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| ID | Type | Description | Link |
|---|---|---|---|
| 2019-003203-35 | EudraCT Number |
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| Name | Class |
|---|---|
| SGS Life Sciences, a division of SGS Belgium NV | OTHER |
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This is a randomised, double-blind, placebo-controlled, cross-over phase 2 trial investigating the effect of C21 on cold-induced vasoconstriction in subjects with Raynaud's phenomenon secondary to systemic sclerosis. The purpose of the trial is to achieve a vasodilatory effect in subjects with Raynaud's phenomenon by stimulation of the AT2R (angiotensin II type 2 receptor) with C21.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| C21 followed by placebo | Experimental |
| |
| Placebo followed by C21 | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| C21 | Drug | C21 as first treatment |
| |
| C21 |
| Measure | Description | Time Frame |
|---|---|---|
| Area Under the Curve for Rewarming of Each Finger After Cold Challenge (AUC) as Measured by Thermography | Area under the curve for rewarming of each finger after cold challenge as measured by thermography for 15 min | For 15 min after cold challenge (40-55 min after IMP [investigational manufacturing product] administration) |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Skin Temperature After Rewarming (MAX) | Maximum skin temperature after rewarming within 15 min after cold challenge | For 15 min after cold challenge (40-55 min after IMP administration) |
| The Distal Dorsal Difference, Defined as the Difference in Temperature Between the Dorsum and the Finger (DDD) |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Finger Temperature From Intake of IMP to Start of Cold Challenge | From intake of IMP to start of cold challenge (0-40 min) | |
| Nailfold Capillaroscopy (Including Red Blood Cell Velocity Measurements) | Nailfold capillaroscopy mean velocity was measured as red blood cell velocity before cold challenge and post recovery |
Inclusion Criteria:
Exclusion Criteria:
Smoking (including E-cigarettes) or use of nicotine replacement therapy for three months prior to Visit 1 and during the trial.
BMI >30
Mixed connective tissue disease or "overlap" (i.e. those who satisfy more than one set of ACR criteria for a rheumatic disease).
Concurrent serious medical condition with special attention to cardiac or ophthalmic conditions which in the opinion of the investigator makes the patient inappropriate for this study
Malignancy within the past 5 years with the exception of in situ removal of basal cell carcinoma and cervical intraepithelial neoplasia grade I
Planned major surgery within the duration of the study
Subjects who forsake any alcohol intake or have known uncontrolled allergic conditions or allergy/hypersensitivity to any components of the trial drug or placebo excipients (see Section 7.1)
Blood donation (or corresponding blood loss) within three months prior to Visit 1
Treatment with any of the medications listed below within 4 weeks prior to Visit 1:
Any dose-change or initiation of vasoactive substances
, and not able or willing to withhold these medications for 3 days preceding Visit 2 and Visit 3, respectively
Iloprost
Any treatment with CYP3A4 inducers (e.g. rifampicin, phenytoin, St John's Wort)
Any treatment with CYP3A4 inhibitors (e.g. clarithromycin, ketoconazole, nefazodone, itraconazole, ritonavir)
Any treatment with medicines that are substrates of CYP1A2, CYP3A4 or CYP2C9 with a narrow therapeutic range
Any experimental drug
Any systemic immunosuppressive therapy other than:
Any of the following findings at the time of screening:
Pregnant or breast-feeding female subjects.
Female subjects of childbearing potential not willing to use contraceptive methods described in Section 5.3.1.
Male subjects not willing to use contraceptive methods described in Section 5.3.1.
Participation in any other interventional trial during the trial period
Subjects known or suspected of not being able to comply with this trial protocol (e.g. due to alcoholism, drug dependency or psychological disorder)
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| Name | Affiliation | Role |
|---|---|---|
| Ariane Herrick, MD | Department of Rheumatology Salford Royal Hospital, Manchester,United Kingdom | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Rheumatology, Salford Royal Hospital | Manchester | Salford | M6 8HD | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35894657 | Derived | Herrick AL, Batta R, Overbeck K, Raud J, Manning J, Murray A, Dinsdale G, Tornling G. A phase 2 trial investigating the effects of the angiotensin II type 2 receptor agonist C21 in systemic sclerosis-related Raynaud's. Rheumatology (Oxford). 2023 Feb 1;62(2):824-828. doi: 10.1093/rheumatology/keac426. |
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A total of 20 unique subjects provided informed consent and were enrolled in the trial. Seven of these were screening failures. In addition, 2 subjects were not randomised; 1 subject due to the COVID-19 pandemic and 1 subject due technical issues with the Holter ECG. The latter subject was re-screened. A total of 12 subjects were randomised.
The trial planned to include 16 subjects, however as recruitment was challenging during the COVID-19 (coronavirus disease 2019) pandemic, enrolment was stopped prematurely when 12 subjects were randomised. This ensured that trial results could be available in a timely manner.
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| ID | Title | Description |
|---|---|---|
| FG000 | C21 Followed by Placebo | C21: C21 as first treatment Placebo: Placebo as second treatment |
| FG001 | Placebo Followed by C21 | C21: C21 as second treatment Placebo: Placebo as first treatment |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | C21 Followed by Placebo | C21: C21 as first treatment Placebo: Placebo as second treatment |
| BG001 | Placebo Followed by C21 | C21: C21 as second treatment Placebo: Placebo as first treatment |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Area Under the Curve for Rewarming of Each Finger After Cold Challenge (AUC) as Measured by Thermography | Area under the curve for rewarming of each finger after cold challenge as measured by thermography for 15 min | Full analysis set | Posted | Geometric Mean | Geometric Coefficient of Variation | C*sec | For 15 min after cold challenge (40-55 min after IMP [investigational manufacturing product] administration) |
|
From signing of informed consent through study completion, an average of 30 days
At each visit the subject was asked about adverse events (AEs) in an objective manner, e.g.: "Have you experienced any problems since the last visit?"
