Conditions: Healthy
Allocation: NON_RANDOMIZED | Intervention model: CROSSOVER
Enrollment: 14
Healthy volunteers: yes

Brief summary:
The main objective of this trial is to investigate the relative bioavailability of BI 730357 in plasma when given as oral single dose together with multiple oral doses of itraconazole (Test, T) as compared to when given alone as oral single dose (Reference, R)

Detailed description:

Arms:
arm 1: Participants were administered 50 mg BI 730357 tablet orally on Day 1 along with 20 mL of 10 mg/ mL Itraconazole oral solution in treatment period 2 only (T). Itraconazole was administered once daily for 12 days from Day -3 to Day 9. arm 2: Participants were administered 50 mg BI 730357 tablet orally on Day 1 alone in treatment period 1 (R).

Interventions: intervention 1: BI 730357 intervention 2: Itraconazole
Intervention descriptions: intervention 1: 0 mg BI 730357 tablet orally on Day 1 intervention 2: 20 mL of 10 mg/ mL Itraconazole oral solution in treatment period 2 only (T). Itraconazole was administered once daily for 12 days from Day -3 to Day 9.

Protocol document:
Prot_000.pdf: 
001-MCS-40-106-RD-13 (6.0) / Saved on: 13 Jun 2018
Clinical Trial Protocol
TITLE PAGE
Document Number:
c24616632 -03
EudraCT No.
2018-003495-13
BI Trial No.
1407-0014
BI Investigational
Medicinal Product
BI 730357
Title
Relative bioavailability of a single oral dose of BI 730357 when 
administered alone or in combination with multiple oral doses of 
itraconazole in healthy male subjects (an open-label, one-way 
crossover study)
Lay Title
A study in healthy men to test how itraconazole influences the 
amount of BI 730357 in the blood
Clinical Phase
I
Clinical Trial Leader
Phone:
Fax: 
Principal 
Investigator
 
Phone: 
Fax: 
Status
Final Protocol (Revised Protocol (based on global amendment 2))
Version and Date
Version: 3.0
Date: 20 February 2019
Page 1 of 66
Proprietary confidential information
© 2019 Boehringer Ingelheim International GmbH or one or more of its affiliated companies. All rights reserved.
This document may not - in full or in part - be passed on, reproduced, published or otherwise used without prior written permission


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CLINICAL TRIAL PROTOCOL SYNOPSIS
Company name
Boehringer Ingelheim
Protocol date
30 October 2018
Revision date
20 February 2019
BI trial number
1407-0014
Title of trial
Relative bioavailability of a single oral dose of BI 730357 when administered alone 
or in combination with multiple oral doses of itraconazole in healthy male subjects
(an open-label, one-way crossover study)
Principal Investigator:
Trial site
Clinical phase
I
Trial rationale
Based on in vitro data, CYP3A is involved in metabolism of BI 730357. It is 
therefore necessary to explore the relative bioavailability of BI 730357 in plasma 
when given alone versus when given together with a strong CYP3A inhibitor.
Trial objective
To investigate the relative bioavailability of BI 730357 in plasma when given as 
oral single dose together with multiple oral doses of itraconazole (Test, T) as 
compared to when given alone as oral single dose (Reference, R).
Trial design
Open-label, one-way crossover design
Trial endpoints
Primary endpoints: AUC0-tz and Cmax of BI 730357 in plasma
Secondary endpoints: AUC0-of BI 730357 in plasma
Number of subjects 
total entered
14
each treatment
14
Diagnosis
Not applicable
Main criteria
for inclusion
Healthy male subjects, age of 18 to 50 years (inclusive), body mass index (BMI) of 
18.5 to 29.9 kg/m2 (inclusive)
Test product 1
BI 730357 as tablet formulation (tablet strength: 50 mg)
dose
Single doses of 50 mg in treatments T and R
mode of admin.
Oral with 240 mL of water after an overnight fast of at least 10 h


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Test product 2
Itraconazole oral solution (Sempera® Liquid 10 mg/mL)
dose
200 mg once daily for 12 days in treatment T
mode of admin.
Oral with 240 mL of water after an overnight fast of at least 9 h
Duration of treatment
Treatment R (BI 730357 alone):
Single dose of 50 mg BI 730357 (Day 1)
Treatment T (itraconazole + BI 730357):
12 days of itraconazole treatment (200 mg itraconazole once daily) combined with a 
single dose of 50 mg BI 730357 (Day 1) on the fourth day of the itraconazole 
treatment (1 h after the itraconazole administration)
Wash-out period
Administrations of BI 730357 will be separated by a wash-out phase of at least 10
days
Statistical methods
Relative bioavailability will be estimated by the ratios of the geometric means 
(test/reference) for the primary and secondary endpoints. Additionally, their two-
sided 90% confidence intervals (CIs) will be provided. This method corresponds to 
the two one-sided t-tests procedure, each at a 5% significance level. Since the main 
focus is on estimation and not testing, a formal hypothesis test and associated 
acceptance range is not specified. The statistical model will be an analysis of 
variance (ANOVA) on the logarithmic scale including effects for ‘subjects’ and 
‘treatment’. CIs will be calculated based on the residual error from the ANOVA.
Descriptive statistics will be calculated for all endpoints.


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FLOW CHART
Period
Visit
Day
Planned time (relative to
BI 73 0357 administration)
[h:min]
Approximate clock time  of 
actual day [h:min]
Event and comment
Safety laboratory 9
PK blood (BI 730357
12-lead ECG
Vital signs (BP, PR)
Questioning for AEs and 
concomitant therapy 6
SCR
1
-21 to -1
Screening (SCR)1
A
x
x
Period 1 / Treatment R (BI 730357 alone) 7
2
-3 to -1
-75:008
06:00
Ambulatory visit
B8
x
1
-3:00
06:00 Admission to trial site
x3,5
x3
x3
x3
x3
0:00
09:00 BI 730357 administration
0:30
09:30
x
1:00
10:00
x
1:30
10:30
x
2:00
11:00 240 mL fluid intake
x
2:30
11:30
x
3:00
12:00
x
3:30
12:30
x
4:00
13:00 240 mL fluid intake, thereafter lunch 10
x
x
5:00
14:00
x
6:00
15:00
x
7:00
16:00 Snack (voluntary)
8:00
17:00
x
10:00
19:00 Dinner
12:00
21:00
x
x
2
24:00
09:00 Breakfast (voluntary) 10,
discharge from trial site
B
x
x
x
x
34:00
19:00 Ambulatory visit
x
x
3
47:00
08:00 Ambulatory visit
x
x
4
71:00
08:00 Ambulatory visit
x
x
6
119:00
08:00 Ambulatory visit
B
x
x
8
167:00
08:00 Ambulatory visit
x
x


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FLOW CHART (cont’d)
Period
Visit
Day
Planned time (relative to 
BI 73 0357 administration)
[h:min]
Approximate clock time  of 
actual day [h:min]
Event and comment
Safety laboratory 9
PK blood (BI 730357 + 
12-lead ECG
Vital signs (BP, PR)
Questioning for AEs and 
concomitant therapy 6
Period 2 / Treatment T (BI 730357 + itraconazole) 7
3
-3
-73:00
08:00
Ambulatory visit, itraconazole administration
B2,5
x2
-2
-49:00
08:00
Ambulatory visit, itraconazole administration
x2
-1
-25:00
08:00
Ambulatory visit, itraconazole administration
x2
1
-3:00
06:00 Admission to trial site
x2
x2
x2
x2
-1:00
08:00 Itraconazole administration 
0:00
09:00 BI 730357 administration
0:30
09:30
x
1:00
10:00
x
1:30
10:30
x
x
x
x
2:00
11:00 240 mL fluid intake
x
2:30
11:30
x
3:00
12:00
x
3:30
12:30
x
4:00
13:00 240 mL fluid intake, thereafter lunch 10
x
x
x
x
5:00
14:00
x
6:00
15:00
x
7:00
16:00 Snack (voluntary)
8:00
17:00
x
10:00
19:00 Dinner
12:00
21:00
x
x
2
23:00
08:00 Itraconazole administration 
x
24:00
09:00 Breakfast (voluntary) 10,
discharge from trial site
B2
x
x
x
x
34:00
19:00 Ambulatory visit
x
x
3
47:00
08:00 Ambulatory visit, itraconazole administration
x11
x2
4
71:00
08:00 Ambulatory visit, itraconazole administration
C2
x11
x2
5
95:00
08:00 Ambulatory visit, itraconazole administration
x2
6
119:00
08:00 Ambulatory visit, itraconazole administration
B2
x11
x2
7
143:00
08:00 Ambulatory visit, itraconazole administration
x2
8
167:00
08:00 Ambulatory visit, itraconazole administration
C2
x11
x2
9
191:00
08:00 Ambulatory visit, itraconazole administration
x2
10
215:00
08:00 Ambulatory visit
x
x
12
263:00
08:00 Ambulatory visit
x
x
FU
4
18 to 25
End of trial (EoTrial) examination4
D
x
x
x
1.
Subject must be informed and written informed consent obtained prior to starting any screening procedures. Screening 
procedures include physical examination, check of vital signs, ECG, safety laboratory (including drug screening), 
demographics (including determination of body height and weight, smoking status and alcohol history), relevant 
medical history, concomitant therapy and review of inclusion/exclusion criteria. Pharmacogenetic samples will be 
collected if needed.
2.
The time is approximate; the procedure is to be performed and completed within 2h prior to itraconazole administration.
3.
The time is approximate; the procedure is to be performed and completed within 3h prior to BI 730357 administration.
4.
At the end of trial visit the EoTrial examination includes physical examination, vital signs, ECG, safety laboratory, 
recording of AEs and concomitant therapies.


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5.
Period 1: Urine drug screening and alcohol breath test only; Period 2: Including urine drug screening and alcohol breath
test.
6.
AEs and concomitant therapies will be recorded throughout the trial, but will be specifically asked for at the times
indicated in the Flow Chart above.
7.
Treatments R and T will be separated by a wash-out period of at least 10 days between administrations of BI 730357
8.
Safety laboratory to be taken and to be medically evaluated within 75 hours prior to first dosing of BI 730357; this
safety laboratory assessment can be omitted if the screening examination is performed on Days -3, -2 or -1
9.
Letter A, B, C and D define different sets of safety laboratory examinations (see Section 5.2.3)
10. If several actions are indicated at the same time, the intake of meals will be the last action.
11. Blood collection takes place exactly at the indicated times. 


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TABLE OF CONTENTS
TITLE PAGE ......................................................................................................1
CLINICAL TRIAL PROTOCOL SYNOPSIS ................................................2
FLOW CHART...................................................................................................4
TABLE OF CONTENTS ...................................................................................7
ABBREVIATIONS.......................................................................................... 11
1.
INTRODUCTION.................................................................................... 14
1.1
MEDICAL BACKGROUND............................................................................14
1.2
DRUG PROFILE...............................................................................................14
1.2.1
BI 730357 ...............................................................................................14
1.2.1.1
Nonclinical data .......................................................................14
Efficacy and selectivity .............................................14
1.2.1.1.1
Safety pharmacology.................................................15
1.2.1.1.2
Toxicology.................................................................15
1.2.1.1.3
Non-clinical pharmacokinetics..................................17
1.2.1.1.4
1.2.1.2
Clinical data .............................................................................17
Clinical pharmacokinetics and metabolism...............18
1.2.1.2.1
Clinical safety............................................................18
1.2.1.2.2
1.2.2
Itraconazole ...........................................................................................19
1.2.3
Residual Effect Period..........................................................................19
1.3
RATIONALE FOR PERFORMING THE TRIAL........................................20
1.4
BENEFIT - RISK ASSESSMENT ...................................................................20
1.4.1
Expected benefit to the target population...........................................20
1.4.2
Procedure-related risks ........................................................................20
1.4.3
Drug-related risks and safety measures..............................................21
1.4.3.1
BI 730357.................................................................................21
1.4.3.2
Itraconazole..............................................................................21
1.4.3.3
Potential drug-drug interaction between itraconazole and 
BI 730357.................................................................................22
1.4.3.4
Drug-induced liver injury ........................................................22
1.4.4
Overall assessment of benefit-risk ratio..............................................23
2.
TRIAL OBJECTIVES AND ENDPOINTS........................................... 24
2.1
MAIN OBJECTIVES, PRIMARY AND SECONDARY ENDPOINTS ......24
2.1.1
Main objectives......................................................................................24
2.1.2
Primary endpoints ................................................................................24
2.1.3
Secondary endpoint ..............................................................................24


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2.2.2.2
Safety and tolerability..............................................................25
3.
DESCRIPTION OF DESIGN AND TRIAL POPULATION.............. 26
3.1
OVERALL TRIAL DESIGN AND PLAN ......................................................26
3.2
DISCUSSION OF TRIAL DESIGN, INCLUDING THE CHOICE OF 
CONTROL GROUP..........................................................................................26
3.3
SELECTION OF TRIAL POPULATION ......................................................26
3.3.1
Main diagnosis for trial entry..............................................................27
3.3.2
Inclusion criteria...................................................................................27
3.3.3
Exclusion criteria ..................................................................................27
3.3.4
Withdrawal of subjects from treatment or assessments ...................29
3.3.4.1
Discontinuation of trial treatment............................................29
3.3.4.2
Withdrawal of consent to trial participation ............................29
3.3.4.3
Discontinuation of the trial by the sponsor..............................30
3.3.5
Replacement of subjects .......................................................................30
4.
TREATMENTS........................................................................................ 31
4.1
INVESTIGATIONAL TREATMENTS ..........................................................31
4.1.1
Identity of the Investigational Medicinal Products ...........................31
4.1.2
Selection of doses in the trial................................................................31
4.1.3
Method of assigning subjects to treatment groups ............................32
4.1.4
Drug assignment and administration of doses for each subject .......32
4.1.5
Blinding and procedures for unblinding ............................................33
4.1.6
Packaging, labelling, and re-supply ....................................................33
4.1.7
Storage conditions.................................................................................34
4.1.8
Drug accountability ..............................................................................34
4.2
OTHER TREATMENTS, EMERGENCY  PROCEDURES,
RESTRICTIONS ...............................................................................................35
4.2.1
Other treatments and emergency procedures....................................35
4.2.2
Restrictions............................................................................................35
4.2.2.1
Restrictions regarding concomitant treatment .........................35
4.2.2.2
Restrictions on diet and life style.............................................35
4.3
TREATMENT COMPLIANCE.......................................................................36
5.
ASSESSMENTS....................................................................................... 37
5.1
ASSESSMENT OF EFFICACY NOT APPLICABLE. ................................37
5.2
ASSESSMENT OF SAFETY............................................................................37
5.2.1
Physical examination ............................................................................37
5.2.2
Vital signs...............................................................................................37
5.2.3
Safety laboratory parameters..............................................................37
5.2.4
Electrocardiogram................................................................................39
5.2.5
Other safety parameters.......................................................................40
5.2.6
Assessment of adverse events...............................................................40
5.2.6.1
Definitions of adverse events...................................................40


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Adverse event ............................................................40
5.2.6.1.1
Serious adverse event ................................................40
5.2.6.1.2
AEs considered ‘Always Serious’.............................41
5.2.6.1.3
Adverse events of special interest .............................41
5.2.6.1.4
Intensity (severity) of AEs.........................................42
5.2.6.1.5
Causal relationship of AEs ........................................42
5.2.6.1.6
5.2.6.2
Adverse event collection and reporting ...................................43
AE collection.............................................................43
5.2.6.2.1
AE reporting to the sponsor and timelines ................44
5.2.6.2.2
Information required..................................................44
5.2.6.2.3
5.3
DRUG CONCENTRATION MEASUREMENTS AND 
PHARMACOKINETICS..................................................................................45
5.3.1
Assessment of pharmacokinetics .........................................................45
5.3.2
Methods of sample collection...............................................................45
5.3.2.1
Blood sampling for pharmacokinetic analysis.........................45
5.3.3
Analytical determinations ....................................................................46
5.3.3.1
Analytical determination of analyte plasma concentration......46
5.4
ASSESSMENT OF BIOMARKER(S) .............................................................46
5.5
BIOBANKING ...................................................................................................46
5.6
OTHER ASSESSMENTS .................................................................................46
5.6.1
Pharmacogenomic evaluation..............................................................46
5.7
APPROPRIATENESS OF MEASUREMENTS.............................................47
6.
INVESTIGATIONAL PLAN.................................................................. 48
6.1
VISIT SCHEDULE............................................................................................48
6.2
DETAILS OF TRIAL PROCEDURES AT SELECTED VISITS ................48
6.2.1
Screening period....................................................................................48
6.2.2
Treatment periods.................................................................................48
6.2.3
Follow-up period and trial completion ...............................................49
7.
STATISTICAL METHODS AND DETERMINATION OF
SAMPLE SIZE......................................................................................... 50
7.1
STATISTICAL DESIGN – MODEL ...............................................................50
7.2
NULL AND ALTERNATIVE HYPOTHESES ..............................................50
7.3
PLANNED ANALYSES....................................................................................50
7.3.1
Primary endpoint analyses...................................................................51
7.3.2
Secondary endpoint analyses ...............................................................52
7.3.4
Safety analyses.......................................................................................53
7.4
INTERIM ANALYSES .....................................................................................54
7.5
HANDLING OF MISSING DATA ..................................................................54
7.5.1
Safety......................................................................................................54
7.5.2
Pharmacokinetics..................................................................................54


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7.6
RANDOMISATION ..........................................................................................54
7.7
DETERMINATION OF SAMPLE SIZE ........................................................54
8.
INFORMED CONSENT, TRIAL RECORDS, DATA 
PROTECTION, PUBLICATION POLICY, AND 
ADMINISTRATIVE STRUCTURE...................................................... 56
8.1
TRIAL APPROVAL, SUBJECT INFORMATION, INFORMED 
CONSENT ..........................................................................................................56
8.2
DATA QUALITY ASSURANCE .....................................................................57
8.3
RECORDS..........................................................................................................57
8.3.1
Source documents .................................................................................57
8.3.2
Direct access to source data and documents.......................................58
8.3.3
Storage period of records.....................................................................58
8.4
EXPEDITED REPORTING OF ADVERSE EVENTS .................................59
8.5
STATEMENT OF CONFIDENTIALITY AND SUBJECT PRIVACY.......59
8.5.1
Collection, storage and future use of biological samples and 
corresponding data ...............................................................................59
8.6
TRIAL MILESTONES .....................................................................................59
8.7
ADMINISTRATIVE STRUCTURE OF THE TRIAL ..................................60
9.
REFERENCES......................................................................................... 61
9.1
PUBLISHED REFERENCES...........................................................................61
9.2
UNPUBLISHED REFERENCES.....................................................................62
10. APPENDICES .......................................................................................... 64
11. DESCRIPTION OF GLOBAL AMENDMENT(S).............................. 65
11.1
GLOBAL AMENDMENT 1 .............................................................................65
11.2
GLOBAL AMENDMENT 2 .............................................................................66


