Natalizumab (BG00002, Tysabri) Study in Japanese Participants With Relapsing-Remitting Multiple Sclerosis (RRMS) (Tysabri Japan)
Primary Purpose
Multiple Sclerosis
Status
Completed
Phase
Phase 2
Locations
Japan
Study Type
Interventional
Intervention
Natalizumab (BG00002)
Placebo
Sponsored by

About this trial
This is an interventional treatment trial for Multiple Sclerosis
Eligibility Criteria
Part A
Key Inclusion Criteria:
- Must give written informed consent and any authorizations required by local law.
- Must have a diagnosis of relapsing-remitting MS, as defined by the revised McDonald criteria 1 through 4 (Polman et al, 2005). All other possible neurologic diagnoses must have been reasonably excluded by means of laboratory and/or imaging studies, in the opinion of the Investigator.
- Japanese men and women aged 18 to 65, inclusive, at the time of informed consent.
- All male subjects and female subjects of childbearing potential must practice effective contraception during the study and be able to continue contraception for 12 weeks after their last dose of study treatment.
- Must have an Expanded Disability Status Scale (EDSS) score between 0.0 and 6.0, inclusive.
- Must have experienced at least 1 medically documented clinical exacerbation within 12 months of enrollment.
- Must be willing to remain free from concomitant immunosuppressive or immunomodulatory treatment (including interferon beta [IFNβ] and chronic systemic corticosteroids) for the duration of the study.
- Must have a baseline MRI, conducted within 35 calendar days prior to enrollment.
Key Exclusion Criteria:
- Diagnosis or history of neuromyelitis optica (NMO), e.g., a long spinal lesion extending over 3 or more vertebral bodies was detected, or the subject has a history of positive tests for anti-aquaporin-4 (anti-AQP4) antibodies.
- The subject is considered by the Investigator to be immunocompromised, based on medical history, physical examination, laboratory testing, or prior immunosuppressive or immunomodulating treatment.
- An MS exacerbation (relapse) within 30 days prior to enrollment or, in the opinion of the Investigator, the subject has not stabilized from a relapse prior to enrollment at Week 0.
- History of malignancy.
- Known history of, or positive test result for human immunodeficiency virus (HIV) infection.
- Known history of or positive test result for hepatitis C virus or hepatitis B virus within the year prior to enrollment.
- History of severe allergic or anaphylactic reactions or known drug hypersensitivity.
- A clinically significant infectious illness within 30 days prior to enrollment.
- Abnormal liver function test results at screening: alanine aminotransferase (ALT), or aspartate aminotransferase (AST) >2 times of the upper limit of normal (ULN) or bilirubin >1.5 times of the ULN during screening.
- Previous treatment with natalizumab, any murine protein, or any other therapeutic monoclonal antibody.
- Any prior treatment with any of the following medications: total lymphoid irradiation, cladribine, T-cell or T-cell receptor vaccination.
- Treatment with immunosuppressant medications, e.g., azathioprine, cyclophosphamide, methotrexate, and fingolimod within 6 months prior to enrollment, or mitoxantrone and cyclosporine within 12 months prior to enrollment.
- Treatment with any of the following medications or procedures within 6 months prior to enrollment: intravenous immunoglobulin (IVIg), plasmapheresis, or cytapheresis.
- Treatment with immunomodulatory medications (including IFNβ and glatiramer acetate [GA]) within 2 weeks of enrollment.
- Treatment with any of the following medications within 30 days of enrollment: intravenous corticosteroid treatment, systemic corticosteroid treatment, 4-aminopyridine or related products.
- Participation in any other investigational treatment within the 6 months prior to enrollment or concurrent with this study.
Part B
Key Inclusion Criteria:
- Must give written informed consent and any authorizations required by local law.
- Must have a diagnosis of relapsing-remitting MS, as defined by the revised McDonald criteria 1 through 4 (Polman et al, 2005). All other possible neurologic diagnoses must have been reasonably excluded by means of laboratory and/or imaging studies, in the opinion of the Investigator.
- Japanese men and women aged 18 to 65, inclusive, at the time of informed consent.
- All male subjects and female subjects of childbearing potential must practice effective contraception during the study and be able to continue contraception for 12 weeks after their last dose of study treatment.
- Must have an EDSS score between 0.0 and 5.5, inclusive.
- Must have experienced at least 1 medically documented clinical exacerbation within 12 months of enrollment.
- Must be willing to remain free from concomitant immunosuppressive or immunomodulatory treatment (including IFNβ and chronic systemic corticosteroids) for the duration of the study.
