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Note: This record shows only 22 elements of the WHO Trial Registration Data Set. To view changes that have been made to the source record, or for additional information about this trial, click on the URL below to go to the source record in the primary register.
Register: EUCTR
Last refreshed on: 8 August 2016
Main ID:  EUCTR2013-004622-29-CZ
Date of registration: 13/08/2014
Prospective Registration: Yes
Primary sponsor: Biogen Idec Research Limited
Public title: Impact of Natalizumab versus Fingolimod on Central Nervous System (CNS) Tissue Damage and Recovery in Active Relapsing-Remitting Multiple Sclerosis (RRMS) Subjects
Scientific title: A Multicenter, Randomized, Open-Label Study to Assess the Impact of Natalizumab versus Fingolimod on Central Nervous System Tissue Damage and Recovery in Active Relapsing-Remitting Multiple Sclerosis Subjects
Date of first enrolment: 31/10/2014
Target sample size: 540
Recruitment status: Not Recruiting
URL:  https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2013-004622-29
Study type:  Interventional clinical trial of medicinal product
Study design:  Controlled: yes Randomised: yes Open: yes Single blind: no Double blind: no Parallel group: yes Cross over: no Other: no If controlled, specify comparator, Other Medicinial Product: yes Placebo: no Other: no Number of treatment arms in the trial: 2  
Phase:  Human pharmacology (Phase I): no Therapeutic exploratory (Phase II): no Therapeutic confirmatory - (Phase III): no Therapeutic use (Phase IV): yes
Countries of recruitment
Australia Czech Republic Denmark France Germany Italy Spain Sweden
United Kingdom United States
Contacts
Name: N/A   
Address:  Innovation House, 70 Norden Road SL6 4AY Maidenhead, Berkshire United Kingdom
Telephone:
Email: clinicaltrials@biogen.com
Affiliation:  Biogen Idec Research Limited
Name: N/A   
Address:  Innovation House, 70 Norden Road SL6 4AY Maidenhead, Berkshire United Kingdom
Telephone:
Email: clinicaltrials@biogen.com
Affiliation:  Biogen Idec Research Limited
Key inclusion & exclusion criteria
Inclusion criteria:
Inclusion Criteria for MS Patients:
- Must have a documented diagnosis of relapsing MS (McDonald 2010
Criteria [Polman 2011]) at study screening.
- for subjects with a previous history of treatment with BRACE-TA
he/she must have:
• Been on therapy for at least 6 months (unless experiencing highly
active disease; see #6 below)
• At least 9 T2-hyperintense lesions on a brain MRI scan, and
• Experienced =1 relapse while on therapy within the last 6 months
prior to study screening and either:
* =1 new T1-Gd+ lesion or =2 new T2 lesions on a brain MRI scan
performed =6 months prior to study screening
or
* =2 new T2 lesions on a brain MRI scan performed =6 months prior
to study screening, with comparison made to a T2
MRI scan performed up to 18 months before study screening.
- For subjects with highly active disease (defined by the criteria below),
regardless of whether they are disease-modifying therapy (DMT)-naïve
or had previous exposure to BRACE TA, he/she must have had:
• =2 disabling relapses in the 12 months prior to study screening and
either:
?* =1 new T1 Gd+ lesion on a brain MRI scan performed =6 months
prior to study screening
or
?* =2 new T2 lesions on a brain MRI scan performed =6 months prior to
study screening with comparison made to a T2
MRI scan performed up to 18 months before study screening
- Willing to take natalizumab or fingolimod as the only DMTs for the
duration of the study treatment period.
- Must have an EDSS score from 0 to 5.5 inclusive at study screening.
Inclusion Criteria for Healthy Volunteers:
- Subjects who are generally healthy as demonstrated by physical
examination and by medical history, with no history or evidence of major
illnesses, diseases, or disorders.
- Subjects of childbearing potential must practice effective contraception
and be willing and able to continue contraception for duration of the
study.
- No history of drug or alcohol abuse (as defined by the Investigator)
within 1 year prior to study screening.
- Willing and able to comply with scheduled visits and imaging services.
NOTE: Other protocol defined Inclusion criteria may apply
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 540
F.1.3 Elderly (>=65 years) no
F.1.3.1 Number of subjects for this age range