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ABBREVIATIONS
ADME
Absorption, distribution, metabolism, and excretion
AE
Adverse event
AESI
Adverse events of special interest
ANOVA
Analysis of variance
AUC0-∞
Area under the concentration-time curve of the analyte in plasma over the 
time interval from 0 extrapolated to infinity
AUC0-tz
Area under the concentration-time curve of the analyte in plasma over the 
time interval from 0 to the last quantifiable data point
BCRP
Breast cancer resistance protein
BI
Boehringer Ingelheim
BMI
Body mass index (weight divided by height squared)
BP
Blood pressure
CA
Competent authority
CI
Confidence interval
CPLG
Innovation and Quality in Pharmaceutical Development’s Clinical 
Pharmacology Leadership Group
Cmax
Maximum measured concentration of the analyte in plasma
CNS
Central nervous system
CRF
Case Report Form, paper or electronic (sometimes referred to as ‘eCRF’)
CT Leader
Clinical Trial Leader
CT Manager
Clinical Trial Manager
CTP
Clinical Trial Protocol
CTR
Clinical Trial Report
CV
Arithmetic coefficient of variation
CYP
Cytochrome P450
DDI
Drug-drug interaction
DILI
Drug induced liver injury
DNA
Deoxyribonucleic acid
ECG
Electrocardiogram
eCRF
Electronic case report form
eDC
Electronic data capture
EDTA
Ethylenediaminetetraacetic acid


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EEG
Electroencephalogram
EMA
European Medicines Agency
EMG
Electromyelogram
EoTrial
End of trial
EudraCT
European Clinical Trials Database
F
Absolute bioavailability factor
FDA
Food and Drug Administration (US)
FU
Follow-up
fu
Fraction unbound
GCP
Good Clinical Practice
gCV
Geometric coefficient of variation
GLP
Good Laboratory Practice
gMean
Geometric mean
hERG
Human-ether-à-go-go related gene
hLXRα
Human liver X receptor alpha
HPC
Human Pharmacology Centre
hPXR
Human pregnane X receptor
IB
Investigator’s Brochure
IC50
50% inhibitory concentration
ICF
Informed consent form
ICH
International Council on Harmonisation
IEC
Independent Ethics Committee
IL
Interleukin
IPD
Important protocol deviation
IQRM
Integrated quality and risk management
IRB
Institutional Review Board
ISF
Investigator site file
LC-MS/MS
Liquid chromatography with tandem mass spectrometry
MATE1
Multidrug and toxin extruder 1
MATE2-K
Multidrug and toxin extruder 2-K
MDA
Methylenedioxyamphetamine
MDMA
Methylenedioxymethamphetamine
MedDRA
Medical Dictionary for Regulatory Activities
mRNA
Messenger ribonucleic acid
NOAEL
No observed adverse event level
P-gp
P-glycoprotein


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PK
Pharmacokinetic(s)
PKS
Pharmacokinetic set
PMDA
Pharmaceuticals and Medical Devices Agency (Japan)
PR
Pulse rate
PUVA
Psoralen ultraviolet A
QT
Time between start of the Q-wave and the end of the T-wave in an 
electrocardiogram
QTc
QT interval corrected for heart rate using the method of Fridericia (QTcF) 
or Bazett (QTcB)
R
Reference treatment
REP
Residual effect period
RORα
Retinoic acid-related orphan receptor α (protein)
RORβ
Retinoic acid-related orphan receptor β (protein)
RORγ
Retinoic acid-related orphan receptor γ (full length protein)
RORγt
Retinoic acid-related orphan receptor γt (splice variant of RORγ protein)
SAE
Serious adverse event
SCR
Screening
SmPC
Summary of Product Characteristics
SOP
Standard operating procedure
SRD
Single-rising dose
ss
(at) steady state
T
Test product or treatment
TS
Treated set
TSAP
Trial statistical analysis plan
ULN
Upper limit of normal
WOCBP
Woman of childbearing potential
XTC
Ecstasy 


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1.
INTRODUCTION
BI 730357 is an antagonist at the retinoic acid-related orphan receptor γt (RORγt). It is being 
developed as an oral therapy for the treatment of patients with psoriasis as well as other 
Th17-mediated diseases. RORγ antagonism is a novel mechanism of action.
This trial will be performed to investigate the relative bioavailability of BI 730357 in plasma 
when given alone in comparison to when given together with the CYP3A and P-glycoprotein 
inhibitor itraconazole.
1.1
MEDICAL BACKGROUND
Retinoic acid-related orphan receptor γt (RORγt) is a nuclear hormone receptor/transcription 
factor expressed in Th17 cells and in distinct subsets of lymphoid cells, including natural 
killer cells, innate lymphoid cells, and γδ T-cells. Upon cell activation, in response to 
multiple activation signals including cytokines and T cell receptor engagement, RORγt 
regulates the transcription of interleukin (IL)-17A, IL-17F, and IL-22 genes, and of IL-23 
receptor gene. Emerging clinical science indicates a pivotal role for the Th17 axis in the 
pathogenesis of psoriasis, and other immunologically-mediated diseases. By blocking 
RORγt-mediated transcription of critical pro-inflammatory cytokines, and IL-23R, and 
consequently their downstream signalling, RORγt antagonism could prove efficacious in the 
treatment of Th17-mediated diseases [c09228382].
1.2
DRUG PROFILE
1.2.1
BI 730357
1.2.1.1
Nonclinical data
Efficacy and selectivity
1.2.1.1.1
BI 730357 was profiled in cellular assays comprising primary human cells central to the 
pathogenesis underlying psoriasis, psoriatic arthritis and ankylosing spondylitis. BI 730357 
provided consistent potency across all stimuli, cell types, and species tested, including in 
whole blood conditions. The compound showed equivalent in vitro potency in human, mouse, 
and rat. BI 730357 provided substantial inhibition of disease-relevant biomarker and 
histology reads in mechanistic preclinical in vivo mouse models of inflammation.
BI 730357 showed good off-target selectivity in that it exhibited no activity on RORβ and
only low-level inverse-agonism against RORα, low-level antagonism against hLXRα and
low-level agonism activity against hPXR. No other off-target activities were detected.


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Safety pharmacology
1.2.1.1.2
General and safety pharmacology studies have been conducted with BI 730357 to address the 
core battery of CNS, cardiovascular, respiratory, and renal functions, and the results 
demonstrated an acceptable profile for clinical trials in healthy volunteers.
Toxicology
1.2.1.1.3
The toxicological profile of BI 730357 has been assessed in genetic toxicity, phototoxicity 
and repeated dose toxicity studies in rats and dogs [c09228382]:


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The results of the in vitro and in vivo genetic toxicology studies (in bacterial and mammalian 
systems) showed that BI 730357 
 were free of any genotoxic 
potential.


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Non-clinical pharmacokinetics
1.2.1.1.4
The disposition of BI 730357 is characterized in rat, dog, and minipig by low clearance and 
moderate volume of distribution. Moderate-to-high oral bioavailability was observed across 
species, which suggests that following oral administration, the bioavailability of 
BI 730357 in humans is likely to be moderate to high. 
For a more detailed description of the BI 730357 non-clinical profile please refer to the 
current Investigator’s Brochure (IB) [c09228382].
1.2.1.2
Clinical data
So far, BI 730357 has clinically been tested by Boehringer Ingelheim in a completed first-in-
human trial and an on-going multiple-rising dose study [c09228382]. 

In the first-in-human trial BI 730357 was administered in doses ranging from 2 mg 
through 800 mg as oral solution (2 and 8 mg) and film-coated tablets (25 to 800 mg) 
to a total of 66 healthy male volunteers. 

An ongoing multiple-rising-dose trial is evaluating administration of BI 730357 over 
14 to 28 days with daily doses of 25 to 400 mg administered as film-coated tablets to 
healthy male volunteers.


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Clinical pharmacokinetics and metabolism
1.2.1.2.1
Clinical safety
1.2.1.2.2


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For a more detailed description of the BI 730357 profile, please refer to the current 
Investigator’s Brochure (IB) [c09228382].
1.2.2
Itraconazole
Absorption of itraconazole solution is fast with maximum plasma concentration being 
reached within 2.5 h after oral administration in fasting condition. Bioavailability of 
itraconazole liquid is increased by 30% when given under fasting condition compared to 
administration together with food [R18-2644]. Mean peak plasma concentrations were 
547.7 ng/mL after a single dose of 200 mg itraconazole solution (fasting) and 1965 ng/mL 
after 15 days of daily treatment with 200 mg itraconazole (solution, fasting). Kinetics of 
itraconazole is non-linear. The half-life of itraconazole after multiple doses of 200 mg once 
daily with solution formulation was about 40 h [R17-3742].
In the liver, itraconazole is metabolised extensively to more than 30 metabolites [R17-3743]. 
Its main metabolite, OH-itraconazole, accounts for about twice the amount of plasma 
itraconazole at trough. It has been shown in vitro that CYP3A4 is mainly responsible for the 
formation of this metabolite [R18-2644]. FDA classifies itraconazole as strong index 
inhibitor of CYP3A and as inhibitor of P-glycoprotein (P-gp) [R18-0241]. However, not only 
itraconazole contributes to the in vivo inhibition of CYP3A observed after itraconazole 
administration but also three of its metabolites (OH-itraconazole, keto-itraconazole and 
N-desalkyl-itraconazole) [R10-1102].
For a more detailed description of itraconazole, please refer to the German Summary of 
Product Characteristics (SmPC) for Sempera® Liquid 10 mg/ml [R18-2644] and the UK 
SmPC for Sporanox® 10 mg/ml Oral Solution [R18-2643].
1.2.3
Residual Effect Period
The Residual Effect Period (REP, i.e., the period after the last dose with measurable drug 
levels and/or pharmacodynamic effects still likely to be present) of BI 730357 is 7 days for 
the mono-therapy (Treatment R). When given together with itraconazole (Treatment T), it is 
expected that plasma exposure of BI 730357 could be increased (albeit within the range 
explored in the clinical trial 1407-0001), and the time of relevant plasma exposure could be 
prolonged, which in turn could result in a prolonged period in which adverse effects could 
potentially occur. 
For the use of itraconazole in Treatment T, the REP is defined as 9 days after last 
administration of itraconazole on Day 9 in Period 2. Therefore, the follow-up period will start
earliest on Day 18 following BI 730357 dosing in Period 2, as this is expected to cover the 
period in which any potential adverse effects could reasonably occur.


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1.3
RATIONALE FOR PERFORMING THE TRIAL
Based on in vitro data, CYP3A is responsible for approximately 90% of the metabolism of BI 
730357. Therefore, the DDI victim potential of BI 730357 with regards to CYP3A inhibition 
is considered high if metabolism is the main clearance pathway. Inhibition of CYP3A4 may 
result in an increased drug exposure which might impact the safety of the patients.
This clinical trial will be performed in order to assess whether and to which extent the 
kinetics of BI 730357 is affected by the co-administration of a drug that inhibits CYP3A4.
The probe drug to test the in-vivo inhibition of CYP3A4 is itraconazole.
Itraconazole is chosen for this trial as perpetrator drug, as this drug is recommended as strong 
inhibitor of CYP3A by EMA [P15-06991], as strong index inhibitor of CYP3A by FDA 
[R18-0241], and as strong inhibitor of CYP3A by PMDA [P15-06298]. Moreover, safety and 
tolerability of itraconazole were acceptable in previous drug-drug interaction trials 
(c02336088, c03355329, c08928447).
1.4
BENEFIT - RISK ASSESSMENT
Participation in this clinical trial is without any (therapeutic) benefit for healthy subjects. 
Their participation, however, is of major importance for the development of BI 730357. 
Subjects are exposed to risks of study procedures and risks related to the exposure to the trial 
medication.
1.4.1
Expected benefit to the target population
RORγt sits at a key focal point, integrating multiple signals, including T cell receptor 
engagement and cytokines, and driving the expression of multiple genes (IL-17A, IL-17F, IL-
22, and IL-23R). Via sitting at this focal node integrating multiple signals and effecting
multiple outputs, BI 730357 has the potential to have a broader effect in Th17-mediated
diseases than individual cytokine blockades alone (e.g., IL-23 or IL-17), thereby filling an
unmet medical need for the introduction of new, efficacious oral treatment options in the
treatment of psoriasis and other Th17-mediated diseases.
1.4.2
Procedure-related risks
The use of an indwelling venous catheter or venepuncture for e.g. blood sampling may result 
in mild bruising, and in rare cases, in transient inflammation of the wall of the vein, or nerve 
injury, potentially resulting in paraesthesia, reduced sensibility, and/or pain for an indefinite 
period.
ECG electrodes may cause local and typically transient skin reactions.
The total volume of blood withdrawn per subject during the entire study will not exceed the 
volume of a normal blood donation (500 mL). No health-related risk to healthy subjects is 
expected from withdrawal of this volume of blood.


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1.4.3
Drug-related risks and safety measures
1.4.3.1
BI 730357
As the nature of the target and the mechanism of action of BI 730357 are well understood 
from pre-clinical studies, comparable compounds have been tested by other companies before 
(although not a lot of published data are available), and the animal models are believed to be 
predictive for the effects in humans, BI 730357 is not seen as a high-risk compound.
As with other immune-targeted therapies, impaired host defense is a theoretical target-related 
toxicity, potentially resulting in increased risk of infection and/or malignancy. Th17 cells 
play an important role in defense against extracellular bacteria and fungi at mucosal surfaces 
[R16-3166, R16-3149]. IL-17 antagonists are associated with increased infections 
[R13-2643]. Homozygous, but not heterozygous RORγ knockout mice have a high incidence 
of T-cell lymphoma, thought to originate in the thymus [R16-2630]. While the translatability 
of the knockout phenotype to pharmacological RORγ antagonism and to humans is unknown, 
this raises the hypothetical concern for clinical T-cell lymphoma risk. The exact cause of 
T-cell lymphomas in RORγ knockout mice is not fully understood, but changes in 
homeostasis in the thymus, such as thymocyte apoptosis and proliferation, are thought to play 
a role. AEs and SAEs consistent with malignancy, and specifically those representing 
lymphoma, are to be carefully monitored and evaluated throughout the BI 730357 clinical 
development program. Based on the data obtained with BI 730357 so far, and based on the 
fact that in the current study single doses will be used, the increased risk of infection and/or 
malignancy is considered to be extremely small.
As with all drugs, the potential for hypersensitivity and allergic reactions has to be taken into 
consideration when BI 730357 is administered.
1.4.3.2
Itraconazole
In this trial itraconazole will be used in a standard dose of 200 mg once daily for 12 days.
Multiple dosing of 200 mg itraconazole up to 15 days was of acceptable tolerability in 
healthy subjects [c02336088, c03355329, c08928447, R17-3742]. 


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In order to address the risk of hepatotoxicity, only subjects with normal liver enzyme values 
will be included into the study (see Section 3.3.3, criterion 23). Safety laboratory parameters 
will be monitored closely. An individual subject will be removed from the trial if the subject 
shows an elevation of AST and/or ALT ≥3-fold ULN combined with an elevation of total 
bilirubin ≥2-fold ULN (measured in the same blood sample, see Section 3.3.4.1). Further, 
most of the reported cases of serious hepatotoxicity during itraconazole treatment occurred in 
patients that suffered from concomitant liver diseases, had other significant diseases, or took 
concomitant hepatotoxic drugs. Subjects with liver diseases or a medical history of drug-
induced liver failure are excluded from trial participation (Section 3.3.3, criteria 5 and 24).
Itraconazole has shown a dose-related increase in maternal toxicity, embryotoxicity and 
teratogenicity in nonclinical studies at high doses, and therefore itraconazole must not be 
used during pregnancy. Woman of childbearing potential have to use a highly effective 
method of contraception until the menstrual period after the last itraconazole dose [R18-2644,
R18-2643]. For risk mitigation, only male subjects will be included into this clinical trial.
Considering these safety measures and taking into account the reported acceptable tolerability 
of itraconazole, the planned administration of itraconazole does not represent an undue risk to 
healthy male volunteers.
1.4.3.3
Potential drug-drug interaction between itraconazole and BI 730357
It is likely that concomitant administration of BI 730357 with itraconazole may cause an 
increase of plasma concentrations and t1/2 of BI 730357. The effect of itraconazole in 
increasing Cmax and AUC of other drugs can be as high as 3.4-fold and 11-fold, respectively, 
as seen with oral midazolam, a sensitive CYP3A4 substrate, when co-administered with oral 
itraconazole 200 mg/d [R01-0516, R18-2644]. Therefore, a low dose of 50 mg BI 730357 has 
been selected for this trial. 
 the ratios of gMean plasma exposure 
parameters at 800 mg and at 50 mg were approximately 14 (Cmax) and 13 (AUC0-24). These 
ratios are assessed to be sufficient as safety margins for the current trial, even in case of 
substantial increases of BI 730357 plasma concentrations by itraconazole as it has been 
described for midazolam (see above).
1.4.3.4
Drug-induced liver injury
Although rare, a potential for drug-induced liver injury (DILI) is under constant surveillance 
by sponsors and regulators. Therefore, this trial requires timely detection, evaluation, and 
follow-up of laboratory alterations in selected liver laboratory parameters to ensure subjects´ 
safety; see also section 5.2.6.1.4, adverse events of special interest.


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1.4.4
Overall assessment of benefit-risk ratio
BI 730357 is a novel RORγt antagonist that has been adequately characterised in pre-clinical 
studies. The non-clinical safety package supports clinical trials in males and females with 
administration of BI 730357 for up to 39 weeks.
Preliminary data of the SRD part of trial 1407-0001 indicate good safety and tolerability of 
single oral doses of BI 730357 at all dose levels, i.e. up to 800 mg (see IB [c09228382]).
Due to the low dose of BI 730357 selected for this trial, BI 730357 plasma exposures, even in 
case of a substantial effect of itraconazole, are expected to be well within plasma exposure 
values that were observed in the SRD part of trial 1407-0001 and that were associated with 
good safety and tolerability.
The trial design is optimized to collect as much relevant information as possible on the 
pharmacokinetics of BI 730357 without exposing participating volunteers to undue risk. The 
potential for side effects has been assessed to be minimal and thus acceptable. However, there 
is always the potential for subjects receiving medication to experience adverse events (AEs), 
and rarely also serious adverse events (SAEs). Risks for subjects will be minimized and 
addressed by eligibility criteria, safety laboratory examinations, ECG and vital sign 
measurements, in-house observation periods and AE questioning.
Itraconazole is a recommended inhibitor of CYP3A in clinical trials and has been used 
successfully previously in clinical trials in healthy volunteers. The drug has a potential for 
hepatotoxicity, which is however accounted for by stringent exclusion criteria, liver enzyme 
measurement as part of safety laboratory examinations and stopping criteria for the individual 
subject.
If the investigator should have any clinical concern, the safety of subjects will be of upmost 
importance. The Investigator has the discretion to remove subjects from the trial should there 
be any safety concerns, or if the subjects’ wellbeing is at jeopardy.
BI 730357 has the potential to have a broader effect in Th17-mediated diseases than 
individual cytokine blockades alone (e.g., IL-23 or IL-17), thereby filling an unmet medical 
need for the introduction of new, efficacious oral treatment options in the treatment of 
psoriasis and other Th17-mediated diseases.
This trial is required for the development of BI 730357. It is designed to assess the in vivo
victim potential of BI 730357 for CYP3A inhibition. The resulting data are planned to inform 
concomitant medication restrictions in planned patient trials.
Considering the medical need for an effective and safe treatment of psoriasis, the benefit of 
this trial is assessed to outweigh the potential risks.


