alfa.
    4. Solo per i soggetti TDT: i soggetti devono sottoporsi a trasfusioni regolari, definite come unità di RBC >3-10 nelle 12 settimane precedenti lo screening e nessun periodo senza trasfusioni per >=35 giorni in quell’arco di tempo.
    Solo per i soggetti NTDT: I soggetti devono essere trasfusione-indipendenti, ovvero, possono avere ricevuto da 0 a <=3 unità di RBC durante il periodo di 12 settimane che precede la randomizzazione, non devono seguire un regolare programma trasfusionale, non devono avere ricevuto trasfusioni di RBC per almeno >= 4 settimane prima della randomizzazione e non devono avere in programma di sottoporsi a un regolare trapianto di cellule staminali emopoietiche entro 9 mesi.
    5. I soggetti devono disporre della documentazione in cui siano riportati le date delle trasfusioni e il numero di tutte le unità di RBC trasfuse nelle 12 settimane precedenti lo screening.
    6. I soggetti devono essere disposti e in grado di completare tutte le valutazioni e le procedure dello studio, nonché comunicare in maniera efficace con lo sperimentatore e il personale del centro.
    7. I soggetti devono avere un punteggio dello stato di validità secondo il Gruppo cooperativo orientale di oncologia (ECOG) compreso tra 0 e 1 (Appendice 1).
    8. I soggetti di sesso femminile non devono essere né in stato di gravidanza né in fase di allattamento e devono avere scarse probabilità di avviare una gravidanza. I soggetti di sesso maschile devono avere una bassa probabilità di procreare. Informazioni dettagliate sono disponibili nel protocollo.
    9. I soggetti che assumono idrossiurea devono averla ricevuta in modo continuativo per almeno 6 mesi prima della firma dell’ICF e devono aver ricevuto una dose stabile per almeno 3 mesi prima della firma dell’ICF, senza alcuna necessità prevista di aggiustamenti della dose durante lo studio, incluso il periodo di screening, a giudizio dello sperimentatore.
    10. Solo per i soggetti NTDT: i soggetti devono presentare livelli medi di Hb al basale <= 10,0 g/dl, in base a un minimo di 2 misurazioni eseguite a distanza di >= 1 settimana entro 4 settimane prima della randomizzazione; valori di Hb entro 21 giorni post trasfusione saranno esclusi.
    E.4Principal exclusion criteria
    Subjects meeting any of the following criteria must be excluded from the study:
    1. Any significant medical condition, lab abnormality, or psychiatric illness that would prevent the subject from participating in the study, including the presence of laboratory abnormalities that may place the subject at unacceptable risk if he/she were to participate in the study.
    2. Any situation or condition that confounds the ability to interpret data from the study (e.g., subjects also receiving RBC transfusions at centers not able to obtain laboratory samples for central processing).
    3. Diagnosis of a-thalassemia (e.g., HbH) or HbS/ ß-thalassemia.
    4. BMI <17.0 kg/m2 or a total body weight <45 kg; or BMI >35 kg/m2.
    5. Subjects with known active HAV, HBV, or HCV, with active or acute event of malaria, or who are known to be positive for HIV.
    6. Stroke requiring medical intervention <=24 weeks prior to randomization.
    7. Subjects taking direct acting oral anti-coagulants (DOACs) apixaban, dabigatran, rivaroxaban, edoxaban, or ticagrelor, or taking warfarin, are excluded due to the possibility of a cytochrome P450 (CYP)3A-mediated drug interaction, unless they stopped the treatment at least 28 days prior to randomization (Day 1); other oral anti-coagulants and anti-platelet drugs are permitted. Anticoagulant
    therapies for prophylaxis of venous thromboembolism, including pulmonary emboli including when undergoing surgery or high-risk procedures, are allowed if low molecular weight heparins are used
    in the peri-operative period. Aspirin use is allowed before and during the study.
    8. Treatment with an investigational drug or device or participation in an investigational drug or device study <=28 days prior to randomization.
    9. Platelet count >1000 × 10^9/L.
    10. Subjects on iron chelation therapy (ICT) at the time of ICF signing must have initiated the treatment with ICT at least 24 weeks before the predicted randomization date. ICT can be initiated at any time during treatment and should be used according to the label.