- Prior to enrollment all subjects must have: a screening MRI, or documentation of an MRI within the subject's medical record within 1 year of the screening visit, which reveals 3 or more T2 hyperintense lesions consistent with MS, and a baseline MRI, conducted within 7 calendar days prior to enrollment, which reveals at least 1 MRI lesion consistent with MS.
Key Exclusion Criteria
- Diagnosis or history of NMO, e.g., a long spinal lesion extending over 3 or more vertebral bodies was detected, or the subject has a history of positive tests for anti-AQP4 antibodies.
- The subject is considered by the Investigator to be immunocompromised, based on medical history, physical examination, laboratory testing, or prior immunosuppressive or immunomodulating treatment.
- An MS exacerbation (relapse) within 30 days prior to enrollment or, in the opinion of the Investigator, the subject has not stabilized from a relapse prior to enrollment at Week 0.
- History of malignancy.
- Known history, or positive test result of HIV infection.
- Known history of or positive test result for hepatitis C virus or hepatitis B virus within the year prior to Enrollment.
- History of severe allergic or anaphylactic reactions or known drug hypersensitivity.
- A clinically significant infectious illness within 30 days prior to Enrollment.
- Abnormal liver function test results at screening: ALT or AST >2 times of the ULN or bilirubin >1.5 times of the ULN during screening.
- Previous treatment with natalizumab, any murine protein, or any other therapeutic monoclonal antibody.
- Any prior treatment with any of the following medications: total lymphoid irradiation, cladribine, T-cell or T-cell receptor vaccination.
- Treatment with immunosuppressant medications, e.g., azathioprine, cyclophosphamide, methotrexate, and fingolimod within 6 months prior to enrollment, or mitoxantrone and cyclosporine within 12 months prior to enrollment.
- Treatment with any of the following medications or procedures within 6 months prior to enrollment: IVIg, plasmapheresis, or cytapheresis.
- Treatment with immunomodulatory medications (including IFNβ and GA) within 2 weeks of enrollment.
- Treatment with any of the following medications within 30 days of enrollment: intravenous corticosteroid treatment, systemic corticosteroid treatment, 4-aminopyridine or related products.
- Participation in any other investigational treatment within the 6 months prior to enrollment or concurrent with this study.
NOTE: Other protocol defined inclusion/exclusion criteria may apply.
Sites / Locations
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Placebo Comparator
Experimental
Arm Label
Double-blind Natalizumab 300 mg
Double-blind Placebo
Open-label Natalizumab
Arm Description
300 mg IV infusions of natalizumab over 60 minutes every 4 weeks for 20 weeks
IV infusions of placebo over 60 minutes every 4 weeks for 20 weeks
300 mg IV infusions of natalizumab over 60 minutes every 4 weeks for 20 weeks
Outcomes
Primary Outcome Measures
Part A: Number of Participants With Adverse Events (AEs)
AE=any untoward medical occurrence that did not necessarily have a causal relationship with this treatment. Serious AE (SAE)=any untoward medical occurrence that at any dose: resulted in death; in the view of the Investigator, was a life threatening event; required inpatient hospitalization or prolongation of existing hospitalization; resulted in persistent or significant disability/incapacity; resulted in a congenital anomaly/birth defect; or any other medically important event that, in the opinion of the Investigator, may have jeopardized the participant or may have required intervention to prevent one of the other outcomes listed in the definition above. Events were categorized as related or not related; severity was categorized as mild, moderate, or severe.
Part B: Rate of Development of New Active Lesions Over 24 Weeks
New active lesions were the sum of the gadolinium-enhancing (Gd+) lesions and any new or newly enlarging T2 hyperintense lesions that did not enhance as seen on cranial magnetic resonance imaging (MRI) scans. The rate is calculated for each participant as the ordinary least squares slope of the cumulative new active lesions over time.
Secondary Outcome Measures
Part B: Cumulative Number of New Active Lesions Over 24 Weeks
Part B: Adjusted Annualized Relapse Rate Over 24 Weeks
The frequency of clinical exacerbations over 24 weeks was assessed using an annualized relapse rate that was calculated for each treatment group as the total number of relapses experienced in the group over the 24 weeks of treatment, divided by the total number of subject-years followed in the study. Obtained from a Poisson regression model, adjusted for the baseline relapse rate.
Part B: Cumulative Number of Gd+ Lesions Over 24 Weeks
Part B: Cumulative Number Of New Or Newly Enlarging, Non-Enhancing T2-Hyperintense Lesions Over 24 Weeks
Part B: Number of Participants Who Were Relapse Free Over 24 Weeks
Participants were categorized as relapse free=yes, relapse free=no, or relapse free=unknown. The category of relapse free=unknown includes participants who withdrew from the study and did not experience a relapse prior to withdrawal.