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2.
TRIAL OBJECTIVES AND ENDPOINTS
2.1
MAIN OBJECTIVES, PRIMARY AND SECONDARY ENDPOINTS
2.1.1
Main objectives
The main objective of this trial is to investigate the relative bioavailability of BI 730357 in 
plasma when given as oral single dose together with multiple oral doses of itraconazole 
(Test, T) as compared to when given alone as oral single dose (Reference, R).
2.1.2
Primary endpoints
The following pharmacokinetic parameters will be determined for BI 730357:

AUC0-tz (area under the concentration-time curve of the analyte in plasma over the 
time interval from 0 to the last quantifiable data point)

Cmax (maximum measured concentration of the analyte in plasma)
2.1.3
Secondary endpoint
The following pharmacokinetic parameter will be determined for BI 730357:

AUC0-∞(area under the concentration-time curve of the analyte in plasma over the 
time interval from 0 extrapolated to infinity)


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2.2.2.2
Safety and tolerability
Safety and tolerability of BI 730357 and itraconazole will be assessed based on:  

Adverse events (including clinically relevant findings from the physical examination)

Safety laboratory tests

12-lead ECG

Vital signs (blood pressure, pulse rate)


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3.
DESCRIPTION OF DESIGN AND TRIAL POPULATION
3.1
OVERALL TRIAL DESIGN AND PLAN
The study will be performed as an open-label, two-treatment, two-period, one-way crossover 
trial in healthy male subjects in order to compare the test treatment (T) to the reference 
treatment (R). The treatments will be one oral single dose of 50 mg BI 730357 as tablet 
formulation (tablet strength: 50 mg) together with multiple oral doses of 200 mg itraconazole 
as oral solution formulation (concentration: 10 mg/mL) (T) and one oral single dose of 50 mg 
BI 730357 as tablet formulation (tablet strength: 50 mg) given alone (R). In both treatments, 
BI 730357 is administered to subjects in the fasting state. In the first treatment period 
(Period 1, Visit 2), all subjects are planned to undergo treatment R, and in the second 
treatment period (Period 2, Visit 3), all subjects are planned to undergo treatment T. For 
details, refer to Section 4.1.
There will be a washout interval of at least 10 days between the administrations of 
BI 730357.
An overview of all relevant trial activities is provided in the Flow Chart. For visit schedule 
and details of trial procedures at selected visits, refer to Sections 6.1 and 6.2, respectively.
3.2
DISCUSSION OF TRIAL DESIGN, INCLUDING THE CHOICE OF 
CONTROL GROUP
For relative bioavailability trials, the crossover design is preferred because of its efficiency: 
since each subject serves as his own control, the comparison between treatments is based on 
an intra-subject comparison, thus removing inter-subject variability from the comparison 
between treatments [R94-1529].
Because of the long half-life of itraconazole (about 40 hours) and its metabolites, a one-way 
crossover design was selected, with administration of itraconazole in the second study period 
only. This design is not expected to lead to systematic errors in the estimation of the 
treatment effects since nonspecific time-effects are unlikely due to the short trial duration. 
For itraconazole studies, this design is recommended by the Innovation and Quality in 
Pharmaceutical Development’s Clinical Pharmacology Leadership Group (CPLG) 
[R17-3744].
For this pharmacokinetic drug-drug interaction trial, open-label treatment is acceptable, 
because the primary and secondary endpoints of this trial are pharmacokinetic endpoints 
derived from measurement of plasma concentrations of BI 730357. These endpoints are not 
expected to be affected by knowledge of treatment.
3.3
SELECTION OF TRIAL POPULATION
It is planned that 14 healthy male subjects will enter the study. They will be recruited from 
the volunteers' pool of the trial site. Because of the reproduction toxicity itraconazole has 
shown in nonclinical studies, only male subjects will be included in this study.


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A log of all subjects enrolled into the trial (i.e. who have signed informed consent) will be 
maintained in the Investigator Site File (ISF) irrespective of whether they have been treated 
with investigational drug or not.
3.3.1
Main diagnosis for trial entry
The study will be performed in healthy subjects.
3.3.2
Inclusion criteria
Subjects will only be included in the trial if they meet the following criteria:
1. Healthy male subjects according to the assessment of the investigator, as based on a 
complete medical history including a physical examination, vital signs (BP, PR), 12-lead 
ECG, and clinical laboratory tests 
2. Age of 18 to 50 years (inclusive) 
3. BMI of 18.5 to 29.9 kg/m2 (inclusive) 
4. Signed and dated written informed consent prior to admission to the study, in accordance
with GCP and local legislation
3.3.3
Exclusion criteria
Subjects will not be allowed to participate, if any of the following general criteria apply:
1. Any finding in the medical examination (including BP, PR or ECG) deviating from 
normal and assessed as clinically relevant by the investigator
2. Repeated measurement of systolic blood pressure outside the range of 90 to 140 mmHg, 
diastolic blood pressure outside the range of 50 to 90 mmHg, or pulse rate outside the 
range of 45 to 90 bpm
3. Any laboratory value outside the reference range that the investigator considers to be of 
clinical relevance
4. Any evidence of a concomitant disease assessed as clinically relevant by the investigator
5. Gastrointestinal, hepatic, renal, respiratory, cardiovascular, metabolic, immunological or 
hormonal disorders
6. Cholecystectomy or other surgery of the gastrointestinal tract that could interfere with the 
pharmacokinetics of the trial medication (except appendectomy or simple hernia repair)
7. Diseases of the central nervous system (including but not limited to any kind of seizures 
or stroke), and other relevant neurological or psychiatric disorders 
8. History of relevant orthostatic hypotension, fainting spells, or blackouts
9. Chronic or relevant acute infections
10. History of relevant allergy or hypersensitivity (including allergy to the trial medication or 
its excipients) 


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11. Use of drugs within 30 days of planned administration of trial medication that might 
reasonably influence the results of the trial (including drugs that cause QT/QTc interval
prolongation)
12. Intake of an investigational drug in another clinical trial within 60 days of planned  
administration of investigational drug in the current trial, or concurrent participation in 
another clinical trial in which investigational drug is administered
13. Smoker (more than 10 cigarettes or 3 cigars or 3 pipes per day)
14. Inability to refrain from smoking on specified trial days
15. Alcohol abuse (consumption of more than 30 g per day)
16. Drug abuse or positive drug screening
17. Blood donation of more than 100 mL within 30 days of planned administration of trial 
medication or intended blood donation during the trial
18. Intention to perform excessive physical activities within one week prior to the 
administration of trial medication or during the trial
19. Inability to comply with the dietary regimen of the trial site
20. A marked baseline prolongation of QT/QTc interval (such as QTc intervals that are 
repeatedly greater than 450 ms) or any other relevant ECG finding at screening
21. A history of additional risk factors for Torsade de Pointes (such as heart failure, 
hypokalaemia, or family history of Long QT Syndrome)
22. Subject is assessed as unsuitable for inclusion by the investigator, for instance, because 
the subject is not considered able to understand and comply with study requirements, or 
has a condition that would not allow safe participation in the study 
In addition, the following trial-specific exclusion criteria apply:
23. Liver enzyme (ALT, AST, GGT) values above upper limit of normal at the screening 
examination
24. History of drug-induced liver injury
25. History of heart failure, or any evidence of ventricular dysfunction in the history
26. History of hereditary fructose intolerance
27. Male subjects with WOCBP partner who are unwilling to use male contraception 
(condom or sexual abstinence) from time point of first administration of trial medication 
until 30 days after the last administration of trial medication
28. Haemoglobin or Red Blood Cell Count below the lower limit of normal at the screening 
examination
29. White Blood Cell Count or Neutrophil Count outside the normal range at the screening 
examination
For study restrictions, refer to Section 4.2.2.


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3.3.4
Withdrawal of subjects from treatment or assessments
Subjects may discontinue trial treatment or withdraw consent to trial participation as a whole 
(‘withdrawal of consent’) with very different implications; please see sections 3.3.4.1 and 
3.3.4.2 below.
If a subject is removed from or withdraws from the trial prior to the first administration of 
trial medication, the data of this subject will not be entered in the case report form (CRF) and 
will not be reported in the clinical trial report (CTR). If a subject is removed from or 
withdraws from the trial after the first administration of trial medication, this will be 
documented and the reason for discontinuation must be recorded in the CRF; in addition, the 
data will be included in the CRF and will be reported in the CTR. At the time of 
discontinuation, a complete end of trial examination will be performed, if possible, and the 
information will be recorded in the CRF. If the discontinuation occurs before the end of the 
REP (see Section 1.2.3), the discontinued subject should if possible be questioned for AEs 
and concomitant therapies at or after the end of the REP in order to ensure collection of AEs 
and concomitant therapies throughout the REP, if not contrary to any consent withdrawal of 
the subject.
3.3.4.1
Discontinuation of trial treatment
An individual subject will discontinue trial treatment if:
1. The subject wants to discontinue trial treatment, without the need to justify the decision
2. The subject has repeatedly shown to be non-compliant with important trial procedures 
and, in the opinion of both, the investigator and sponsor representative, is not willing or 
able to adhere to the trial requirements in the future.
3. The subject needs to take concomitant medication that interferes with the investigational 
medicinal product or other trial treatment
4. The subject can no longer receive trial treatment for medical reasons (such as surgery, 
adverse events [AEs], or diseases)
5. The subject has an elevation of AST and/or ALT ≥3-fold ULN and an elevation of total 
bilirubin ≥2-fold ULN (measured in the same blood sample) and/or needs to be followed 
up according to the DILI checklist provided in the ISF
In addition to these criteria, the investigator may discontinue subjects at any time based on 
his or her clinical judgment.
Even if the trial treatment is discontinued, the subject remains in the trial and, given his/her 
agreement, will undergo the procedures for early treatment discontinuation and follow up as 
outlined in the Flow Chart and section 6.2.3.
3.3.4.2
Withdrawal of consent to trial participation
Subjects may withdraw their consent to trial participation at any time without the need to 
justify the decision. If a subject wants to withdraw consent, the investigator should be 
involved in the discussion with the subject and explain the difference between trial treatment 


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discontinuation and withdrawal of consent to trial participation, as well as explain the options 
for continued follow up after trial treatment discontinuation, please see section 3.3.4.1 above
3.3.4.3
Discontinuation of the trial by the sponsor
Boehringer Ingelheim reserves the right to discontinue the trial at any time for any of the 
following reasons:
1. Failure to meet expected enrolment goals overall or at a particular trial site
2. New toxicological findings, serious adverse events, or any safety information invalidating
the earlier positive benefit-risk-assessment. More specifically, the trial will be terminated 
if more than 50% of the subjects have drug-related and clinically relevant adverse events 
of moderate or severe intensity, or if at least 1 drug-related serious adverse event is 
reported
3. Violation of GCP or the CTP impairing the appropriate conduct of the trial
4. The sponsor decides to discontinue the further development of the investigational product
3.3.5
Replacement of subjects
In case more than 2 subjects do not complete the trial, the Clinical Trial Leader together with 
the Trial Pharmacokineticist and the Trial Statistician are to decide, if and how many subjects 
will be replaced. A replacement subject will be assigned a unique trial subject number, and 
will be assigned to the same treatment as the subject 
 replaces.


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4.
TREATMENTS
4.1
INVESTIGATIONAL TREATMENTS
The investigational product BI 730357 as tablet formulation has been manufactured by 
BI Pharma GmbH & Co. KG. Itraconazole oral solution will be obtained from a public 
pharmacy.
4.1.1
Identity of the Investigational Medicinal Products
The characteristics of the two test products are given below:
Test product 1
Substance:
BI 730357
Pharmaceutical formulation:
Tablet
Source:
BI Pharma GmbH & Co. KG, Germany
Unit strength:
50 mg
Posology:
1 – 0 – 0
Route of administration:
Oral
Duration of use:
1 day (in treatments R and T)
Test product 2
Name:
Sempera® Liquid 10 mg/ml
Substance:
Itraconazole
Pharmaceutical formulation:
Oral solution
Source:
Public pharmacy (obtained by the clinical site)
Holder of marketing authorization: JANSSEN-CILAG GmbH, Neuss, Germany
Unit strength:
10 mg/mL
Posology:
20 mL – 0 – 0
Route of administration:
Oral
Duration of use:
12 days (in treatment T, only)
4.1.2
Selection of doses in the trial
Perpetrator (itraconazole)
The dose of itraconazole selected for this trial reflects standard clinical doses, is considered 
sufficient to yield significant CYP3A inhibition and has been used successfully and safely in 
previous drug-drug interaction trials (c02336088, c03355329, c08928447).


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Victim (BI 730357)
Based on in vitro data, CYP3A is responsible for approximately 90% of the metabolism of 
BI 730357. If metabolic clearance is the main pathway of BI 730357 elimination, 
concomitant administration of BI 730357 with the strong CYP3A inhibitor itraconazole may 
result in substantial increases of BI 730357 plasma concentrations. 
For the current trial, a dose of 50 mg BI 730357 is selected, in order to ensure that BI 730357
plasma concentrations, even in case of a substantial increase when given with itraconazole, 
are within the range of concentrations that were explored in the SRD part of trial 1407-0001 
and that were associated with good safety and tolerability.  
In the SRD part of trial 1407-0001, single oral doses of 2 to 800 mg BI 730357 were 
administered as oral solution or tablet formulation under fasting or fed conditions, and 
available data indicate that, at all doses tested, BI 730357 administration was safe and well 
tolerated. 
 
 
 
I.e., the ratios of gMean plasma exposure parameters at 800 mg and at 50 mg were 
approximately 14 (Cmax) and 13 (AUC0-24). These ratios are assessed to be sufficient as safety 
margins for the current trial, to cover for increases of BI 730357 plasma exposures when 
given together with itraconazole (see also section 1.4.3.3).
4.1.3
Method of assigning subjects to treatment groups
There is only one treatment sequence investigated in this trial, and each subject will be 
allocated to the same treatment sequence (R-T). The subjects will be allocated to a study 
subject number by drawing lots prior to first administration of trial medication in the morning 
of Day 1 of Visit 2. The randomization list of study subject numbers and assigned treatment 
sequence will be provided to the trial site in advance. Note that the randomization list is just 
needed for logistical reasons in this non-randomized, open-label trial. Hence, no bias is 
introduced when providing the randomization list in advance to the site. Reference and test 
treatments will be administered in the sequence specified in the Flow Chart.
Once a subject number has been assigned, it cannot be reassigned to any other subject.
All subjects may be treated in one cohort, i.e. all subjects may receive treatment on the same 
calendar day. In case this is not feasible (e.g., due to logistical or recruitment reasons), the
group may be split into several cohorts as required. Treatment of all subjects on the same 
calendar day is acceptable (for safety margin to exposure reached in previous SRD trial 
1407.1 refer to Section 1.4.3.3; for discussion of study-associated risks and safety measures 
see Section 1.4.3).
The randomisation procedure is described in Section 7.6.
4.1.4
Drug assignment and administration of doses for each subject
This trial is a one-way crossover study. All subjects will receive the 2 treatments in fixed 
order. The treatments to be evaluated are outlined in Table 4.1.4: 1 below.


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Table 4.1.4: 1
Dosage and treatment schedule
Treatment 
period
Treatment
Substance
Formulation
Unit 
strength
Dosage
Total
dose
1
R (Reference)
BI 730357
Tablet
50 mg
1 tablet on Day 1
50 mg
2
T (Test)
BI 730357
Itraconazole
Tablet
Oral solution
50 mg
10 mg/mL
1 tablet on Day 1
20 mL (200 mg) on 
Days -3 to Day 9
50 mg
2400 mg
Administration of trial medication will be performed after subjects have fasted overnight; 
fasting is to start no later than 10 h before the scheduled dosing of BI 730357 and no later 
than 9 h before dosing of itraconazole.
The investigator (or authorised designee) will administer the trial medication as an oral dose 
together with about 240 mL of water to subjects who are in a standing position. For drug 
administration, the so-called four-eye principle (two-person rule) should be applied. For this, 
one authorised employee of the trial site should witness the administration of trial medication, 
and – if applicable – its preparation (e.g. reconstitution), if correct dosage cannot be ensured 
otherwise.
For restrictions with regard to diet, see Section 4.2.2.2.
Subjects will be kept under close medical surveillance until 24 h after drug administration of 
BI 730357. During the first 4 h after drug administration of BI 730357, subjects are not 
allowed to lie down (i.e. no declination of the upper body of more than 45 degrees from 
upright posture), except for medical reasons or for recording of 12-lead ECG and vital signs 
measurements.
The treatments will be separated by a wash-out phase of at least 10 days between 
administrations of BI 730357.
4.1.5
Blinding and procedures for unblinding
This Phase I trial will be handled in an open fashion throughout (that is, during the conduct,
including data cleaning and preparation of the analysis). This is considered acceptable 
because the potential for bias seems to be low and does not outweigh practical considerations.
Emergency envelopes will not be provided, because the dose of trial medication is known to 
investigators and subjects.
4.1.6
Packaging, labelling, and re-supply
BI 730357 tablets
BI 730357 tablets will be provided by BI. They will be packaged and labelled in accordance 
with local law and the principles of Good Manufacturing Practice. For details of packing and 
the description of the label, refer to the ISF.
The telephone number of the sponsor and the name, address and telephone number of the trial 
site are provided in the subject information form. The EudraCT number is indicated on the 
title page of this protocol as well as on the subject information and informed consent forms. 


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No re-supply is planned.
Itraconazole oral solution
Itraconazole oral solution will be obtained by the clinical trial site from a public pharmacy. 
The drug will be dispensed out of the original, unmodified packages.
4.1.7
Storage conditions
Drug supplies will be kept in their original packaging and in a secure limited access storage 
area in accordance with the recommended (labelled) storage conditions. If necessary, a 
temperature log must be maintained to make certain that the drug supplies are stored at the 
correct temperature. If the storage conditions are found to be outside the specified range, the 
Clinical Trial Manager (as provided in the list of contacts) is to be contacted immediately.
4.1.8
Drug accountability
The investigator or designee will receive the investigational drugs delivered from the sponsor
following requirements are fulfilled:

Approval of the clinical trial protocol by the IRB / ethics committee

Approval/notification of the regulatory authority,  e.g. competent authority

Availability of the curriculum vitae of the Principal Investigator

Availability of a signed and dated clinical trial protocol  
Only authorised personnel documented in the form 'Trial Staff List' may dispense medication 
to trial subjects. The trial medication must be administered in the manner specified in the 
CTP.
The investigator or designee must maintain records of the product’s delivery to the trial site, 
the inventory at the site, the use by each subject, and the disposal of unused products.These 
records will include dates, quantities, batch / serial numbers, expiry ('use-by') dates, and the 
unique code numbers assigned to the investigational medicinal product and trial subjects. The 
investigator or designee will maintain records that document adequately that the subjects 
were provided the doses specified by the CTP and reconcile all investigational medicinal 
products received from the sponsor. At the time of disposal of remaining trial medication, the 
investigator or designee must verify that no remaining supplies are in the investigator’s 
possession.
All unused medication will be disposed of locally by the trial site upon written authorisation 
of the Clinical Trial Leader. Receipt, usage and disposal of trial medication must be 
documented on the appropriate forms. Account must be given for any discrepancies.


