E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) |
Malattia associata agli anticorpi anti-glicoproteina oligodendrocitaria mielinica (MOGAD) |
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E.1.1.1 | Medical condition in easily understood language |
MOGAD is a recently coined neuro-inflammatory condition that preferentially causes demyelinating inflammation in the optic nerve but can also cause inflammation in the spinal cord and brain. |
MOGAD è una condizione neuro-infiammatoria che causa preferenzialmente infiammazione demielinizzante nel nervo ottico, ma può anche causare infiammazione nel midollo spinale e nel cervello. |
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E.1.1.2 | Therapeutic area | Body processes [G] - Immune system processes [G12] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10075688 |
E.1.2 | Term | Autoimmune demyelinating disease |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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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 the efficacy of satralizumab compared with placebo based on time from randomization to the first occurrence of an adjudicated MOGAD relapse in the double-blind (DB) treatment period |
Valutare l’efficacia di satralizumab rispetto al placebo in base al tempo dalla randomizzazione alla prima comparsa di una recidiva di MOGAD nel periodo di trattamento DB |
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E.2.2 | Secondary objectives of the trial |
To evaluate the efficacy of satralizumab compared with placebo based on rate of adjudicated MOGAD relapses, presence of active lesions on magnetic resonance imaging (MRI) of the neuroaxis, rescue therapy use, inpatient hospitalizations, and proportion of relapse-free participants at 6-month intervals To evaluate the safety of satralizumab compared with placebo |
Valutare l’efficacia di satralizumab rispetto al placebo in base al tasso annualizzato di recidive validate di MOGAD, presenza di lesioni attive alla RM del neurasse, terapia di salvataggio, ricoveri in ospedale e percentuale di partecipanti liberi da recidiva a intervalli di 6 mesi. Valutare la sicurezza di satralizumab rispetto al placebo |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Participants who are aged >=12 years at the time of signing Informed Consent Form - Confimed diagnosis of MOGAD with a history of >=1 MOGAD relapse in the 12 months prior to screening or >=2 attacks in the 24 months prior to screening - Expanded Disability Status Scale (EDSS) score of 0-6.5 at screening - Best corrected visual acuity (BCVA) better than 20/800 in both eyes at screening - Participants receiving either no ongoing chronic immunosuppressant treatment (IST) for MOGAD at the time of screening or receiving ongoing treatment with azathioprine (AZA), mycophenolate mofetil (MMF), oral corticosteroids (OCS) prior to and at the time of screening - No contraindications to rescue treatments - No contraindications to MRI - For women of childbearing potential: participants who agree to remain abstinent or use adequate contraception during the treatment period and for at least 3 months after the final dose of satralizumab |
- Partecipanti di età >=12 anni al momento della firma del Modulo di consenso informato - Diagnosi confermata di MOGAD con una storia di recidiva di MOGAD>=1 nei 12 mesi precedenti lo screening o >=2 attacchi nei 24 mesi precedenti lo screening - Punteggio EDSS (Expanded Disability Status Scale) di 0-6,5 allo screening - Migliore acuità visiva corretta (BCVA) superiore a 20/800 in entrambi gli occhi a selezione - Partecipanti che non ricevono alcun trattamento immunosoppressore cronico (IST) per MOGAD al momento dello screening o che ricevono un trattamento in corso con azatioprina (AZA), micofenolato mofetile (MMF), corticosteroidi orali (OCS) prima e al momento dello screening - Nessuna controindicazione ai trattamenti di salvataggio - Nessuna controindicazione alla risonanza magnetica - Per le donne in età fertile: partecipanti che accettano di rimanere in astinenza o di utilizzare un metodo contraccettivo adeguato durante il periodo di trattamento e per almeno 3 mesi dopo la dose finale di satralizumab |
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E.4 | Principal exclusion criteria |
