E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Idiopathic pulmonary fibrosis (IPF) |
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E.1.1.1 | Medical condition in easily understood language |
IPF is a chronic and irreversible lung disease. Because of the progressive nature of the disease, lung function deteriorates over time ultimately leading to death. |
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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 | PT |
E.1.2 | Classification code | 10021240 |
E.1.2 | Term | Idiopathic pulmonary fibrosis |
E.1.2 | System Organ Class | 10038738 - Respiratory, thoracic and mediastinal 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 demonstrate superiority of 10 mg/kg PRM-151 + standard of care (SOC) treatment as needed administered every 4 weeks (Q4W) via intravenous (IV) infusion, over matching placebo + SOC treatment as needed, on lung function on the basis of absolute change from baseline to Week 52 in forced vital capacity (FVC) |
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E.2.2 | Secondary objectives of the trial |
To evaluate: • Superiority of 10 mg/kg PRM-151 + SOC treatment as needed administered Q4W via IV infusion, over matching placebo + SOC, on lung function on the basis of absolute change from baseline to Week 52 in 6-minute walk distance (6MWD), FVC, progression-free survival, time to first respiratory-related hospitalizations, change from baseline to Week 52 in University of California, San Diego-Shortness of Breath Questionnaire (UCSD-SOBQ), change from baseline to Week 52 in St. George Respiratory Questionnaire (SGRQ) total score, time to first acute exacerbation of IPF, or suspected acute exacerbation of IPF, change from baseline to Week 52 in carbon monoxide diffusing capacity (DLCO)and survival • Safety, tolerability of 10 mg/kg of PRM-151 administered Q4W via IV infusion + standard of care treatment as needed relative to matching placebo + SOC as needed in a population of all dosed patients • Pharmacokinetics of PRM-151 in patients with IPF • Immune response to PRM-151
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Age 40–85 years • Documented diagnosis of IPF per the 2018 American Thoracic Society / European Respiratory Society / Japanese Respiratory Society / Latin American Thoracic Society Clinical Practice Guideline • High-resolution computed tomography pattern consistent with the diagnosis of IPF, confirmed by central review of Chest HRCT and central review of any available lung biopsy (LB) • Minimum 6MWD of 150 meters with maximum use of 6 L/min at sea-level and up to 8 L/min at altitude of supplemental oxygen while maintaining oxygen saturation of >= 83% during the 6MWT during screening • FVC >= 45% predicted during screening • Forced expiratory volume in 1 second (FEV1)/FVC ratio > 0.70 during screening • DLCO >= 30% and <= 90% of predicted during screening • If receiving pirfenidone or nintedanib treatment for IPF, the patient must have been on treatment for at least 3 months and on a stable dose for at least 4 weeks prior to screening and during screening • If not currently receiving nintedanib or pirfenidone treatment must have discontinued such treatment >= 4 weeks prior to screening and during screening • For women of childbearing potential: agreement to remain abstinent or use contraception, women must remain abstinent or use contraceptive methods with a failure rate of < 1% per year during the treatment period and for 8 weeks after the final dose of PRM-151 • For men: agreement to remain abstinent or use a condom, and agreement to refrain from donating sperm, with a female partner of childbearing potential or pregnant female partner, men must remain abstinent or use a condom during the treatment period and for 8 weeks after the final dose of PRM-151 to avoid exposing the embryo. Men must refrain from donating sperm during this same period • Anticipated life expectancy of at least 12 months at baseline, according to the investigator’s judgment • Patient and investigator considered all medicinal treatment options and/or possibly lung transplantation prior to considering participation in the study. If the patient is on a lung transplant list, the investigator anticipates the patient will be able to complete the study prior to transplant • For patients enrolled in the extended China enrollment phase at NMPA-recognized sites: current resident of mainland China, Hong Kong, or Taiwan, and of Chinese ancestry
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E.4 | Principal exclusion criteria |
• Evidence of other known causes of interstitial lung disease • FVC% predicted value showing improvement in the 6-month period prior to screening and including screening value, as assessed by the investigator Emphysema present on >= 50% of the HRCT, or the extent of emphysema is greater than the extent of fibrosis, according to central review of the HRCT • Receiving nintedanib in combination with pirfenidone • Received cytotoxic, immunosupressive, cytokine modulating, or receptor antagonist agents within 4 weeks of screening • Receiving systemic corticosteroids equivalent to prednisone > 10 mg/day or equivalent within 2 weeks prior to screening • Receiving strong inhibitor or inducer of CYP1A2 in patients taking pirfenidone • Receiving potent inhibitor or inducer of P-gp in patients taking nintedanib • Acute respiratory or systemic bacterial, viral, or fungal infection either during