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    Summary
    EudraCT Number:2021-000448-23
    Sponsor's Protocol Code Number:RD.06.SPR.118126
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-08-31
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2021-000448-23
    A.3Full title of the trial
    A Multicenter, Open-Label, Single-Group Clinical Trial to Assess the Pharmacokinetics, Safety and Efficacy of Nemolizumab (CD14152) in Pediatric Subjects (aged 2 to 11 years) with Moderate-to-Severe Atopic Dermatitis
    Ensayo clínico multicéntrico, abierto y de un solo grupo para evaluar la farmacocinética, la seguridad y la eficacia de nemolizumab (CD14152) en sujetos pediátricos (de 2 a 11 años de edad) con dermatitis atópica moderada o grave
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Multicenter trial to Assess the Pharmacokinetics, Safety and Efficacy of Nemolizumab in Pediatric Subjects with Moderate-to-Severe Atopic Dermatitis
    Ensayo multicéntrico para evaluar la farmacocinética, la seguridad y la eficacia de Nemolizumab en sujetos pediátricos con dermatitis atópica moderada o grave.
    A.4.1Sponsor's protocol code numberRD.06.SPR.118126
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04921345
    A.5.4Other Identifiers
    Name:IND numberNumber:117122
    A.7Trial is part of a Paediatric Investigation Plan Yes
    A.8EMA Decision number of Paediatric Investigation PlanP/106/2015
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorGalderma S.A.
    B.1.3.4CountrySwitzerland
    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 supportGalderma S.A.
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGalderma S.A.
    B.5.2Functional name of contact pointClinical Trial Information Desk
    B.5.3 Address:
    B.5.3.1Street AddressRue entre-deux-Ville 10
    B.5.3.2Town/ cityLa Tour-de-Peilz
    B.5.3.3Post code1814
    B.5.3.4CountrySwitzerland
    B.5.4Telephone number+34900834223
    B.5.6E-mailRegistroEspanoldeEstudiosClinicos@druginfo.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 nameNemolizumab
    D.3.2Product code CD14152
    D.3.4Pharmaceutical form Powder and solution for solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNEMOLIZUMAB
    D.3.9.1CAS number 1476039-58-3
    D.3.9.2Current sponsor codeCD14152 / CIM331
    D.3.9.3Other descriptive nameHumanised monoclonal antibody IgG2 recognising the interleukin-31 receptor A
    D.3.9.4EV Substance CodeSUB191036
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    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 Yes
    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.IMP: 2
    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 nameNemolizumab
    D.3.2Product code CD14152
    D.3.4Pharmaceutical form Powder and solution for solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNEMOLIZUMAB
    D.3.9.1CAS number 1476039-58-3
    D.3.9.2Current sponsor codeCD14152 / CIM331
    D.3.9.3Other descriptive nameHumanised monoclonal antibody IgG2 recognising the interleukin-31 receptor A
    D.3.9.4EV Substance CodeSUB191036
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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 Yes
    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.IMP: 3
    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 nameNemolizumab
    D.3.2Product code CD14152
    D.3.4Pharmaceutical form Powder and solution for solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNEMOLIZUMAB
    D.3.9.1CAS number 1476039-58-3
    D.3.9.2Current sponsor codeCD14152 / CIM331
    D.3.9.3Other descriptive nameHumanised monoclonal antibody IgG2 recognising the interleukin-31 receptor A
    D.3.9.4EV Substance CodeSUB191036
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number30
    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 Yes
    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 Yes
    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
    Moderate-to-Severe Atopic Dermatitis
    Dermatitis atópica moderada o grave
    E.1.1.1Medical condition in easily understood language
    Moderate-to-Severe Atopic Dermatitis
    Dermatitis atópica moderada o grave
    E.1.1.2Therapeutic area Diseases [C] - Skin and Connective Tissue Diseases [C17]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10003639
    E.1.2Term Atopic dermatitis
    E.1.2System Organ Class 100000004858
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective of the study is to assess the pharmacokinetics (PK) and safety of nemolizumab administered concomitantly with topical corticosteroids (TCS) in pediatric subjects with moderate-to-severe atopic dermatitis (AD) not adequately controlled with topical treatments.
    El objetivo principal del estudio es evaluar la farmacocinética (FC) y la seguridad de nemolizumab administrado de forma concomitante con corticosteroides tópicos (CST) en pacientes pediátricos con dermatitis atópica (DA) moderada o grave no controlada adecuadamente con tratamientos tópicos.