Exclusion criteria:
Exclusion Criteria for MS Patients:
- History of or positive test result at study screening for HIV
- History or positive test result at study screening for HCV antibody or current hepatitis B infection (defined as positive for HBsAg and/or HBcAb). Subjects with immunity to hepatitis B from either active vaccination (defined as negative HBsAg, positive HBsAb and negative
HBcAb) or from previous natural infection (defined as negative HBsAg, positive HBsAb immunoglobulin G, and positive HBcAb) are eligible to participate in the study
- Prior treatment with natalizumab or fingolimod
- Diagnosis of PPMS and/or SPMS
- History of or known active malignant disease, including solid tumors and hematologic malignancies (subjects with cutaneous basal and squamous cell carcinoma that has been completely excised and considered cured prior to study screening remain eligible)
- History of opportunistic infections (including PML) or any clinically significant cardiac, endocrinologic, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, neurologic (other than MS), dermatologic, psychiatric, and renal condition, or other major disease
- A clinically significant infectious illness (eg, pneumonia, septicemia) within the 1 mth prior to study screening
- History of drug or alcohol abuse within 1 yr prior to study screening
- Exposure to IVIg, monoclonal antibodies, cytokines, growth factors,
soluble receptors, other recombinant products, or fusion proteins within 1 yr prior to study screening
- History of immunosuppressant use (eg, mitoxantrone, azathioprine, methotrexate, cyclophosphamide, mycophenolate, cladribine, rituximab) in the last 12 mths prior to study screening. Treatment with IV and/or oral corticosteroids (topical corticosteroids are acceptable) within 4 wks of baseline DTI-MRI assessment
- An MS relapse that has occurred within the 30 days prior to randomization and/or the subject has not stabilized from a previous relapse prior to randomization
- Current/previous participation in investigational drug studies
- Subject has any contraindications to fingolimod or natalizumab, as described in the respective Prescribing Information or has any medical condition as described in the warnings and precautions of the respective
Prescribing Information that makes the subject unsuitable for participation in the study
- Subject treated with teriflunomide who did not undergo an accelerated
elimination procedure prior to study screening.
- History or evidence of macular edema on ophthalmologic exam
- History of congenital QT prolongation, unexplained hypokalemia, myocardial infarction, unstable angina, stroke, transient ischemic attack, decompensated heart failure in last 6 mths
- Mobitz type II second degree or third degree AV block or sick sinus syndrome, symptomatic bradycardia, recurrent syncope, or severe untreated sleep apnea
- Baseline corrected QTc (Fridericia [QTcF] or Bazett's [QTcB] formula)
interval =470 ms in females and =450 ms in males
- Treatment with Class Ia (e.g., procainamide, quinidine, ajmaline,
disopyramide) or Class III (amiodarone, bretylium, dofelitide, sotalol,
ibulitide, azilimide) anti-arrhythmic drugs
- Concurrent therapy with drugs that slow heart rate (eg, beta-blockers,
heart-rate lowering calcium channel blockers such as diltiazem,
verapamil or digoxin), prolong the QTc interval, or are potent inducers of
CYP450
- Hypertension not controlled with prescribed medications
- History


Age minimum:
Age maximum:
Gender:
Female: yes
Male: yes
Health Condition(s) or Problem(s) studied
Multiple Sclerosis (MS)
MedDRA version: 19.0 Level: PT Classification code 10063399 Term: Relapsing-remitting multiple sclerosis System Organ Class: 10029205 - Nervous system disorders
Therapeutic area: Diseases [C] - Nervous System Diseases [C10]
Intervention(s)

Trade Name: Tysabri®
Product Name: AN100226, BG00002
Pharmaceutical Form: Concentrate and solvent for solution for infusion
INN or Proposed INN: NATALIZUMAB
CAS Number: 189261-10-7
Concentration unit: mg/ml milligram(s)/millilitre
Concentration type: equal
Concentration number: 300-

Trade Name: Gilenya
Product Name: Fingolimod
Pharmaceutical Form: Capsule, hard
INN or Proposed INN: fingolimod
CAS Number: 162359-56-0
Other descriptive name: FINGOLIMOD HYDROCHLORIDE
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 0.5-

Primary Outcome(s)
Main Objective: The primary objective of the study is to assess the effect of natalizumab compared to fingolimod on the evolution of
new on-treatment T1-gadolinium-enhancing (Gd+) lesions to persistent black holes (PBH) over 52 weeks.
Primary end point(s): The primary endpoint of the study is the cumulative number of =6-month confirmed T1-hypointense lesions (i.e., PBH) arising from new on-treatment T1-Gd+ lesions.
Secondary Objective: The secondary objectives of this study are to assess the effect of natalizumab compared to fingolimod on:
• MRI measures of CNS tissue destruction as measured by the number of new T1-Gd+ lesions.
• Various other MRI measures of disease activity.
• No Evidence of Disease Activity (NEDA)
• Relapse on treatment over 52 weeks.
• The change in information processing speed as measured by the Symbol Digit Modalities Test (SDMT).
Timepoint(s) of evaluation of this end point: Weeks 4, 8, 12, 16, 20, 24
Secondary Outcome(s)
Secondary end point(s): The secondary endpoints of this study are the follwoing:
• MRI endpoints:
o Cumulative number of new T1-Gd+ lesions .
o Change in total T1-hypointense and total T2-hyperintense lesion volumes.
o Cumulative number of new or enlarging T2 lesions.
• Proportion of subjects with NEDA according to the following definition:
o No relapses.
o No 12-week confirmed disability progression based on EDSS.*
o No new T1-Gd+ lesions on brain MRI.
o No new or enlarging T2-hyperintense lesions.
• Time to first relapse, cumulative risk of relapses and time to complete recovery from first relapse. **
• Change in information processing speed as measured by the SDMT from baseline to Week 24 and Week 52.

* Increase of 1.0 or more on the EDSS from a baseline score of 1.0 or more, or an increase of 1.5 or more from a baseline score of 0 that was sustained for 12 weeks (progression could not be confirmed during a relapse).
** 12-week confirmed complete Expanded Disability Status Scale (EDSS) recovery from first on-treatment relapse is defined as an EDSS score that is equal to or lower than the last pre-relapse EDSS score and sustained for at least 12 week
Timepoint(s) of evaluation of this end point: Weeks 4, 8, 12, 16, 20, 24, 52
Secondary ID(s)
101MS408
2013-004622-29-IT
Source(s) of Monetary Support
Biogen Idec Research Limited
Secondary Sponsor(s)
Ethics review
Results
Results available:
Date Posted:
Date Completed:
URL:
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