- Presence of aquaporin-4-antibodies (AQP4-IgG) in the serum - History of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis - Any concomitant disease other than MOGAD that may require treatment with ISTs or OCS or intravenous (IV) corticosteroids at doses >20 mg prednisone equivalent per day for >21 days during the study Exclusion Criteria Related to Previous or Concomitant Therapy - Intravenous immunoglobulins (IVIg) within 4 weeks prior to screening - Plasma exchange (PLEX) within 4 weeks prior to screening - OCS, AZA or MMF within 4 weeks prior to screening (if not continued as concomitant IST in the study) - Tacrolimus or cyclosporine within 6 weeks prior to screening - B-cell depleting agents, including rituximab (RTX) and ocrelizumab, within 6 months prior to baseline - Methotrexate within 3 months prior to screening - Neonatal Fc receptor antagonists within 6 months prior to screening - IV cyclophosphamide within 6 months prior to screening - Complement inhibitors within 6 months prior to screening - Glatiramer acetate and IFN-ß within 1 month prior to screening - Fumarates within 2 months prior to screening - Teriflunomide within 2 years prior to screening - Other MS disease-modifying treatments within 6 months prior to screening - IL-6 inhibitory therapy at any time - Total body irradiation, bone marrow transplantation, and autologous hematopoietic stem cell transplantation at any time - T-cell depleting agents, including but not limited to alemtuzumab, at any time - Anti-B-lymphocyte stimulator monoclonal antibody at any time - Cladribine, mitoxantrone, or oral cyclophosphamide at any time - Treatment with any investigational agent within 24 weeks or 5 drug-elimination half-lives of the investigational drug prior to screening General Safety Exclusion Criteria - Participants who are pregnant or breastfeeding, or intending to become pregnant during the study or within 3 months after the final dose of satralizumab - Participants with active or presence of recurrent bacterial, viral, fungal, mycobacterial infection, or other infection at baseline - Participants with evidence of latent or active tuberculosis (excluding patients receiving chemoprophylaxis for latent tuberculosis infection) - Participants with positive screening tests for hepatitis B and C - Receipt of live or live attenuated vaccine within 6 weeks prior to baseline - History of severe allergic reaction to a biologic agent |
- Presenza di anticorpi acquaporina-4 (AQP4-IgG) nel siero - Storia di encefalite anti-N-metil-d-aspartato recettore (NMDAR) - Qualsiasi malattia concomitante diversa da MOGAD che può richiedere il trattamento con IST o OCS o corticosteroidi per via endovenosa (IV) a dosi >20 mg di prednisone equivalente al giorno per >21 giorni durante lo studio Criteri di esclusione relativi a terapie precedenti o concomitanti - Immunoglobuline endovenose (IVIg) nelle 4 settimane precedenti lo screening - Scambio di plasma (PLEX) entro 4 settimane prima dello screening -OCS, AZA o MMF nelle 4 settimane precedenti lo screening (se non continuato come IST concomitante nello studio) -Tacrolimus o ciclosporina nelle 6 settimane precedenti lo screening -Agenti che riducono le cellule B, inclusi rituximab (RTX) e ocrelizumab, entro 6 mesi prima del basale -Metotrexato entro 3 mesi prima dello screening -Antagonisti del recettore Fc neonatale entro 6 mesi prima dello screening -Ciclofosfamide IV entro 6 mesi prima dello screening -Inibitori del complemento entro 6 mesi prima dello screening -Glatiramer acetato e IFN-ß entro 1 mese prima dello screening -Fumarati entro 2 mesi prima dello screening -Teriflunomide entro 2 anni prima dello screening -Altri trattamenti modificanti la malattia della SM entro 6 mesi prima dello screening -Terapia inibitoria dell'IL-6 in qualsiasi momento -Irradiazione corporea totale, trapianto di midollo osseo e trapianto autologo di cellule staminali ematopoietiche in qualsiasi momento -Agenti che riducono le cellule T, incluso ma non limitato ad alemtuzumab, in qualsiasi momento -Anticorpo monoclonale stimolatore dei linfociti B in qualsiasi momento -Cladribina, mitoxantrone o ciclofosfamide orale in qualsiasi momento -Trattamento con qualsiasi agente sperimentale entro 24 settimane o 5 emivite di eliminazione del farmaco prima dello screening Criteri generali di esclusione per la sicurezza -Partecipanti in gravidanza o allattamento o che intendono iniziare una gravidanza durante lo studio o entro 3 mesi dalla dose finale di satralizumab -Partecipanti con infezione batterica, virale, fungina, micobatterica o altra infezione ricorrente attiva o di altra natura al basale -Partecipanti con evidenza di tubercolosi latente o attiva (esclusi i pazienti sottoposti a chemioprofilassi per infezione da tubercolosi latente) -Partecipanti con test di screening positivi per l'epatite B e C -Ricezione di vaccino vivo o vivo attenuato entro 6 settimane prima del basale -Storia di grave reazione allergica a un agente biologico |