    11. Subjects who have had treatment with erythropoietin-stimulating agents <=24 weeks prior to randomization.
    12. Uncontrolled hypertension as defined by systolic BP >=160 mm Hg or diastolic BP >=100 mm Hg, medical intervention indicated, and more than one drug or more intensive therapy than previously used indicated.
    13. Poorly controlled diabetes mellitus as defined by 1) fructosamine levels of >340 µmol/L within 12 weeks prior to randomization; 2) short term hyperglycemia leading to hyperosmolar or ketoacidotic crisis; and/or 3) history of diabetic cardiovascular complications.
    14. Subjects who have major organ damage. Please refer to protocol for more information.
    15. Subjects who have received chronic systemic glucocorticoids <=12 weeks prior to randomization (>=5 mg/day). Physiologic replacement therapy for adrenal insufficiency is allowed.
    16. Major surgery <=12 weeks prior to randomization.
    17. A history of a clinically significant allergic reaction or hypersensitivity, as judged by the investigator, to any drug or any component of the study drug formulations used in the study (see IB).
    18. History or current malignancies (solid tumors and hematological malignancies) unless the subject has been free of the disease (including completion of any active or adjuvant treatment for prior malignancy) for >=5 yrs. However, some subjects are allowed if, in the opinion of the investigator, the condition has been adequately diagnosed and is determined to be clinically in remission, and the subject's participation in the study would not represent a safety concern. Please refer to the protocol for more information.
    Please refer to the protocol for exclusion criteria 19-24
    I soggetti che soddisfano uno qualsiasi dei seguenti criteri dovranno essere esclusi dallo studio:
    1. Qualsiasi condizione medica, anomalia di laboratorio o patologia psichiatrica significativa che potrebbe impedire al soggetto di partecipare allo studio, compresa la presenza di anomalie di laboratorio che potrebbero esporre il soggetto a un rischio inaccettabile qualora partecipi allo studio.
    2. Qualsiasi situazione o condizione che confonda la capacità di interpretare i dati dallo studio (es., soggetti che ricevono trasfusioni di RBC anche presso centri non in grado di ottenere campioni di laboratorio da trattare a livello centrale).
    3. Diagnosi di a-talassemia (es., HbH) o HbS/ß talassemia.
    4. IMC <17,0 kg/m2 o peso corporeo totale <45 kg; o IMC >35 kg/m2.
    5. Soggetti con nota infezione attiva da HAV, HBV o HCV, con un evento attivo o acuto di malaria, o positivi HIV.
    6. Ictus che richiede un intervento medico <=24 settimane prima della randomizzazione.
    7. I soggetti che assumono anticoagulanti orali ad azione diretta (DOAC) apixaban, dabigatran, rivaroxaban, edoxaban o ticagrelor, o quelli che assumono warfarin, sono esclusi a causa della possibilità di un’interazione farmacologica mediata dal citocromo P450 (CYP) 3A, a meno che non abbiano interrotto il trattamento almeno 28 giorni prima della randomizzazione (Giorno 1); consentito uso di altri anticoagulanti orali e farmaci antipiastrinici. Terapie anticoagulanti per la profilassi della tromboembolia venosa, inclusa l’embolia polmonare anche in caso di intervento chirurgico o a procedure alto rischio, sono consentite a condizione che nel periodo peri-operatorio vengano usate eparine a basso peso molecolare. Uso di aspirina consentito prima e durante lo studio.
    8. Trattamento con farmaco o dispositivo sperimentale o partecipazione a studio di un farmaco o dispositivo sperimentale =<28 giorni prima della randomizzazione.
    9. Conta piastrinica >1.000 × 10^9/l.
    10. I soggetti in terapia ferrochelante (ICT) alla firma dell’ICF devono aver iniziato il trattamento con ICT almeno 24 settimane prima della data di randomizzazione prevista. L’ICT può essere avviata in qualsiasi momento durante il trattamento e deve essere usata conformemente all’etichetta.
    11. Soggetti che hanno ricevuto un trattamento con agenti che stimolano l’eritropoietina <=24 settimane prima della randomizzazione.
    12. Ipertensione non controllata definita da valori di PA sistolica >=160 mmHg o PA diastolica >=100 mmHg, intervento medico indicato e più di un farmaco o più di una terapia intensiva indicato/a rispetto a quanto precedentemente utilizzato.
