E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Active Idiopathic Inflammatory Myopathies (IIM) |
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E.1.1.1 | Medical condition in easily understood language |
Active Idiopathic Inflammatory Myopathies |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10028640 |
E.1.2 | Term | Myopathies |
E.1.2 | System Organ Class | 100000004859 |
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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 nipocalimab vs placebo in participants with active IIM. |
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E.2.2 | Secondary objectives of the trial |
- To further evaluate the efficacy of nipocalimab vs placebo across a range of outcome measures in participants with active IIM. - To evaluate the efficacy of nipocalimab vs placebo in oral GC reduction in participants with active IIM. - To evaluate the efficacy of nipocalimab vs placebo in disease activity improvement over time in participants with active IIM. - To evaluate the safety and tolerability of nipocalimab vs placebo in participants with active IIM - To evaluate the impact of nipocalimab on PROs in participants with active IIM. - To evaluate the PK and immunogenicity of nipocalimab in participants with active IIM. - DM participants only: To evaluate the efficacy of nipocalimab vs placebo in cutaneous disease activity improvement in participants with active IIM.
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
- Thigh Muscle MRI Sub-study (Optional) - Muscle Biopsy Sub-study (Optional) |
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E.3 | Principal inclusion criteria |
- Disease classification criteria: Participant meets the diagnostic criteria of probable or definite idiopathic inflammatory myopathies (IIM) based on 2017 The European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for adult IIM at least 6 weeks prior to first administration of the study intervention - If a participant is on regular or as needed treatment with low potency topical glucocorticoids (GC) that are allowed in the study or topical tacrolimus (TAC) to treat skin lesions, the dose and frequency should be stable for greater than or equal to (>=) 4 weeks prior to first administration of the study intervention as well as maintained at the same dose until Week 52 of the study - Antibody positivity criteria: Any 1 of the myositis-specific antibodies (MSAs) positive: dermatomyositis (DM): anti-Mi-2 (Mi-2/nucleosome remodeling and deacetylase [NuRD] complex), anti-transcription intermediary factor 1-Gamma (TIF1-Gamma), anti- nuclear matrix protein 2 (NXP-2), anti-serious adverse event (SAE); anti- antimelanoma differentiation-associated gene 5 (MDA-5) antibodies. Or immune-mediated necrotizing myopathy (IMNM): anti- signal recognition particle (SRP) and anti- 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibodies. Or anti-synthetase syndrome (ASyS): anti- histidyl- ribonucleic acid [tRNA] synthetase (Jo-1), anti- threonyl-tRNA synthetase (PL7), anti- alanyl-tRNA synthetase (PL12), anti- isoleucyl-tRNA synthetase (OJ), and anti- glycyl-tRNA synthetase (EJ) antibodies. If all MSAs are negative or more than 1 MSA is positive (defined by the central laboratory) at screening, the tests should be repeated during the screening period. If the same results are observed at retesting, the participant should not be enrolled in the study
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E.4 | Principal exclusion criteria |
- Has a juvenile myositis diagnosis and now >=18 years old - Has cancer-associated myositis defined as cancer diagnosis within 3 years of myositis diagnosis except for cervical carcinoma in situ and non-melanoma skin cancer (squamous cell carcinoma, basal cell carcinoma of the skin) - Has comorbidities (example, asthma, chronic obstructive pulmonary disease [COPD]) which have required 3 or more courses of oral GC within 1 year prior to screening - Has a history of primary immunodeficiency or secondary immunodeficiency not related to the treatment of the participants IIM - Has experienced myocardial infarction (MI), unstable ischemic heart disease, or stroke within 12 weeks of screening
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E.5 End points |
E.5.1 | Primary end point(s) |
Percentage of participants who achieve at least minimal improvement (≥20) in IMACS TIS (International myositis assessment and clinical studies total improvement score) and on ≤5 mg/day of oral prednisone (or equivalent) from week 44 through week 52.