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Time from randomization to the first occurrence of a MOGAD relapse in the DB treatment period, as determined by an adjudication committee (CEC) |
1. Tempo dalla randomizzazione alla prima comparsa di una recidiva di MOGAD nel periodo di trattamento DB secondo quanto stabilito da un comitato di validazione (CEC) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. Up to approximately 44 months |
1. Fino a circa 44 mesi |
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E.5.2 | Secondary end point(s) |
1. Rate of adjudicated MOGAD relapses 2. Active lesions on MRI of the neuroaxis (Gd-enhancing or new/enlarging T2 hyperintense lesions measured across the optic nerve, the spinal cord and the brain, including brainstem and cerebellum) 3. Proportion of participants receiving rescue therapy 4. Rate of inpatient hospitalizations (defined as more than an overnight stay, excluding those for elective procedures) 5. Proportion of relapse-free participants at 6-month intervals 6. Incidence, seriousness and severity of adverse events, with severity determined according to National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 (NCI CTCAE v5.0) 7. Change from baseline in targeted vital signs 8. Change from baseline in targeted electrocardiogram (ECG) parameters 9. Change from baseline in targeted clinical laboratory test results 10. Change from baseline in suicidality, as determined by Columbia-Suicide Severity Rating Scale 11. Change from baseline in weight
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1. Tasso annullizzato di recidive validate MOGAD 2. Lesioni attive alla RM del neuroasse (lesioni iperintense in T2 nuove/in progressione o captanti Gd a livello di nervo ottico, midollo spinale e cervello, compresi tronco encefalico e cervelletto) 3. Percentuale di partecipanti sottoposti a terapia di salvataggio 4. Tasso annualizzato di ricoveri in ospedale (intesi come ricoveri superiori a una notte, eccetto quelli per procedure elettive) 5. Percentuale di partecipanti liberi da recidiva a intervalli di 6 mesi 6. Incidenza, gravità e severità degli eventi avversi, con severità stabilita in funzione dei criteri NCI CTCAE v5.0 7. Variazione dei segni vitali di interesse rispetto al basale 8. Variazione dei parametri dell’elettrocardiogramma (ECG) di interesse rispetto al basale 9. Variazione dei risultati degli esami clinici di laboratorio di interesse rispetto al basale 10. Variazione della suicidalità rispetto al basale in funzione della Columbia-Suicide Severity Rating Scale 11. Variazione del peso rispetto al basale |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1-5. Up to approximately 44 months 6-11. Baseline to up to approximately 44 months
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1-5. Fino a circa 44 mesi 6-11. Dal basale fino a circa 44 mesi |
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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 | No |
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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | 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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 17 |
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 | Information not present in EudraCT |
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 |
Brazil |
Canada |
China |
Japan |
Korea, Republic of |
United States |
France |
Germany |
Italy |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The DB treatment period of the study will end when the total number of participants with adjudicated relapses reaches 28, with the CCOD defined as the date 12 weeks after the RA visit for the 28th adjudicated relapse or the RFA visit of the participant with the 28th adjudicated relapse, whichever occurs later. The end of the OLE treatment period is expected to be approximately 2 years after the end of the DB treatment period. |
Il periodo di trattamento DB dello studio terminerà dopo 28 recidive validate (data del cut-off clinico [CCOD] dopo che il 28° partecipante con recidiva validata sarà stato sottoposto a RFA o 12 settimane dopo la visita RA per la 28° recidiva validata, a seconda della circostanza che si verifichi per ultima). |
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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 | 5 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |