E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Distal Subungual Onychomycosis |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Bacterial Infections and Mycoses [C01] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | SOC |
E.1.2 | Classification code | 10021881 |
E.1.2 | Term | Infections and infestations |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To examine theefficacy of MOB015B in children based on assessment of treatment success, mycological cure, clinical cure, and complete cure. |
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E.2.2 | Secondary objectives of the trial |
To evaluate local tolerability for all treated nails and adjacent skin as well as any other treatment-emergent adverse events (AEs). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subjects must meet all of the following inclusion criteria to be considered for enrollment in the study: 1. Male or female subjects 6 to 17 yearsofage (inclusive). 2. Distal subungual onychomycosis of at least oneof the great toenail(s) affecting at least 20% of the target nail to a maximum of 50% and at least 3 mm of unaffected proximal nail. 3. Positive culture of dermatophyte and positive KOH microscopy in samples taken from the same great toenail. 4. Signed written informed assent/consent. 5. Evidence of ability of the great toenail to grow (eg,subject reports cutting toenails at least monthly). 6. Able to comply with the study protocol (in the opinion of the investigator). |
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E.4 | Principal exclusion criteria |
Subjects meeting any of the following exclusion criteria will not be enrolled in the study: 1. Proximal subungual onychomycosis, superficial white onychomycosis, significant dystrophy, severe onychorrhexis, or anatomic abnormalities of the great toenail(s) that in the opinion of the investigator would impair clinical evaluation of onychomycosis. 2. Distal subungual onychomycosis where involvement has extended into the proximal portion of the target nail (unaffected proximal nail is less than 3 mm). 3. Target toenail with greater than 50% disease involvement. 4. Target toenail thickness more than 3 mm. 5. “Spike” of onychomycosisextending to eponychium of the target nail. 6. Presence of dermatophytoma (defined as thick masses of fungal hyphae and necrotic keratin between the nail plate and nail bed) on the target nail. 7. Conditions other than distal subungual onychomycosis known to cause abnormal nail appearance, presence of melanonychia or subungual hematoma that could obscure visualization of nail clearing. 8. Other microbial infections of the target toenail, for example, candida or mold infections without isolation of a dermatophyte. 9. Subjects with psoriasis, lichen planus, history of mucocutaneous candidiasis,or other conditions that affect nail appearance and/or growth. 10. Previous target toenail surgery with any residual disfigurement. 11. Topical treatment of the toenails with other antifungal medication within 4 weeks before screening/Visit 1. 12. Use of systemic antifungal treatment within 6 months before screening/Visit1. 13. History or ongoing/active moderate to severe Moccasin tinea pedis. 14. Having a diagnosis of type 1 diabetes or uncontrolled type 2 diabetes. 15. Known immunodeficiency. 16. Known human immunodeficiency virus (HIV)infection. 17. Participation in another clinical study with an investigational drug or device during the previous 3 months before screening/Visit 1. 18. Known allergy to any of the tested treatment products. 19. A positive pregnancy test at enrollment/baseline (Visit 2). 20. Female subjects physiologically capable of becoming pregnant but are unwilling to refrain from sexual intercourse during the whole study duration or unwilling to use acceptable methods of contraception as agreed with the investigator. 21. Female subjects who are pregnant, breastfeeding mothers, those planning a pregnancy during the study or who become pregnant. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Treatment success (defined as 0-10% clinical disease involvement of the target toenail and mycologicalcure of target toenail) at Week 48 |
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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) |
Secondary efficacy endpoints at 48 weeks: - Clinical cure (defined as target toenail free of clinicaldiseaseinvolvement) at Week 48. - Complete cure (defined as negative fungal culture, negative direct potassium hydroxide [KOH] microscopy, and free of clinical disease involvement) of target toenail at Week 48. - Mycological cure (defined as negative fungal culture of dermatophytes and negative direct KOH microscopy) of target toenail at Week 48.
Secondary safety endpoints: - Local tolerability of all treated toenails and surrounding skin at baseline and Weeks 4, 8, 12, 24, 36, and 48. - All adverse events (AEs) at baseline and Weeks 4, 8, 12, 24, 36, and 48. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Efficacy: week 48 Safety: weeks 4, 8, 12, 24, 36, and 48 |
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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 | No |
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) | 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.8.3 |
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 | 11 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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 | 3 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
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 | 0 |