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Placebo | A single oral dose of placebo | 0 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Flushing | Vascular disorders | MedDRA 22.1 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Carl-Johan Dalsgaard | Vicore Pharma AB | +46 70 975 98 63 | carl-johan.dalsgaard@vicorepharma.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Oct 22, 2020 | Jan 17, 2022 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Feb 1, 2021 | Jan 17, 2022 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D011928 | Raynaud Disease |
| D012595 | Scleroderma, Systemic |
| ID | Term |
|---|---|
| D000090122 | Livedoid Vasculopathy |
| D013927 | Thrombosis |
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| C000711730 | compound 21 |
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This is a randomised, double-blind, placebo-controlled cold challenge study. A cross-over design is applied to control for inter-individual variability in response to cold challenge.
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The study will be conducted in double-blind fashion and the allocation of treatments will not be disclosed until clean file has been declared and the database has been locked.
| Drug |
C21 as second treatment |
|
| Placebo | Drug | Placebo as second treatment |
|
| Placebo | Drug | Placebo as first treatment |
|
The distal dorsal difference, defined as the difference in temperature between the dorsum and the finger (DDD), from administration of IMP until before cold challenge (0 to 40 min) |
| Baseline, 10, 20, 30 and 40 min |
| Gradient of Rewarming in the First 2 Minutes Post-cold Challenge (GRAD) | 2 min after cold challenge (40-42 min after IMP administration) |
| Before cold challenge (at 40 min) and post-recovery (at 55 min) |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Height | Mean | Full Range | cm |
|
| Weight | Mean | Full Range | kg |
|
| BMI | Mean | Full Range | kg/m^2 |
|
| Units | Counts |
|---|---|
| Participants |
|
|
|
| Secondary | Maximum Skin Temperature After Rewarming (MAX) | Maximum skin temperature after rewarming within 15 min after cold challenge | Full analysis set | Posted | Geometric Mean | Geometric Coefficient of Variation | °C | For 15 min after cold challenge (40-55 min after IMP administration) |
|
|
|
|
| Secondary | The Distal Dorsal Difference, Defined as the Difference in Temperature Between the Dorsum and the Finger (DDD) | The distal dorsal difference, defined as the difference in temperature between the dorsum and the finger (DDD), from administration of IMP until before cold challenge (0 to 40 min) | The full analysis set | Posted | Mean | Standard Error | °C | Baseline, 10, 20, 30 and 40 min |
|
|
|
|
| Secondary | Gradient of Rewarming in the First 2 Minutes Post-cold Challenge (GRAD) | The full analysis set | Posted | Geometric Mean | Geometric Coefficient of Variation | °C/min | 2 min after cold challenge (40-42 min after IMP administration) |
|
|
|
|
| Other Pre-specified | Change in Finger Temperature From Intake of IMP to Start of Cold Challenge | The full analysis set | Posted | Mean | Standard Error | °C | From intake of IMP to start of cold challenge (0-40 min) |
|
|
|
|
| Other Pre-specified | Nailfold Capillaroscopy (Including Red Blood Cell Velocity Measurements) | Nailfold capillaroscopy mean velocity was measured as red blood cell velocity before cold challenge and post recovery | The full analysis set | Posted | Mean | Standard Error | mm/sec | Before cold challenge (at 40 min) and post-recovery (at 55 min) |
|
|
|
|
| 12 |
| 0 |
| 12 |
| 3 |
| 12 |
| EG001 | C21 200 mg | A single oral dose of 200 mg C21 | 0 | 12 | 0 | 12 | 5 | 12 |
| Anaemia | Blood and lymphatic system disorders | MedDRA 22.1 | Systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA 22.1 | Systematic Assessment |
|
| Headache | Nervous system disorders | MedDRA 22.1 | Systematic Assessment |
|
| Hypoaesthesia | Nervous system disorders | MedDRA 22.1 | Systematic Assessment |
|
| Tremor | Nervous system disorders | MedDRA 22.1 | Systematic Assessment |
|
| Tinnitus | Ear and labyrinth disorders | MedDRA 22.1 | Systematic Assessment |
|
| Abdominal pain | Gastrointestinal disorders | MedDRA 22.1 | Systematic Assessment |
|
| Skin tightness | Skin and subcutaneous tissue disorders | MedDRA 22.1 | Systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA 22.1 | Systematic Assessment |
|
| Musculoskeletal chest pain | Musculoskeletal and connective tissue disorders | MedDRA 22.1 | Systematic Assessment |
|
| Urinary tract infection | Infections and infestations | MedDRA 22.1 | Systematic Assessment |
|
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| D002318 |
| Cardiovascular Diseases |
| D016491 | Peripheral Vascular Diseases |
| D017445 | Skin Diseases, Vascular |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D003240 | Connective Tissue Diseases |
| 20 min |
|
| 30 min |
|
| 40 min |
|
| Post recovery |
|
Analysis of capillaroscopy post recovery
| ANCOVA |
| =0.6219 |
| Difference in least square means |
| -0.0637 |
| 2-Sided |
| 90 |
| -0.3037 |
| 0.1763 |
| Equivalence |
A difference between treatment groups was detected with a power of 90% and alpha=0.1 |