E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with Paroxysmal Nocturnal Hemoglobinuria Who Have Clinically Evident Extravascular Hemolysis (EVH) |
Patients atteints d’hémoglobinurie paroxystique nocturne (HPN) qui présentent une hémolyse extravasculaire (HEV) symptomatique |
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E.1.1.1 | Medical condition in easily understood language |
Patients with Paroxysmal Nocturnal Hemoglobinuria Who Have Clinically Evident Extravascular Hemolysis (EVH) |
Patients atteints d’hémoglobinurie paroxystique nocturne (HPN) qui présentent une hémolyse extravasculaire (HEV) symptomatique |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
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 | 10034042 |
E.1.2 | Term | Paroxysmal nocturnal haemoglobinuria |
E.1.2 | System Organ Class | 10038359 - Renal and urinary disorders |
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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 evaluate the efficacy of danicopan as compared to placebo as add-on therapy to a C5 inhibitor at 12 weeks |
Évaluer l’efficacité du danicopan par rapport au placebo, comme traitement d’appoint à un inhibiteur du C5, après 12 semaines. |
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E.2.2 | Secondary objectives of the trial |
• Percentage Of Participants With Transfusion Avoidance
• Change From Baseline In Functional Assessment Of Chronic Illness Therapy (FACIT) Fatigue Scores
• Change From Baseline In Absolute Reticulocyte Count |
•Proportion de patients présentant un évitement des transfusions
•Changement par rapport à la baseline du score FACIT Fatigue
•Variation de la numération absolue des réticulocytes par rapport à la baseline. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Diagnosis of PNH
• Clinically Evident EVH defined by:
- Anemia (Hgb ≤9.5 gram/deciliter) with absolute reticulocyte count ≥120 x 10^9/liter.
- At least 1 packed red blood cell or whole blood transfusion within 6 months prior to the start of the study.
• Receiving a C5 inhibitor for at least 6 months prior to Day 1
• Platelet count ≥30,000/microliters (µL)
• Absolute neutrophil counts ≥750/μL.
• Documentation of/or willingness to receive vaccinations and prophylactic antibiotics as required. |
•Diagnostic d’HPN
•Hémolyse extravasculaire (HEV) cliniquement symptomatique définie par :
- une anémie (hémoglobine ≤ 9,5 g/dl) avec numération des réticulocytes absolue ≥ 120 × 109/l.
- au moins 1 transfusion de concentré de GR ou de sang total dans les 6 mois précédant le début de l’étude.
•Patient recevant un inhibiteur du C5 depuis au moins 6 mois avant le Jour 1
•Numération plaquettaire ≥ 30 000/µl
•Numération absolue des neutrophiles ≥ 750/μl.
•Documentation de/ou volonté de recevoir des vaccinations et des antibiotiques prophylactiques au besoin |
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E.4 | Principal exclusion criteria |
• History of a major organ transplant or hematopoietic stem cell transplantation (HSCT).
• Participants with known aplastic anemia or other bone marrow failure that requires HSCT or other therapies including anti-thymocyte globulin and/or immunosuppressants.
• Known or suspected complement deficiency.
• Laboratory abnormalities at screening, including:
- Alkaline phosphatase >2 x upper limit of normal (ULN).
- Alanine aminotransferase >2 x ULN.
- Direct bilirubin >2 x ULN (unless due to EVH or documented Gilbert’s Syndrome.
• Current evidence of biliary cholestasis.
• Estimated glomerular filtration rate <30 milliliters/minute/1.73 meter squared and/or are on dialysis. |
• Antécédents de greffe d’organe majeure ou de greffe de cellules souches hématopoïétiques (GCSH).
• Patient ayant une anémie aplasique connue ou une autre insuffisance de la moelle osseuse qui nécessite une GCSH ou d’autres traitements, y compris globuline anti-thymocyte et/ou immunosuppresseurs.
•Carence du complément connue ou suspectée.
•Anomalies de laboratoire à la sélection, notamment :
- Phosphatase alcaline > 2 × limite supérieure de la normale (LSN)
- Alanine aminotransférase > 2 × LSN
•Bilirubine directe > 2 × LSN (sauf si cela est dû à une hémolyse extravasculaire ou syndrome de Gilbert)
•Preuve actuelle de cholestase biliaire.
•Débit de filtration glomérulaire estimé < 30 ml/min/1,73m2 et/ou patient sous dialyse. |
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E.5 End points |
E.5.1 | Primary end point(s) |
• Change From Baseline In Hemoglobin (Hgb) |
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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) |
• Percentage Of Participants With Transfusion Avoidance
• Change From Baseline In Functional Assessment Of Chronic Illness Therapy (FACIT) Fatigue Scores
• Change From Baseline In Absolute Reticulocyte Count |
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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 | No |
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 | No |
E.6.10 | Pharmacogenetic | Yes |
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 |
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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 | 46 |
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 |
Brazil |
Canada |
Japan |
Korea, Republic of |
Malaysia |
Taiwan |
Thailand |
United States |
Austria |
Denmark |
Finland |
France |
Germany |
Italy |
Netherlands |
Poland |
Spain |
Sweden |
Switzerland |
United Kingdom |
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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 | 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 | 3 |