E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Acute myocardial infarction |
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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] - Cardiovascular Diseases [C14] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10000891 |
E.1.2 | Term | Acute myocardial infarction |
E.1.2 | System Organ Class | 10007541 - Cardiac 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 |
The primary objective of the study is to assess the clinical efficacy of selatogrel when self-administered upon occurrence of symptoms suggestive of an acute myocardial infarction (AMI) in subjects at risk of having a recurrent AMI. |
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E.2.2 | Secondary objectives of the trial |
The secondary objective is to assess the safety of self-administration of selatogrel.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Signed and dated informed consent prior to any study-mandated procedure • Male or female subject ≥ 18 years old at the time of signing the informed consent form • Confirmed diagnosis of symptomatic Type 1 acute myocardial infarction ST-elevation myocardial infarction (STEMI) or Non-STelevation myocardial infarction (NSTEMI), no longer than 4 weeks prior to randomization • Subject with multivessel coronary artery disease defined as ≥50% stenosis on 2 or more coronary artery territories or on the left main artery during a prior cardiac catheterization or cardiac catheterization during the qualifying AMI event and Presence of at least 2 of the following risk factors: - Second prior AMI; - Diabetes mellitus defined by ongoing glucose lowering treatment; - Chronic kidney disease with estimated glomerular filtration rate lessthan 60 mL/min/1.73 m2; - Peripheral artery disease at any time prior to randomization; - Absence of, or unsuccessful coronary revascularization of the qualifying AMI. • Successfully self-administered placebo according to the autoinjector Instructions for use during screening
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E.4 | Principal exclusion criteria |
• Increased risk of serious bleeding including any of the following: - History of intracranial bleed at any time. - Known uncorrected intracranial vascular abnormality. - Gastrointestinal bleed requiring hospitalization or transfusion within 1 year prior to screening. - Already on oral triple antithrombotic therapy (i.e., Dual antiplatelet therapy and oral anticoagulant). - Known liver impairment significantly affecting the hepatic function. - Current dialysis. - Ischemic stroke or transient ischemic attack within 3 months of screening. • Chronic anemia with hemoglobin < 10 g/dL. • Chronic thrombocytopenia with platelet count < 100,000/mm3. • Concomitant diseases or conditions that, in the opinion of the investigator, are not compatible with study participation. • Known hypersensitivity to selatogrel, any of its excipients, or drugs of the P2Y12 class. • Previous exposure to an investigational drug within 3 months prior to randomization. • Participation in another clinical trial with an investigational product or device within 3 months prior to randomization.
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E.5 End points |
E.5.1 | Primary end point(s) |
• The primary efficacy endpoint is defined as the occurrence of death from any cause, or non-fatal AMI after any study treatment self-administration.
The outcomes will be ranked based on severity, from the most severe to the least severe outcome, as follows: 1. Death (all causes). 2. AMI with compromised electro-hemodynamics. 3. STEMI. 4. High-risk NSTEMI. 5. NSTEMI with peak Cardiac troponin (cTn) > 10 × (upper limit of normal) ULN. 6. None of the above.
The Clinical Event Committee (CEC) will adjudicate all events in a blinded manner. Each outcome will be assessed after each study treatment administration and, for each subject, only the worst outcome will be retained as a primary endpoint.
• The primary safety endpoint is the occurrence of type 3 or 5 treatment-emergent bleeding events according to the Bleeding Academic Research Consortium (BARC) definition. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
• Primary efficacy endpoint: Outcome 1, i.e. death (all causes) within 7 days after study treatment administration. Outcomes 2,3,4,5, and 6 within 2 days after any study treatment administration.
• Primary safety endpoint within 2 days after any study treatment administration. |
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E.5.2 | Secondary end point(s) |
The secondary efficacy endpoint is a composite of death from all causes, non-fatal AMI, or hospitalization or unplanned visit to emergency department for heart failure. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
within 30 days after any study treatment administration |
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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 | No |
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 | Yes |
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) | 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 | 9 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 220 |
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 |
Chile |
Colombia |
New Zealand |
Peru |
Singapore |
Switzerland |
Hong Kong |
Taiwan |
Australia |
Brazil |
Canada |
China |
Israel |
Korea, Republic of |
Mexico |
Serbia |
South Africa |
Thailand |
United Kingdom |
United States |
Austria |
Belgium |
Bulgaria |
Czechia |
Denmark |
Estonia |
Finland |
France |
Germany |
Greece |
Hungary |
Italy |
Latvia |
Lithuania |
Netherlands |
Norway |
Poland |
Portugal |
Romania |
Slovakia |
Spain |
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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 | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 4 |