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RNF and Betaseron® Tolerability Study (REFORMS)

Primary Purpose

Relapsing Remitting Multiple Sclerosis (RRMS)

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
New Formulation of rebif - human interferon beta-1a
Interferon beta -1b
Sponsored by
EMD Serono
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsing Remitting Multiple Sclerosis (RRMS)

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject with diagnosis of RRMS according to McDonald criteria or Poser
  2. Subject is between 18 and 60 years old inclusive
  3. Subject is willing to follow study procedures
  4. Subject has given written informed consent
  5. Female subjects must be neither pregnant nor breast-feeding and must lack childbearing potential, as defined by either:

    • Being post-menopausal or surgically sterile, or
    • Using a hormonal contraceptive, intra-uterine device, diaphragm with spermicide, or condom with spermicide, for the duration of the study.

Exclusion Criteria:

  1. Subject has Clinically Isolated Syndrome (CIS), Primary Progressive MS, or Secondary Progressive MS without superimposed relapses.
  2. Subject has had any prior interferon beta therapy (either beta-1b or beta-1a) prior to study Day 1.
  3. Subject received any other approved disease modifying therapy for MS (glatiramer acetate) or any cytokine or anti-cytokine therapy within the 3 months prior to Study Day 1.
  4. Subject received immunomodulatory or immunosuppressive therapy (including but not limited to cyclophosphamide, cyclosporin, methotrexate, azathioprine, linomide, mitoxantrone, teriflunomide, natalizumab, laquinimod, Campath and cladribine) within the 12 months prior to Study Day 1.
  5. Subject had prior use of Cladribine or has previously received total lymphoid irradiation.
  6. Subject has known allergy to natural or recombinant interferon or any other component of formulation excipient(s) of Rebif® or Betaseron®: Mannitol, Poloxamer 188, Methionine, Benzyl alcohol or Albumin (human).
  7. Use of any other injectable medications on a regular basis during the week prior to the screening period or during the screening or treatment periods. Receiving a single injection for treatment or prophylaxis of a condition unrelated to the subject's multiple sclerosis or the subject's Rebif® or Betaseron® therapy (e.g. receiving a influenza or pneumococcus vaccination) is acceptable.
  8. History of any chronic pain syndrome.
  9. Subject has any other disease apart from MS that could better explain the subjects signs and symptoms.
  10. Subject has complete transverse myelitis or bilateral optic neuritis.
  11. Subjects who used any investigational drug or experimental procedure within 12 weeks prior to visit 1.
  12. Subject has inadequate liver function, defined by a total bilirubin, aspartate aminotransferase (AST) or alanine aminotransferase (ALT) or alkaline phosphatase > 2.5 times the upper limit of the normal values.
  13. Subject has inadequate bone marrow reserve, defined as a white blood cell count less than 0.5 x lower limit of normal.
  14. Subject suffers from current autoimmune disease (other than RRMS).
  15. Subject suffers from major medical or psychiatric illness that in the opinion of the investigator creates undue risk to the subject or could affect compliance with the study protocol
  16. Subject is pregnant or attempting to conceive
  17. Visual or physical impairment that precludes completion of diaries and questionnaires.
  18. Subject received oral or systemic corticosteroids or ACTH within 30 days of visit 1.

Sites / Locations

  • EMD Serono Med Info

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

interferon beta-1a

interferon beta-1b

Outcomes

Primary Outcome Measures

Visual Analog Scale (VAS) of Patient Reported Pain: Change in Mean VAS for the 21 Full-dose Injections at Pre-injection and 30 Minutes Post-injection Timepoints
Subject reported perception of pain on the VAS where the slash drawn by the patient represents pain of increasing intensity from 0 (no pain) to 100 (worse possible pain), measured in millimeters. Mean VAS of 21 injections for each patient at pre-injection compared to mean VAS of 21 injections for each patient 30 minutes post-injection

Secondary Outcome Measures

Change in Mean VAS for the 21 Full-dose Injections at Pre-injection and Immediately After Injection Timepoints
A visual analog scale (VAS) ranging from 0 to 100 mm on which subjects rate pain from no pain (0 mm) to worst possible pain (100 mm) was used. Mean VAS of 21 injections for each patient at pre-injection compared to mean VAS of 21 injections for each patient immediately after injection.
Change in Mean VAS for the 21 Full-dose Injections at Pre-injection and 10 Minutes Post-injection Timepoints
A visual analog scale (VAS) ranging from 0 to 100 mm on which subjects rate pain from no pain (0 mm) to worst possible pain (100 mm) was used. Mean VAS of 21 injections for each patient at pre-injection compared to mean VAS of 21 injections for each patient 10 minutes post injection.
Number of Pain Free Patients at 30 Minutes Post-injection
A visual analog scale (VAS) ranging from 0 to 100 mm on which subjects rate pain from no pain (0 mm) to worst possible pain (100 mm) was used. Pain-free was defined as a VAS score of 0 for all 21 full-dose injections for the Intent-to-Treat (ITT) population.
Diameter of Injection Site Redness
Blinded assessment of mean change in diameter of redness (in mm) at an injection site following an injection

