E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Primary immune thrombocytopenia |
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E.1.1.1 | Medical condition in easily understood language |
Immune thrombocytopenia is a disorder characterized by a blood abnormality called thrombocytopenia, which is a shortage of blood cells called platelets that are needed for normal blood clotting. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 23.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10083843 |
E.1.2 | Term | Primary immune thrombocytopenia |
E.1.2 | System Organ Class | 100000004851 |
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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 |
To evaluate absolute value of platelet count of treated participants at Week 12
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E.2.2 | Secondary objectives of the trial |
To evaluate proportion of participants with modified overall response (mOR) at Week 12 To evaluate proportion of participants with complete response (CR) at Week 12 To evaluate safety and tolerability of PF-06835375 To evaluate effect of PF-06835375 treatment on platelet count over time To evaluate the effect of PF-06835375 on depletion of circulating B cells and cTfh cells over time |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Age and Sex: 1. Participants between the ages of 18 (or the minimum country-specific age of consent if >18) and 70 years, inclusive, at Screening. Type of Participant and Disease Characteristics: 2. Willing and able to comply with all scheduled visits, treatment plan, laboratory tests, lifestyle considerations and other study procedures. 3. Diagnosis of Primary ITP. ITP must be diagnosed in accordance with established guidelines. Ongoing ITP (platelet counts <50 x 109/L) [No severe bleeding within 1 month or during screening] AND Persistent ITP (3 to 12 months) or Chronic ITP >12 months. Weight: 4. BMI 17.5 to 40 kg/m2, and minimum weight >40 kg (88 lbs). Informed Consent: 5. Capable of giving signed informed consent as described in Appendix 1 which includes compliance with the requirements and restrictions listed in the ICD and in this protocol |
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E.4 | Principal exclusion criteria |
Medical Conditions: 1. Bleeding event according to the WHO grading scale 30 ≥2 occurring ≤4 weeks prior to screen OR a current bleeding event that, in the opinion of the investigator, requires treatment with standard of care therapy OR require blood or blood products during screening 2. Splenectomy within 3 months of randomization or planned during the study duration. 3. Have current or recent history of clinically significant, acute or chronic, severe, progressive, or uncontrolled renal, hepatic, gastrointestinal, metabolic, endocrine, pulmonary, cardiovascular, psychiatric, immunologic/rheumatologic or neurologic disease; or have any other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study intervention administration, or interfere with the interpretation of study results; or in the opinion of the investigator, the participant is inappropriate for entry into this study. 4. Other medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or, in the investigator’s judgment, make the participant inappropriate for the study. 15. Current use of any prohibited concomitant medication(s) or those unwilling/unable to use a permitted concomitant medication(s). 16. Any prior treatment with rituximab (or any other B cell depleting agent) must have been completed 12 months prior to first dose of study drug and CD19 count (>100 cells per microliter) must be normal prior to first dose. 5. Contraindication for the pre and post medication treatments (NSAID, APAP,corticosteroids, antihistamine). 6. Pregnant female participants; breastfeeding female subjects; and female participants of childbearing potential who are unwilling or unable to use one method of contraception as outlined in this protocol for the duration of the study and for at least 43 days after the last dose of study intervention. 7. Have a history of alcohol or substance abuse within 12 months prior to Day 1 that in the opinion of the investigator will preclude participation in the study or protocol adherence in the study. A positive urine drug screen must be reflective of a clinically appropriate use. 8. Currently active autoimmune disorders or other conditions that compromise or impair the immune system (including but not limited to: CD, RA, scleroderma, vasculitis, SLE, Grave’s disease or asthma) in the opinion of the investigator. 9. Co-existing myelodysplastic disorder. If clinically significant anemia, neutropenia, or pancytopenia exists, documentation of a bone marrow aspirate/biopsy within 24 months prior to the first study dose showing no evidence of myelodysplasia is required. 10. Co-existing thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, coagulopathies or other bleeding disorders. 11. History of immune deficiency or current evidence of total IgG or total IgA deficiency. 12. History of allergic or anaphylactic reaction to any components of the study intervention. 13. Have cancer or a history of cancer within 5 years of screening (other than adequately resected cutaneous basal cell, squamous cell carcinoma, or carcinoma in situ of the uterine cervix with no evidence of recurrence within the previous 3 years). 14. Any psychiatric condition including recent or active suicidal ideation or behavior that meets any of the following criteria: Suicidal ideation associated with actual intent and a method or plan in the past year: “Yes” answers on items 4 or 5 of the C-SSRS. Previous history of suicidal behaviors in the past 5 years: “Yes” answer (for events that occurred in the past 5 years) to any of the suicidal behavior items of the C-SSRS.Any lifetime history of serious or recurrent suicidal behavior. 15. Current use of any prohibited concomitant medication(s) or those unwilling/unable to use a permitted concomitant medication(s). 16. Any prior treatment with rituximab (or any other B cell depleting agent) must have been completed 12 months prior to first dose of study drug and CD19 count (>100 cells per microliter) must be normal prior to first dose. 17. Recent high doses corticosteroids (> 20 mg prednisone or equivalent per day). If on corticosteroids, must be on a stable dose for ≥28 days prior to the first dose (maximum dose up to 20 mg/day prednisone equivalent) and expected to remain on a stable dose throughout the study. 18. Treatment with IVIg ≤28 days prior to the first dose. 19. Treatment with plasmapheresis within 3 months prior to the first dose. 20. Treatment with an anti-Rh D antigen agent (eg, WinRho®) ≤28 days prior to the first dose. Further exclusion criteria are detailed in the protocol |
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E.5 End points |
E.5.1 | Primary end point(s) |
Log2 (platelet count) at Week 12 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Modified overall response (mOR) at Week 12 Complete response (CR) at Week 12 Incidence of AEs as characterized by type, frequency, severity, timing, seriousness, and relationship to study intervention, Day 1 through end of study Log2 (platelet count) Modified response (mOR) Complete response (CR) Absolute values and change of platelet count from baseline Absolute values and change from baseline of circulating B and Tfh cell counts
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Week 12 Week 12 Day 1 through end of study The secondary endpoints/estimands will include evaluation of expected value (with 90% confidence intervals) for means of log2(Platelet counts) and proportions of mOR and CR responders over time. Censoring of the log2 (Platelet counts), definitions of mOR and CR responses will be similar and methods for the analysis (MMRM and Wald) will be the same as the methods described in the Section 9.3.2 for the key secondary endpoints. The only difference will be that the MMRM model will use the data collected at all available visits rather than the data collected up to and including Week 12 visit.
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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 | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | Yes |
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 | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 11 |
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 | Yes |
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 |
Australia |
Canada |
Czechia |
Hungary |
Poland |
United States |
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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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The end of the study is defined as the date of the last visit of the last participant in the study or last scheduled procedure shown in the Schedule of Activities for the last participant in the trial globally. |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 10 |
E.8.9.2 | In all countries concerned by the trial days | 0 |