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4.2
OTHER TREATMENTS, EMERGENCY  PROCEDURES,
RESTRICTIONS
4.2.1
Other treatments and emergency procedures
There are no special emergency procedures to be followed. No additional treatment is 
planned. However, if adverse events require treatment, the investigator can authorise 
symptomatic therapy. In those cases, subjects will be treated as necessary and, if required, 
kept under supervision at the trial site or transferred to a hospital until all results of medical 
evaluations are acceptable.
4.2.2
Restrictions
4.2.2.1
Restrictions regarding concomitant treatment
In principle, no concomitant therapy is allowed. All concomitant or rescue therapies will be 
recorded (including time of intake on study days) on the appropriate pages of the CRF.
Known inhibitors/inducers of CYP3A as well as drugs with a known hepatotoxicity profile 
should be avoided during the entire study.
4.2.2.2
Restrictions on diet and life style
Poppy-seeds containing foods should not be consumed starting 3 days before the first drug 
administration in each treatment period, in order to avoid false-positive results in the drug 
screen.
While admitted to the trial site, the subjects will be instructed not to consume any foods or 
drinks other than those provided by the staff. Standardised meals will be served at the times
indicated in the Flow Chart.
No food is allowed within 10 h before and 4 h after intake of BI 730357.
Subjects will be advised to not consume any food within 9 h before and 1 h after itraconazole 
administration.
From 1 h before intake of BI 730357 on Day 1 of Period 1 until lunch, and from 1 h before 
intake of itraconazole on Day 1 of period 2 until lunch, fluid intake is restricted to the water 
administered with the drug, and an additional 240 mL of water at 2 h and 4 h post-dose 
(mandatory for all subjects). From lunch until 24 h post-dose, total fluid intake is restricted to
3000 mL.
Grapefruits, Seville oranges (sour or bitter oranges) and their juices, and dietary supplements 
and products containing St. John's wort (Hypericum perforatum) are not permitted from 
7 days before the first administration of trial medication in Period 1 until after the last PK 
sample of Period 2 is collected.
Alcoholic beverages are not permitted from 2 days before the first administration of trial 
medication in period 1 until after the last PK sample in period 2 is collected.
Methylxanthine-containing drinks or foods (such as coffee, tea, cola, energy drinks, or 
chocolate) are not allowed from 10 h before until 24 h after administration of BI 730357.


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Smoking is not allowed during in-house confinement while admitted to the trial site.
Excessive physical activity (such as competitive sport) should be avoided from 7 days before 
the first administration of trial medication until the end of trial examination.
Direct exposure to the sun or exposure to solarium radiation, treatment with ultraviolet light 
(e.g. PUVA), or medication with known phototoxicity potential (e.g, doxycycline) should be 
avoided from the first administration of trial medication until the EoTrial examination. The 
use of sunscreens is mandatory in that time.
4.3
TREATMENT COMPLIANCE
Compliance will be assured by administration of all trial medication in the study centre under 
supervision of the investigating physician or a designee. The measured plasma concentrations 
of trial medication will provide additional confirmation of compliance.
Subjects who are non-compliant (for instance, who do not appear for scheduled visits or 
violate trial restrictions) may be removed from the trial and the CRF will be completed 
accordingly (for further procedures, please see Section 3.3.4.1).


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5.
ASSESSMENTS
5.1
ASSESSMENT OF EFFICACY
Not applicable.
5.2
ASSESSMENT OF SAFETY
5.2.1
Physical examination
At screening, the medical examination will include demographics, height and body weight, 
smoking and alcohol history, relevant medical history and concomitant therapy, review of 
inclusion and exclusion criteria, review of vital signs (BP, PR), 12-lead ECG, laboratory 
tests, and a physical examination. At the end of trial examination, it will include review of 
vital signs, 12-lead ECG, laboratory tests, and a physical examination.
5.2.2
Vital signs
Systolic and diastolic blood pressures (BP) as well as pulse rate (PR) will be measured by a 
blood pressure monitor (Dinamap Pro 100, GE Medical Systems, Freiburg, Germany) at the 
times indicated in the Flow Chart, after subjects have rested for at least 5 min in a supine 
position. All recordings should be made using the same type of blood pressure recording 
instrument on the same arm, if possible.
5.2.3
Safety laboratory parameters
For the assessment of laboratory parameters, blood and urine samples will be collected by the 
trial site at the times indicated in the Flow Chart after the subjects have fasted for at least 
10 h. For retests, at the discretion of the investigator or designee, overnight fasting is not 
required.
The parameters that will be determined are listed in Tables 5.2.3: 1 and 5.2.3: 2. Reference 
ranges will be provided in the ISF, Section 10. 
Manual differential white blood cell count or urine sediment examinations will only be 
performed if there is an abnormality in the automatic blood cell count or in the urinalysis, 
respectively.


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Table 5.2.3: 1
Routine laboratory tests
Functional lab group
BI test name [comment/abbreviation]
A1
B1
C1
D1
Haematology
Haematocrit
Haemoglobin
Red Blood Cell Count/Erythrocytes 
White Blood Cells/Leucocytes
Platelet Count/Thrombocytes (quant)
X
X
X
X
X
X
X
X
X
X
--
--
--
--
--
X
X
X
X
X
Automatic WBC 
differential, relative
Neutrophils/Leukocytes; Eosinophils/Leukocytes; Basophils/ 
Leukocytes; Monocytes/Leukocytes; 
Lymphocytes/Leukocytes 
X
X
--
X
Automatic WBC 
differential, absolute 
Neutrophil, absol.; Eosinophils, absol.; Basophils, absol.; 
Monocytes, absol.; Lymphocytes, absol.
X
X
--
X
Manual differential 
WBC (if automatic
differential WBC is 
abnormal)
Neut. Poly (segs); Neut. Poly (segs), absol.; Neutrophils 
Bands;  Neutrophils Bands, absol.; Eosinophils/Leukocytes; 
Eosinophils, absol.; Basophils/ Leukocytes; Basophils, absol.; 
Monocytes/ Leukocytes; Monocytes, absol.; 
Lymphocytes/Leukocytes; Lymphocytes, absol.
Coagulation
Activated Partial Thromboplastin Time
Prothrombin time
Prothrombin time - INR (International Normalization Ratio)
X
X
X
X
X
X
--
--
--
X
X
X
Enzymes
AST [Aspartate transaminase] /GOT, SGOT 
ALT [Alanine transaminase] /GPT, SGPT
Alkaline Phosphatase
Gamma-Glutamyl Transferase 
Glutamate Dehydrogenase (GLDH)
Creatine Kinase [CK]
Creatine Kinase Isoenzyme MB [only if CK is elevated] 
Lipase
X
X
X
X
X
X
X
X
X
X
X
X
X
--
--
--
X
X
X
X
X
--
--
--
X
X
X
X
X
X
X
X
Hormones
Thyroid Stimulating Hormone 
X
--
--
--
Substrates
Glucose (Plasma)
Creatinine 
Bilirubin, Total 
Bilirubin, Direct
Protein, Total
C-Reactive Protein (Quant)  
Cholesterol, total 
Triglyceride
X
X
X
X
X
X
X
X
X
X
X
X
X
X
--
--
--
--
--
--
--
--
--
--
X
X
X
X
X
X
X
X
Electrolytes
Sodium
Potassium
X
X
X
X
--
--
X
X
Urinalysis (Stix) 2
Urine Nitrite (qual)
Urine Protein (qual)
Urine Glucose (qual)
Urine Ketone (qual)
Urobilinogen (qual)
Urine Bilirubin (qual)
Urine RBC/Erythrocytes (qual)
Urine WBC/Leucocytes (qual)
Urine pH
X
X
X
X
X
X
X
X
X
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
X
X
X
X
X
X
X
X
X
Urine sediment 2
Only positive findings will be reported (for instance, the 
presence of sediment bacteria, casts in sediment, squamous 
epithelial cells, erythrocytes, leukocytes)
1 A, B, C and D are different sets of laboratory values. The Flow Chart details at which time point which set is 
to be investigated.
2 Microscopic examination if erythrocytes, leukocytes, nitrite or protein are abnormal in urine


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The tests listed in Table 5.2.3: 2 are exclusionary laboratory tests that may be repeated as 
required. The results will not be entered in the CRF/database and will not be reported in the 
CTR. Except for drug screening, it is planned to perform these tests during screening only. 
Drug screening will be performed at screening and prior to first dosing in each treatment 
period.
Table 5.2.3: 2
Exclusionary laboratory tests
Functional lab group
Test name 
Drug screening (urine)
Amphetamine/MDA
Barbiturates
Benzodiazepine
Cannabis
Cocaine 
Methadone
Methamphetamines/MDMA/XTC
Opiates 
Phencyclidine
Tricyclic antidepressants
Infectious serology (blood)
Hepatitis B surface antigen (qualitative)
Hepatitis B core antibody (qualitative)
Hepatitis C antibodies (qualitative)
HIV-1 and HIV-2 antibody (qualitative)
Interferon-γ release assay to tuberculosis (qualitative), e.g.  
QuantiFERON®-TB Gold Test
To encourage compliance with alcoholic restrictions, a breath alcohol test (e.g. Alcotest®
7410, Dräger AG, Lübeck, Germany) will be performed prior to drug administration on 
Day 1 of treatment period 1 and on Day -3 of treatment period 2, and may be repeated at any 
time during the study at the discretion of an investigator or designee. The results will not be 
included in the CTR.
The laboratory tests listed in Tables 5.2.3: 1 and 5.2.3: 2 will be performed at MVZ Labor 
Ravensburg GbR, Elisabethenstraße 11, 88212 Ravensburg, Germany, with the exception of 
drug screening tests. These tests will be performed at the trial site using AccuSign® DOA 10 
test, or comparable test systems.
Laboratory data will be transmitted electronically from the laboratory to the trial site.
5.2.4
Electrocardiogram
Twelve-lead ECGs (I, II, III, aVR, aVL, aVF, V1 - V6) will be recorded using a 
computerised electrocardiograph (CardioSoft EKG System, GE Medical Systems, Freiburg, 
Germany) at the times provided in the Flow Chart.
To achieve a stable heart rate at rest and to assure high quality recordings, the site personnel 
will be instructed to assure a relaxed and quiet environment, so that all subjects are at 
complete rest.


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All ECGs will be recorded for a 10 sec duration after subjects have rested for at least 5 min in
a supine position. ECG assessment will always precede all other study procedures scheduled 
for the same time to avoid compromising ECG quality. 
All ECGs will be stored electronically on the Muse CV Cardiology System (GE Medical 
Systems, Freiburg, Germany). Electrode placement will be performed according to the 
method of Wilson, Goldberger and Einthoven modified by Mason and Likar (hips and 
shoulders instead of ankles and wrists). 
All locally printed ECGs will be evaluated by the investigator or a designee. Abnormal 
findings will be reported as AEs (during the trial) or baseline conditions (at screening) if 
assessed to be clinically relevant by the investigator. Any ECG abnormalities will be 
carefully monitored and, if necessary, the subject will be removed from the trial and will 
receive the appropriate medical treatment. 
ECGs may be repeated for quality reasons (for instance, due to alternating current artefacts, 
muscle movements, or electrode dislocation) and the repeated ECG will be used for analysis. 
Additional (unscheduled) ECGs may be collected by the investigator for safety reasons. 
5.2.5
Other safety parameters
Not applicable.
5.2.6
Assessment of adverse events
5.2.6.1
Definitions of adverse events
Adverse event
5.2.6.1.1
An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical 
investigation subject administered a medicinal product and which does not necessarily have 
to have a causal relationship with this treatment.
An AE can therefore be any unfavourable and unintended sign (including an abnormal 
laboratory finding), symptom, or disease temporally associated with the use of a medicinal 
product, whether or not considered related to the medicinal product.
The following should also be recorded as an AE in the CRF and BI SAE form (if applicable):

Worsening of the underlying disease or of other pre-existing conditions 

Changes in vital signs, ECG, physical examination, and laboratory test results, if they 
are judged clinically relevant by the investigator
If such abnormalities already pre-exist prior to trial inclusion, they will be considered as 
baseline conditions and should be collected in the eCRF only.
Serious adverse event
5.2.6.1.2
A serious adverse event (SAE) is defined as any AE which fulfils at least one of the 
following criteria:

Results in death 


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
Is life-threatening, which refers to an event in which the patient was at risk of death 
at the time of the event; it does not refer to an event that hypothetically might have 
caused death if more severe 

Requires inpatient hospitalisation  

Requires prolongation of existing hospitalisation

Results in persistent or significant disability or incapacity 

Is a congenital anomaly/birth defect 

Is deemed serious for any other reason if it is an important medical event when based 
upon appropriate medical judgment which may jeopardise the patient and may 
require medical or surgical intervention to prevent one of the other outcomes listed in 
the above definitions. Examples of such events are intensive treatment in an 
emergency room or at home for allergic bronchospasm, blood dyscrasias or 
convulsions that do not result in hospitalisation or development of dependency or 
abuse
AEs considered ‘Always Serious’
5.2.6.1.3
Cancers of new histology and exacerbations of existing cancer must be classified as a serious 
event regardless of the time since discontinuation of the trial medication and must be reported 
as described in 5.2.6.2, subsections ‘AE Collection’ and ‘AE reporting to sponsor and 
timelines’.
In accordance with the European Medicines Agency initiative on Important Medical Events, 
Boehringer Ingelheim has set up a list of further AEs, which, by their nature, can always be 
considered to be ‘serious’ even though they may not have met the criteria of an SAE as 
defined above.
The latest list of ‘Always Serious AEs’ can be found in the eDC system, an electronic data 
capture system which allows the entry of trial data at the trial site. These events should 
always be reported as SAEs as described above.
Adverse events of special interest
5.2.6.1.4
The term adverse events of special interest (AESI) relates to any specific AE that has been 
identified at the project level as being of particular concern for prospective safety monitoring 
and safety assessment within this trial, e.g. the potential for AEs based on knowledge from 
other compounds in the same class. AESIs need to be reported to the sponsor’s 
Pharmacovigilance Department within the same timeframe that applies to SAEs, please see 
section 5.2.6.2.2.
The following are considered as AESIs:

Hepatic injury
A hepatic injury is defined by the following alterations of hepatic laboratory 
parameters: 


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o
An elevation of AST (aspartate transaminase) and/or ALT (alanine 
transaminase) ≥3-fold ULN combined with an elevation of total bilirubin 
≥2-fold ULN measured in the same blood sample, or
o
Aminotransferase (ALT, and/or AST) elevations ≥10 fold ULN
These lab findings constitute a hepatic injury alert and the subjects showing these lab 
abnormalities need to be followed up according to the ‘DILI checklist’ provided in the 
ISF. In case of clinical symptoms of hepatic injury (icterus, unexplained 
encephalopathy, unexplained coagulopathy, right upper quadrant abdominal pain, 
etc.) without lab results (ALT, AST, total bilirubin) available, the Investigator should 
make sure that these parameters are analysed, if necessary in an unscheduled blood 
test. Should the results meet the criteria of hepatic injury alert, the procedures 
described in the DILI checklist should be followed.

Severe infections (grading according to Rheumatology Common Toxicity Criteria 
(RCTC) developed by OMERACT [R13-3515])

Opportunistic and mycobacterium tuberculosis infections
These include pneumocystis jirovecii, BK virus disease including polyomavirus-
associated nephropathy, cytomegalovirus, posttransplant lymphoproliferative disorder 
(Epstein-Barr virus), progressive multifocal leukoencephalopathy, bartonellosis 
(disseminated only), blastomycosis, toxoplasmosis, coccidioidomycosis, 
histoplasmosis, aspergillosis (invasive only), candidiasis (invasive or pharyngeal), 
cryptococcosis, other invasive fungi (mucormycosis (zygomycosis, rhizopus, mucor, 
lichtheimia), scedosporium/pseudallescheria boydii, fusarium), legionellosis, listeria 
monocytogenes (invasive only), tuberculosis, nocardiosis, non-tuberculous 
mycobacterium, salmonellosis (invasive only), hepatitis B virus reactivation, herpes 
simplex (invasive only), herpes zoster, strongyloides (hyperinfection syndrome and 
disseminated forms only), paracoccidioides, penicillium marneffei, sporothrix 
schenckii, cryptosporidium species (chronic only), microsporidiosis, leishmaniasis 
(visceral only), trypanosoma cruzi Infection (Chagas’ disease) (disseminated only), 
campylobacteriosis (invasive only), shigellosis (invasive only), vibriosis (invasive due 
to vibrio vulnificus), hepatitis C virus progression.
Intensity (severity) of AEs
5.2.6.1.5
The intensity (severity) of the AE should be judged based on the following:
Mild:
Awareness of sign(s) or symptom(s) that is/are easily tolerated
Moderate:
Sufficient discomfort to cause interference with usual activity
Severe:
Incapacitating or causing inability to work or to perform usual activities
Causal relationship of AEs
5.2.6.1.6
Medical judgment should be used to determine the relationship, considering all relevant 
factors, including pattern of reaction, temporal relationship, de-challenge or re-challenge, 
confounding factors such as concomitant medication, concomitant diseases and relevant 
history.


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Arguments that may suggest that there is a reasonable possibility of a causal relationship 
could be:

The event is consistent with the known pharmacology of the drug 

The event is known to be caused by or attributed to the drug class

A plausible time to onset of the event relative to the time of drug exposure

Evidence that the event is reproducible when the drug is re-introduced

No medically sound alternative aetiologies that could explain the event (e.g. pre-
existing or concomitant diseases, or co-medications)

The event is typically drug-related and infrequent in the general population not 
exposed to drugs (e.g. Stevens-Johnson syndrome)

An indication of dose-response (i.e. greater effect size if the dose is increased, smaller 
effect size if dose is reduced)
Arguments that may suggest that there is no reasonable possibility of a causal relationship 
could be:

No plausible time to onset of the event relative to the time of drug exposure is evident 
(e.g. pre-treatment cases, diagnosis of cancer or chronic disease within days / weeks 
of drug administration; an allergic reaction weeks after discontinuation of the drug 
concerned)

Continuation of the event despite the withdrawal of the medication, taking into 
account the pharmacological properties of the compound (e.g. after 5 half-lives). Of 
note, this criterion may not be applicable to events whose time course is prolonged 
despite removing the original trigger

Additional arguments amongst those stated before, like alternative explanation (e.g. 
situations where other drugs or underlying diseases appear to provide a more likely 
explanation for the observed event than the drug concerned)

Disappearance of the event even though the trial drug treatment continues or remains 
unchanged
5.2.6.2
Adverse event collection and reporting
AE collection
5.2.6.2.1
Upon enrolment into a trial, the subject’s baseline condition is assessed (for instance, by 
documentation of medical history/concomitant diagnoses), and relevant changes from 
baseline are noted subsequently. 
Subjects will be required to report spontaneously any AEs as well as the time of onset, end
time, and intensity of these events. In addition, each subject will be regularly assessed by the 
medical staff throughout the clinical trial and whenever the investigator deems necessary. As 
a minimum, subjects will be questioned for AEs (and concomitant therapies) at the time 
points indicated in the Flow Chart. Assessment will be made using non-specific questions 
such as ‘How do you feel?’. Specific questions will be asked wherever necessary in order to 
more precisely describe an AE.


