E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
gain of function (GoF) variants in the GRIN 1, 2A, 2B or 2D genes |
varianti con guadagno di funzione (GoF) nei geni GRIN 1, 2A, 2B or 2D |
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E.1.1.1 | Medical condition in easily understood language |
GRIN-related disorder |
Disturbo correlato a GRIN |
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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 | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10064062 |
E.1.2 | Term | Neurodevelopmental disorder |
E.1.2 | System Organ Class | 10037175 - Psychiatric 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 determine the safety and tolerability of multiple individually titrated doses of radiprodil as an add-on therapy to standard of care (SOC) in pediatric participants •To establish a safe and well tolerated dose after 8 weeks of continuous treatment •To determine the pharmacokinetics (PK) and plasma exposure of radiprodil |
• Determinare la sicurezza e la tollerabilità di dosi multiple titolate individualmente di radiprodil come terapia aggiuntiva allo standard di cura (SOC) nei partecipanti pediatrici • Stabilire una dose sicura e ben tollerata dopo 8 settimane di trattamento continuo • Determinare la farmacocinetica (PK) e l’esposizione plasmatica di radiprodil |
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E.2.2 | Secondary objectives of the trial |
•To evaluate initial signs of efficacy on frequency and severity of epileptic seizures in those participants with seizures •To evaluate initial signs of efficacy of radiprodil on additional central nervous system (CNS) features including, behavior, motor symptoms, sleep, and quality of life •To determine the PK and the plasma exposure of radiprodil major metabolites obtained at different doses
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• Valutare i segni iniziali di efficacia su frequenza e gravità delle crisi epilettiche nei partecipanti che manifestano crisi epilettiche • Valutare i segni iniziali dell’efficacia di radiprodil su altri aspetti del sistema nervoso centrale (SNC), inclusi comportamento, sintomi motori, sonno e qualità della vita • Determinare la PK e l’esposizione plasmatica dei principali metaboliti di radiprodil ottenuti a dosaggi differenti |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Pediatric participants aged =6 months to =12 years with GRIN 1, 2A, 2B, or 2D gene variants known to result in GoF of the NMDA receptor. 2.Participant to be enrolled in the first cohort experiences the following: a)At least 1 observable motor seizure per week and =4 observable motor seizures (generalized or focal) during the prospective 4 week Observation Period. b)Has failed to obtain adequate seizure control with at least 2 ASMs used at appropriate dose and duration with assured medication adherence (if applicable). 3.Participant to be enrolled in the second cohort experiences the following: a)Significant behavioral and/or motor symptoms based on caregiver report with a CGI-S score =4 at the Screening Visit and Day -1 of Visit T1. 4.Current antiseizure therapies should be maintained stable throughout the whole study duration, and nonpharmacological treatments such as ketogenic diet should be kept as stable as possible during the participation in the study. 5.Participant’s caregivers have signed informed consent and participant has signed assent (if applicable). 6.Participant’s caregivers are willing and able to complete entries in the eDiary on a daily basis. 7.Participant is 1 of the following: a.Not of childbearing potential (premenarchal or male/not in possession of a uterus). b.If of childbearing potential, is nonpregnant (negative serum pregnancy test results at Screening), nonlactating, and practicing 1 of the following medically acceptable methods of birth control: •Abstinence as a lifestyle choice. •Hormonal methods such as oral, implantable, injectable, or transdermal contraceptives for a minimum of 1 full cycle (based on the participant’s usual menstrual cycle period) before IP administration. •Intrauterine device. c.If male, is willing to use a highly effective method of contraception throughout the study period.