Part B: Change From Baseline to Weeks 12 and 24 in the Global Assessment of Well-Being As Assessed by Participants Using a Visual Analog Scale (VAS)
The participant's self-rating of global impression of his/her well-being was assessed with a VAS. The instrument ranged from 0 to 100 (mm), where a score of 0 denoted 'poor' and a score of 100 denoted 'excellent.'
Part A: Concentration of Natalizumab in Serum
The concentration of BG00002 in serum was determined using an Enzyme Linked Immunosorbent Assay (ELISA).
Part B: Concentration of Natalizumab in Serum
The concentration of BG00002 in serum was determined using an Enzyme Linked Immunosorbent Assay (ELISA).
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: Cmax
Observed maximum concentration (Cmax) was calculated using non-compartmental methods.
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: AUC(0-last) and (0-AUC∞)
Area under the curve to the last measurable concentration (AUC[0-last]); and area under the curve extrapolated to infinity (0-AUC∞) were calculated using non-compartmental methods.
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: Tmax and T1/2
Time to maximum concentration (Tmax) and half-life (T1/2) were calculated using non-compartmental methods.
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: Vd
Volume of distribution (Vd) was calculated using non-compartmental methods.
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: CL
Systemic clearance (CL) was calculated using non-compartmental methods.
Part B: Status of Serum Antibodies to Natalizumab
Persistent positivity is defined as 2 positive results separated by at least 6 to 12 weeks.
Part B: Number of Participants With Adverse Events (AEs)
AE=any untoward medical occurrence that did not necessarily have a causal relationship with this treatment. Serious AE (SAE)=any untoward medical occurrence that at any dose: resulted in death; in the view of the Investigator, was a life threatening event; required inpatient hospitalization or prolongation of existing hospitalization; resulted in persistent or significant disability/incapacity; resulted in a congenital anomaly/birth defect; or any other medically important event that, in the opinion of the Investigator, may have jeopardized the participant or may have required intervention to prevent one of the other outcomes listed in the definition above. Events were categorized as related or not related; severity was categorized as mild, moderate, or severe.
Part A: Natalizumab Binding Saturation Of α4 Integrin Sites On Peripheral Blood Mononuclear Cells (PBMC)
Pharmacodynamic activity was assessed by measuring the degree of saturation by BG00002 of the very late antigen-4 (VLA-4, also known as α4β1 integrin) receptor on peripheral blood mononuclear cell populations. This was accomplished by staining cells with phycoerythrin-conjugated anti-human immunoglobulin G4 (IgG4) antibody (hIgG4-PE) to label the cell-bound BG00002, followed by flow cytometric detection and quantification.
Part A: Summary of Lymphocyte Counts Over Time
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01440101
Brief Title
Natalizumab (BG00002, Tysabri) Study in Japanese Participants With Relapsing-Remitting Multiple Sclerosis (RRMS)
Acronym
Tysabri Japan
Official Title
Multicenter Study of BG00002 in Japanese Subjects With RRMS, Consisting of a Multiple-Dose, Open-Label Evaluation of Its Safety, Tolerability, Pharmacokinetics and Pharmacodynamics (Part A) and a Randomized, Double-Blind, Placebo-Controlled, Multiple-Dose Evaluation of Safety and Efficacy (Part B)
Study Type
Interventional
2. Study Status
Record Verification Date
October 2014
Overall Recruitment Status
Completed
Study Start Date
November 2010 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
August 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Biogen
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The primary objective of Part A is to determine the safety and tolerability of natalizumab administered over 24 weeks in Japanese participants with relapsing-remitting multiple sclerosis (MS). The endpoints for this will include assessment of adverse evetns (AEs), changes in laboratory evaluations, vital signs, Expanded Disability Status Scale (EDSS) scores, and changes in physical and neurological examination findings. The secondary objectives of Part A are to characterize the pharmacokinetics (PK) profile and pharmacodynamics (PD) of natalizumab.
The primary objective of Part B is to determine if natalizumab, when compared to placebo, is effective in treating Japanese participants with relapsing-remitting MS, as measured by new active lesions on cranial magnetic resonance imaging (MRI) scans over 24 weeks. New active lesions are the sum of the gadolinium-enhancing (Gd+) lesions and any new or newly-enlarging T2-hyperintense lesions that do not enhance. The primary endpoint is the rate of development of new active lesions over 24 weeks.