Full Information

First Posted
January 29, 2007
Last Updated
August 1, 2013
Sponsor
EMD Serono
Collaborators
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT00428584
Brief Title
RNF and Betaseron® Tolerability Study
Acronym
REFORMS
Official Title
A Randomized, Multicenter, Two Arm, Open Label, Twelve Week Phase IIIb Study to Evaluate the Tolerability of Rebif (New Formulation) (IFN Beta-1a) and Betaseron (IFN Beta-1b) in IFN-naive Subjects With Relapsing Remitting Multiple Sclerosis (RRMS) Followed by a Single Arm, Eighty-two Week Minimum, Rebif (New Formulation) Only Safety Extension
Study Type
Interventional

2. Study Status

Record Verification Date
August 2013
Overall Recruitment Status
Completed
Study Start Date
December 2006 (undefined)
Primary Completion Date
November 2007 (Actual)
Study Completion Date
September 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
EMD Serono
Collaborators
Pfizer

4. Oversight

5. Study Description

Brief Summary
To evaluate the tolerability of a new formulation of rebif and Betaseron in subjects with relapsing-remitting multiple sclerosis (RRMS) by comparing the mean change in injection site pain scores from pre-injection to 30 minutes post therapy administration.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsing Remitting Multiple Sclerosis (RRMS)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
129 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
interferon beta-1a
Arm Title
2
Arm Type
Active Comparator
Arm Description
interferon beta-1b
Intervention Type
Drug
Intervention Name(s)
New Formulation of rebif - human interferon beta-1a
Intervention Description
New Formulation of rebif- 44 mcg, SC (sub-cutaneous) thrice weekly (tiw) injection.
Intervention Type
Drug
Intervention Name(s)
Interferon beta -1b
Intervention Description
Betaseron - 250 mcg, SC (sub-cutaneous) every other day injection.
Primary Outcome Measure Information:
Title
Visual Analog Scale (VAS) of Patient Reported Pain: Change in Mean VAS for the 21 Full-dose Injections at Pre-injection and 30 Minutes Post-injection Timepoints
Description
Subject reported perception of pain on the VAS where the slash drawn by the patient represents pain of increasing intensity from 0 (no pain) to 100 (worse possible pain), measured in millimeters. Mean VAS of 21 injections for each patient at pre-injection compared to mean VAS of 21 injections for each patient 30 minutes post-injection
Time Frame
From pre-injection to 30 minutes post injection of the VAS pain scores across the first 21 injections of full dose therapy of a new formulation of rebif and Betaseron
Secondary Outcome Measure Information:
Title
Change in Mean VAS for the 21 Full-dose Injections at Pre-injection and Immediately After Injection Timepoints
Description
A visual analog scale (VAS) ranging from 0 to 100 mm on which subjects rate pain from no pain (0 mm) to worst possible pain (100 mm) was used. Mean VAS of 21 injections for each patient at pre-injection compared to mean VAS of 21 injections for each patient immediately after injection.
Time Frame
Pre-Injection to Immediately after Injection
Title
Change in Mean VAS for the 21 Full-dose Injections at Pre-injection and 10 Minutes Post-injection Timepoints
Description
A visual analog scale (VAS) ranging from 0 to 100 mm on which subjects rate pain from no pain (0 mm) to worst possible pain (100 mm) was used. Mean VAS of 21 injections for each patient at pre-injection compared to mean VAS of 21 injections for each patient 10 minutes post injection.
Time Frame
Pre-injection to 10 minutes post-injection
Title
Number of Pain Free Patients at 30 Minutes Post-injection
Description
A visual analog scale (VAS) ranging from 0 to 100 mm on which subjects rate pain from no pain (0 mm) to worst possible pain (100 mm) was used. Pain-free was defined as a VAS score of 0 for all 21 full-dose injections for the Intent-to-Treat (ITT) population.
Time Frame
30 minutes post injection
Title
Diameter of Injection Site Redness
Description
Blinded assessment of mean change in diameter of redness (in mm) at an injection site following an injection
Time Frame
1-72 hours post injection over the first 12 weeks including the titration period
Other Pre-specified Outcome Measures:
Title
Secondary Outcome - Extension Phase: Change in Mean (mm) VAS for Pre-injection and Immediately After Injection Timepoints
Description
A visual analog scale (VAS) ranging from 0 to 100 mm on which subjects rate pain from no pain (0 mm) to worst possible pain (100 mm) was used. Mean VAS of 21 injections for each patient at pre-injection compared to mean VAS of 21 injections for each patient immediately after injection.
Time Frame
Pre-injection and immediately after injection
Title
Secondary Outcome - Extension Phase: Change in Mean VAS at Pre-injection and 10 Minutes Post Injection
Time Frame
Pre-injection and 10 minutes post injection
Title
Secondary Outcome - Extension Phase: Number of Pain Free Patients at 30 Minutes Post Injection
Time Frame
Pain free patients at 30 minutes post injection
Title
Secondary Outcome - Extension Phase: Diameter in Injection Site Redness
Time Frame
1 to 72 hours post injection
Title
Primary Outcome - Extension Phase: Visual Analog Scale (VAS) of Patients Reported Pain; Change in Mean VAS at Pre-injection and 30 Minutes Post Injection
Time Frame
Pre-injection and 30 minutes post injection