    E.2.2Secondary objectives of the trial
    The secondary objective of the study is to assess the efficacy of nemolizumab (CD14152) and to further characterize the relationship between nemolizumab concentrations and clinical efficacy endpoints.
    El objetivo secundario del estudio es evaluar la eficacia del nemolizumab (CD14152) y caracterizar mejor la relación entre las concentraciones de nemolizumab y los criterios de valoración de la eficacia clínica.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Subjects ≥7 to <12 years of age or ≥2 to <7 years of age at the screening visit.
    Note: Subjects aged 2 to 6 years can be enrolled only after the IA and the IDMC has assessed interim safety data from Cohort 1 (age 7 to 11 years) and provided recommendations to the Sponsor, who will then determine the eligibility of this age group for enrollment in the study and confirm the dose. The Sponsor will send a written communication to the sites confirming that the study is open for enrollment of Cohort 2 (age 2 to 6 years). This cohort must not be enrolled in the study until such communication is received.
    2. Chronic AD that has been documented for at least 6 months for subjects aged 2-6 years and at least 1 year for subjects aged 7-11 years before the screening visit and confirmed according to the American Academy of Dermatology Consensus Criteria (Appendix 1) at the time of the screening visit.
    3. Eczema Area and Severity Index (EASI) score ≥16 at both screening and baseline visits.
    4. Investigator’s Global Assessment (IGA) score ≥3 (based on the IGA scale ranging from 0 to 4, in which 3 is moderate and 4 is severe) at both screening and baseline visits.
    5. AD involvement ≥10% of Body Surface Area (BSA) at both screening and baseline visits.
    6. Peak (maximum) Pruritus Numeric Rating Scale (PP NRS) score of at least 4.0 at both screening and baseline visits:
    • Screening PP NRS score will be determined by a single PP NRS assessment (score ranging from 0 to 10) for the 24-hour period immediately preceding the screening visit.
    • Baseline PP NRS score will be determined based on the average of daily PP NRS scores (score ranging from 0 to 10) during the 7 days immediately preceding baseline (rounding not permitted). A minimum of 4 daily scores out of the 7 days immediately preceding baseline is required for this calculation.
    7. Documented history by a physician and/or investigator (within 6 months before the screening visit) of inadequate response to existing topical medication or use of systemic therapies for control of the disease.
    8. Agree to apply a moisturizer throughout the study from the screening visit daily, and liberally as needed; agree to apply an authorized TCS, with or without TCI, from the screening visit and throughout the study as determined appropriate by the investigator.
    9. Any female of childbearing potential (i.e., a subject who has started menstruating) who is, in the opinion of the investigator, sexually active and at risk for pregnancy must be willing and able either to be strictly abstinent or to use an adequate and approved method of contraception throughout the study and for 12 weeks after the last study drug injection.
    Adequate and approved methods of contraception applicable for the subject and/or her partner are defined below:
    • true abstinence, when in line with the preferred and usual lifestyle of the subject (Periodic abstinence [e.g., calendar, ovulation, symptothermal, post-ovulation methods] and withdrawal are not acceptable methods of contraception.)
    • combination of male condom with cap, diaphragm, or sponge with spermicide (double barrier methods)
    Note: “Double barrier methods” refers to simultaneous use of a physical barrier by each partner. Use of a single barrier method (e.g. condom) together with a spermicide is not acceptable.
    • oral hormonal contraception
    10. Subject and caregiver willing and able to comply with all of the time commitments and procedural requirements of the clinical trial protocol.
    11. Understand and sign an Informed Consent Form (ICF) and Assent Form before any investigational procedures being performed.
    1. Pacientes de ≥7 a <12 años de edad o de ≥2 a <7 años de edad en la visita de selección.
    Nota: Los sujetos de 2 a 6 años de edad podrán ser inscritos solo después del AI y de que el CIVD haya evaluado los datos de seguridad intermedios de la cohorte 1 (de 7 a 11 años de edad) y haya dado recomendaciones al promotor, quien determinará a continuación la elegibilidad de este grupo de edad para la inscripción en el estudio y confirmará la dosis. El promotor enviará una comunicación por escrito a los centros confirmando que el estudio está abierto para la inclusión de la cohorte 2 (2 a 6 años de edad). No se podrá incluir a los sujetos en esta cohorte hasta que se reciba dicha comunicación.
    2. DA crónica documentada durante al menos 6 meses en sujetos de 2-6 años y durante al menos 1 año en sujetos de 7-11 años antes de la visita de selección y confirmada según los criterios de consenso de la American Academy of Dermatology (Anexo 1) en el momento de la visita de selección.
