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Systemic sclerosis (SSc), or scleroderma is a connective tissue disease of autoimmune origin. It is a life-threatening orphan disease with severe physical and psychosocial consequences. IVA337 has a novel mechanism of action and this study is designed to compare IVA337 at two dose levels with a placebo control treatment. Patients will be unaware of the treatment they are receiving and will be randomized to one of three treatment arms , either IVA337 400mg bid, IVA337 600mg bid or placebo bid. They will receive drug for 48 weeks and during that time assessments will be made to monitor both the efficacy and safety of the treatment.
Study design: randomized, double-blind, placebo-controlled, multicentre phase 2 proof-of-concept trial of IVA337 for the treatment DcSSc.
The treatments are randomly assigned. The randomisation is stratified for background therapy to ensure even distribution of background therapies among treatment groups.
There are 3 parallel treatment groups: placebo, IVA337 400mg bid and IVA337 600mg bid (identical capsules of 200mg IVA337 or placebo). Both, patient and investigator are blinded.
The treatment lasts 48 weeks. A follow-up assessment takes place 4 weeks after the last dose.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IVA337 800mg | Active Comparator | Patients receive twice daily 400mg IVA337. |
|
| IVA337 1200mg | Active Comparator | Patients receive twice daily 600mg IVA337. |
|
| Placebo | Placebo Comparator | Patients receive twice daily placebo. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IVA337 | Drug | Capsules of 200mg IVA337 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Measurement of skin thickness by the Modified Rodnan Skin Score (MRSS) | Mean change of the MRSS from baseline | 48 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Response rates based on MRSS improvement | MRSS response rates: Initial definition: improvers are defined by a reduction ≥5 points and ≥25 % of MRSS; Additional definition: improvers are defined by a reduction ≥ 4 points and ≥ 20% of MRSS based on Quillinan et al. (2014, 2017) | 12, 24, 32, 48 weeks |
| Overall progression of the disease: defined as absence of rescue therapy and absence of severe organ involvement |
| Measure | Description | Time Frame |
|---|---|---|
| Raynaud attacks assessed by a diary and the Raynaud condition score (VAS) | Daily during week 9 and week 25 | |
| Progression of the disease assessed by changes of the activity of specific SSc biomarkers in the blood | Mean changes in activity biomarkers |
Inclusion Criteria:
Patients on stable treatment (for >3 months) with prednisone ≤ 10 mg, methotrexate≤ 20 mg/w, azathioprine ≤ 150 mg/d, mycophenolate mofetil ≤ 2g/d, or leflunomide ≤ 20 mg/d may be included in the study; the therapy must be maintained as background therapy.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yannick Allanore, Professor | Université Paris Descartes, Hôpital Cochin, Service de Rhumatologie A & INSERM, Paris, France, | Principal Investigator |
| Christopher Denton, Professor | Royal Free Hospital NHS Foundation Trust | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Multiprofile Hospital for Active Treatment - Dr. Georgi Stranski | Pleven | Bulgaria | ||||
| Multiprofile Hospital for Active Treatment Plovdiv |
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| Placebo | Drug | Identical capsules without active substance |
|
|
Overall progression of the disease: defined as absence of rescue therapy and absence of severe organ involvement |
| 28, 32,40, and 48 weeks |
| Lung function measured by FVC% predicted | Change in pulmonary function | 24 and 48 weeks |
| Lung function by cDLCO% predicted | Change in pulmonary function | 24 and 48 weeks |
| Scleroderma Health Assessment Questionnaire (SHAQ) | Changes in patient reported outcomes | 24 and 48 weeks |
| Gastrointestinal tract symptoms severity and its impact on patients' well-being assessed by the UCLA SCTC GIT | Changes in patient reported outcomes | 24 and 48 weeks |
| Patient-reported health status assessed by PROMIS29 | Changes in patient reported outcomes | 24 and 48 weeks |
| Physical and mental health assessed by SF36 | Changes in patient reported outcomes | 24 and 48 weeks |
| Digital ulcer net burden (defined as total number of ulcers at a certain time point minus number of ulcers at baseline) and proportion of patients who do not develop new ulcers | Digital ulcer net burden (defined as total number of ulcers at a certain time point minus number of ulcers at baseline) and proportion of patients who do not develop new ulcers | 12, 24, 32 and 48 weeks |
| Hand function assessed by the Cochin Hand Function Scale | Hand function assessed by the Cochin Hand Function Scale | 12, 24, 32 and 48 weeks |
| Patient global assessment of disease activity assessed by a visual analogue scale | Patient global assessments of disease activity (VAS) | 24 and 48 weeks |
| Physician global assessment of disease activity assessed by a visual analogue scale | Physician global assessment of disease activity (VAS) | 24 and 48 weeks |
