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    Summary
    EudraCT Number:2020-001496-32
    Sponsor's Protocol Code Number:KB070
    National Competent Authority:Portugal - INFARMED
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2020-08-11
    Trial 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 ConcernedPortugal - INFARMED
    A.2EudraCT number2020-001496-32
    A.3Full title of the trial
    A Phase III, Open-label, Prospective, Multicenter Study to Assess Efficacy, Safety, and Pharmacokinetics of Kedrion Intravenous Human Normal Immunoglobulin (IVIg) 10% in Pediatric Patients Affected by Primary Immunodeficiency Disease (PID)
    Estudo de fase III, aberto, prospetivo e multicêntrico para avaliar a eficácia, a segurança e a farmacocinética da imunoglobulina humana normal (intravenosa) (IgIV) 10% da Kedrion em doentes pediátricos afetados por imunodeficiências primárias (IDP).
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study, in which all know the treatment assigned to the patient, conducted in more sites, to evaluate the efficaty, safety, and metabolism of Kedrion in venous Human Normal Immunoglobulin (IVIg) 10% in child with Primary Immunodeficiency Disease (PID)
    Estudo, no qual todos conhecem o tratamento atribuído ao paciente, realizado em vários centros, para avaliar a eficácia, segurança e metabolismo da imunoglobulina normal humana venosa (IVIg) 10%, da Kedrion, em crianças com imunodeficiências primárias (IDP).
    A.3.2Name or abbreviated title of the trial where available
    PID-PED study
    Estudo PID-PED
    A.4.1Sponsor's protocol code numberKB070
    A.7Trial is part of a Paediatric Investigation Plan Yes
    A.8EMA Decision number of Paediatric Investigation PlanP/246/2017
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorKEDRION S.P.A
    B.1.3.4CountryItaly
    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 supportPharmaceutical company, KEDRION S.p.A
    B.4.2CountryItaly
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCromsource S.r.l
    B.5.2Functional name of contact pointClinical Research Department
    B.5.3 Address:
    B.5.3.1Street AddressVia Giorgio De Sandre 3
    B.5.3.2Town/ cityVerona
    B.5.3.3Post code37135
    B.5.3.4CountryItaly
    B.5.4Telephone number39 0458222811
    B.5.5Fax number390458222812
    B.5.6E-mailoriana.zerbini@cromsource.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 nameKIg10
    D.3.2Product code KIg10
    D.3.4Pharmaceutical form Concentrate and solvent for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNHuman Immunoglobulin
    D.3.9.2Current sponsor codeKIg10
    D.3.9.4EV Substance CodeSUB127300
    D.3.10 Strength
    D.3.10.1Concentration unit mg/kg milligram(s)/kilogram
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number200 to 800
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    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
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Pediatric Patients Affected by Primary Immunodeficiency Disease.
    Doentes pediátricos afetados por imunodeficiências primárias (IDP)
    E.1.1.1Medical condition in easily understood language
    Child with Immunodeficiency Disease.
    Crianças com Doença de Imunodeficiência
    E.1.1.2Therapeutic area Diseases [C] - Immune System Diseases [C20]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10064859
    E.1.2Term Primary immunodeficiency syndrome
    E.1.2System Organ Class 10010331 - Congenital, familial and genetic disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Primary Efficacy Objective
    To assess the efficacy of KIg10 administered to patients with PID to demonstrate that the rate of acute serious bacterial infections (i.e., the mean number of acute serious bacterial infections per patient-year) is less than 1.0 to provide substantial evidence of efficacy from day 1 to week 51/52.
    Safety Objective
    To assess the safety of KIg10 in the overall study population from day 1 to week 51/52.
    Pharmacokinetic Objectives
    To assess the distribution, metabolism, and elimination of KIg10, total IgG, IgG subclasses, and antigen-specific IgGs at steady state in PID patients treated at different dosing schedules.
    To evaluate trough concentrations of total IgG and compare to trough concentrations prior to the study entry.
