Study Evaluating Efficacy and Safety of Octanorm in Patients With Dermatomyositis
Condition: Dermatomyositis
MeSH terms: Dermatomyositis
Intervention: Octanorm; Placebo
Intervention description: Octanorm 0.5g/kg/week; Placebo
Phase: Phase 3
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Enrollment: 1.0
Sex: All
Minimum age: 18 Years
Maximum age: 80 Years
Healthy volunteers: No

Summary:

      DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED PHASE III STUDY EVALUATING EFFICACY AND SAFETY
      OF SUBCUTANEOUS HUMAN IMMUNOGLOBULIN (OCTANORM) IN PATIENTS WITH DERMATOMYOSITIS
    

Eligibility criteria:

        Inclusion Criteria:

          1. Subjects with diagnosis of definite or probable DM according to the Bohan and Peter
             criteria.

          2. Subjects who have responded to IGIV treatment as assessed by the treating physician
             and being on a stable dose for at least 3 months on 2 g/kg bodyweight (+/- 10%).

          3. For subjects being on other medication(s) for the treatment of DM (immunosuppressants,
             corticosteroids): a) subject was on such medication(s) at the start of IGIV treatment
             in the first place, and b) received such medication(s) for at least 3 months prior to
             study enrolment and at a stable dose for at least 4 weeks prior to study enrolment at
             the maximally allowed conditions as per Table 2 (see section 4.2.1).

          4. MMT-8 score ≥144, with at least 3 other CSM to be normal or near normal as per the
             following criteria: Visual Analogue Scale [VAS] of patient global disease activity ≤2
             cm, physician's global disease activity ≤2 cm, extra-muscular disease activity ≤2 cm;
             no muscle enzyme >4 times upper limit of normal due to myositis, Health Assessment
             Questionnaire [HAQ] ≤0.25.

          5. Males or females ≥ 18 to <80 years of age.

          6. Voluntarily given, fully informed written consent obtained from subject before any
             study-related procedures are conducted.

          7. Subject must be capable and willing to understand and comply with the relevant aspects
             of the study protocol.

        Exclusion Criteria:

          1. Cancer-associated myositis, defined as the diagnosis of myositis within 2 years of the
             diagnosis of cancer (except basal or squamous cell skin cancer or carcinoma in situ of
             the cervix that has been excised and cured and at least 1 or 5 years, respectively,
             have passed since excision).

          2. Evidence of active malignant disease or malignancies diagnosed within the previous 5
             years (including hematological malignancies and solid tumors) or breast cancer
             diagnosed within the previous 10 years. Subjects >5 years (>10 years for breast
             cancer) of cancer diagnosis who have been treated and are in remission are allowed.

          3. Subjects with overlap myositis (except for overlap with Sjögren's syndrome),
             connective tissue disease associated DM, inclusion body myositis, polymyositis or
             drug-induced myopathy.

          4. Subjects with immune-mediated necrotizing myopathy with absence of typical DM rash.

          5. Subjects with generalized, severe musculoskeletal conditions other than DM that
             prevent a sufficient assessment of the subject by the physician.

          6. Subjects who received blood or plasma-derived products (other than IGIV) or plasma
             exchange within the last 3 months before enrolment.

          7. Subjects with administration of permitted concomitant medications exceeding the
             maximally allowed conditions as per section 4.2.1.

          8. Subjects with administration of forbidden concomitant medications within the washout
             periods as defined in Table 3: see section 4.2.2.

          9. Subjects starting or planning to start a physical therapy-directed exercise regimen
             during the trial. Subjects on stable physical therapy for >4 weeks are allowed but the
             regimen should remain the same throughout the trial.

         10. Cardiac insufficiency (New York Heart Association III/IV), cardiomyopathy, significant
             cardiac dysrhythmia requiring treatment, unstable or advanced ischemic heart disease.

         11. Severe liver disease, with signs of ascites and hepatic encephalopathy.

         12. Severe kidney disease (as defined by estimated glomerular filtration rate (eGFR) < 30
             mL/min/1.73 m2).

         13. Known hepatitis B, hepatitis C or HIV infection.

         14. Subjects with a history of deep vein thrombosis within the last year prior to study
             enrolment or pulmonary embolism ever.

         15. Body mass index >40 kg/m2 and/or body weight >120 kg.

         16. Medical conditions whose symptoms and effects could alter protein catabolism and/or
             IgG utilization (e.g. protein-losing enteropathies, nephrotic syndrome).

         17. Known IgA deficiency with antibodies to IgA.

         18. History of hypersensitivity, anaphylaxis or severe systemic response to
             immunoglobulin, blood or plasma derived products or any component of octanorm 16.5%
             such as polysorbate 80 or to sodium chloride.

         19. Known blood hyperviscosity, or other hypercoagulable states.

         20. Subjects with a history of drug abuse within the past 5 years prior to study
             enrolment.

         21. Participating in another interventional clinical study with investigational treatment
             within 3 months prior to study enrolment. Subjects who participated in the Octagam 10%
             Dermatomyositis Study (GAM10-08) can be included.

         22. Women who are breast feeding, pregnant, or planning to become pregnant, or are
             unwilling to apply an effective birth control method (as per protocol section 7.3.9 b)
             up to four weeks after the last IMP infusion received.