| Change in the Combined Response Index for Systemic Sclerosis (CRISS) | Composed of five variables: MRSS, FVC % predicted, physician and patient global assessments, and HAQ-DI score | 24 and 48 weeks |
| Percent of patients who need escape therapy | Need for escape therapy | 28, 32,40, and 48 weeks |
| Percent of patients who experience a new severe organ involvement | Severe organ involvement | 2, 4, 8,12, 16, 24, 28, 32, 40, 48, and 52 weeks |
| Number of participants with adverse events as a measure of safety and tolerability | Frequency and type of AEs | 2, 4, 8, 12, 16, 20, 24, 28, 32, 40, 44, 48, and 52 weeks |
| Routine and specific laboratory tests (composite) to assess safety and tolerability | creatine kinase, N-terminal pro-brain natriuretic peptide, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, γ-glutamyl transferase, total bilirubin, direct bilirubin,RBC and WBC count, reticulocytes, haemoglobin, haematocrit, albumin , Quick, aPTT, INR, BUN, plasma creatinine, microalbuminuria, homocysteine, urinalysis (dip stick), glycated haemoglobin, creatine phosphokinase increase, platelet counts, plasma osteocalcin, serum beta C-terminal telopeptide (β-CTx or B-Crosslaps), Differential: neutrophils, eosinophils, basophils, monocytes, lymphocytes, cholesterol, triglycerides, albumin, total protein, C-reactive protein (CRP), adiponectin, serology HIV and hepatitis infection: Hep. A antibodies, B antibodies and antigen, C antibodies, serum b-HCG. | 2, 12, 20, 24, 32, 36, 44, 48, and 52 weeks |
| 12, 24, and 48 weeks |
| Progression of the disease assessed by changes of the activity of specific SSc biomarkers in the skin | Mean changes in activity biomarkers | 48 weeks |
| Population pharmacokinetics to confirm the pharmacokinetic profile, including Cmax, Tmax, AUC, half-life (t1/2), clearance (CL/F) and volume of distribution (Vd/F) | 2, 24, and 48 weeks |
| Plovdiv |
| Bulgaria |
| University Multiprofile Hospital for Active Treatment -Kaspela | Plovdiv | Bulgaria |
| University Multiprofile Hospital for Active Treatment - "Sveti Ivan Rilski" | Sofia | Bulgaria |
| Hôpital Pellegrin | Bordeaux | 33076 | France |
| CHRU de Lille- Hôpital Claude Huriez | Lille | 59037 | France |
| Hopital Cochin | Paris | 75014 | France |
| University Hospital of Strasbourg | Strasbourg | 67098 | France |
| Kerckhoff-Klinik | Bad Nauheim | 61231 | Germany |
| Charité- Universitätsmedizin Berlin | Berlin | 10117 | Germany |
| Chaité-Universtätsmedezin Berlin | Berlin | Germany |
| Klinik fur Dermatologie und Venerologie der Universitat zu Köln | Cologne | 50931 | Germany |
| Univertaetsklinikum Carl Gustav Carus | Dresden | 01307 | Germany |
| University of Erlangen-Nuremberg | Erlangen | 91054 | Germany |
| CIRI GmbH Centrum für Innovative Diagnostik und Therapie | Frankfurt | Germany |
| University Medical Center Freiburg | Freiburg im Breisgau | 79106 | Germany |
| Kilinik für Hautkrankenheiten | Münster | 48149 | Germany |
| Universtätsklinik Ulm | Ulm | 89081 | Germany |
| Istituto di Clinica Medica Generale Polo Didattico | Ancona | 60020 | Italy |
| Azienda Ospedalaria Spedali Civili di Brescia | Brescia | 25123 | Italy |
| Azienda Ospedaliera Universitaria Careggi | Florence | 50139 | Italy |
| Ospedale San Salvatore ASL L'Aquila | L’Aquila | 67100 | Italy |
| Azienda Ospedaliera Universitaria Federico II | Naples | 80131 | Italy |
| University of Padova | Padova | 35128 | Italy |
| Ospedale di Alta Specializzazione "San Camillo" | Roma | 00152 | Italy |
| Policlinico Umberto I | Roma | 00161 | Italy |
| Universita degli Studi de Verona | Verona | 37134 | Italy |
| Leiden University Medical Center | Leiden | Netherlands |
| Erasmus MC Universitair Medisch Centrum Rotterdam | Rotterdam | Netherlands |
| Centrum Miriada Prywatny | Bialystok | Poland |
| University Hospital in Bydgoszcz | Bydgoszcz | Poland |
| CM Plejady | Krakow | Poland |
| Reumed | Lublin | Poland |
| Medycine Centrum Hetmanska Poznan | Poznan | Poland |
| Centrum Medyczne Oporow | Wroclaw | Poland |
| University Medical centre Ljubljana | Ljubljana | Slovenia |
| University Medical Centre Maribor | Maribor | Slovenia |
| Hospital de la Santa Creu i Sant Pau | Barcelona | 08026 | Spain |
| Hopital Universitario Gregorio Marañon | Madrid | 28007 | Spain |
| Hopital 12 de Octubre | Madrid | 28041 | Spain |
| Hopital Universitario Sanchinarro | Madrid | 28050 | Spain |
| Hospital La Paz | Madrid | Spain |
| Hospital La Princesa | Madrid | Spain |
| Hospital Universitario Ramon y Cajal | Madrid | Spain |
| Hospital Universitario Dr Peset | Valencia | 46017 | Spain |
| University Hospital Lausanne | Lausanne | Switzerland |
| University Hospital Zurich | Zurich | Switzerland |
| Leeds Institut of Rheumatic and Musculoskeletal Medicine | Leeds | LS7 4SA | United Kingdom |
| Royal Free Hospital | London | NW3 2QG | United Kingdom |
| ID | Term |
|---|---|
| D045743 | Scleroderma, Diffuse |
| ID | Term |
|---|---|
| D012595 | Scleroderma, Systemic |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| C000619516 | lanifibranor |
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