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A carefully written record of all AEs shall be kept by the investigator in charge of the trial. 
Records of AEs shall include data on the time of onset, end time, intensity of the event, and 
any treatment or action required for the event and its outcome.
The following must be collected and documented on the appropriate CRF(s) by the 
investigator:

From signing the informed consent onwards until an individual subject’s end of trial: 
o
All AEs (serious and non-serious) and all AESIs 
o
The only exception to this rule are AEs (serious and non-serious) and AESIs 
in Phase I trials in healthy volunteers, when subjects discontinue from the trial 
due to screening failures prior to administration of any trial medication. In 
these cases, the subjects’ data must be collected at trial site but will not be 
entered in the CRF or trial database and will not be reported in the CTR.

After the individual subject’s end of trial: 
o
The investigator does not need to actively monitor the subject for AEs but 
should only report any occurrence of cancer and related SAEs and related 
AESIs of which the investigator may become aware of by any means of 
communication, e.g. phone call. Those AEs should, however, not be reported 
in the CRF.
AE reporting to the sponsor and timelines
5.2.6.2.2
The Investigator must report SAEs, AESIs, and non-serious AEs which are relevant for the 
reported SAE or AESI, on the BI SAE form via fax immediately (within 24 hours) to the 
sponsor’s unique entry point (country specific contact details will be provided in the ISF). 
The same timeline applies if follow-up information becomes available. In specific occasions 
the Investigator could inform the sponsor upfront via telephone. This does not replace the 
requirement to complete and fax the BI SAE form. 
With receipt of any further information to these events, a follow-up SAE form has to be 
provided. For follow-up information, the same rules and timeline apply as for initial 
information.
Information required
5.2.6.2.3
All (S)AEs, including those persisting after the individual subject’s end of trial, must be 
followed up until they have resolved, have been sufficiently assessed as ‘chronic’ or ‘stable’, 
or no further information can be obtained.


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5.3
DRUG CONCENTRATION MEASUREMENTS AND 
PHARMACOKINETICS
5.3.1
Assessment of pharmacokinetics
For the assessment of pharmacokinetics, blood samples will be collected at the time points 
indicated in the Flow Chart. The actual sampling times will be recorded and used for 
determination of pharmacokinetic parameters. 
5.3.2
Methods of sample collection
5.3.2.1
Blood sampling for pharmacokinetic analysis
BI 730357
For quantification of BI 730357
in plasma, 2.7 mL of blood will 
be drawn from an antecubital or forearm vein into an K2-EDTA (dipotassium 
ethylenediaminetetra-acetic acid)-anticoagulant blood drawing tube at the times indicated in 
the Flow Chart. Blood will be withdrawn by means of either an indwelling venous catheter or 
by venipuncture with a metal needle.
The EDTA-anticoagulated blood samples will be centrifuged for approximately 10 min at 
approximately 2000 g to 4000 g and at 4 to 8 °C. Two plasma aliquots will be obtained and 
stored in polypropylene tubes. The first aliquot should contain at least 0.5 mL of plasma. The 
process from blood collection until transfer of plasma aliquots into the freezer should be 
completed within 90 min, with interim storage of blood samples and aliquots at room 
temperature avoiding exposure to direct sunlight. The time each aliquot was placed in the 
freezer will be documented. Until transfer on dry ice to the analytical laboratory, the aliquots 
will be stored upright at approximately -20°C or below at the trial site. The second aliquot 
will be transferred to the analytical laboratory after the bioanalyst has acknowledged safe 
arrival of the first aliquot. At the analytical laboratory, the plasma samples will be stored at 
approximately -20 °C or below until analysis. 
At a minimum, the sample tube labels should list BI trial number, subject number, visit, 
planned sampling time, and the analyte (e.g. ‘BI 730357
).


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Further use
After completion of the quantification of BI 730357, 
 in plasma, the 
left-over and/or back-up aliquot may be used for further methodological investigations, e.g. 
for stability testing
(including, if applicable, re-analysis 
of parent compound). However, only data related to the analyte
 
 will be generated by these additional 
investigations. The study samples will be discarded after completion of the additional 
investigations but not later than 5 years after the CTR is archived.
The results of any further investigations are not planned to be part of the CTR but can be 
included into the CTR if necessary.
5.3.3
Analytical determinations
5.3.3.1
Analytical determination of analyte plasma concentration
Concentrations of BI 730357, 
 in plasma 
will be determined by validated LC-MS/MS (liquid chromatography tandem mass 
spectrometry) assays. All details of the analytical methods will be available prior to the start 
of sample analysis. 
5.4
ASSESSMENT OF BIOMARKER(S) 
Not applicable.
5.5
BIOBANKING
Not applicable.
5.6
OTHER ASSESSMENTS
5.6.1
Pharmacogenomic evaluation
Pharmacogenomic investigations explore the role of genetic variation in determining an 
individual’s response to drugs. For this purpose, a sample of at most 10 mL of blood will be 
obtained at the screening examination from each subject whose genotype has not been 
previously determined. Separate informed consent for genotyping will be obtained from each 
volunteer prior to sampling.
DNA will be extracted from the blood sample in order to sequence genes coding for proteins 
that are involved in the absorption, distribution, metabolism, and excretion (ADME) of drugs. 


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The gene sequences to be determined include known and likely functional variations of key 
ADME genes and incorporate more than 90% of ADME-related genetic markers identified by 
the PharmaADME group (weblink.pharmaadme.org). It is not intended to include the 
pharmacogenomic data in the CTR. However, the data may be part of the CTR, if necessary.
5.7
APPROPRIATENESS OF MEASUREMENTS
All measurements performed during this trial are standard measurements and will be 
performed in order to monitor subjects’ safety and to determine pharmacokinetic parameters 
in an appropriate way. The scheduled measurements will allow monitoring of changes in vital 
signs, standard laboratory values, and ECG parameters that might occur as a result of 
administration of trial medication. The safety assessments are standard, are accepted for 
evaluation of safety and tolerability of an orally administered drug, and are widely used in 
clinical trials. The pharmacokinetic parameters and measurements outlined in Sections 2.1.2, 
2.1.3, 2.2.2.1, and 5.3 are generally used assessments of drug exposure.


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6.
INVESTIGATIONAL PLAN
6.1
VISIT SCHEDULE
Exact times of measurements outside the permitted time windows will be documented. The 
acceptable time windows for screening and the end of trial examination are provided in the 
Flow Chart.
Study measurements and assessments scheduled to occur ‘before’ trial medication 
administration are to be performed and completed within a 3h-period prior to BI 730357 
administration in Visit 2, and within a 2h-period prior to the next itraconazole administration 
in Visit 3, if not indicated otherwise in the Flow Chart.
Following administration of trial drugs in Visits 2 and 3, the acceptable deviation from the 
scheduled time for vital signs, ECG, and laboratory tests will be ± 30 min on Day 1, ± 45 min 
on Day 2, and ± 60 min from Day 3 onwards.
If scheduled in the Flow Chart at the same time as a meal, blood sampling, vital signs, and 
12-lead ECG recordings have to be done first. Furthermore, if several measurements 
including venepuncture are scheduled for the same time, venepuncture should be the last of 
the measurements due to its inconvenience to the subject and possible influence on 
physiological parameters.
For planned blood sampling times, refer to the Flow Chart. While these nominal times should 
be adhered to as closely as possible, the actual sampling times will be recorded and used for 
the determination of pharmacokinetic parameters.
Starting from 119 hours after BI 730357 administration (and beyond), a time window of 
± 60 min will be allowed for PK blood sampling times.
If a subject misses an appointment, it will be rescheduled if possible. The relevance of 
measurements outside the permitted time windows will be assessed no later than at the Report 
Planning Meeting.
6.2
DETAILS OF TRIAL PROCEDURES AT SELECTED VISITS
6.2.1
Screening period
After having been informed about the trial, all subjects will provide written informed consent 
in accordance with GCP and local legislation prior to enrolment in the study.
For information regarding laboratory tests (including drug and virus screening), ECG, vital 
signs, and physical examination, refer to Sections 5.2.3 to 5.2.5.
Genotyping will be performed in those volunteers whose genotypes have not been previously 
determined (for details, see Section 5.3).
6.2.2
Treatment periods
Each subject is expected to participate in 2 treatment periods. At least 10 days will separate 
administrations of BI 730357 in the first and second treatment period.


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On Day 1 of each treatment period, study participants will be admitted to the trial site and 
kept under close medical surveillance for at least 24 h following administration of BI 730357.
The subjects will then be allowed to leave the trial site after formal assessment and 
confirmation of their fitness. On all other study days, subjects will be treated in an 
ambulatory fashion.
For details on time points and procedures for collection of plasma samples for PK analysis, 
refer to Flow Chart and Section 5.3.2.
The safety measurements performed during the treatment period are specified in Section 5.3
of this protocol and in the Flow Chart. For details on times of all other trial procedures, refer 
to the Flow Chart. AEs and concomitant therapy will be assessed continuously from 
screening until the end of trial examination.
6.2.3
Follow-up period and trial completion
For AE assessment, laboratory tests, recording of ECG and vital signs, and physical 
examination during the follow-up period, see Sections 5.2.2 to 5.2.5.
Subjects who discontinue treatment before the end of the planned treatment period should 
undergo the EoTrial Visit.
All abnormal values (including laboratory parameters) that are assessed as clinically relevant 
by the investigator will be monitored using the appropriate tests until a return to a medically 
acceptable level is achieved. (S)AEs persisting after a subject’s EoTrial Visit must be 
followed until they have resolved, have been sufficiently characterised, or no further 
information can be obtained. 


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7.
STATISTICAL METHODS AND DETERMINATION OF
SAMPLE SIZE
7.1
STATISTICAL DESIGN – MODEL
The main objective of this trial is to investigate the relative bioavailability of BI 730357 in 
plasma when given as oral single dose together with multiple oral doses of itraconazole 
(Test, T) as compared to when given alone as oral single dose (Reference, R) on the basis of 
the primary and secondary pharmacokinetic endpoints, as listed in Section 2.1.2 and 2.1.3.
The trial is designed to allow intra-subject comparisons and will be evaluated statistically by 
use of a linear model for logarithmically transformed PK endpoints.
A further objective is to evaluate and compare further pharmacokinetic parameters between 
the treatments, see Section 2.2.1. These further pharmacokinetic parameters will be assessed 
by descriptive statistics.
The assessment of safety and tolerability is a further objective of this trial, and will be 
evaluated by descriptive statistics for the parameters specified in Section 2.2.2.2.
7.2
NULL AND ALTERNATIVE HYPOTHESES
The relative bioavailability of BI 730357 in plasma after test versus reference treatment will 
be estimated by the ratios of the geometric means (test/reference), and their corresponding 2-
sided 90% confidence intervals (CIs) will be provided. This method corresponds to the two 
one-sided t-tests procedure, each at the 5% significance level. Since the main focus is on 
estimation and not testing, a formal hypothesis test and associated acceptance range is not 
specified.
7.3
PLANNED ANALYSES
Analysis sets
Statistical analyses will be based on the following analysis sets:

Treated set (TS): The treated set includes all subjects who were entered and treated 
with at least one dose of study drug. The treated set will be used for safety analyses.
Pharmacokinetic parameter analysis set (PKS): This set includes all subjects in the 
treated set (TS) who provide at least one PK endpoint that was defined as primary or 
secondary and was not excluded due to a protocol deviation relevant to the evaluation 
of PK or due to PK non-evaluability (as specified in the following subsection 
‘Pharmacokinetics’). Thus, a subject will be included in the PKS, even if he 
contributes only one PK parameter value for one period to the statistical assessment.
Descriptive and model based analyses of PK parameters will be based on the PKS.
Adherence to the protocol will be assessed by the trial team. Important protocol deviation
(IPD) categories will be suggested in the IQRM plan, IPDs will be identified no later than in 
the Report Planning Meeting, and the IPD categories will be updated as needed.


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Pharmacokinetics
The pharmacokinetic parameters listed in Section 2.1 for drug BI 730357 will be calculated
by means of non-compartmental analysis. Noncompartmental pharmacokinetic parameters 
will be calculated based on actual sampling times using a validated pharmacokinetic software 
(Phoenix® WinNonlin® 6.3). Descriptive statistics will be used to evaluate plasma 
concentration data and PK parameters. The derivation of PK parameters is described in BI
internal SOP (001-MCS-36-472_RD-01). Further details on analysis will be described in the
TSAP. 
Plasma concentration data and parameters of a subject will be included in the statistical 
pharmacokinetic (PK) analyses if they are not flagged for exclusion due to a protocol 
deviation relevant to the evaluation of PK (to be decided no later than in the Report Planning 
Meeting) or due to PK non-evaluability (as revealed during data analysis, based on the 
criteria specified below). Exclusion of a subject’s data will be documented in the CTR.
Relevant protocol deviations may be

Incorrect trial medication taken, i.e. the subject received at least one dose of trial
medication the subject was not assigned to

Incorrect dose of trial medication taken

Use of restricted medications
Plasma concentrations and/or parameters of a subject will be considered as non-evaluable, if 
for example

The subject experienced emesis that occurred at or before two times median tmax of 
the respective treatment (Median tmax is to be determined excluding the subjects 
experiencing emesis), 

A predose concentration of BI 730357 is >5% Cmax value of that subject in the 
respective treatment period

Missing samples/concentration data at important phases of PK disposition curve
Plasma concentration data and parameters of a subject which is flagged for exclusion will be 
reported with its individual values but will not be included in the statistical analyses. 
Descriptive and inferential statistics of PK parameters will be based on the PKS.
Only concentration values within the validated concentration range and actual sampling times 
will be used for the calculation of pharmacokinetic parameters. Concentrations used in the 
pharmacokinetic calculations will be in the same format provided in the bioanalytical report, 
(that is, to the same number of decimal places provided in the bioanalytical report). 
7.3.1
Primary endpoint analyses
Primary analyses
The primary endpoints (refer to Section 2.1.2) will be calculated according to the BI Standard 
Operating Procedure (SOP) ‘Standards and processes for analyses performed within Clinical 
Pharmacokinetics/ Pharmacodynamics’ (001-MCS-36-472).


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The statistical model used for the analysis of the primary endpoints will be an analysis of 
variance (ANOVA) model on the logarithmic scale. That is, the PK endpoints will be log-
transformed (natural logarithm) prior to fitting the ANOVA model. This model will include 
effects accounting for the following sources of variation: subjects and treatment. The effect 
‘subject’ will be considered as random, whereas ‘treatment’ will be considered as fixed. The 
model is described by the following equation:
ykm = + sm + k + ekm, where
ykm = logarithm of response measured on subject m receiving treatment k ,
= the overall mean,
sm = the effect associated with the mth subject, m = 1, 2, ..., n
k = the kth treatment effect, k = 1, 2,
ekm = the random error associated with the mth subject who received treatment k.
where s ~ N(0, σ
) i.i.d., e ~ N(0, σ
 ) i.i.d. and sm, ekm are independent random 
variables.
Point estimates for the ratios of the geometric means (test/reference) for the primary 
endpoints (see Section 2.1) and their two-sided 90% confidence intervals (CIs) will be 
provided.
For each endpoint, the difference between the expected means for log(T)-log(R) will be 
estimated by the difference in the corresponding adjusted means (Least Squares Means).
Additionally their two-sided 90% confidence intervals will be calculated based on the 
residual error from the ANOVA and quantiles from the t-distribution. These quantities will 
then be back-transformed to the original scale to provide the point estimate and 90% CIs for 
each endpoint.
Further exploratory analyses
The same statistical model as stated above will be repeated for the primary endpoints but with 
‘subject’ considered as fixed effects.
In addition to the model based approach all parameters will be calculated and analysed 
descriptively.
7.3.2
Secondary endpoint analyses
The secondary endpoints (refer to Section 2.1.3) will be calculated according to the BI SOP 
‘Standards and processes for analyses performed within Clinical Pharmacokinetics/ 
Pharmacodynamics’ (001-MCS-36-472) and will be assessed statistically using the same 
methods as described for the primary endpoints.


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7.3.4
Safety analyses
Safety will be analysed based on the assessments described in Section 2.2.2.2. All treated 
subjects (TS, refer to Section 7.3) will be included in the safety analysis. Safety analyses will 
be descriptive in nature and based on BI standards. No hypothesis testing is planned.
For all analyses, the treatment actually administered (= treatment at onset) to the subject will 
be used (any deviations from the randomised treatment will be discussed in the minutes of the 
Report Planning Meeting).
Treatments will be compared in a descriptive way. Tabulations of frequencies/proportions 
will be used to evaluate categorical (qualitative) data, and tabulations of descriptive statistics 
will be used to analyse continuous (quantitative) data.
Measurements (such as ECG, vital signs, or laboratory parameters) or AEs will be assigned to 
treatments (see Section 4.1) based on the actual treatment at the planned time of the 
measurement or on the recorded time of AE onset (concept of treatment emergent AEs).
Therefore, measurements planned or AEs recorded prior to first intake of trial medication will 
be assigned to the screening period, those between first trial medication intake and end of 
REP (see Section 1.2.3) will be assigned to the treatment period. Events occurring after the 
REP but prior to next intake or end of trial termination date will be assigned to ’follow-up’. 
In case of two or more treatments, the follow-up will be summarized according to the 
previous treatment. These assignments including the corresponding time intervals will be 
defined in detail in the TSAP. Note that AEs occurring after the last per protocol contact but 
entered before final database lock will be reported to Pharmacovigilance only and will not be 
captured in the trial database.
Additionally, further treatment intervals (analysing treatments) may be defined in the TSAP 
in order to provide summary statistics for time intervals, such as combined treatments, on-
treatment totals, or periods without treatment effects (such as screening and follow-up 
intervals).
Adverse events will be coded using the Medical Dictionary for Regulatory Activities 
(MedDRA). Frequency, severity, and causal relationship of AEs will be tabulated by 
treatment, system organ class, and preferred term. SAEs, AESIs (see Section 5.2.6.1), and
other significant AEs (according to ICH E3) will be listed separately.
Previous and concomitant therapies will be presented per treatment group without 
consideration of time intervals and treatment periods.
Laboratory data will be compared to their reference ranges. Values outside the reference 
range as well as values defined as possibly clinically significant will be highlighted in the 
listings. 
Relevant ECG findings will be reported as AEs.