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1. Partecipanti pediatrici di età compresa tra = 6 mesi e < 12 anni con le varianti del gene 1, 2A, 2B, or 2D note per causare il GoF del recettore NMDA. 2. Il partecipante da arruolare nella prima coorte presenta quanto segue: a) Almeno 1 crisi epilettica motoria a settimana osservabile e =4 crisi epilettiche motorie (generalizzate o focali) osservabili nelle 4 settimane del Periodo di osservazione prospettico. b) Mancato controllo adeguato delle crisi epilettiche con almeno 2 farmaci antiepilettici usati alla dose e per la durata appropriati con aderenza al farmaco verificata(se pertinente). 3. Il partecipante da arruolare nella seconda coorte presenta quanto segue: a) Sintomi comportamentali e/o motori significativi in base al resoconto del caregiver con un punteggio CGI-S =4 alla Visita di screening e al Giorno -1 della Visita T1. 4. Le terapie antiepilettiche correnti devono essere mantenute stabili per tutta la durata dello studio e i trattamenti non farmacologici come la dieta chetogenica devono essere mantenuti più stabili possibile durante la partecipazione allo studio. 5. I caregiver del partecipante hanno firmato il consenso informato e il partecipante ha firmato l’assenso (se pertinente). 6. I caregiver del partecipante sono disposti e in grado di completare quotidianamente i dati nell’eDiary. 7. Il partecipante è uno dei seguenti: a. Non in età fertile (pre-menarca o maschio/senza utero). b. Se in età fertile, non è in gravidanza (test di gravidanza sul siero con risultato negativo allo Screening), non in allattamento e utilizza 1 dei seguenti metodi contraccettivi accettabili dal punto di vista medico: • Astinenza come stile di vita. • Metodi contraccettivi ormonali, come i contraccettivi orali, impiantabili, iniettabili o transdermici per almeno 1 ciclo completo (in base al ciclo mestruale usuale della partecipante) prima della somministrazione dell’IP. • Dispositivo intrauterino. c. Se maschio, è disposto a usare un metodo contraccettivo altamente efficace per tutto il periodo di studio. |
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E.4 | Principal exclusion criteria |
1.Participant with any other clinically relevant medical, neurologic, or psychiatric condition and/or behavioral disorder unrelated to GRIN-related disorder that would preclude or jeopardize participant’s safe participation or the conduct of the study according to the judgement of the investigator. 2.Participant with any clinically significant laboratory or ECG abnormalities. 3. Participant has severe hepatic dysfunction (Child-Pugh grade C). 4.Participant has a history of brain surgery for epilepsy or any other reason. 5.Participant with any contraindications to radiprodil or with known hypersensitivity to the active substance or the excipients or other chemically closely related substances. 6.Participant receiving treatment with contraindicated concomitant drugs such as agonists or antagonists of the glutamate receptor, including but not limited to felbamate, memantine, and perampanel. 7.Participant is on treatment with hormonal therapy such as adrenocorticotrophic hormone or prednisolone. 8.Participant has participated in any other investigational clinical study within 3 months of Screening. 9.Participant has previously been enrolled in the current study |
1. Partecipante con qualsiasi altra condizione medica, neurologica o psichiatrica e/o disturbo comportamentale clinicamente rilevante non correlato a GRIN che possa precludere o compromettere la partecipazione in sicurezza del partecipante o la conduzione dello studio, a giudizio dello sperimentatore. 2. Partecipante con anomalie di laboratorio o all'ECG clinicamente significative. 3. Partecipante con grave disfunzione epatica (grado C secondo la classificazione Child-Pugh) 4. Partecipante con un’anamnesi di chirurgia cerebrale per l’epilessia o qualsiasi altra ragione. 5. Partecipante con qualsiasi controindicazione a radiprodil o con ipersensibilità nota al principio attivo o agli eccipienti o ad altre sostanze chimicamente molto simili. 6. Partecipante che riceve il trattamento con farmaci concomitanti controindicati come gli agonisti o gli antagonisti del recettore del glutammato, compresi, ma non solo, felbamato, memantina e perampanel. 7. Partecipante in trattamento con terapia ormonale, come ad esempio l’ormone adrenocorticotropo o prednisolone. 8. Il partecipante ha partecipato a un altro studio clinico sperimentale nei 3 mesi anteriori dallo Screening. 9. Il partecipante è stato arruolato in precedenza in questo studio. |