    Objetivo primário de eficácia
    Avaliar a eficácia do KIg10 administrado a doentes pediátricos com IDP para demonstrar que a taxa de infeções bacterianas agudas graves (ou seja, o número médio de infeções bacterianas agudas por doente-ano) é inferior a 1,0, constituindo evidência significativa da eficácia do medicamento, desde o dia 1 até à semana 51/52.
    Objetivo de segurança
    Avaliar a segurança do KIg10 na população total do estudo desde o dia 1 até à semana 51/52.
    Objetivos da análise farmacocinética
    Avaliar a distribuição, o metabolismo e a eliminação da IgG total, das subclasses de IgG e das IgG específicas de antigénio com o KIg10 no estado estacionário em doentes pediátricos afetados por IDP tratados com diferentes esquemas posológicos.
    Avaliar as concentrações mínimas de IgG total e compará-las com as concentrações mínimas antes da entrada do doente no estudo.
    E.2.2Secondary objectives of the trial
    Levels:
    • Of IgG trough before each infusion and at the study termination visit (w51/52)
    • Of IgG subclasses (IgG1, IgG2, IgG3, IgG4) before infusions 1, 5, 9, and 13 for 28-day infusion schedule and at infusions 1, 7, 11, and 17 for 21-day infusion schedule.
    • Of Anti-tetanus toxoid, anti-pneumococcal capsular polysaccharide, anti Haemophilus influenza, and anti-measles antibodies before infusions 1, 5, 9, and 13 for 28-day infusion schedule and before infusions 1, 7, 11, and 17 for 21-day infusion schedule. Occurrence and duration of any infection other than acute serious bacterial infections, of fever episodes, of overall hospitalization, of hospitalization due to infection, of patients on antibiotics for the treatment of any kind of infections from day 1 to w 51/52. The missed days of work/school/other major activities due to infections, from day 1 to week 51/52.
    QoL using the PedsQL™ questionnaires collected at baseline, at 24 w, and at the study termination visit.
    Níveis:
    • De IgG antes de cada infusão e na visita de término do estudo (sem51/52)
    • Das subclasses de IgG (IgG1, IgG2, IgG3, IgG4) antes das infusões 1, 5, 9 e 13 para regime de infusão 28 dias e nas infusões 1, 7, 11 e 17 para regime de infusão 21 dias.
    • Anticorpos toxóide antitetânico, polissacarídeo capsular anti-pneumocócico, gripe anti-Haemophilus e anticorpos anti-sarampo antes das infusões 1, 5, 9 e 13 para regime de infusão 28 dias e antes das infusões 1, 7, 11 e 17 para regime de infusão 21 dias. Ocorrência e duração de qualquer infecção que não sejam infecções bacterianas graves agudas, episódios de febre, hospitalização geral, hospitalização por infecção, de pacientes em uso de antibióticos para o tratamento de qualquer tipo de infecção do dia 1 à sem51/52. Os dias perdidos de trabalho/escola/outras atividades importantes devido a infecções, do dia 1 à sem51/52.
    QoL usando os questionários PedsQL ™ recolhidos na visita de seleção, sem24 e visita de término do estudo.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Written informed consent/assent obtained from the patient and his/her parent(s) or egally acceptable representative indicating that they understand the purpose of and procedures required for the study and are willing to participate in it.
    2. Confirmed clinical diagnosis of a PID as defined by 2017 International Union of Immunological Societies (IUIS) Phenotypic Classification for Primary Immunodeficiencies (Bousfiha A, 2018) and The European Society for Immunodeficiencies (ESID) Registry
    Working Definitions for the Clinical Diagnosis of Inborn Errors of Immunity (Seidel MG at al., 2019) and requiring treatment with IVIg. Documented agammaglobulinemia (defined as the total absence of one or more classes of antibodies) or hypogammaglobulinemia
    (defined as low levels of one or more classes [ie, at least 2 standard deviations under the mean level per age]). (NOTE: IVIg treatment is generally requested in the absence of IgG independently from whether other antibodies are absent).
    3. Male or female, age from 2 up to 16 years and 11 months, at the time of screening, as the patient must be under 18 years (< 18) at the time of study termination visit.
    4. Received 200 to 800 mg/kg of a commercially available IVIg therapy in the range of 1- or 28-day intervals (±3 or ±4 days, respectively) for at least 3 infusion cycles prior to screening. (NOTE: Other IVIgs will be prohibited after ICF signature and until study end, week 51/52).
    5. At least 2 documented IgG trough levels while receiving an IVIg, of = 6 g/L obtained at 2 infusion cycles within 12 months (1 must be within 6 months) prior to ICF ignature.
    6. Patient and his/her parent(s)/legal guardian(s) are willing to comply with all requirements of the protocol.
    7. Females of child-bearing potential with a negative pregnancy test (serum or urine) and who agree to employ adequate birth control measures during the study, such as:
    a. sexual abstinence, to be evaluated in relation to the preferred and usual lifestyle of the subject;
    b. male or female condom with or without spermicide;
    c. cap, diaphragm or sponge with spermicide;
    d. progestogen-only oral hormonal contraception, if already used in the past on medical prescription.
    7. Adequate birth control measures should be maintained throughout the study under parental control.
    8. Authorization to access personal health information.
    9. Patients previously participating in a clinical trial with another experimental IVIg may be enrolled if they have received stable commercially available IVIg therapy for at least 3 infusion cycles (21 or 28 days) prior to screening.
    10. Patients currently on treatment with any subcutaneous immunoglobulin (SCIG) can be nrolled if they are switched to stable commercially available IVIg therapy for at least 3 infusion cycles (21 or 28 days) prior to screening.
    11. Males or females with a body weight greater than or equal to 15 kg (≥15 kg)
    1. Consentimento/acordo informado por escrito do doente e do(s) seu(s) progenitor(es) ou representante legalmente aceite indicando que compreendem o objetivo e os procedimentos necessários para o estudo e que estão dispostos a participar.
    2. Diagnóstico clínico confirmado de IDP tal como definido pela Classificação Fenotípica de Imunodeficiências Primárias da União Internacional de Sociedades de Imunologia (International Union of Immunological Societies (IUIS) Phenotypic Classification for Primary Immunodeficiencies) de 2017 (Bousfiha A, 2018) e do registo de definições de trabalho para o diagnóstico clínico de erros congénitos de imunidade da Sociedade Europeia de Imunodeficiências Primárias (European Society for Immunodeficiencies (ESID) Registry Working Definitions for the Clinical Diagnosis of Inborn Errors of Immunity) (Seidel MG et al., 2019) com necessidade de tratamento com IgIV. Agamaglobulinemia documentada (definida como a ausência total de uma ou mais classes de anticorpos) ou hipogamaglobulinemia (definida como níveis baixos de uma ou mais classes [pelo menos 2 desvios padrão abaixo do nível médio para a idade]).
    (NOTA: O tratamento com IgIV é geralmente pedido na ausência de IgG independentemente da ausência de outros anticorpos).
    3. Doente do sexo masculino ou feminino, idade entre 2 e 16 anos e 11 meses no momento da seleção, sendo que o doente tem de ter uma idade inferior a 18 anos (<18) aquando da consulta de fim do estudo.
    4. Ter recebido 200 a 800 mg/kg de uma terapia IgIV disponível no mercado em intervalos de 21 ou 28 dias (±3 ou ±4 dias, respetivamente) durante pelo menos 3 ciclos de perfusão antes da seleção.
    (NOTA: A administração de outras IgIV será proibida desde a assinatura do FCI até ao final do estudo, semana 51/52).
    5. Pelo menos 2 níveis mínimos de IgG documentados durante o tratamento com uma perfusão de IgIV ≥6 g/L obtidos em 2 ciclos de perfusão num período de 12 meses (1 dos quais nos últimos 6 meses) antes da assinatura do FCI.
    6. Disponibilidade por parte do doente e do(s) seu(s) progenitor(es)/tutor(es) legal(is) para cumprir todos os requisitos do protocolo.
    7. Doentes do sexo feminino com potencial de engravidar com um teste de gravidez negativo (sangue ou urina) e que concordem em utilizar medidas contracetivas adequadas durante o estudo, tais como:
    a. abstinência sexual, a avaliar consoante o estilo de vida preferido e habitual da doente;
    b. preservativo masculino ou feminino com ou sem espermicida;
    c. tampão contracetivo, diafragma ou esponja com espermicida;
    d. contraceção hormonal contendo apenas progestagénio, se já tiver sido usada anteriormente sob prescrição médica.
