E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Diffuse Cutaneous Systemic Sclerosis |
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E.1.1.1 | Medical condition in easily understood language |
Disease characterized by skin hardening (fibrosis) and problems in many organs of the body. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10042953 |
E.1.2 | Term | Systemic sclerosis |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue 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 |
The overall objective is to investigate the efficacy, safety and tolerability of HZN-825, a selective antagonist of LPAR1, administered BID to subjects with diffuse cutaneous SSc in a 52-week open-label extension following completion of the randomized, double-blind, 52-week clinical trial (HZNP-HZN-825-301). The primary efficacy objective is to assess the efficacy of 52 weeks of open-label treatment with HZN-825 in subjects with diffuse cutaneous SSc, as measured by change from both Baselines in FVC % predicted. The primary safety objective is to examine the safety and tolerability of 52 weeks of open-label treatment with HZN-825, inclusive of, but not limited to, AEs, SAEs and the AESI from Day 1 to 4 weeks after last dose. |
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E.2.2 | Secondary objectives of the trial |
The exploratory objectives are to evaluate the following after 52 weeks of open-label treatment with HZN-825: • Change from both Baselines in HAQ-DI; Physician Global Assessment (MDGA); Patient Global Assessment (PTGA); the Physical Effects and Physical Limitations subscales of the scleroderma skin patient-reported outcome (SSPRO-18); the mRSS; American College of Rheumatology-Composite Response Index in Systemic Sclerosis (ACR-CRISS), among others as indicated in protocol section 8.2. • The PK of HZN-825 and metabolite(s) |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Written informed consent. 2. Completed the double-blind Treatment Period (Week 52) in Trial HZNP-HZN-825-301; subjects prematurely discontinued from trial drug in Trial HZNP-HZN-825-301 for reasons other than safety or toxicity can be included at the discretion of the Investigator after completing Trial HZNP-HZN-825-301 scheduled visits, including Week 52 assessments. 3. Willing and able to comply with the prescribed treatment protocol and evaluations for the duration of the trial.
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E.4 | Principal exclusion criteria |
1. Anticipated use of another investigational agent for any condition during the course of the trial. 2. New diagnosis of malignant condition after enrolling in Trial HZNP-HZN-825-301 (except successfully treated basal/squamous cell carcinoma of the skin or cervical cancer in situ). 3. Women of childbearing potential (WOCBP) or male subjects not agreeing to use highly effective method(s) of birth control throughout the trial and for 4 weeks after last dose of trial drug. Male subjects must refrain from sperm donation and females from egg/ova donation for this same time period. Women are considered of childbearing potential if they are not postmenopausal and not surgically sterile (documented bilateral salpingectomy, bilateral oophorectomy or hysterectomy). A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. A high follicle-stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy. However, in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient. Fertile male subjects must use a condom throughout the trial and for 4 weeks after the last dose of trial drug. A man is considered fertile after puberty unless permanently sterile by bilateral orchidectomy. 4. Pregnant or lactating women. 5. Any new development with the subject’s disease or condition or any significant laboratory test abnormality during the course of Trial HZNP-HZN-825-301 that, in the opinion of the Investigator, would potentially put the subject at unacceptable risk. 6. Subjects will be ineligible if, in the opinion of the Investigator, they are unlikely to comply with the trial protocol or have a concomitant disease or condition that could interfere with the conduct of the trial. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from both Baselines in FVC % predicted at 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) |
Exploratory Efficacy Endpoints 1. Change from both Baselines in HAQ-DI at Week 52. 2. Change from both Baselines in MDGA at Week 52. 3. Change from both Baselines in PTGA at Week 52. 4. Change from both Baselines in the Physical Effects subscale of the SSPRO-18 at Week 52. 5. Change from both Baselines in the Physical Limitations subscale of the SSPRO-18 at Week 52. 6. Proportion of subjects with an mRSS decrease of ≥5 points and 25% from both Baselines at Week 52. 7. Responder rate (defined as ACR-CRISS [predicted probability] of at least 0.6) at Week 52. 8. Proportion of subjects with an improvement in ≥3 of 5 core measures from both Baselines: ≥20% in mRSS, ≥20% in HAQ-DI, ≥20% in PTGA, ≥20% in MDGA and ≥5% in FVC % predicted at Week 52 (ACR-CRISS-20). 9. Change from both Baselines in the SSPRO-18 at Week 52. 10. Change from both Baselines in each scale of the UCLA SCTC GIT 2.0 and the total GIT score at Week 52. 11. Change from both Baselines in Raynaud’s phenomenon using the Raynaud’s Assessment at Week 52. 12. Change from both Baselines in the SHAQ at Week 52. 13. Change from both Baselines in SScQoL scores at Week 52. 14. Change from both Baselines in SF-12 scores at Week 52. 15. Change from both Baselines in pain and pain component scale scores at Week 52. 16. Change from both Baselines in the FACIT-F score at Week 52. 17. Change from both Baselines in the mRSS at Week 52. 18. Change from both Baselines in lung fibrosis based on HRCT at Week 52. 19. Change from both Baselines in DLCO at Week 52. 20. Change from both Baselines in serum and plasma biomarkers associated with LPAR1 pathway, inflammation and/or fibrosis at Week 52. 21. Change from both Baselines in swollen and tender joint count, digital ulcer assessment and joint contracture assessment at Week 52. |
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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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
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 |
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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) | 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 | 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 | 8 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 61 |
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 |
Argentina |
Switzerland |
Israel |
Japan |
Korea, Republic of |
Mexico |
United Kingdom |
United States |
Austria |
Belgium |
France |
Germany |
Greece |
Italy |
Netherlands |
Poland |
Portugal |
Romania |
Spain |
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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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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 | 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 | 7 |
E.8.9.2 | In all countries concerned by the trial days | 0 |