Secondary objectives of Part B are to determine over 24 weeks whether natalizumab, when compared to placebo, is effective in reducing the frequency of clinical exacerbations, reducing the number of Gd+ lesions, reducing the number of new or newly-enlarging T2-hyperintense lesions on brain MRI scans, increasing the proportion of relapse-free participants, and improving outcomes on visual analog scale (VAS) assessing the participant's global impression of his/her well-being. Additional objectives are to assess the safety and tolerability, the incidence of serum antibodies to natalizumab and the PK profile of natalizumab.
Detailed Description
This multicenter study has 2 parts and is designed to provide data in Japanese participants, as required for registration of natalizumab (BG00002) in Japan. Part A will consist of an open-label cohort of 12 participants who will receive 300 mg natalizumab intravenously (IV) every 4 weeks over a 6-month treatment period. Part B will consist of a double-blind, placebo-controlled cohort of approximately 90 participants randomized in a ratio of 1:1 to receive IV infusions of placebo or 300 mg BG00002 every 4 weeks over a 6-month period.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
106 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Double-blind Natalizumab 300 mg
Arm Type
Experimental
Arm Description
300 mg IV infusions of natalizumab over 60 minutes every 4 weeks for 20 weeks
Arm Title
Double-blind Placebo
Arm Type
Placebo Comparator
Arm Description
IV infusions of placebo over 60 minutes every 4 weeks for 20 weeks
Arm Title
Open-label Natalizumab
Arm Type
Experimental
Arm Description
300 mg IV infusions of natalizumab over 60 minutes every 4 weeks for 20 weeks
Intervention Type
Drug
Intervention Name(s)
Natalizumab (BG00002)
Other Intervention Name(s)
Tysabri
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Part A: Number of Participants With Adverse Events (AEs)
Description
AE=any untoward medical occurrence that did not necessarily have a causal relationship with this treatment. Serious AE (SAE)=any untoward medical occurrence that at any dose: resulted in death; in the view of the Investigator, was a life threatening event; required inpatient hospitalization or prolongation of existing hospitalization; resulted in persistent or significant disability/incapacity; resulted in a congenital anomaly/birth defect; or any other medically important event that, in the opinion of the Investigator, may have jeopardized the participant or may have required intervention to prevent one of the other outcomes listed in the definition above. Events were categorized as related or not related; severity was categorized as mild, moderate, or severe.
Time Frame
Baseline (Week 0) to Week 24
Title
Part B: Rate of Development of New Active Lesions Over 24 Weeks
Description
New active lesions were the sum of the gadolinium-enhancing (Gd+) lesions and any new or newly enlarging T2 hyperintense lesions that did not enhance as seen on cranial magnetic resonance imaging (MRI) scans. The rate is calculated for each participant as the ordinary least squares slope of the cumulative new active lesions over time.
Time Frame
Baseline (Week 0) to Week 24
Secondary Outcome Measure Information:
Title
Part B: Cumulative Number of New Active Lesions Over 24 Weeks
Time Frame
Baseline (Week 0) to Week 24
Title
Part B: Adjusted Annualized Relapse Rate Over 24 Weeks
Description
The frequency of clinical exacerbations over 24 weeks was assessed using an annualized relapse rate that was calculated for each treatment group as the total number of relapses experienced in the group over the 24 weeks of treatment, divided by the total number of subject-years followed in the study. Obtained from a Poisson regression model, adjusted for the baseline relapse rate.
Time Frame
Week 24
Title
Part B: Cumulative Number of Gd+ Lesions Over 24 Weeks
Time Frame
Baseline (Week 0) to Week 24
Title
Part B: Cumulative Number Of New Or Newly Enlarging, Non-Enhancing T2-Hyperintense Lesions Over 24 Weeks
Time Frame
Baseline (Week 0) to Week 24
Title
Part B: Number of Participants Who Were Relapse Free Over 24 Weeks
Description
Participants were categorized as relapse free=yes, relapse free=no, or relapse free=unknown. The category of relapse free=unknown includes participants who withdrew from the study and did not experience a relapse prior to withdrawal.
Time Frame
Baseline (Week 0) to Week 24
Title
Part B: Change From Baseline to Weeks 12 and 24 in the Global Assessment of Well-Being As Assessed by Participants Using a Visual Analog Scale (VAS)
Description
The participant's self-rating of global impression of his/her well-being was assessed with a VAS. The instrument ranged from 0 to 100 (mm), where a score of 0 denoted 'poor' and a score of 100 denoted 'excellent.'
Time Frame
Baseline (Week 0), Week 12, Week 24
Title
Part A: Concentration of Natalizumab in Serum
Description
The concentration of BG00002 in serum was determined using an Enzyme Linked Immunosorbent Assay (ELISA).