    As medidas contracetivas adequadas devem ser mantidas durante o estudo sob supervisão parental.
    8. Autorização para aceder aos dados pessoais de saúde.
    9. Os doentes que tenham participado anteriormente num ensaio clínico com outra IgIV experimental podem ser incluídos se tiverem recebido terapia IgIV estável disponível no mercado durante pelo menos 3 ciclos de perfusão (21 ou 28 dias) antes da seleção.
    10. Os doentes atualmente em tratamento com uma imunoglobulina subcutânea (IgSC) podem ser incluídos se o seu tratamento for substituído por uma terapia IgIV estável disponível no mercado durante pelo menos 3 ciclos de perfusão (21 ou 28 dias) antes da seleção.
    11. Doentes do sexo masculino ou feminino com um peso corporal igual ou superior a 15 kg (≥15 kg).

    E.4Principal exclusion criteria
    1-Newly diagnosed PID and naïve to IgG replacement therapy.
    2-Dysgammaglobulinemia (defined as a deficiency in one or more classes of antibodies, but not severe enough to require substitutive therapy) or isolated IgG subclass deficiency, or profound primary T cell deficiency (defined as the absence or severe reduction of T
    lymphocytes [CD3+ <300 cell/mm3] and an absent or particularly low proliferative response [10% of the lower normal range] to phytohaemagglutinin P [PHA]).
    3- History of severe or serious reactions or hypersensitivity to IVIg or other injectable forms of IgG.
    4- History of thrombotic events including deep vein thrombosis, cerebrovascular accident, pulmonary embolism, transient ischemic attacks, or myocardial infarction, as defined by at least 1 event in patient’s lifetime.
    5- IgA deficiency with documented antibodies to IgA.
    6- Received blood products that have not undergone viral inactivation measures within 12 months prior to ICF signature.
    7- Significant protein losing enteropathy, nephrotic syndrome, or lymphangiectasia.
    8- An acute infection as documented by culture or diagnostic imaging and/or a body temperature =38.5° C (=101.3° F) within 7 days prior to screening.
    9- Acquired immunodeficiency syndrome (AIDS) and/or hepatitis B/C active disease at ICF signature.
    10- Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 times of the upper limit of normal for the laboratory designated for the study.
    11- Using an implanted venous access device.
    12- Profound anemia, defined according to the patient's age as shown in table Dallman PR, 1979 or persistent severe neutropenia (= 500 neutrophils per mm3) or persistent lymphopenia of less than 500 cells per microliter.
    13- A severe chronic condition such as renal failure [defined as abnormalities in kidney structure or function that are present for more than 3 months and have health implications. The disease is classified on the basis of cause and category of glomerular filtration rate (GFR) (G1 to G5) and albuminuria (A1 to A3) (KIDIGO, 2017). See the following table], congestive heart failure (New York Heart Association III/IV), cardiomyopathy, cardiac arrhythmia associated with thromboembolic events (e.g., atrial fibrillation), unstable or advanced ischemic heart disease, hyperviscosity, or any other condition that the Investigator believes is likely to interfere with evaluation of the study drug or with satisfactory conduct of the trial.
    14- History of a malignant disease other than properly treated carcinoma in situ of the cervix or basal cell or squamous cell carcinoma of the skin within 24 months prior to ICF signature.
    15- History of pharmacoresistant epilepsy or multiple episodes of migraine (defined as at least 1 episode within 6 months of ICF signature) not controlled by medication.
    16- Patient must not be receiving the following medication from at least 30 days prior to ICF signature:
    a) Steroids, oral or parenteral, at a daily dose of ≥ 0.15 mg/kg/day of prednisone or equivalent.
    b) Other immunosuppressive drugs (including monoclonal antibodies) or chemotherapy.
    17- Females who are pregnant, breast feeding or planning a pregnancy during the course of the study. Women who become pregnant during the study will be withdrawn from the study.
    18- Participated in another clinical study within 30 days prior to ICF signature.
    19- Active drug or alcohol abuse or history of drug or alcohol abuse within the 6 months before screening.
    20- Direct relative of an employee of the CRO, the study site, or Kedrion.
    21- Previously treated under this protocol.
    22- Unable to provide informed consent.
    23- Patients with any condition which, in the opinion of the Investigator, might interfere with the evaluation of the study objectives or the patient’s participation in this trial.
    24. Patients with Hypersensitivity to the active substance or to any of the excipients.
    25. Patients with allergy or other contraindication to local anaesthetic used before blood collection.
    1. Doente com IDP recém-diagnosticada e que nunca foi tratado com terapia de substituição de IgG.
    2. Disgamaglobulinemia (definida como uma deficiência de uma ou mais classes de anticorpos, mas não suficientemente grave para requerer terapia de substituição) ou deficiência isolada de uma subclasse IgG ou deficiência primária profunda de células T (definida como a ausência ou redução grave de linfócitos T [CD3+ <300 células/mm3] e ausência ou redução acentuada da resposta proliferativa [10% do limite inferior normal] à fito-hemaglutinina P [PHA]).
    3. Antecedentes de reações severas ou graves ou hipersensibilidade à IgIV ou outras formas injetáveis de IgG.
    4. Antecedentes de eventos trombóticos incluindo trombose venosa profunda, acidente vascular cerebral, embolia pulmonar, acidente isquémico transitório ou enfarte do miocárdio, definidos como pelo menos 1 evento no tempo de vida do doente.
    5. Deficiência de IgA com anticorpos anti-IgA documentada.
    6. Doente que tenha recebido componentes sanguíneos não sujeitos a medidas de inativação viral nos 12 meses anteriores à assinatura do FCI.
    7. Enteropatia, síndrome nefrótica ou linfangiectasia com perda significativa de proteínas.
    8. Infeção aguda documentada por cultura ou técnica imagiológica de diagnóstico e/ou temperatura corporal ≥38,5 °C (≥101,3 °F) nos 7 dias anteriores à seleção.
    9. Síndrome de imunodeficiência adquirida (SIDA) e/ou Hepatite B/C ativa aquando da assinatura do FCI.
    10. Alanina aminotransferase (ALT) ou aspartato aminotransferase (AST) >2,5 vezes o limite superior normal segundo os critérios do laboratório designado para o estudo.
    11. Doente a utilizar um dispositivo de acesso venoso implantável.
    12. Anemia profunda, definida de acordo com a idade do doente, tal como apresentada na tabela seguinte (Dallman PR, 1979) ou neutropenia grave persistente (≤≤ 500 neutrófilos por mm3) ou linfopenia persistente de menos de 500 células por microlitro.
    13. Doença crónica grave como insuficiência renal [definida como anomalias na estrutura ou função renal, presentes durante mais de 3 meses e com implicações na saúde. A doença classifica-se com base na causa e na categoria de taxa de filtração glomerular (TFG) (G1 a G5) e albuminúria (A1 a A3) (KIDIGO, 2017). Consultar a tabela seguinte], insuficiência cardíaca congestiva (classes III/IV da New York Heart Association), cardiomiopatia, arritmia cardíaca associada a eventos tromboembólicos (p. ex., fibrilhação auricular), doença cardíaca isquémica instável ou avançada, hiperviscosidade ou qualquer outra condição clínica que o Investigador considere provável que interfira com a avaliação do medicamento do estudo ou com a condução satisfatória do estudo.
    14. Antecedentes de doença maligna que não carcinoma in situ do colo do útero ou carcinoma de células basais ou de células escamosas da pele tratado adequadamente nos 24 meses anteriores à assinatura do FCI.
    15. Antecedentes de epilepsia resistente a fármacos ou episódios múltiplos de enxaqueca (definida como pelo menos 1 episódio nos 6 meses anteriores à assinatura do FCI) não controlados com medicação.
    16. O doente não pode estar a receber os seguintes medicamentos pelo menos nos 30 dias anteriores à assinatura do FCI:
    a) Esteroides, orais ou parentéricos, numa dose diária ≥ 0,15 mg/kg/dia de prednisona ou equivalente.
    b) Outros medicamentos imunossupressores (incluindo anticorpos monoclonais) ou quimioterapia.
    17. Mulheres que estejam grávidas, a amamentar ou a planear engravidar durante o período do estudo. As mulheres que engravidarem durante o estudo serão retiradas do mesmo.
    18. Doentes que tenham participado noutro ensaio clínico nos 30 dias anteriores à assinatura do FCI.
    19. Abuso ativo de drogas ou álcool ou antecedentes de abuso de drogas ou álcool nos 6 meses anteriores à seleção.
    20. Familiar direto de um colaborador da empresa de investigação contratada (CRO), do centro do estudo ou da Kedrion.
    21. Doente anteriormente tratado com este protocolo.
    22. Doente incapaz de dar o seu consentimento informado.
    23. Doente com outros problemas de saúde que, na opinião do Investigador, possam interferir com a avaliação dos objetivos do estudo ou com a participação do doente neste ensaio.
    24. Doentes com hipersensibilidade à substância ativa ou a qualquer um dos excipientes.
    25. Doentes com alergia ou outra contraindicação ao anestésico local usado antes da colheita de sangue.
    E.5 End points
    E.5.1Primary end point(s)
    Incidence rate (i.e., the mean number of acute serious bacterial infections per patient year) of acute serious bacterial infections (bacterial pneumonia, bacteremia/sepsis, bacterial meningitis, visceral abscess, osteomyelitis/septic arthritis) according to
    pre-specified criteria). Primary analysis of the primary endpoint will be performed on the FAS. Primary efficacy will be analyzed using a Poisson model using as offset the length of the observation period per patient. The estimate and 1-sided 99% upper confidence limit
    will be reported. Efficacy will be claimed if this limit is less than 1.0.
    Taxa de incidência (isto é, o número médio de infecções bacterianas graves agudas por paciente / ano) de infecções bacterianas graves agudas (pneumonia bacteriana, bacteremia / sepsis, meningite bacteriana, abscesso visceral, osteomielite / artrite séptica) de acordo com
    critérios pré-especificados). A análise primária do endpoint primário será realizada no FAS. A eficácia primária será analisada usando um modelo de Poisson usando como deslocamento a duração do período de observação por paciente. A estimativa e o limite de confiança superior de 99% unilateral
    será relatado. A eficácia será reivindicada se esse limite for menor que 1,0.
    E.5.1.1Timepoint(s) of evaluation of this end point
    All visits
    Em todas as visitas
    E.5.2Secondary end point(s)
    1. Serum IgG trough levels before each infusion of KIg10 and at the study termination visit (week 51/52).
    2. IgG subclasses levels (IgG1, IgG2, IgG3, IgG4) before infusions 1, 5, 9 and 13 for the 28-day infusion schedule, and before infusions 1, 7, 11 and 17 for the 21-day infusion schedule.
    3. Frequency of patients with total IgG below 6 g/L criteria.
    4. Anti-tetanus toxoid antibody level (quantitative assay) before infusions 1, 5, 9 and 13 for the 28-day infusion schedule and before infusions 1, 7, 11 and 17 for the 21-day infusion schedule.
    5. Anti-pneumococcal capsular polysaccharide antibody level (quantitative assay) before infusions 1, 5, 9 and 13 for the 28-day infusion schedule and before infusions 1, 7, 11 and 17 for the 21-day infusion schedule.
    6. Anti-measles antibody level (quantitative assay) before infusions 1, 5, 9 and 13 for the 28-day infusion schedule and before infusions 1, 7, 11 and 17 for the 21-day infusion schedule.
    7. Anti-Haemophilus influenza type b antibody level (quantitative assay) before infusions 1, 5, 9 and 13 for the 28-day infusion schedule and before infusions 1, 7, 11 and 17 for the 21-day infusion schedule.
    8. Incidence rate (i.e., the mean number per patient-year) of any infection other than acute serious bacterial infections from day 1 to week 51/52.
    9. Duration of any infection other than acute serious bacterial infections from day 1 to week 51/52.
    10.Incidence rate (i.e. the mean number per patient-year) of fever episodes, from day 1 to week 51/52.