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7.4
INTERIM ANALYSES
No interim analysis is planned.
7.5
HANDLING OF MISSING DATA
7.5.1
Safety
It is not planned to impute missing values for safety parameters.
7.5.2
Pharmacokinetics
Handling of missing PK data will be performed according to the relevant Corporate 
Procedure (001-MCS-36-472).
PK parameters that cannot be reasonably calculated based on the available drug 
concentration-time data will not be imputed.
7.6
RANDOMISATION
In this trial subjects receive both treatments in the same order, thus no randomisation for the 
treatment assignment is performed (see also Section 4.1.3).The sponsor will arrange for the 
packaging and labelling of BI 730357 trial medication. The randomisation list is just needed 
for logistical reasons in this trial. The randomisation list will be generated using a validated 
system that uses a pseudo-random number generator and a supplied seed number so that the 
resulting allocation is both reproducible and non-predictable.
The randomisation list will contain additional blocks to allow for subject replacement (refer 
to Section 3.3.5).
7.7
DETERMINATION OF SAMPLE SIZE
It is planned to enter a total of 14 subjects in the trial, accounting for up to 2 non PK 
evaluable subjects. The planned sample size is not based on a power calculation but is 
considered sufficient to achieve the aims of this exploratory trial. With this sample size, the 
following precision in estimating the ratio of geometric means (test/reference) can be 
expected with 95% probability. Precision is defined as the ratio of upper CI limit to the 
relative BA estimate. Note that the precision is independent of the actual ratio of geometric 
means.
The intra-individual coefficient of variation (gCV) is estimated from inter-individual gCV 
from pharmacokinetic data of the SRD part of a previous trial (Study 1407-0001) using the 
result of 50 mg dose. The observed inter-individual gCV was 41.9% for Cmax and 51.5% for 
AUC0-tz. Assuming a within-subject correlation of 0.6 for Cmax and 0.8 for AUC0-tz, the 
estimated intra-individual gCV will roughly be 26% for Cmax and 22% for AUC0-tz. 
Assuming a gCV of 22% for BI 730357 and given a sample size of 12 subjects with 
evaluable data for primary analysis, the precision of the two-sided 90% confidence interval of 
the bioavailability ratio will be approximately 1.238, for a greater gCV of26%, the precision 
would still be approximately 1.285. Table 7.7: 1 provides an overview of the achievable 


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precision for estimating the ratio of geometric means (test/reference). For illustrative 
purposes, the expected 90% confidence intervals with 95% tolerance probability are 
displayed for different values of the ratios T/R of geometric means.
Table 7.7: 1
Precision that can be expected with 95% tolerance probability and 
illustrative two-sided 90% confidence intervals around the ratios of 
geometric means (T/R) for different gCVs in a one-way crossover
trial (N=12)
gCV [%]
Precision upper 
CL / relative BA 
estimate
Ratio [%]*
Lower CL [%]
Upper CL [%]
22
1.238
50
40.40
61.88
22
1.238
100
80.80
123.76
22
1.238
150
121.20
185.64
22
1.238
200
161.60
247.52
26
1.285
50
38.91
64.25
26
1.285
100
77.82
128.50
26
1.285
150
116.73
192.75
26
1.285
200
155.64
257.01
*Ratio of geometric means (test/reference) for a PK endpoint is defined by exp(T)/exp(R).
The expected 90% confidence interval limits in the table were derived by
CI limit, = exp(ln(θ) ± ω),
with θ being the ratio (T/R) on original scale and ω the distance from the estimate θ to either 
confidence interval limit on the log-scale, which was obtained from the achievable precision 
on the original scale.
The calculation was performed as described by Julious [R11-5230] using R Version 3.0.3.


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8.
INFORMED CONSENT, TRIAL RECORDS, DATA 
PROTECTION, PUBLICATION POLICY, AND 
ADMINISTRATIVE STRUCTURE
The trial will be carried out in compliance with the protocol, the ethical principles laid down 
in the Declaration of Helsinki, in accordance with the ICH Harmonized Guideline for Good 
Clinical Practice (GCP), relevant BI Standard Operating Procedures (SOPs), the EU 
regulation 536/2014, and other relevant regulations. Investigators and site staff must adhere 
to these principles.
Standard medical care (prophylactic, diagnostic, and therapeutic procedures) remains the 
responsibility of the subject’s treating physician.
The investigator will inform the sponsor immediately of any urgent safety measures taken to 
protect the trial subjects against any immediate hazard, as well as of any serious breaches of 
the protocol or of ICH GCP.
The Boehringer Ingelheim transparency and publication policy can be found on the following 
web page: trials.boehringer-ingelheim.com. As a general rule, no trial results should be 
published prior to archiving of the CTR.
The terms and conditions of the insurance coverage are made available to the investigator and 
the subjects, and are stored in the ISF.
8.1
TRIAL APPROVAL, SUBJECT INFORMATION, INFORMED CONSENT
This trial will be initiated only after all required legal documentation has been reviewed and 
approved by the respective Institutional Review Board (IRB / Independent Ethics Committee 
(IEC and competent authority (CA) according to national and international regulations. The 
same applies for the implementation of changes introduced by amendments.
Prior to a subject’s participation in the trial, written informed consent must be obtained from 
each subject (or the subject’s legally accepted representative) according to ICH-GCP and to 
the regulatory and legal requirements of the participating country. Each signature must be 
personally dated by each signatory and the informed consent and any additional subject-
information form retained by the investigator as part of the trial records. A signed copy of the 
informed consent and any additional subject information must be given to each subject or the 
subject’s legally accepted representative.
The subject must be given sufficient time to consider participation in the trial. The 
investigator or delegate obtains written consent of the subject’s own free will with the 
informed consent form after confirming that the subject understands the contents. The 
investigator or 
 delegate must sign (or place a seal on) and date the informed consent form. 
If a trial collaborator has given a supplementary explanation, the trial collaborator also signs 
(or places a seal on) and dates the informed consent.
Re-consenting may become necessary when new relevant information becomes available and 
should be conducted according to the sponsor’s instructions.
The consent and re-consenting process should be properly documented in the source 
documentation.


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8.2
DATA QUALITY ASSURANCE
A risk-based approach is used for trial quality management. It is initiated by the assessment 
of critical data and processes for trial subject protection and reliability of the results as well as 
identification and assessment of associated risks. An Integrated Quality and Risk 
Management Plan documents the rationale and strategies for risk management during trial 
conduct including monitoring approaches, vendor management and other processes focusing 
on areas of greatest risk. 
Continuous risk review and assessment may lead to adjustments in trial conduct, trial design 
or monitoring approaches. 
A quality assurance audit/inspection of this trial may be conducted by the sponsor, sponsor’s 
designees, or by IRB / IEC or by regulatory authorities. The quality assurance auditor will 
have access to all medical records, the investigator’s trial-related files and correspondence, 
and the informed consent documentation of this clinical trial..
8.3
RECORDS
CRFs for individual subjects will be provided by the sponsor. For drug accountability, refer 
to Section 4.1.8.
ClinBaseTM
In the Human Pharmacology Centre (HPC) – Boehringer Ingelheim's Phase I unit – the 
validated ClinBaseTM system is used for processing information and controlling data 
collected in clinical studies. In addition to its function as a procedure control system, 
ClinBaseTM serves as data base. Instead of being entered into CRFs, selected data are directly 
entered into the system.
8.3.1
Source documents
In accordance with regulatory requirements, the investigator should prepare and maintain 
adequate and accurate source documents and trial records for each trial subject that include 
all observations and other data pertinent to the investigation. Source data as well as reported 
data should follow the ‘ALCOA principles’ and be attributable, legible, contemporaneous, 
original, and accurate. Changes to the data should be traceable (audit trail).
Data reported on the CRF must be consistent with the source data or the discrepancies must 
be explained.
Before providing any copy of subjects’ source documents to the sponsor, the investigator 
must ensure that all subject identifiers (e.g., subject’s name, initials, address, phone number, 
and social security number) have properly been removed or redacted to ensure subject 
confidentiality.
If the subject is not compliant with the protocol, any corrective action (e.g. re-training) must 
be documented in the subject file.
For the CRF, data must be derived from source documents, for example:

Subject identification: sex, year of birth (in accordance with local laws and 
regulations)


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
Subject participation in the trial (substance, trial number, subject number, date subject 
was informed)

Dates of subject’s visits, including dispensing of trial medication

Medical history (including trial indication and concomitant diseases, if applicable)

Medication history

AEs and outcome events (onset date [mandatory], and end date [if available])

SAEs (onset date [mandatory], and end date [if available])

Concomitant therapy (start date, changes)

Originals or copies of laboratory results and other imaging or testing results, with 
proper documented medical evaluation (in validated electronic format, if available)

ECG results (original or copies of printouts)

Completion of subject’s participation in the trial (end date; in case of premature 
discontinuation, document the reason for it, if known)

Prior to allocation of a subject to a treatment into a clinical trial, there must be 
documented evidence in the source data (e.g. medical records) that the trial participant 
meets all inclusion criteria and does not meet any exclusion criteria. The absence of 
records (either medical records, verbal documented feedback of the subject or testing 
conducted specific for a protocol) to support inclusion/exclusion criteria does not 
make the subject eligible for the clinical trial.
Data directly entered into ClinBaseTM (that is, without prior written or electronic record) are 
considered to be source data. The place where data are entered first will be defined in a trial 
specific Source Data Agreement. The data in ClinBaseTM are available for inspection at any 
time.
8.3.2
Direct access to source data and documents
The investigator /institution will allow site trial-related monitoring, audits, IRB/IEC review 
and regulatory inspections. Direct access must be provided to the CRF and all source 
documents/data, including progress notes, copies of laboratory and medical test results, which 
must be available at all times for review by the Clinical Research Associate, auditor and 
regulatory inspector (e.g. FDA). They may review all CRFs and informed consents. The 
accuracy of the data will be verified by direct comparison with the source documents 
described in section 8.3.1. The sponsor will also monitor compliance with the protocol and 
GCP.
8.3.3
Storage period of records
Trial site:
The trial site(s) must retain the source and essential documents (including ISF) according to 
the local requirements valid at the time of the end of the trial.
Sponsor:
The sponsor must retain the essential documents according to the sponsor’s SOPs.


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8.4
EXPEDITED REPORTING OF ADVERSE EVENTS
BI is responsible to fulfil their legal and regulatory reporting obligation in accordance with 
regulatory requirements.
8.5
STATEMENT OF CONFIDENTIALITY AND SUBJECT PRIVACY
Individual subject data obtained as a result of this trial is considered confidential and 
disclosure to third parties is prohibited with the exceptions noted in section 8.7. 
Data protection and data security measures are implemented for the collection, storage and 
processing of patient data in accordance with the principles 6 and 12 of the WHO GCP 
handbook.
Personalised treatment data may be given to the subject’s personal physician or to other 
appropriate medical personnel responsible for the subject’s welfare. Data generated at the site 
as a result of the trial need to be available for inspection on request by the participating 
physicians, the sponsor’s representatives, by the IRB / IEC and the regulatory authorities.
8.5.1
Collection, storage and future use of biological samples and corresponding 
data
Measures are in place to comply with the applicable rules for the collection, biobanking and 
future use of biological samples and clinical data, in particular

Sample and data usage has to be in accordance with the separate biobanking informed 
consent

The BI-internal facilities storing biological samples from clinical trial participants as 
well as the external banking facility are qualified for the storage of biological samples 
collected in clinical trials.

An appropriate sample and data management system, incl. audit trail for clinical data 
and samples to identify and destroy such samples according to ICF is in place

A fit for the purpose documentation (biomarker proposal, analysis plan and report) 
ensures compliant usage

A fit for purpose approach will be used for assay/equipment validation depending on 
the intended use of the biomarker data
Samples and/or data may be transferred to third parties and other countries as specified in the 
biobanking ICF
8.6
TRIAL MILESTONES
The start of the trial is defined as the date of the enrolment of the first subject in the trial.
The end of the trial is defined as the ‘date of the last visit of the last subject in whole trial’ 
(‘Last Subject Completed’) or ‘end date of the last open AE’ or ‘date of the last follow-up 
test’ or ‘date of an AE has been decided as sufficiently followed-up’, whichever is latest.
Early termination of the trial is defined as the premature termination of the trial for any 
reason before the end of the trial as specified in this protocol.


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Temporary halt of the trial is defined as any unplanned interruption of the trial by the 
sponsor with the intention to resume it.
Suspension of the trial is defined as an interruption of the trial based on a Health Authority 
request.
The ethics committee/competent authority in each participating EU member state will be 
notified about the trial milestones according to the laws of each member state. 
A final report of the clinical trial data will be written only after all subjects have completed 
the trial in all countries (EU or non-EU), so that all data can be incorporated and considered 
in the report.
The sponsor will submit to the EU database a summary of the final trial results within one 
year from the end of a clinical trial as a whole, regardless of the country of the last patient 
(EU or non-EU).
8.7
ADMINISTRATIVE STRUCTURE OF THE TRIAL
The trial is sponsored by Boehringer Ingelheim (BI).
The trial will be conducted at the Human Pharmacology Centre (HPC) of BI Pharma GmbH 
& Co. KG, Biberach, Germany, under the supervision of the Principal Investigator. Relevant 
documentation on the participating (Principal) Investigators (e.g. their curricula vitae) will be 
filed in the ISF.
BI has appointed a Clinical Trial Leader (CT Leader), responsible for coordinating all 
required trial activities, in order to 

Manage the trial in accordance with applicable regulations and internal SOPs

Direct the clinical trial team in the preparation, conduct, and reporting of the trial

ensure appropriate training and information of Clinical Trial Manager (CT Manager), 
Clinical Research Associates, and investigators of participating trial sites
The trial medication will be provided by the Clinical Trial Supplies Unit, BI Pharma GmbH 
& Co. KG, Biberach, Germany (BI 730357) or will be obtained by the clinical trial site from 
a public pharmacy (itraconazole).
Safety laboratory tests will be performed by the local laboratory of the trial site
 
.
Analyses of BI 730357 and itraconazole concentrations in plasma will be performed under 
the responsibility of the Department of Drug Metabolism and Pharmacokinetics, BI Pharma 
GmbH & Co. KG, Biberach, Germany at suitable contract research organisations.
On-site monitoring will be performed by BI or a contract research organisation appointed by 
BI.
Data management and statistical evaluation will be done by BI or a contract research 
organization appointed by BI according to BI SOPs.
Tasks and functions assigned in order to organise, manage, and evaluate the trial are defined 
according to BI SOPs. A list of responsible persons and relevant local information can be 
found in the ISF.


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9.
REFERENCES 
9.1
PUBLISHED REFERENCES
P15-06298
Ministry of Health, Labour and Welfare. Drug interaction guideline for
drug  development and labeling recommendations (draft). 
http://www.solvobiotech.com/documents/Japanese_DDI_guideline_(draft)
_2014Jan.pdf (access date: 22 June 2015) ; Ministry of Health, Labour 
and Welfare; 2014.
P15-06991
European Medicines Agency (EMA). Committee for Human Medicinal 
Products (CHMP): guideline on the investigation of drug interactions (21 
June 2012, CPMP/EWP/560/95/rev. 1 corr. 2). 
http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guid
eline/2012/0 7/WC500129606.pdf (access date: 8 July 2015) ; London: 
European Medicines Agency (EMA); 2012.
R01-0516
Olkkola KT, Backman JT, Neuvonen PJ. Midazolam should be avoided in 
patients receiving the systemic antimycotics ketoconazole or itraconazole. 
Clin Pharmacol Ther 1994;55(5):481-485.
R10-1102
Templeton IE, Thummel KE, Kharasch ED, Kunze KL, Hoffer C, Nelson 
WL, Isoherranen N. Contribution of itraconazole metabolites to inhibition 
of CYP3A4 in vivo. Clin Pharmacol Ther 2008;83(1):77-85.
R11-5230
Julious SA. Sample sizes for clinical trials. Boca Raton: Taylor & Francis 
Group; 2010.
R13-2643
Hueber W, Sands BE, Lewitzky S, Vandemeulebroecke M, Reinisch W, 
Higgins PDR, Wehkamp J, Feagan BG, Yao MD, Karczewski M, 
Karczewski J, Pezous N, Bek S, Bruin G, Mellgard B, Berger C, Londei 
M, Bertolino AP, Tougas G, Travis SPL, Secukinumab in Crohn's Disease 
Study Group. Secukinumab, a human anti-IL-17A monoclonal antibody, 
for moderate to severe Crohn's disease: unexpected results of a 
randomised, double-blind placebo-controlled trial. Gut 2012;61 
(12):1693-1700.
R13-3515
Woodworth T, Furst DE, Alten R, Bingham C, Yocum D, Sloan V, Tsuji 
W, et.al. Standardizing assessment and reporting of adverse effects in 
rheumatology clinical trials II: the Rheumatology Common Toxicity 
Criteria v.2.0. J Rheumatol 34:6. 1401-1414. 2007.
R16-2630
Ueda E, Kurebayashi S, Sakaue M, Backlund M, Koller B, Jetten AM. 
High  incidence of T-cell lymphomas in mice deficient in the retinoid-
related  orphan receptor RORgamma. Cancer Res 2002;62(3):901-909.
R16-3149
Onishi RM, Gaffen SL. Interleukin-17 and its target genes: mechanisms of  
interleukin-17 function in disease. Immunology 2010;129:311-321.


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R16-3166
Miossec P. Clinical implications of Th17/IL-17: diseases that may benefit 
from manipulating the Th17 pathway. Eur J Immunol 2009;39:667-669.
R17-3742
Barone JA, Moskovitz BL, Guarnieri J, Hassell AE, Colaizzi JL, Bierman 
RH, et al. Food interaction and steady-state pharmacokinetics of 
itraconazole oral solution in healthy volunteers. Pharmacotherapy 
1998;18(2):295-301.
R17-3743
Willems L, Geest R van der, Beule K de. Itraconazole oral solution and 
intravenous formulations: a review of pharmacokinetics and 
pharmacodynamics. J Clin Pharm Ther 2001;26:159-169.
R17-3744
Liu L, Bello A, Dresser MJ, Heald D, Komjathy SF, O'Mara E, et al. Best  
practices for the use of itraconazole as a replacement for ketoconazole in  
drug-drug interaction studies. J Clin Pharmacol 2016;56(2):143-151.
R18-0241
Guidance for industry: clinical drug interaction studies - study design, data 
analysis, and clinical implications (draft guidance, this guidance document  
is being distributed for comment purposes only) (October 2017, clinical  
pharmacology). 
https://www.fda.gov/downloads/drugs/guidances/ucm292362.pdf (access 
date: 19 January 2018) ; Silver Spring: U.S. Department of Health and  
Human Services, Food and Drug Administration, Center for Drug 
Evaluation and Research (CDER); 2017.
R18-2643
  Sporanox 10 mg/ml oral solution (Janssen-Cilag) (summary of product  
characteristics, updated 01-Mar-2018). 
https://www.medicines.org.uk/emc/product/1522/smpc/print (access date: 
14 August 2018); 2018.
R18-2644
Sempera Liquid 10 mg/ml, Lösung zum Einnehmen (Janssen-Cilag) 
(Fachinformation, Stand der Information: Dezember 2017).
R94-1529 
Chow SC, Liu JP. Design and Analysis of Bioavailability and 
Bioequivalence Studies. New York: Marcel Dekker Inc; 1992.
9.2
UNPUBLISHED REFERENCES
001-MCS-36-472 Standards and processes for analyses performed within Clinical 
Pharmacokinetics/Pharmacodynamics. Current version
c02336088
 Relative bioavailability of a 
single oral dose of BI 691751 when administered alone or in combination 
with multiple oral doses of itraconazole in healthy male subjects (an open-
label, randomised, two-period, two-sequence crossover study). 1334.10. 
09 Jan 2015
c03355329 
. Relative bioavailability of a 
single oral dose of BI 425809 when administered alone or in combination 


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with multiple oral doses of itraconazole in healthy male subjects (an open-
label, two-period, fixed-sequence trial) 1346.10. 03 Dec 2015
c16462083-01
. A partially randomised, single-
blind, placebo-controlled trial to investigate safety, tolerability, 
pharmacokinetics and pharmacodynamics of single rising doses of 
BI 730357 administered as oral solution and tablets to healthy human 
subjects, and a randomized, open-label, single-dose, three-way cross-over 
bioavailability comparison of BI 730357 as tablet versus oral solution and 
tablet with and without food. 1407.1. 13 Jul 2018.
c08928447
 Effect of multiple doses of 
itraconazole on the pharmacokinetics of a single oral dose of BI 1026706 
in healthy male subjects (an open-label, randomised, two-period, two-
sequence crossover study)
1320.20. 29 Sep 2016
c09228382
Investigator Brochure BI 730357. Psoriasis - 1407.P01; Current version.


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10.
APPENDICES
Not applicable. 


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11.
DESCRIPTION OF GLOBAL AMENDMENT(S)
11.1
GLOBAL AMENDMENT 1
Date of amendment
11 December 2018
EudraCT number
EU number
2018-003495-13
BI Trial number
1407-0014
BI Investigational Medicinal 
Product(s)
BI 730357
Title of protocol
Relative bioavailability of a single oral dose of BI 
730357 when administered alone or in combination 
with multiple oral doses of itraconazole in healthy 
male subjects (an open-label, one-way crossover 
study)
To be implemented only after approval of the IRB / IEC / Competent 
Authorities
To be implemented immediately in order to eliminate hazard – IRB / IEC / 
Competent Authority to be notified of change with request for approval
Can be implemented without IRB / IEC / Competent Authority approval as 
changes involve logistical or administrative aspects only
Section to be changed
1. Section 3.3.3, exclusion criteria 28 and 29
2. Section 5.2.3 (Table 5.2.3:2)
Description of change
1. Haematological parameters added  
2. Interferon-γ release assay to tuberculosis added
Rationale for change
1. Requested by Ethics Committee to exclude 
anaemia and infections 
2. To exclude subjects with tuberculosis infection


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11.2
GLOBAL AMENDMENT 2
Date of amendment
20 February 2019
EudraCT number
EU number
2018-003495-13
BI Trial number
1407-0014
BI Investigational Medicinal 
Product
BI 730357
Title of protocol
Relative bioavailability of a single oral dose of BI 
730357 when administered alone or in combination 
with multiple oral doses of itraconazole in healthy 
male subjects (an open-label, one-way crossover 
study)
To be implemented only after approval of the IRB / IEC / Competent 
Authorities
To be implemented immediately in order to eliminate hazard – IRB / IEC / 
Competent Authority to be notified of change with request for approval
Can be implemented without IRB / IEC / Competent Authority approval as 
changes involve logistical or administrative aspects only
Section to be changed
Section 5.2.6.1.4 and 9.1
Description of change
Addition of adverse events of special interest (one 
paragraph for severe infections including published 
reference and one paragraph for opportunistic and 
mycobacterium tuberculosis infections)
Rationale for change
As with other immune-targeted therapies, impaired 
host defence is a theoretical target-related toxicity, 
potentially resulting in increased risk of infection 
and/or malignancy. Therefore, as stated in the 
current version of the Investigator's Brochure, AEs 
and SAEs consistent with infection and malignancy 
are to be evaluated throughout the BI 730357 
clinical development program.


 
 
 
 
APPROVAL / SIGNATURE PAGE 
 
Document Number: 
 
Technical Version Number:
 
Document Name: 
 
 
 
                                                                                                                 
 
Title: 
 
 
 
 
                                                                                                                   
 
Signatures (obtained electronically) 
 
Meaning of Signature  
Signed by 
Date Signed 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
c24616632
3.0
clinical-trial-protocol-revision-2
Relative bioavailability of a single oral dose of BI 730357 when administered alone
or in combination with multiple oral doses of itraconazole in healthy male subjects
(an open-label, one-way crossover study)
Author-Trial Statistician
20 Feb 2019 15:13 CET
Author-Trial Clinical
Pharmacokineticist
20 Feb 2019 16:00 CET
Author-Clinical Trial Leader
20 Feb 2019 16:19 CET
Approval-Therapeutic Area 
20 Feb 2019 16:20 CET
Verification-Paper Signature
Completion
21 Feb 2019 07:00 CET
Approval-Team Member Medicine
21 Feb 2019 13:36 CET


Boehringer Ingelheim 
Page 2 of 2
Document Number: 
 Technical Version Number:
 
 
 
(Continued) Signatures (obtained electronically) 
 
Meaning of Signature  
Signed by 
Date Signed 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
c24616632
3.0

SAP_001.pdf: 
TITLE PAGE
TRIAL STATISTICAL ANALYSIS PLAN
c26812923-01
BI Trial No.:
1407-0014
Title:
Relative bioavailability of a single oral dose of BI 730357 when 
administered alone or in combination with multiple oral doses of 
itraconazole in healthy male subjects (an open-label, one way 
crossover study)
(including Protocol Amendments No.1[c24616632 -02] and No. 2 
[c24616632 -03])
Investigational
Product:
BI 730357
Responsible trial 
statisticians:
 
Phone:
Fax:
Phone:
Fax:
Date of statistical 
analysis plan:
08APR2019 SIGNED
Version:
Final
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2019 Boehringer Ingelheim International GmbH or one or more of its affiliated companies. All rights reserved.
This document may not - in full or in part - be passed on, reproduced, published or otherwise used without prior written permission.


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1.
TABLE OF CONTENTS
TITLE PAGE ...........................................................................................................................1
1.
TABLE OF CONTENTS......................................................................................2
LIST OF TABLES...................................................................................................................3
2.
LIST OF ABBREVIATIONS ..............................................................................4
3.
INTRODUCTION.................................................................................................7
4.
CHANGES IN THE PLANNED ANALYSIS OF THE STUDY......................8
5.
ENDPOINTS .........................................................................................................9
5.1
PRIMARY ENDPOINTS.....................................................................................9
5.2
SECONDARY ENDPOINTS...............................................................................9
5.2.1
Key secondary endpoints......................................................................................9
5.2.2
Secondary endpoints.............................................................................................9
6.
GENERAL ANALYSIS DEFINITIONS ..........................................................11
6.1
TREATMENTS...................................................................................................11
6.2
IMPORTANT PROTOCOL DEVIATIONS....................................................13
6.3
SUBJECT SETS ANALYSED...........................................................................13
6.5
POOLING OF CENTRES .................................................................................15
6.6
HANDLING OF MISSING DATA AND OUTLIERS....................................15
6.7
BASELINE, TIME WINDOWS AND CALCULATED VISITS ...................15
7.
PLANNED ANALYSIS......................................................................................17
7.1
DEMOGRAPHIC AND OTHER BASELINE CHARACTERISTICS.........19
7.2
CONCOMITANT DISEASES AND MEDICATION .....................................19
7.3
TREATMENT COMPLIANCE........................................................................19
7.4
PRIMARY ENDPOINTS...................................................................................19
7.5
SECONDARY ENDPOINTS.............................................................................20
7.5.1
Key secondary endpoints....................................................................................20
7.5.2
Secondary endpoints...........................................................................................20
7.7
EXTENT OF EXPOSURE.................................................................................21
7.8
SAFETY ANALYSIS..........................................................................................21
7.8.1
Adverse events.....................................................................................................21
7.8.2
Laboratory data ..................................................................................................23
7.8.3
Vital signs.............................................................................................................24
7.8.4
ECG......................................................................................................................24
7.8.5
Others...................................................................................................................24
8.
REFERENCES....................................................................................................25
10.
HISTORY TABLE..............................................................................................27


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LIST OF TABLES
Table 6.1: 1
Treatments and labels used in the analysis.......................................................11
Table 6.3: 1
Subject sets analysed........................................................................................14
Table 10: 1
History table .....................................................................................................27


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2.
LIST OF ABBREVIATIONS
Term
Definition / description
ADS
Analysis Dataset
AE
Adverse Event
AESI
Adverse Event of Special Interest
ALT
Alanine Aminotransferase
ANOVA
Analysis of Variance
AST
Aspartate Aminotransferase
AUC0-tz
Area under the concentration-time curve of the analyte in plasma over the 
time interval from 0 to the last quantifiable 
AUC0-∞
Area under the concentration-time curve of the analyte in plasma over the 
time interval from 0 extrapolated to infinity
BI
Boehringer Ingelheim
BMI
Body Mass Index
BP
Blood Pressure
BWU
Bioavailability/Bioequivalence, Within-Subject Design, uncontrolled
CI
Confidence interval
Cmax
Maximum measured concentration of the analyte in plasma
CRF
Case Report Form
CTP
Clinical Trial Protocol
CTR
Clinical Trial Report
CV
Arithmetic Coefficient of Variation
DBLM
Database Lock Meeting
ECG
Electrocardiogram
EDC
Electronic Data Capture
EudraCT
European Union Drug Regulating Authorities Clinical Trials
FU
Follow-up 
gCV
Geometric Coefficient of Variation
gMean
Geometric Mean
ICH
International Conference On Harmonisation
iPD
Important Protocol Deviation
ITZ
Itraconazole


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Term
Definition / description
LLT
Lower Level Term
Max
Maximum
MedDRA
Medical Dictionary For Regulatory Activities
Min
Minimum
N
Number non-missing observations
O*C
Oracle Clinical
P10
10th percentile
P90
90th percentile
PK
Pharmacokinetic(s)
PKS
PK Parameter Analysis Set
PR
Pulse Rate
PT
Preferred Term
PV
Protocol Violation
Q1
1st quartile
Q3
3rd quartile
QD
Quaque die, once daily
R / Ref
Reference treatment
RAGe
Report Appendix Generator system
REP
Residual Effect Period
RPM
Report Planning Meeting
SAS®
Statistical Analysis System
SD
Standard Deviation
SOC
System Organ Class
SOP
Standard Operating Procedure
T
Test treatment
tmax
Time from dosing to maximum measured concentration of the analyte in 
plasma
tz
Time of last measurable concentration of the analyte in plasma
TS
Treated Set
TSAP
Trial Statistical Analysis Plan
ULN
Upper Limit of Normal


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Term
Definition / description
WHO-DD
World Health Organization- Drug Dictionary
XPKISTAT
SAS® Macro for analysis of PK data


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3.
INTRODUCTION
As per ICH E9 (1), the purpose of this document is to provide a more technical and detailed 
elaboration of the principal features of the analysis described in the protocol, and to include 
detailed procedures for executing the statistical analysis of the primary and secondary 
variables and other data.
This trial statistical analysis plan (TSAP) assumes familiarity with the Clinical Trial Protocol 
(CTP), including Protocol Amendments. In particular, the TSAP is based on the planned 
analysis specification as written in CTP Section 7 “Statistical Methods and Determination of 
Sample Size”. Therefore, TSAP readers may consult the CTP for more background 
information on the study, e.g., on study objectives, study design and population, treatments, 
definition of measurements and variables, planning of sample size, randomisation.
Study data will be stored in a trial database within the Oracle ClinicalTM (O*C) system.
Pharmacokinetic (PK) parameters will be calculated using Phoenix WinNonlinTM software 
(version 6.3, Certara USA Inc., Princeton, NJ, USA).
The statistical analyses will be performed within the validated working environment CARE, 
including SAS® (current Version 9.4, by SAS Institute Inc., Cary, NC, USA), and a number 
of SASTM-based tools (e.g., macros for the analyses of AE data or laboratory data; Report 
Appendix Generator system (RAGe) for compilation/formatting of the CTR appendices).


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4.
CHANGES IN THE PLANNED ANALYSIS OF THE STUDY
All analyses as planned in the CTP will be performed and are described in more detail in this 
TSAP. 


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5.
ENDPOINTS
5.1
PRIMARY ENDPOINTS
Section 2.1.2 of the CTP: 
The following pharmacokinetic parameters will be determined for BI 730357: 

AUC0-tz (area under the concentration-time curve of the analyte in plasma over the 
time interval from 0 to the last quantifiable data point)

Cmax (maximum measured concentration of the analyte in plasma)
5.2
SECONDARY ENDPOINTS
5.2.1
Key secondary endpoints
This section is not applicable as no key secondary endpoints have been defined in the CTP.
5.2.2
Secondary endpoints
Section 2.1.3 of the CTP:
The following pharmacokinetic parameter will be determined for BI 730357:

AUC0-∞(area under the concentration-time curve of the analyte in plasma over the
time interval from 0 extrapolated to infinity)


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Safety:
Section 2.2.2.2 of the CTP:
Safety and tolerability of BI 730357 and itraconazole will be assessed based on:

Adverse events (including clinically relevant findings from the physical examination)

Safety laboratory tests

12-lead ECG

Vital signs (blood pressure, pulse rate)
These parameters will be evaluated in a descriptive way only, and are therefore considered to 
be ‘further parameters of interest’. A confirmatory analysis is not planned.


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6.
GENERAL ANALYSIS DEFINITIONS
6.1
TREATMENTS
For basic study information on investigational products, assignment of treatment sequences 
and selection of doses, please see CTP, Section 4.
The study was performed as an open-label, one-way crossover trial with 2 treatments (T and 
R). It was planned to assign 14 healthy male subjects (at least 12 completed).
For details of dosage and formulation see Table 6.1: 1 below:
Table 6.1: 1
Treatments and labels used in the analysis
Treatment
Short label
R
BI 730357, tablet, 50 mg, qd (Day 1)
BI
T
BI 730357, 50 mg tablet, qd (Day 1) + Itraconazole 
200 mg, qd (Day -3 to Day 9)
BI + ITZ
The following separate study phases will be defined for the analyses of AEs:

Screening (ranging from 0:00 h on day of informed consent until first administration 
time of study drug)

On treatment
o
BI treatment (including residual effect period (REP); i.e. ranging from the time 
of first administration of BI 730357 until 7 days thereafter)
o
Itraconazole (ITZ) (ranging from the time of first administration of Itraconazole 
until time of BI 730357 administration in treatment period 2)
o
BI + ITZ (including residual effect period (REP); i.e. ranging from time of 
BI 730357 administration in treatment period 2 until 9 days after the last
administration of Itraconazole (up to 18 days))

Follow up
o
Follow-up BI (ranging from end of BI treatment phase until next drug 
administration (of itraconazole) or alternatively, 0:00h on the day after trial-
termination date in case of no further treatment, labelled “FU-BI”)
o
Follow-up BI+ITZ (ranging from end of BI+ITZ phase until 0:00h on the day 
after trial termination date, labelled “FU-BI+ITZ”)


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Displays of AEs will be presented separately for the following treatments during on treatment 
phase:

BI 730357, 50 mg tablet, qd (labelled “BI“)

Itraconazole, 200 mg oral solution, qd (labelled “ITZ”)

BI 730357, 50 mg tablet, qd + Itraconazole, 200 mg oral solution, qd (labelled 
“BI + ITZ”)
Two types of AE displays will be provided in the report:
A) Section 15.3 and Appendix 16.1.13.1.8 (for ClinicalTrials.gov and EudraCT) of the CTR 
displays:
In these displays, the on treatment phase will be analysed (labelled with the name of the 
study treatment (short label)). Screening and follow-up periods will not be included in 
this analysis. 
The following totals will be provided in addition (Section 15.3 only):
a total over all on treatment phases involving BI ("Total on treatment BI")
a total over all on treatment phases included in this analysis ("Total on treatment")
B) Section 15.4 and Appendix 16.1.13.1.8 (except for ClinicalTrials.gov and EudraCT) of 
the CTR displays:
Screening 
On treatment (labelled with the name of the study treatment (short label))
Follow-up BI (labelled "FU BI")
Follow-up BI+ITZ (labelled "FU BI+ITZ")
In Section 16.1.13.1.8 AE tables, the following totals will be provided in addition:
a total over all on treatment phases involving BI ("Total BI")
a total over all study phases ("Total")
Tables of vital signs and laboratory values will present results by study period including 
baseline of the respective period.
For detailed information on the handling of the treatments in the O*C views refer to 
Technical TSAP ADS plan and Analysis Data Reviewers guide. 


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6.2
IMPORTANT PROTOCOL DEVIATIONS
Data discrepancies and deviations from the CTP will be identified for all treated subjects.
Section 7.3 of the CTP: Important protocol deviations (iPD) categories will be suggested in 
the integrated quality and risk management (IQRM) plan, iPDs will be identified no later 
than in the Report Planning Meeting, and the iPD categories will be updated as needed.
Consistency check listings (for identification of deviations of time windows) and a list of 
protocol deviations (e.g. deviations in drug administration, in blood sampling times, etc.) will 
be provided to be discussed at the Report Planning Meeting and database lock meeting
(RPM/DBLM). At this meeting, all manual deviations identified at the sites by the CRAs and 
deviations too complex to program will be reviewed by the trial team to decide which are 
considered important. For definition of important protocol deviations (iPD), and for the 
process of identification of these, refer to the Boehringer Ingelheim (BI) SOP "Identify and 
Manage Important Protocol Deviations (iPD)" (2).
If any iPDs are identified, they are to be summarised into categories and will be captured in 
the RPM/DBLM minutes via an accompanying Excel spreadsheet (3). 
The iPDs will be summarised and listed.
6.3
SUBJECT SETS ANALYSED

Treated set (TS):
This subject set includes all subjects who were entered and treated with at least one dose 
of study drug.
This is the full analysis set population in the sense of ICH-E9 (1).
The TS is used for safety analyses.
Section 7.3.1 of the CTP: Plasma concentration data and parameters of a subject will be 
included in the statistical pharmacokinetic (PK) analyses if they are not flagged for exclusion 
due to a protocol deviation relevant to the evaluation of PK (to be decided no later than in 
the Report Planning Meeting) or due to PK non-evaluability (as revealed during data 
analysis, based on the criteria specified below). Exclusion of a subject’s data will be 
documented in the CTR.
Relevant protocol deviations may be
•
Incorrect trial medication taken, i.e. the subject received at least one dose of 
trial medication the subject was not assigned to
•
Incorrect dose of trial medication taken
•
Use of restricted medications


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Plasma concentrations and/or parameters of a subject will be considered as non-evaluable, if 
for example
•
The subject experienced emesis that occurred at or before two times median 
tmax of the respective treatment (Median tmax is to be determined excluding the 
subjects experiencing emesis),
•
A predose concentration of BI 730357 is >5% Cmax value of that subject in the 
respective treatment period
•
Missing samples/concentration data at important phases of PK disposition 
curve

PK parameter analysis set (PKS):
This subject set includes all subjects in the TS who provide at least one PK endpoint that 
was defined as primary or secondary and was not excluded due to a protocol deviation 
relevant to the evaluation of PK or due to PK non-evaluability. Thus, a subject will be 
included in the PKS, even if he contributes only one PK parameter value for one period 
to the statistical assessment. Descriptive and model based analyses of PK parameters will 
be based on the PKS.
The descriptive analysis of PK concentrations will be based on the ADS ADPC as described 
at the beginning of Section 7.
Table 6.3: 1
Subject sets analysed
Subject set
Class of endpoint
TS
PKS
Analyses of PK endpoints
X
Safety endpoints 
X
Demographic/baseline endpoints
X
Important PDs
X
Disposition
X


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6.5
POOLING OF CENTRES
This section is not applicable, because the study was performed in only one centre.
6.6
HANDLING OF MISSING DATA AND OUTLIERS
Handling of missing data and outliers will be performed as described in the CTP, Section 7.5.
The only exceptions where imputation might be necessary for safety evaluation are AE dates. 
Missing or incomplete AE dates are imputed according to BI standards (see 001-MCG-
156_RD-01 (4)).
Missing data and outliers of PK data are handled according to BI standards (see 001-MCS-
36-472_RD-01) (5).
6.7
BASELINE, TIME WINDOWS AND CALCULATED VISITS
The baseline value is defined as the last measurement before administration of BI 730357 in 
each period.
Section 6.1 of the CTP: Exact times of measurements outside the permitted time windows 
will be documented. The acceptable time windows for screening and the end of trial 
examination are provided in the CTP Flow Chart.
Study measurements and assessments scheduled to occur ‘before’ trial medication 
administration are to be performed and completed within a 3h-period prior to BI 730357 
administration in Visit 2, and within a 2h-period prior to the next itraconazole 
administrationin Visit 3, if not indicated otherwise in the Flow Chart.
Following administration of trial drugs in Visits 2 and 3, the acceptable deviation from the 
scheduled time for vital signs, ECG, and laboratory tests will be ± 30 min on Day 1, ± 45 min 
on Day 2, and ± 60 min from Day 3 onwards.
[…]
For planned blood sampling times, refer to the Flow Chart. While these nominal times should 
be adhered to as closely as possible, the actual sampling times will be recorded and used for 
the determination of pharmacokinetic parameters.
Starting from 119 hours after BI 730357 administration (and beyond), a time window of ± 60 
min will be allowed for PK blood sampling times.
If a subject misses an appointment, it will be rescheduled if possible. The relevance of 
measurements outside the permitted time windows will be assessed no later than at the 
Report Planning Meeting.


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Adherence to time windows will be checked via the consistency check listings at the 
RPM/DBLM.


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7.
PLANNED ANALYSIS
Safety analysis (refer to Section 7.8) will be performed by 
 and 
will be presented in Sections 15.1 to 15.4 of the CTR and in Appendix 16.2 and 16.1.13.1.
Inferential statistical analyses of PK endpoints (refer to Sections 7.4 and 7.5.2) will also be 
performed by
 and will be presented in Section 15.5 of the CTR 
and in Appendix 16.1.13.3.
Descriptive data analysis of PK endpoints will be performed by 
 
and will be presented in Section 15.6 of 
the CTR.
The format of the listings and tables will follow the standards defined in the BI corporate 
guideline “Reporting of Clinical Trials and Project Summaries” [001-MCG-159] (6) with the 
exception of those generated for PK-calculations (8).
The individual values of all subjects will be listed, sorted by treatment sequence, subject
number, visit and actual treatment (if appropriate).
The listings will be included in Appendix 16.2 of the CTR.
For end-of-text tables, the set of summary statistics for non-PK parameters is: 
N 
number non-missing observations 
Mean
arithmetic mean
SD
standard deviation 
Min
minimum 
Median
median 
Max
maximum
For analyte concentrations, the following descriptive statistics will additionally be calculated:
CV 
arithmetic coefficient of variation
gMean
geometric mean
gCV
geometric coefficient of variation
The data format for descriptive statistics of concentrations will be identical with the data 
format of the respective concentrations. The descriptive statistics of PK parameters will be 
calculated using the individual values with the number of decimal places as provided by the 
evaluation program. Then the individual values as well as the descriptive statistics will be 
reported with three significant digits in the CTR.
Tabulations of frequencies for categorical data will include all possible categories and will 
display the number of observations in a category, as well as the percentage (%) for each 
treatment group. Percentages will be rounded to one decimal place and will be based on all 


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subjects in the respective subject set whether they have non-missing values or not. The 
category 'missing' will be displayed only if there are actually missing values.
Units of variables should be given in the titles or column/row descriptors in square brackets 
(e.g. [mg]).
Exclusion of PK parameters
The ADS ADPP (PK parameters) contains column variables indicating inclusion/exclusion
(APEXC) of a PK parameter and an analysis flag comment (APEXCO). All analyses based 
on the PKS will include parameters if they are not flagged for exclusion, that is APEXCO is 
equal to “Included”.
Exclusion of PK concentrations
The ADS ADPC (PK concentrations per time-point or per time-interval) contains column 
variables ACEXC or ACEXCO indicating inclusion/exclusion (ACEXC) of a concentration 
and an analysis flag comment (ACEXCO). Exclusion of a concentration depends on the 
analysis flag comment ACEXCO. For example, if ACEXCO is set to ‘ALL CALC’, the value 
will be excluded for all types of analyses based on concentrations. If ACEXCO is set to 
‘DESC STATS’, the value will be excluded from descriptive evaluations per planned time 
point/time interval. If ACEXCO contains the addition ‘TIME VIOLATION’ or ‘TIME 
DEVIATION’, the value can be used for further analyses based on actual times. If ACEXCO 
is set to ‘HALF LIFE’, the value will be excluded from half-life calculation (and, as a 
consequence, any calculation that relies on λz) only; the value is included for all other 
analyses.
Further details are given in 001-MCS-36-472_RD-01 “Noncompartmental Pharmacokinetic / 
Pharmacodynamic Analyses of Clinical Studies” (5) and 001-MCS-36-472_RD-03 
“Description of Analytical Transfer Files and PK/PD Data Files” (7).


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7.1
DEMOGRAPHIC AND OTHER BASELINE CHARACTERISTICS
Only descriptive statistics are planned for this section of the report, based on the TS.
The data will be summarised in total. 
7.2
CONCOMITANT DISEASES AND MEDICATION
Frequency tables are planned for this section of the report, based on the TS.
Concomitant diseases will be coded using the coding system of the Medical Dictionary for 
Drug Regulatory Activities (MedDRA). Medications will be coded using the World Health 
Organization Drug Dictionary (WHO-DD). The coding version number will be displayed as a 
footnote in the respective output.
The diagnoses and medications will be listed. Subjects without any concomitant diagnoses or 
concomitant therapies should be marked with a “No” in the respective column.
The relevance of the concomitant therapies to the evaluation of PK will be decided no later 
than at the RPM/DBLM.
7.3
TREATMENT COMPLIANCE
Section 4.3 of the CTP: Compliance will be assured by administration of all trial medication 
in the study centre under supervision of the investigating physician or a designee. The 
measured plasma concentrations of trial medication will provide additional confirmation of 
compliance.
It is not intended to list the compliance separately. Any deviations from complete intake will 
be addressed in the RPM/DBLM (cf. TSAP Section 6.2) and described in the CTR.
7.4
PRIMARY ENDPOINTS
Primary analysis
Relative bioavailability is to be determined on the basis of the primary PK endpoints 
(AUC0-tz, Cmax). Those parameters will be ln-transformed (natural logarithm) prior to fitting 
the ANOVA model (see below).
Section 7.3.1 of the CTP: The statistical model used for the analysis of the primary 
endpoints will be an analysis of variance (ANOVA) model on the logarithmic scale. That is, 
the PK endpoints will be log-transformed (natural logarithm) prior to fitting the ANOVA 
model. This model will include effects accounting for the following sources of variation: 
subjects and treatment. The effect ‘subjects’ will be considered as random, whereas 
‘treatment’ will be considered as fixed. The model is described by the following equation:


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ykm = µ + sm + τk + ekm, where
ykm = logarithm of response measured on subject m receiving treatment k,
µ = the overall mean,
sm = the effect associated with the mth subject, m = 1, 2, ..., n
τk = the kth treatment effect, k = 1, 2,
ekm = the random error associated with the mth subject who received treatment k.
The difference between the expected means for test treatments and reference treatment
ln(T)-ln(R), estimated by the difference in the corresponding Least Square Means (point 
estimate) and two-sided 90% confidence intervals based on the t-distribution, will be 
computed. These quantities will then be back-transformed to the original scale to give the 
point estimator (geometric mean) and interval estimates for the ratio between response under 
test and response under reference.
The implementation for this analysis will be accomplished by using the XPKISTAT macro, 
based on PKS, and option BWU (Bioavailability/Bioequivalence, within-subject design, 
uncontrolled w.r.t. time).
Further analysis
Section 7.3.1 of the CTP: The same statistical model as stated above will be repeated for the 
primary endpoints but with ‘subject’ considered as fixed effects.
The following SAS code can be used to fit the model:
PROC GLM DATA=indata; 
CLASS subject treatment;
MODEL logkp = treatment subject; 
LSMEANS treatment / PDIFF=CONTROL(“Ref_trt”) CL ALPHA=0.1; 
RUN;
Further analysis of primary endpoints is explorative.
7.5
SECONDARY ENDPOINTS
7.5.1
Key secondary endpoints
This section is not applicable as no key secondary endpoints have been specified in the 
protocol.
7.5.2
Secondary endpoints
The secondary PK endpoint AUC0-∞will be assessed using the same methods as described for 
the primary endpoints but will not be interpreted in a confirmatory sense.


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7.7
EXTENT OF EXPOSURE
Descriptive statistics are planned for this section of the report based on the TS. The date and 
time of drug administration will be listed for each subject.
7.8
SAFETY ANALYSIS
All safety analyses will be performed on the TS.
The safety data for treated subjects who failed to complete the study (dropouts or
withdrawals) will be reported as far as their data are available. All withdrawals will be 
documented and the reason for withdrawal recorded.
7.8.1
Adverse events
AEs will be coded with the most recent version of MedDRA.
The analyses of AEs will be descriptive in nature and will be based on BI standards as 
presented in the corporate guideline: “Analysis and Presentation of Adverse Event Data from 
Clinical Trials” [001-MCG-156] (9).
The standard AE analyses will be based on the number of subjects with AEs (and not on the 
number of AEs). 
For analysis, multiple AE occurrence data on the CRF will be collapsed into an AE provided 
that all of the following applies:


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
All AE attributes are identical (lower level term (LLT), intensity, action taken, 
therapy required, seriousness, reason for seriousness, relationship, outcome, AE of 
special interest)

The occurrences were time-overlapping or time-adjacent (time-adjacency of 
two occurrences is given if the second occurrence started within one hour after end of 
the first occurrence)
For further details on summarization of AE data, please refer to [001-MCG-156] (9).
Section 5.2.6.1.4 of the CTP: The following are considered as AESIs:

Hepatic injury
A hepatic injury is defined by the following alterations of hepatic laboratory 
parameters:
o
An elevation of AST (aspartate transaminase) and/ or ALT (alanine transaminase)
≥3-fold ULN combined with an elevation of total bilirubin ≥2-fold ULN measured 
in the same blood sample, and/or
o
Aminotransferase (ALT, and/ or AST) elevations ≥10 fold ULN

Severe infections (grading according to Rheumatology Common Toxicity Criteria 
(RCTC) developed by OMERACT [R13-3515](12))

Opportunistic and mycobacterium tuberculosis infections
These include pneumocystis jirovecii, BK virus disease including polyomavirus-
associated nephropathy, cytomegalovirus, posttransplant lymphoproliferative 
disorder (Epstein-Barr virus), progressive multifocal leukoencephalopathy, 
bartonellosis (disseminated only), blastomycosis, toxoplasmosis, coccidioidomycosis, 
histoplasmosis, aspergillosis (invasive only), candidiasis (invasive or pharyngeal), 
cryptococcosis, other invasive fungi (mucormycosis (zygomycosis, rhizopus, mucor, 
lichtheimia), scedosporium/pseudallescheria boydii, fusarium), legionellosis, listeria 
monocytogenes (invasive only), tuberculosis, nocardiosis, non-tuberculous 
mycobacterium, salmonellosis (invasive only), hepatitis B virus reactivation, herpes 
simplex (invasive only), herpes zoster, strongyloides (hyperinfection syndrome and 
disseminated forms only), paracoccidioides, penicillium marneffei, sporothrix 
schenckii, cryptosporidium species (chronic only), microsporidiosis, leishmaniasis 
(visceral only), trypanosoma cruzi Infection (Chagas’ disease) (disseminated only), 
campylobacteriosis (invasive only), shigellosis (invasive only), vibriosis (invasive due 
to vibrio vulnificus), hepatitis C virus progression.
The analysis of adverse events will be based on the concept of treatment emergent adverse 
events. 
Section 1.2.3 of the CTP: The Residual Effect Period (REP, i.e., the period after the last 
dose with measurable drug levels and/or pharmacodynamic effects still likely to be present) 
of BI 730357 is 7 days for the mono-therapy (Treatment R). When given together with 
itraconazole (Treatment T), it is expected that plasma exposure of BI 730357 could be 
increased (albeit within the range explored in the clinical trial 1407-0001), and the time of 


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relevant plasma exposure could be prolonged, which in turn could result in a prolonged 
period in which adverse effects could potentially occur.
For the use of itraconazole in Treatment T, the REP is defined as 9 days after last 
administration of itraconazole on Day 9 in Period 2. Therefore, the follow-up period will 
start earliest on Day 18 following BI 730357 dosing in Period 2, as this is expected to cover 
the period in which any potential adverse effects could reasonably occur.
According to ICH E3 (10), AEs classified as ‘other significant’ needs to be reported and will 
include those non-serious and non-significant adverse events with 
(i) ‘action taken = discontinuation’ or ‘action taken = reduced’, or
(ii) marked haematological and other lab abnormalities or lead to significant concomitant 
therapy as identified by the Clinical Trial Leader/Investigator at the Report Planning 
Meeting.
An overall summary of AEs (including AESIs) will be presented.
The frequency of subjects with AEs will be summarized by treatment, primary system organ 
class (SOC) and preferred term (PT). Separate tables will be provided for subjects with other 
significant AEs according to ICH E3 (10), for subjects with serious AEs, for subjects with 
drug-related AEs, for subjects with drug related serious adverse events and for subjects with 
AESIs.
The SOC and PTs will be sorted by frequency (within system organ class). The MedDRA 
version number will be displayed as a footnote in the respective output.
In addition, frequencies of subjects with non-serious AEs that had an incidence of > 5% for at 
least one treatment will be summarised by treatment, primary SOC and PT.
For disclosure of adverse events on EudraCT additional information not included in a 
standard AE analysis will be performed. The following three entries will be created:

Adverse Events per arm for disclosure on EudraCT

Non-serious Adverse Events for disclosure on EudraCT

Serious Adverse Events for disclosure on EudraCT
7.8.2
Laboratory data
The analyses of laboratory data will be descriptive in nature and will be based on 
BI standards [001-MCG-157] (11).
Laboratory data will be analysed qualitatively via comparison of laboratory data to their 
reference ranges. Values outside the reference range as well as values defined as possible
clinically significant will be highlighted in the data listings.
It is the investigator's responsibility to decide whether a lab value is clinically significant 
abnormal or not (at the RPM/DBLM at the latest).


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7.8.3
Vital signs
Descriptive statistics over time including change from baseline will be performed for vital 
signs (blood pressure and pulse rate). In the listing the difference from baseline will also be 
displayed.
Clinically relevant findings in vital signs will be reported as AEs.
7.8.4
ECG
ECG recordings will be checked by the investigator for pathological results. Clinically 
relevant abnormal findings for ECG will be listed under 'Relevant Medical History / Baseline 
Conditions' (when they occurred during screening) or will be reported as AEs (when they 
occurred during treatment).
7.8.5
Others
Physical examination
Physical examination findings will be reported as relevant medical history/baseline condition 
(i.e., a condition already existent before intake of study drug) or as AE and will be 
summarised as such. No separate listing or analysis of physical examination findings will be 
prepared.


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8.
REFERENCES
1.
CPMP/ICH/363/96: "Statistical Principles for Clinical Trials", ICH Guideline Topic 
E9, Note For Guidance on Statistical Principles for Clinical Trials, current version.
2.
001-MCS-40-413: "Identify and Manage Important Protocol Deviations (iPD) ", 
current version,  IDEA for CON.
3.
BI-KMED-COPS-TMP-0001: "iPD log", current version; IDEA for GEN.
4.
001-MCG-156_RD-01: "Handling of Missing and Incomplete AE Dates", current 
version; IDEA for CON.
5.
001-MCS-36-472_RD-01: “Noncompartmental Pharmacokinetic/Pharmacodynamic
Analyses of Clinical Studies”, current version; IDEA for CON.
6.
001-MCG-159: “Reporting of Clinical Trials and Project Summaries”, current version; 
IDEA for CON.
7.
001-MCS-36-472_RD-03: “Description of Analytical Transfer Files and PK/PD Data 
Files”, current version; IDEA for CON.
8.
001-MCS 36-472: "Standards and processes for analyses performed within Clinical 
Pharmacokinetics/Pharmacodynamics", current version; IDEA for CON.
9.
001-MCG-156: “Analysis and Presentation of Adverse Event Data from Clinical 
Trials”, current version; IDEA for CON.
10. CPMP/ICH/137/95: “Structure and Content of Clinical Study Reports”, ICH Guideline 
Topic E3; Note For Guidance on Structure and Content of Clinical Study Reports, 
current version
11. 001-MCG-157: "Handling, Display and Analysis of Laboratory Data", current version; 
IDEA for CON.
12. Woodworth T, Furst DE, Alten R, Bingham C, Yocum D, Sloan V, Tsuji W, et.al. 
Standardizing assessment and reporting of adverse effects in rheumatology clinical 
trials II: the Rheumatology Common Toxicity Criteria v.2.0. J Rheumatol 34:6. 
1401-1414. 2007 [R13-3515].


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10.
HISTORY TABLE
Table 10: 1
History table
Version
Date
(DD-MMM-
YY)
Author
Sections 
changed
Brief description of change
Final
08APR2019
None
This is the final TSAP without any 
modification