    13. Diabete mellito scarsamente controllato definito da 1) livelli di fruttosamina >340 µmol/l entro 12 settimane prima della randomizzazione; 2) iperglicemia a breve termine con conseguente crisi iperosmolare o chetoacidosica; e/o 3) anamnesi di complicazioni cardiovascolari del diabete.
    14. Soggetti con un danno d’organo significativo. Far riferimento al protocollo per maggiori dettagli.
    15. Soggetti che hanno ricevuto un trattamento cronico con glucocorticoidi per via sistemica <=12 settimane prima della randomizzazione (>=5 mg/giorno). La terapia sostitutiva fisiologica per insufficienza surrenale è consentita.
    16. Intervento di chirurgia maggiore <=12 settimane prima della randomizzazione.
    17. Anamnesi di reazione allergica o ipersensibilità clinicamente significativa, secondo il parere dello sperimentatore, a qualsiasi farmaco o componente delle formulazioni di farmaco sperimentale usate nello studio (vedi IB).
    18. Neoplasie maligne riportate in anamnesi o in corso, a meno che il soggetto non presenti malattia da >=5 anni. Alcuni soggetti sono ammessi. Far riferimento al protocollo per maggiori dettagli.
    Far riferimento al protocollo per i criteri di esclusione 19-24.
    E.5 End points
    E.5.1Primary end point(s)
    IMR-687 safety and tolerability as measured by:
    • Incidence and severity of adverse events and serious adverse events
    • Observed values and changes from baseline in 12-lead ECG parameters, clinical laboratory tests (chemistry, hematology, coagulation, urinalysis), and vital signs for any timepoint
    • Physical examination findings
    • Use of concomitant medications and therapies
    Sicurezza e tollerabilità di IMR-687 misurate da:
    • Incidenza e gravità degli eventi avversi e degli eventi avversi gravi
    • Valori osservati e variazioni rispetto al basale dei parametri ECG a 12 derivazioni, test clinici di laboratorio (chimica, ematologia, coagulazione, analisi delle urine) e segni vitali per qualsiasi punto temporale
    • Risultati dell'esame fisico
    • Uso di farmaci e terapie concomitanti
    E.5.1.1Timepoint(s) of evaluation of this end point
    Throughout the study
    Durante tutto lo studio
    E.5.2Secondary end point(s)
    Population 1:
    * Proportion of subjects with a >=20% hematological improvement from Week 12 to Week 24 and Week 24 to Week 36, compared to the 12- week prescreening timeframe.
    * Proportion of subjects with a >=20% hematological improvement from Week 12 to Week 36, compared to the 12-week prescreening timeframe.
    * Proportion of subjects with a >=33% hematological improvement from Week 12 to Week 24 and Week 24 to Week 36, compared to the 12- week prescreening timeframe.
    * Proportion of subjects with a >=33% hematological improvement from Week 12 to Week 36, compared to the 12-week prescreening timeframe.
    * Mean number of transfusion events from baseline to Week 36 compared to placebo.
    * The plasma PK profile of IMR-687 (and metabolites) after administration to subjects will be evaluated by determination of PK parameters (e.g., Cmax, tmax, t½, AUC0-24, AUClast, and AUC0-inf) based on drug concentration levels in plasma obtained over time.
    * Mean change from baseline to Week 36, and proportion of subjects with improvement for iron chelation therapy daily dose and serum ferritin.

    Population 2:
    * The plasma PK profile of IMR-687 (and metabolites) after administration to subjects will be evaluated by determination of PK parameters (e.g., Cmax, tmax, t½, AUC0-24, AUClast, and AUC0-inf) based on drug concentration levels in plasma obtained over time.
    * Mean change from baseline to Week 36, and proportion of subjects with improvement for iron chelation therapy daily dose and serum ferritin.
    * Mean change in Hb and HbF concentrations from baseline to Week 24 and Week 36 in the IMR-687 group compared with the placebo group.
    * Mean change in percent HbF at Week 24 and Week 36 compared to HbF at baseline in the IMR-687 group versus the placebo group.
    * Subject response in HbF, where a responder has an increase of >=3% at Week 24 compared to HbF at baseline in the IMR-687 group compared to the placebo group.
    * Mean change in Hb and HbF concentrations over a continuous 12-week interval from Week 12 to Week 24 and Week 24 to Week 36 in the absence of transfusions in IMR-687 group compared with the placebo group.

    Please refer to the protocol for the Exploratory Endpoints.