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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) |
Key Secondary Endpoints: - Percentage of Participants who Achieve at Least Minimal Improvement (≥20) in IMACS TIS at Week 24. - IMACS TIS at Week 52 - Percentage of Participants who Achieve at Least Moderate Improvement (≥40) in IMACS TIS at Week 24. - Change From Baseline in Manual Muscle Testing (MMT)-8 at Week 52. - Percentage of Participants who Achieve Oral GC Reduction to 5 mg/day of Oral Prednisone (or Equivalent) at Week 44 and Maintain That Reduction Through Week 52, Among Participants on Oral GC >5 mg/day at Baseline. - Percentage of Participants who Achieve at Least Minimal Improvement (≥20) in IMACS TIS from Week 44 Through Week 52 and on ≤5 mg/day of Oral Prednisone (or Equivalent) from Week 44 Through Week 52. - Change From Baseline in Patient-Reported Outcomes Measurement Information System (PROMIS)-Physical Function (PF-20) at Week 52
Other Secondary Endpoints: - IMACS TIS at Week 24 - Percentage of Participants who Achieve at Least Moderate Improvement (≥40) in IMACS TIS at Week 52. - Percentage of Participants who Achieve at Least Major Improvement (≥60) in IMACS TIS at Weeks 24 and 52. - Change from Baseline in MMT-8 at Week 24 - Change from Baseline in Physician Global Assessment (PhGA) at Weeks 24 and 52 - Change from Baseline in Extramuscular Global Assessment (Myositis Disease Activity Assessment Tool (MDAAT) at Weeks 24 and 52 - Change from Baseline in Serum Muscle Enzymes Levels at Weeks 24 and 52 - Percentage of Participants on ≤5 mg/day of Oral prednisone (or equivalent) From Week 44 Through Week 52 - Percentage of Participants who Achieve at Least Minimal Improvement (≥20) in IMACS TIS and Achieve oral GC Reduction to 5 mg/day at Week 44 and Maintain that Reduction Through Week 52, Among Participants on Oral GC >5mg/day at Baseline - Percentage of Participants who Achieve at Least Minimal Improvement (≥20) in IMACS TIS From Week 44 Through Week 52 and on ≤7.5 mg/day of Oral Prednisone (or Equivalent) From Week 44 Through Week 52 - Percentage of Participants who Achieve Oral GC Reduction to ≤7.5 mg/day of Oral Prednisone (or Equivalent) at Week 44 and Maintain That Reduction Through Week 52, Among Participants on Oral GC >7.5 mg/day at Baseline - Percentage of Participants who Achieve at Least Minimal Improvement (≥20) in IMACS TIS and Achieve Oral GC Reduction to ≤7.5 mg/day at Week 44 and Maintain That Reduction Through Week 52, Among Participants on Oral GC >7.5 mg/day at Baseline - IMAC TIS Over time (Up to 106 Weeks) - Change in Baseline in the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) Scale Score at Weeks 24 and 52 - Change in CDASI Scale Score Over Time (Up to 106 Weeks) - Percentage of Participants with Treatment-Emergent Adverse Events (AEs) (up to 106 Weeks) - Percentage of Participants with Treatment-Emergent Serious Adverse Events (SAEs) (up to 106 Weeks) - Change From Baseline In Functional Disability Using the Health Assessment Questionnaire-disability Index (HAQ-DI) at Weeks 24 and 52 - Serum Nipocalimab Concentration Over Time (Baseline Up To Week 98) - Number of Participants With Anti-Drug Antibody (ADA) (Baseline Up To Week 106) - Number of Participants With Neutralizing Antibodies (Nabs) to Nipocalimab (Baseline Up To Week 106) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | 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 | Yes |
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
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 16 |
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 | No |
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 |
Japan |
Korea, Republic of |
Mexico |
United States |
France |
Poland |
Netherlands |
Spain |
Czechia |
Germany |
Italy |
Hungary |
United Kingdom |
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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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | |
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 | 2 |
E.8.9.2 | In all countries concerned by the trial days | 0 |