    3. Puntuación EASI (Índice de extensión e intensidad del eccema)  16 en las visitas de selección y basal.
    4. Puntuación IGA (Evaluación global por el investigador)  3 (basada en una escala IGA de 0 a 4, en la que 3 es moderada y 4 es grave) en las visitas de selección y basal.
    5. Afectación por DA  10 % de la superficie corporal (SC) en las visitas de selección y basal.
    6. Puntuación de, como mínimo, 4,0 en la escala numérica de valoración del prurito máximo (EVN PP) en las visitas de selección y basal:
    • La puntuación de la EVN PP de selección se determinará mediante una sola evaluación EVN PP (puntuación de 0 a 10) durante el período de 24 horas inmediatamente anterior a la visita de selección.
    • La puntuación de la EVN PP basal se determinará basándose en el promedio de las puntuaciones de la EVN PP diarias (puntuación de 0 a 10) durante los 7 días inmediatamente anteriores al momento basal (no se permite redondeo). Para este cálculo se requiere un mínimo de 4 puntuaciones diarias de los 7 días inmediatamente anteriores al momento basal.
    7. Antecedentes documentados por un médico o investigador (en los 6 meses previos a la visita de selección) de respuesta insuficiente a la medicación tópica existente o uso de tratamientos sistémicos para controlar la enfermedad.
    8. Comprometerse a aplicar una crema hidratante durante todo el estudio a partir de la visita de selección a diario y de forma generosa según sea necesario; comprometerse a aplicar un CST autorizado, con o sin ICT, desde la visita de selección y durante todo el estudio según lo considere oportuno el investigador.
    9. Toda mujer en edad fértil (es decir, que haya empezado a tener la menstruación) que, en opinión del investigador, sea sexualmente activa y corra riesgo de quedarse embarazada deberá estar dispuesta y ser capaz de practicar la abstinencia estricta o de utilizar un método anticonceptivo adecuado y aprobado durante todo el estudio y hasta 12 semanas después de la última inyección del fármaco del estudio.
    A continuación se definen los métodos anticonceptivos adecuados y aprobados aplicables al sujeto o a su pareja:
    • abstinencia real, cuando se adecua al modo de vida preferido y habitual del sujeto. (La abstinencia periódica [por ejemplo, métodos del calendario, ovulación, sintotérmico o postovulatorio] y el coito interrumpido no serán métodos anticonceptivos aceptables).
    • Combinación de preservativo masculino con capuchón, diafragma o esponja con espermicida (métodos de doble barrera)
    Nota: “Métodos de doble barrera” se refiere al uso simultáneo de una barrera física por cada pareja. No es aceptable el uso de un método de barrera único (p. ej., preservativo) junto con un espermicida.
    • Anticonceptivos hormonales orales
    10. Sujeto y cuidador dispuestos y capaces de cumplir todos los compromisos de tiempo y los requisitos procedimentales del protocolo del ensayo clínico.
    11. Comprender y firmar un documento de consentimiento informado (DCI) y un documento de asentimiento antes de que se realice ningún procedimiento de investigación.
    E.4Principal exclusion criteria
    1. Body weight <10 kg.
    2. Child in Care: a child who has been placed under the control or protection of an agency, organization, institution or entity by the courts, the government or a government body, acting in accordance with powers conferred on them by law or regulation.
    3. Subjects meeting one or more of the following criteria at screening or baseline:
    3a. Had a documented asthma exacerbation requiring hospitalization in the preceding 12 months.
    3b. Reporting asthma that has not been well controlled as defined by one or more of the following:
    • Daytime asthma symptoms >2 times per week during the preceding 3 months
    • Nighttime awakenings with asthma symptoms >2 times per month during the preceding 3 months
    • Asthma exacerbation requiring oral corticosteroid use >2 times per year
    3c. Childhood Asthma Control Test (cACT) ≤19 (applies only for subjects with a history of asthma age 7 to 11 years; cACT will not be performed for subjects age 2 to 6 years).
    3d. Peak expiratory flow (PEF) <80% of the predicted value (applies only for subjects age 7 to 11 years; PEF will not be performed for subjects age 2 to 6 years).
    Note: In the event that PEF is <80% of the predicted value at screening in patients without any history of asthma or in patients with history of asthma but with the cACT score >19, PEF testing can be repeated once within 48 hours.
    4. Subjects with a current medical history of chronic bronchitis.
    5. Cutaneous infection within 1 week before the baseline visit or any infection requiring treatment with oral or parenteral antibiotics, antivirals, antiparasitics, or antifungals within 2 weeks before the baseline visit, or any confirmed or suspected coronavirus disease (COVID-19) infection within 2 weeks before the screening or baseline visit. Subjects may be rescreened once the infection has resolved. Resolution of COVID-19 infection can be confirmed by recovery assessment methods, as described in Section 8.3.4.2.
    6. Requiring rescue therapy for AD during the run-in period or expected to require rescue therapy within 2 weeks following the baseline visit.
    7. Positive serology results for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb), hepatitis C (HCV) antibody with positive confirmatory test for HCV (eg polymerase chain reaction [PCR]), or human immunodeficiency virus (HIV) antibody at the screening visit.
    Note: Subjects with a positive HBcAb and a negative HBsAg can be included in this clinical trial if hepatitis B surface antibody (HBsAb) is positive (considered immune after a natural infection). Subjects with negative confirmatory test for HCV can be included in this clinical study.
    In the event of rescreening, the serology tests results (e.g. HBV, HCV, HIV) from the first screening can be used by the investigator to assess the eligibility of rescreened subjects if those tests were performed within 6 weeks prior to the baseline visit.
    8. Current active tuberculosis (TB) or latent TB infection or history of either untreated or inadequately treated latent or active TB according to the local applicable guidelines.
    Note: Subjects who have a documented history of completion of an appropriate TB treatment regimen for latent or active TB with no history of re-exposure to TB since their treatment was completed are eligible to participate in the study.
    In the event of rescreening, the TB tests result from the first screening can be used by the investigator to assess the eligibility of rescreened subjects if the test was performed within 6 weeks prior to the baseline visit.
    9. History of lymphoproliferative disease or history of malignancy of any organ system within the last 5 years or since birth for subjects <5 years of age.
    10. History of hypersensitivity (including anaphylaxis) to an immunoglobulin product (plasma-derived or recombinant, e.g., monoclonal antibody) or to any of the study drug excipients.
    11. History of intolerance to low or mid potency TCS or for whom TCS is not advisable (e.g., hypersensitivity to TCS, significant skin atrophy, etc.).
    12. Known or suspected immunosuppression.
    13. Presence of skin conditions that may interfere with study assessments (e.g., Netherton syndrome, psoriasis, contact dermatitis, chronic actinic dermatitis, dermatitis herpetiformis, erythroderma, ichthyosis, or scabies).
    14. Having received any of the following treatments in Table 2 within the specified timeframe before the baseline visit.
    Full list of exclusion criteria is included within the protocol.
    1.Peso corporal < 10 kg. 2.Niños en acogida: niños que hayan sido puestos bajo el control o la protección de una agencia, organización, institución o entidad por los tribunales, el gobierno o un organismo público, actuando de conformidad con las competencias que les confiere la ley o reglamentación. 3.Sujetos que cumplan uno o más de los criterios siguientes en la selección o el momento basal: 3a.Tener una exacerbación del asma documentada con necesidad de hospitalización en los 12 meses anteriores. 3b.Notificación de asma que no ha sido bien controlada, definida por una o más de las circunstancias siguientes:•Síntomas asmáticos diurnos > 2 veces a la semana durante los 3 meses precedentes
    •Despertares nocturnos con síntomas asmáticos > 2 veces al mes durante los 3 meses precedentes •Exacerbación asmática con necesidad de corticosteroides orales > 2 veces al año3c.Prueba de control del asma infantil (cACT) ≤ 19 (se aplica únicamente a los pacientes con antecedentes de asma de 7 a 11 años; no se realizará cACT en los pacientes de 2 a 6 años). 3d.Flujo espiratorio máximo (FEM) < 80 % del valor previsto (se aplica únicamente a los pacientes de 7 a 11 años; no se realizará el FEM en los pacientes de 2 a 6 años).Nota: En caso de que el FEM sea < 80 % del valor previsto en la selección en pacientes sin antecedentes de asma o en pacientes con antecedentes de asma pero con una puntuación cACT > 19, podrá repetirse la prueba del FEM una vez en un plazo de 48 horas.
    4.Pacientes con antecedentes médicos de bronquitis crónica.
    5.Infección cutánea en la semana previa a la visita basal o cualquier infección que requiera tratamiento con antibióticos, antivirales, antiparasitarios o antifúngicos orales o parenterales en las 2 semanas previas a la visita basal, o cualquier infección confirmada o sospecha de esta por coronavirus (COVID-19) en las 2 semanas previas a la visita de selección o basal. Los sujetos podrán someterse de nuevo al proceso de selección una vez resuelta la infección. La resolución de la infección por COVID-19 puede confirmarse mediante métodos de evaluación de la recuperación, como se describe en la sección 8.3.4.2.
    6.Necesidad de tratamiento de rescate para la DA durante el período de preinclusión o previsión de necesitar tratamiento de rescate en las 2 semanas siguientes a la visita basal.
    7.Resultados serológicos positivos para antígeno de superficie del virus de la hepatitis B (HBsAg) o anticuerpos contra el antígeno central del virus de la hepatitis B (HBcAb), anticuerpos contra el virus de la hepatitis C (VHC) con prueba de confirmación positiva para el VHC (por ejemplo, reacción en cadena de la polimerasa [PCR]) o anticuerpos contra el virus de la inmunodeficiencia humana (VIH) en la visita de selección.
    Nota: Los sujetos con un HBcAb positivo y un HBsAg negativo podrán participar en este ensayo clínico si el anticuerpo de superficie contra la hepatitis B (HBsAb) es positivo (se considera con inmunidad después de una infección natural). En este estudio clínico podrán participar sujetos con una prueba de confirmación negativa para el VHC.
    En caso de repetirse la selección, el investigador podrá utilizar los resultados de las pruebas serológicas (p. ej., VHB, VHC, VIH) de la primera selección para evaluar la elegibilidad de los sujetos que se sometan de nuevo al proceso de selección si dichas pruebas se realizaron en las 6 semanas previas a la visita basal.
    8.Tuberculosis (TB) activa actual o TB latente o antecedentes de TB latente o activa no tratada o tratada insuficientemente según las directrices locales aplicables.
    Nota: Podrán participar en el estudio los sujetos que tengan antecedentes documentados de haber completado una pauta adecuada de tratamiento para la TB latente o activa sin antecedentes de reexposición a la TB desde el final del tratamiento.
    En caso de repetición de la selección, el investigador podrá utilizar los resultados de las pruebas de TB de la primera selección para evaluar la elegibilidad de los sujetos que se sometan de nuevo a la selección si la prueba se realizó en las 6 semanas previas a la visita basal.
    9.Antecedentes de enfermedad linfoproliferativa o de neoplasia maligna de cualquier sistema orgánico en los últimos 5 años o desde el nacimiento en sujetos menores de 5 años.
    10.Antecedentes de hipersensibilidad (incluida anafilaxia) a un producto de inmunoglobulinas (derivado del plasma o recombinante, p. ej., anticuerpo monoclonal) o a cualquiera de los excipientes del fármaco del estudio.
    11.Antecedentes de intolerancia al CST de potencia baja o intermedia o en los que no sea aconsejable el CST (por ejemplo, hipersensibilidad al CST, atrofia cutánea importante, etc.).
    12.Certeza o sospecha de inmunodepresión.
    El protocolo incluye una lista completa de los criterios de exclusión.
    E.5 End points
    E.5.1Primary end point(s)
    Pharmacokinetics (PK):
    •Nemolizumab serum concentrations at Weeks 4, 8, 12, 16, 32, and 52
    •Nemolizumab serum PK parameters estimated with a population PK analysis
    Farmacocinética (FC):
    •Concentraciones séricas de nemolizumab en las semanas 4, 8, 12, 16, 32 y 52
    •Parámetros FC séricos de nemolizumab calculados con un análisis de FC poblacional
    E.5.1.1Timepoint(s) of evaluation of this end point
    As specified within the list of endpoints
    Como se especifica en la lista de criterios de valoración.
    E.5.2Secondary end point(s)
    Efficacy:
    • Absolute and percent change in EASI score from baseline at each visit up to Week 16 and up to Week 52.
    • Proportion of subjects achieving 50%, 75% or 90% response in EASI [EASI-50, EASI-75 and EASI-90] at baseline and at each visit up to Week 16 and Week 52.
    • IGA success rate (defined as an IGA of 0 [Clear] or 1 [Almost clear] and a ≥2-point improvement from baseline) at each visit up to Week 16 and up to Week 52.
    • Change in BSA involvement of AD, reported as a percentage of all major body sections combined, from baseline at each visit up to Week 16 and up to Week 52.
    • Absolute and percent change in weekly average of peak pruritus NRS (PP NRS) score from baseline at each visit up to Week 16 and up to Week 52.
    • Proportion of subjects with an improvement of ≥4 from baseline in weekly average of PP NRS at visit up to Week 16 and Week 52.
    • Absolute and percent change in weekly average of average pruritus NRS score from baseline at each visit and up to Week 16 and up Week 52.
    • Absolute and percent change in weekly sleep disturbance NRS score from baseline at each visit up to Week 16 and up to Week 52.
    • Percent change in SCORing Atopic Dermatitis (SCORAD) score from baseline at each visit up to Week 16 and up to Week 52.
    • Change in Children’s Dermatology Life Quality Index (cDLQI) for subjects ≥4 years of age from baseline up to Week 16 and up to Week 52.
    • Change in Infants’ Dermatitis Quality of Life Index (IDQOL) for subjects <4 years of age from baseline up to Week 16 and up to Week 52.
    • Change in Patient-Oriented Eczema Measure (POEM) from baseline up to Week 16 and up to Week 52.
    Eficacia:
    •Variación absoluta y porcentual de la puntuación EASI entre el momento basal y cada visita hasta las semanas 16 y 52
    •Proporción de sujetos que logran una respuesta del 50 %, 75 % o 90 % en el EASI [EASI-50, EASI-75 y EASI-90] en el momento basal y en cada visita hasta las semanas 16 y 52
    •Tasa de éxito IGA (definido como una puntuación IGA de 0 [sin lesiones] o 1 [casi sin lesiones] y una mejoría ≥ 2 puntos con respecto al momento basal) en cada visita hasta las semanas 16 y 52.
    •Variación de la superficie corporal afectada por la DA, notificada como porcentaje de todas las secciones corporales principales combinadas, entre el momento basal y cada visita hasta las semanas 16 y 52.
    •Variación absoluta y porcentual del promedio semanal de la puntuación de la EVN del prurito máximo (EVN PP) entre el momento basal y cada visita hasta las semanas 16 y 52.
    •Proporción de sujetos con una mejoría ≥ 4 con respecto al momento basal del promedio semanal de la puntuación de la EVN PP en la visita hasta las semanas 16 y 52.
    •Variación absoluta y porcentual del promedio semanal de la puntuación de la EVN del prurito medio entre el momento basal y cada visita y hasta las semanas 16 y 52.
    •Variación absoluta y porcentual de la puntuación semanal en la EVN de trastornos del sueño entre el momento basal y cada visita hasta las semanas 16 y 52.
    •Variación porcentual de la puntuación SCORAD (Puntuación de la dermatitis atópica) entre el momento basal y cada visita hasta las semanas 16 y 52
    •Variación del Índice de calidad de vida en dermatología para niños (cDLQI) en los pacientes de 4 años o más de edad entre el momento basal y las semanas 16 y 52.
    •Variación del índice de calidad de vida en la dermatitis del lactante (IDQOL) en los sujetos menores de 4 años entre el momento basal y las semanas 16 y 52
    •Variación de la medición del eccema orientada al paciente (POEM) entre el momento basal y las semanas 16 y 52.
    E.5.2.1Timepoint(s) of evaluation of this end point
    As specified within the list of endpoints
    Como se especifica en la lista de criterios de valoración.
    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 Yes
    E.6.13.1Other scope of the trial description
    Immunogenicity, Quality of life
    Inmunogenicidad, Calidad de vida
    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) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    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 Yes
    E.8.1.7.1Other trial design description
    único brazo: los pacientes se reclutaran en 2 cohortes: de 7 a 11 años. Cohorte 2, de 2 a 6 años
    single arm. Subject will be enrolled in 2 cohorts : Cohort 1: aged 7-11 years Cohort 2: 2-6 years
    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 EEA18
    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
    United States
    Denmark
    Germany
    Hungary
    Italy
    Poland
    Spain
    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
    UVUS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months9
    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: 70
    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: 70
    F.1.1.6Adolescents (12-17 years) No
    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 No
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    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 Yes
    F.3.3.7.1Details of other specific vulnerable populations
    subject aged 2-11 years
    Sujetos de 2 a 11 años
    F.4 Planned number of subjects to be included
    F.4.1In the member state6
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 35
    F.4.2.2In the whole clinical trial 70
    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)
    Patients will revert back to their primary physician for further evaluation.
    Los pacientes volverán a su médico de cabecera para más evaluaciones
    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 Decision2022-04-05
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-10-27
    P. End of Trial
    P.End of Trial StatusOngoing
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