    Popolazione 1:
    * Proporzione di soggetti con un miglioramento ematologico >=20% dalla settimana 12 alla settimana 24 e dalla settimana 24 alla settimana 36, rispetto al periodo di pre-screening di 12 settimane.
    * Proporzione di soggetti con un miglioramento ematologico >=20% dalla settimana 12 alla settimana 36, rispetto al periodo di pre-screening di 12 settimane.
    * Proporzione di soggetti con un miglioramento ematologico >=33% dalla settimana 12 alla settimana 24 e dalla settimana 24 alla settimana 36, rispetto al periodo di pre-screening di 12 settimane.
    * Proporzione di soggetti con un miglioramento ematologico >=33% dalla settimana 12 alla settimana 36, rispetto al periodo di pre-screening di 12 settimane.
    * Numero medio di eventi trasfusionali dal basale alla Settimana 36 rispetto al placebo.
    * Il profilo plasmatico di PK dell'IMR-687 (e dei metaboliti) dopo la somministrazione ai soggetti sarà valutato mediante determinazione dei parametri PK (ad es. Cmax, tmax, t½, AUC0-24, AUClast e AUC0-inf) in base ai livelli di concentrazione del farmaco nel plasma ottenuto nel tempo.
    * Variazione media dal basale alla Settimana 36 e proporzione di soggetti con miglioramento della dose giornaliera della terapia di chelazione del ferro e ferritina sierica.

    Popolazione 2:
    * Il profilo plasmatico di PK dell'IMR-687 (e dei metaboliti) dopo la somministrazione ai soggetti sarà valutato mediante determinazione dei parametri PK (ad es. Cmax, tmax, t½, AUC0-24, AUClast e AUC0-inf) in base ai livelli di concentrazione del farmaco nel plasma ottenuto nel tempo.
    * Variazione media dal basale alla Settimana 36 e proporzione di soggetti con miglioramento della dose giornaliera della terapia di chelazione del ferro e ferritina sierica.
    * Variazione media delle concentrazioni di Hb e HbF dal basale alla Settimana 24 e alla Settimana 36 nel gruppo IMR-687 rispetto al gruppo placebo.
    * Variazione media dell'HbF percentuale alla settimana 24 e alla settimana 36 rispetto all'HbF al basale nel gruppo IMR-687 rispetto al gruppo placebo.
    * Risposta del soggetto in HbF, in cui un responder ha un aumento >=3% alla settimana 24 rispetto a HbF al basale nel gruppo IMR-687 rispetto al gruppo placebo.
    * Variazione media delle concentrazioni di Hb e HbF in un intervallo continuo di 12 settimane dalla settimana 12 alla settimana 24 e dalla settimana 24 alla settimana 36 in assenza di trasfusioni nel gruppo IMR-687 rispetto al gruppo placebo

    Fare riferimento al protocollo per gli endpoint esplorativi
    E.5.2.1Timepoint(s) of evaluation of this end point
    In 12week intervals from Week 12 to Week 24 and Week 24 to Week 36 and troughout the study.
    PK: Population 1 at Baseline, week 1, week 3, 24 and 36 (or End of Treatment visit); population 2 at Baseline, week 1, week 4, 24 and 36 (or End of Treatment visit)
    A intervalli di 12 settimane dalla settimana 12 alla settimana 24 e dalla settimana 24 alla settimana 36 e per tutto lo studio.
    PK: Popolazione 1 al Basale, settimana 1, settimana 3, 24 e 36 (o visita di fine trattamento); popolazione 2 al Basale, settimana 1, settimana 4, 24 e 36 (o visita di fine trattamento)
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    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.8.4.1Number of sites anticipated in Member State concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA15
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Denmark
    Egypt
    France
    Georgia
    Greece
    India
    Israel
    Italy
    Lebanon
    Malaysia
    Morocco
    Netherlands
    Tunisia
    Turkey
    United Kingdom
    United States
    E.8.7Trial 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
    LVLS
    LVLS (Last Visit Last Subject, Ultima visita dell'ultimo paziente)
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months8
    E.8.9.1In the Member State concerned days5
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months8
    E.8.9.2In all countries concerned by the trial days5
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 118
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 2
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state10
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 25
    F.4.2.2In the whole clinical trial 120
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Standard of Care
    Cura standard
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2020-09-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-09-15
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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