screening or prior to screening and not successfully resolved 4 weeks prior to screening visit • Patients with active or latent tuberculosis (confirmed within the 6 months prior to or during screening, by a positive screening test [interferon gamma release assay]) • Patients who have completed treatment for active or latent tuberculosis within 6 months prior to screening, and have no evidence of recurrent disease, do not need to be tested • Resting oxygen saturation of < 89% using up to 4 L/min of supplemental oxygen at sea level and up to 6 L/min at altitude during screening • Co-existing acute or chronic medical condition that, in the investigator’s opinion, would substantially limit the ability to comply with study requirements or may influence any of the safety or efficacy assessments included in the study • Class IV New York Heart Association chronic heart failure • Historical evidence of left ventricular ejection fraction < 35% • Presence of pulmonary hypertension that, in the investigator’s opinion, would substantially limit the ability to comply with study requirements or may influence any of the safety or efficacy assessments included in the study • Cardiopulmonary rehabilitation program based on exercise training that has been completed within 8 weeks prior to screening or planned to start during the patient’s enrollment in this trial • History of a malignancy within the 5 years prior to screening, with the exception of basal cell or squamous cell skin neoplasms. In addition, a malignant diagnosis or condition that occurred more than 5 years prior to screening, and any basal cell or squamous cell neoplasm must be considered cured, inactive, and not under treatment • Known post-bronchodilator response in FEV1 and/or FVC >= 12% and >= 200 mL, respectively • Receipt of an investigational drug within 4 weeks, or 5 half-lives, whichever is longer, prior to screening • Previous treatment with PRM-151 • Clinically significant abnormality on ECG during screening • Pregnant or breastfeeding, or intending to become pregnant during the study or within 8 weeks after the final dose of PRM-151 |
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Absolute change from baseline to Week 52 in FVC [mL] |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. From baseline (Day 1) to Week 52 |
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E.5.2 | Secondary end point(s) |
1. Absolute change from baseline to Week 52 in 6MWD 2. Absolute change from baseline to Week 52 in FVC% predicted 3. Progression-free survival 4. Time to first respiratory-related hospitalizations 5. Change from baseline to Week 52 in UCSD-SOBQ 6. Change from baseline to Week 52 in SGRQ Total Score 7. Time to first acute exacerbation of IPF, or suspected acute exacerbation of IPF 8. Change from baseline to Week 52 in DLCO 9. Survival, as measured by all-cause mortality 10. Incidence and severity of adverse events, with severity determined according to the 5-point severity scale (National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 [NCI CTCAE, v.5.0]) 11. Incidence and severity of IRRs and other adverse events of special interest 12. Proportion of patients permanently discontinuing study treatment due to adverse events 13. Change from baseline in targeted clinical laboratory test results 14. Plasma concentrations of PRM-151 at specified timepoints 15. Prevalence of anti-drug antibodies (ADAs) at baseline and incidence of ADAs during the study
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1-2. From baseline to Week 52 3-4. Up to 2.5 years 5-6. From baseline to Week 52 7. Up to 2.5 years 8. From baseline to Week 52 9-12. Up to 2.5 years 13. From baseline to 2.5 years 14. Day 1, 5 and Weeks 4, 12, 24, 36, 48 and 52 or treatment discontinuation visit and Week 56 and unscheduled visits 15. Day 1 and Weeks 4, 12, 24, 36, 48 and 52 or treatment discontinuation visit and Week 56 and unscheduled visits
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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 | 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 |
Immunogenicity, Biomarker, Health Status Utility |
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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
| Information not present in EudraCT |
E.8.4 | The trial involves multiple sites in the Member State concerned | Information not present in EudraCT |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 160 |
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 |
Argentina |
Australia |
Brazil |
Canada |
China |
Hong Kong |
Israel |
Korea, Republic of |
Mexico |
New Zealand |
Peru |
Russian Federation |
Singapore |
South Africa |
Taiwan |
Turkey |
Ukraine |
United States |
Austria |
Belgium |
Denmark |
Finland |
France |
Hungary |
Norway |
Poland |
Portugal |
Sweden |
United Kingdom |
Netherlands |
Spain |
Switzerland |
Czechia |
Germany |
Greece |
Italy |
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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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The end of this study is defined as the date when the last patient, last visit (LPLV) occurs or safety follow-up is received from the last patient whichever occurs later. |
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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 | 6 |
E.8.9.1 | In the Member State concerned days | |
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 |