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E.5 End points |
E.5.1 | Primary end point(s) |
•Adverse events (AEs), serious adverse events (SAEs), and adverse drug reactions (ADRs) (frequency, type, severity, and duration) •Changes in vital signs •Physical examination findings •12-lead electrocardiogram (ECG) findings •Clinically significant changes in laboratory parameters •Emergence of new seizure types •Occurrence of suicidal ideation or behavior •Tolerable dose that delivers the highest expected estimated receptor occupancy (RO) of approximately 80% •Plasma concentrations of radiprodil
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• Eventi avversi (AE), eventi avversi gravi (SAE) e reazioni avverse al farmaco (ADR) (frequenza, tipo, gravità e durata) • Variazione dei segni vitali • Risultati dell’esame obiettivo • Risultati dell’elettrocardiogramma a 12 derivazioni (ECG) • Cambiamenti clinicamente significativi nei parametri di laboratorio • Insorgenza di nuovi tipi di crisi epilettiche • Presenza di pensieri o comportamenti suicidi • Dose tollerabile che eroga l’occupazione recettoriale (RO) massima prevista stimata di circa 80% • Concentrazioni plasmatiche di radiprodil |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Please refer to the Schedule of Events presented in the study protocol (table 2-1, page 15-16) |
Fare riferimento al Programma degli Eventi presentato nel protocollo di studio (tabella 2-1, pagina 15-16) |
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E.5.2 | Secondary end point(s) |
•Change from Baseline to end of treatment in seizure frequency from daily seizure electronic diary (eDiary) •Percent change from Baseline to end of treatment in video electroencephalogram (V EEG) seizure burden (e.g., seizure type, severity, and frequency recorded during V EEGs) •Seizure free days and longest period with no seizures •Change from Baseline to end of treatment in behavioral features as measured by the aberrant behavior checklist-community (ABC-C), as well as other disorder features as measured by gross motor function measure (GMFM), sleep disturbance scale for children (SDSC), quality of life (Pediatric Quality of Life Inventory [PedsQL]), Caregiver Burden Inventory (CBI),and global impression (Caregiver Global Impression of Change [CaGI-C]), and Clinical Global Impression of Change [CGI-C] scales) •Plasma concentrations of the 2 major metabolites of radiprodil
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• Variazioni nella frequenza delle crisi epilettiche dal basale alla fine del trattamento rilevate nel diario elettronico (eDiary) • Variazione percentuale rilevata nel video-elettroencefalogramma (V EEG) dell’impatto della crisi epilettica (ad es. tipo, gravità e frequenza delle crisi epilettiche registrate durante i V EEG), dal basale alla fine del trattamento • Giorni in cui non si verificano crisi epilettiche e il periodo più lungo senza crisi epilettiche • Variazioni dal basale alla fine del trattamento nelle caratteristiche comportamentali misurate mediante la Aberrant behavior checklist-community (ABC-C), oltre ad altre caratteristiche patologiche misurate mediante Gross motor function measure (GMFM), Sleep disturbance scale for children (SDSC), qualità della vita (Pediatric Quality of Life Inventory [PedsQL]), Caregiver Burden Inventory (CBI) e impressioni globali (scale Caregiver Global Impression of Change [CaGI C]) e Clinical Global Impression of Change [CGI-C]) • Concentrazioni plasmatiche dei 2 principali metaboliti di radiprodil |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Please refer to the Schedule of Events presented in the study protocol (table 2-1, page 15-16) |
Fare riferimento al Programma degli Eventi presentato nel protocollo di studio (tabella 2-1, pagina 15-16) |
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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 | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Phase 1B study |
Studio di Fase 1B |
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E.7.2 | Therapeutic exploratory (Phase II) | No |
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 | No |
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 | 9 |
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 |
United States |
Netherlands |
Spain |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 15 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 15 |