E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Prevention of maternal-fetal cytomegalovirus transmission after primary maternal infection with gestational age ≤ 14 weeks |
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E.1.1.1 | Medical condition in easily understood language |
Prevention of cytomegalovirus transimission from mother to fetus during early pregnancy |
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E.1.1.2 | Therapeutic area | Diseases [C] - Virus Diseases [C02] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10010430 |
E.1.2 | Term | Congenital cytomegalovirus infection |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10036654 |
E.1.2 | Term | Prevention |
E.1.2 | System Organ Class | 100000004865 |
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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 |
The main purpose of the trial is to demonstrate efficacy and safety of Cytotect CP Biotest in preventing maternal-fetal transmission of cytomegalovirus (CMV). Primary Objective • To determine the overall rate of maternal-fetal transmission at the time of amniocentesis (week 20 [-1 week / +2 weeks] of gestation)
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E.2.2 | Secondary objectives of the trial |
Efficacy: • To determine the rate of maternal-fetal transmission at the time of amniocentesis (week 20 [-1 week / +2 weeks] of gestation) in the 2 subgroups: o Subjects with periconceptionally acquired infection o Subjects with infection acquired during first trimester • To measure maternal CMV viral load, anti-CMV IgG Levels, anti-CMV IgG avidity, anti-CMV IgM index • To determine soluble fms-like tyrosine kinase 1 (sFlt-1) concentration in maternal serum • To evaluate vitality and growth of the fetuses/newborns •To evaluate the rate of congenital CMV infection at delivery or within the first 3 days after delivery • To measure the number of CMV-DNA copies in the urine of newborns Safety: Trial Subject • To assess the number, severity, causality, outcome, and seriousness of all adverse events (AEs)/ treatment-emergent AEs (TEAEs)/ AEs of special interest until delivery (+3 days) in both mother and fetus/ newborn
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Written informed consent obtained from subjects indicating that they understand the purpose of and procedures required for the trial and are willing to participate in it 2. Pregnant women, age 18 to 45 years 3. Pregnant women at trial entry with gestational age ≤14 weeks; pregnancy after in-vitro fertilization permitted 4. Detection of early primary CMV infection
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E.4 | Principal exclusion criteria |
1. Women with current multiple pregnancy 2. History of severe pre-eclampsia or severe gestational hypertension (GHTN), which required medical intervention. Definition according to AWMF guideline (AWMF, 2019) 3. Presence of severe disease impairing course of pregnancy (e.g. diabetes, epilepsy, cancer) 4. Clinically significant congenital or acquired autoimmune disease 5. Known immunosuppressive (e.g., transplanted patients) or immunodeficient condition 6. Known infection with hepatitis B or C, or HIV from the medical history or active infection at screening as assessed by respective virus serology 7. Maternal CMV infection prior to this pregnancy 8. Covid-19 infection at time of inclusion 9. Any signs or symptoms indicating an increased risk of abortion or premature labor or has known negative effect on fetus with exception of a CMV infection 10. Active infection according to TORCH serology with exception of CMV in the assessment of the investigator 11. Known major fetal anomalies or demise 12. Intolerance to proteins of human origin or known allergic reactions to components of the trial product 13. Selective absolute IgA deficiency or known antibodies to IgA 14. Known pre-existing clinically relevant risk factors for thrombotic events 15. Known renal insufficiency with serum creatinine levels >1.4 mg/dL and proteinuria (albuminuria) at screening (≥30 mg/dL or dipstick reading of 1+ and greater) 16. Participation in another clinical trial within 90 days before entering the trial or during the trial 17. Women who are dependent on trial site staff, on Biotest AG or its authorized representatives 18. Inability or lacking motivation to participate in the trial 19. Medical condition, laboratory finding, or physical examination finding that in the opinion of the investigator precludes participation 20. Eligibility for a subgroup where enrollment was stopped
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the overall rate of maternal-fetal transmission at the time of amniocentesis. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
At week 20 [- 1 week / +2 weeks] of gestation |
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E.5.2 | Secondary end point(s) |
• Maternal-fetal CMV transmission in the subgroups • CMV viral load (CMV DNA copies/mL) in maternal blood • Anti-CMV IgG levels • Anti-CMV IgG avidity • Detection of CMV IgG and IgM antibodies • Soluble fms-like tyrosine kinase 1 (sFlt-1) / Placental Growth Factor (PlGF) • Vitality, growth and heart rate of the fetus and Apgar-score, head circumference at delivery • CMV-DNA at delivery or within the first 3 days in urine of the newborn |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
During pregnancy, at week 20 [- 1 week / +2 weeks] of gestation and at delivery |
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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 | No |
E.6.5 | Efficacy | No |
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 | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Prevention of viral maternal-fetal transmission during pregnancy |
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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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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 | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 5 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
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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Date of delivery (+3 days) for the last subject in 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 | 1 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 1 |
E.8.9.2 | In all countries concerned by the trial days | 0 |