    11.Duration of fever episodes, from day 1 to week 51/52.
    12.Overall hospitalization days from day 1 to week 51/52.
    13.Days of hospitalizations due to infection from day 1 to week 51/52.
    14.Incidence rate (i.e. the mean number per patient-year) of patient on antibiotics
    for the treatment of any kind of infection from day 1 to week 51/52.
    15.Duration of patients on antibiotics for the treatment of any kind of infection from day 1 to week 51/52.
    16.Days of missed work/school/other major activities due to infections from day 1 to week 51/52.
    17.PedsQL™ score at baseline, week 24, and study termination visit.
    1. Níveis séricos mínimos de IgG antes de cada infusão de KIg10 e na visita de término do estudo (semana 51/52).
    2. Níveis de subclasses de IgG (IgG1, IgG2, IgG3, IgG4) antes das infusões 1, 5, 9 e 13 para o regime de infusão de 28 dias e antes das infusões 1, 7, 11 e 17 para o regime de infusão de 21 dias.
    3. Frequência de pacientes com IgG total abaixo de 6 g / L.
    4. Nível de anticorpo toxóide antitetânico (ensaio quantitativo) antes das infusões 1, 5, 9 e 13 para o regime de infusão de 28 dias e antes das infusões 1, 7, 11 e 17 para o regime de infusão de 21 dias.
    5. Nível de anticorpo polissacarídeo capsular anti-pneumocócico (ensaio quantitativo) antes das infusões 1, 5, 9 e 13 para o regime de infusão de 28 dias e antes das infusões 1, 7, 11 e 17 para o regime de infusão de 21 dias.
    6. Nível de anticorpos anti-sarampo (ensaio quantitativo) antes das infusões 1, 5, 9 e 13 para o regime de infusão de 28 dias e antes das infusões 1, 7, 11 e 17 para o regime de infusão de 21 dias.
    7. Nível de anticorpo anti-Haemophilus influenzae tipo b (ensaio quantitativo) antes das infusões 1, 5, 9 e 13 para o regime de infusão de 28 dias e antes das infusões 1, 7, 11 e 17 para o regime de infusão de 21 dias.
    8. Taxa de incidência (isto é, o número médio por paciente/ano) de qualquer infecção que não seja infecção bacteriana grave aguda do dia 1 à semana 51/52.
    9. Duração de qualquer infecção que não seja infecção bacteriana grave aguda do dia 1 à semana 51/52.
    10. Taxa de incidência (ou seja, o número médio por paciente/ano) de episódios de febre, do dia 1 à semana 51/52.
    11.Duração dos episódios de febre, do dia 1 à semana 51/52.
    12.Numero de dias de internamento desde o dia 1 até a semana 51/52.
    13.Dias de internamentos por infecção do dia 1 à semana 51/52.
    14. Taxa de incidência (isto é, o número médio por paciente/ano) do paciente com antibióticos para o tratamento de qualquer tipo de infecção do dia 1 à semana 51/52.
    15.Duração, nos pacientes, do uso de antibióticos para o tratamento de qualquer tipo de infecção desde o dia 1 até a semana 51/52.
    16. Dias de falta ao trabalho/escola/outras atividades importantes devido a infecções do dia 1 à semana 51/52.
    17.Escalas do PedsQL ™ na visita de seleção, semana 24 e visita de término do estudo.
    E.5.2.1Timepoint(s) of evaluation of this end point
    All visits
    Em todas as Visitas
    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 No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    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 No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    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 concerned2
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA12
    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 No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Russian Federation
    Hungary
    Italy
    Portugal
    Slovakia
    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
    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 months10
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months10
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    F.1.1Number of subjects for this age range: 30
    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) Yes
    F.1.1.5.1Number of subjects for this age range: 15
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 15
    F.1.2Adults (18-64 years) No
    F.1.3Elderly (>=65 years) No
    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 No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    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 state4
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 22
    F.4.2.2In the whole clinical trial 30
    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)
    None
    Nenhum
    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 Decision2021-05-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-03-19
    P. End of Trial
    P.End of Trial StatusOngoing
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