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject with diagnosis of RRMS according to McDonald criteria or Poser Subject is between 18 and 60 years old inclusive Subject is willing to follow study procedures Subject has given written informed consent Female subjects must be neither pregnant nor breast-feeding and must lack childbearing potential, as defined by either: Being post-menopausal or surgically sterile, or Using a hormonal contraceptive, intra-uterine device, diaphragm with spermicide, or condom with spermicide, for the duration of the study. Exclusion Criteria: Subject has Clinically Isolated Syndrome (CIS), Primary Progressive MS, or Secondary Progressive MS without superimposed relapses. Subject has had any prior interferon beta therapy (either beta-1b or beta-1a) prior to study Day 1. Subject received any other approved disease modifying therapy for MS (glatiramer acetate) or any cytokine or anti-cytokine therapy within the 3 months prior to Study Day 1. Subject received immunomodulatory or immunosuppressive therapy (including but not limited to cyclophosphamide, cyclosporin, methotrexate, azathioprine, linomide, mitoxantrone, teriflunomide, natalizumab, laquinimod, Campath and cladribine) within the 12 months prior to Study Day 1. Subject had prior use of Cladribine or has previously received total lymphoid irradiation. Subject has known allergy to natural or recombinant interferon or any other component of formulation excipient(s) of Rebif® or Betaseron®: Mannitol, Poloxamer 188, Methionine, Benzyl alcohol or Albumin (human). Use of any other injectable medications on a regular basis during the week prior to the screening period or during the screening or treatment periods. Receiving a single injection for treatment or prophylaxis of a condition unrelated to the subject's multiple sclerosis or the subject's Rebif® or Betaseron® therapy (e.g. receiving a influenza or pneumococcus vaccination) is acceptable. History of any chronic pain syndrome. Subject has any other disease apart from MS that could better explain the subjects signs and symptoms. Subject has complete transverse myelitis or bilateral optic neuritis. Subjects who used any investigational drug or experimental procedure within 12 weeks prior to visit 1. Subject has inadequate liver function, defined by a total bilirubin, aspartate aminotransferase (AST) or alanine aminotransferase (ALT) or alkaline phosphatase > 2.5 times the upper limit of the normal values. Subject has inadequate bone marrow reserve, defined as a white blood cell count less than 0.5 x lower limit of normal. Subject suffers from current autoimmune disease (other than RRMS). Subject suffers from major medical or psychiatric illness that in the opinion of the investigator creates undue risk to the subject or could affect compliance with the study protocol Subject is pregnant or attempting to conceive Visual or physical impairment that precludes completion of diaries and questionnaires. Subject received oral or systemic corticosteroids or ACTH within 30 days of visit 1.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Fernando Dangond, MD
Organizational Affiliation
EMD Serono
Official's Role
Study Director
Facility Information:
Facility Name
EMD Serono Med Info
City
Rockland
State/Province
Massachusetts
ZIP/Postal Code
02370
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23216674
Citation
Singer B, Bandari D, Cascione M, LaGanke C, Huddlestone J, Bennett R, Dangond F; REFORMS Study Group. Comparative injection-site pain and tolerability of subcutaneous serum-free formulation of interferonbeta-1a versus subcutaneous interferonbeta-1b: results of the randomized, multicenter, Phase IIIb REFORMS study. BMC Neurol. 2012 Dec 6;12:154. doi: 10.1186/1471-2377-12-154.
Results Reference
derived
Links:
URL
http://www.mslifelines.com
Description
Full FDA approved prescribing information can be found here

Learn more about this trial

RNF and Betaseron® Tolerability Study

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