Time Frame
Week 0: pre-dose, post-dose and 2, 24, 48 and 96 hours post-dose; 7, 14, and 21 days post-dose; Weeks 4, 8, 12, and 16: pre-dose; Week 20 pre-dose, post-dose, and 2, 24, 48 and 96 hours post-dose; 7, 14, 21, and 28 days post-dose
Title
Part B: Concentration of Natalizumab in Serum
Description
The concentration of BG00002 in serum was determined using an Enzyme Linked Immunosorbent Assay (ELISA).
Time Frame
Baseline (Week 0), Week 12, Week 24
Title
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: Cmax
Description
Observed maximum concentration (Cmax) was calculated using non-compartmental methods.
Time Frame
Dose 1/Week 0: pre-dose, post-dose and 4, 24, 48 and 96 hours post-dose; Dose 6/Week 20 pre-dose, post-dose, and 4, 24, 48 and 96 hours post-dose; 7, 14, and 21 days post-dose
Title
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: AUC(0-last) and (0-AUC∞)
Description
Area under the curve to the last measurable concentration (AUC[0-last]); and area under the curve extrapolated to infinity (0-AUC∞) were calculated using non-compartmental methods.
Time Frame
Dose 1/Week 0: pre-dose, post-dose and 4, 24, 48 and 96 hours post-dose; Dose 6/Week 20 pre-dose, post-dose, and 4, 24, 48 and 96 hours post-dose; 7, 14, and 21 days post-dose
Title
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: Tmax and T1/2
Description
Time to maximum concentration (Tmax) and half-life (T1/2) were calculated using non-compartmental methods.
Time Frame
Dose 1/Week 0: pre-dose, post-dose and 4, 24, 48 and 96 hours post-dose; Dose 6/Week 20 pre-dose, post-dose, and 4, 24, 48 and 96 hours post-dose; 7, 14, and 21 days post-dose
Title
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: Vd
Description
Volume of distribution (Vd) was calculated using non-compartmental methods.
Time Frame
Dose 1/Week 0: pre-dose, post-dose and 4, 24, 48 and 96 hours post-dose; Dose 6/Week 20 pre-dose, post-dose, and 4, 24, 48 and 96 hours post-dose; 7, 14, and 21 days post-dose
Title
Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: CL
Description
Systemic clearance (CL) was calculated using non-compartmental methods.
Time Frame
Dose 1/Week 0: pre-dose, post-dose and 4, 24, 48 and 96 hours post-dose
Title
Part B: Status of Serum Antibodies to Natalizumab
Description
Persistent positivity is defined as 2 positive results separated by at least 6 to 12 weeks.
Time Frame
Baseline (Week 0) and Week 24
Title
Part B: Number of Participants With Adverse Events (AEs)
Description
AE=any untoward medical occurrence that did not necessarily have a causal relationship with this treatment. Serious AE (SAE)=any untoward medical occurrence that at any dose: resulted in death; in the view of the Investigator, was a life threatening event; required inpatient hospitalization or prolongation of existing hospitalization; resulted in persistent or significant disability/incapacity; resulted in a congenital anomaly/birth defect; or any other medically important event that, in the opinion of the Investigator, may have jeopardized the participant or may have required intervention to prevent one of the other outcomes listed in the definition above. Events were categorized as related or not related; severity was categorized as mild, moderate, or severe.
Time Frame
Baseline (Week 0) to Week 24
Title
Part A: Natalizumab Binding Saturation Of α4 Integrin Sites On Peripheral Blood Mononuclear Cells (PBMC)
Description
Pharmacodynamic activity was assessed by measuring the degree of saturation by BG00002 of the very late antigen-4 (VLA-4, also known as α4β1 integrin) receptor on peripheral blood mononuclear cell populations. This was accomplished by staining cells with phycoerythrin-conjugated anti-human immunoglobulin G4 (IgG4) antibody (hIgG4-PE) to label the cell-bound BG00002, followed by flow cytometric detection and quantification.
Time Frame
Pre-dose; 4 hours post-dose; 7, 14, 21, and 28 days post-dose; Weeks 8, 12, and 16: pre-dose; Week 20: pre-dose; 4 hours post-dose; 7, 14, 21, and 28 days post-dose
Title
Part A: Summary of Lymphocyte Counts Over Time
Time Frame
Baseline [Week 0]); 28 days post-dose; Weeks 12, 24, and 32 (follow-up)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Part A
Key Inclusion Criteria:
Must give written informed consent and any authorizations required by local law.
Must have a diagnosis of relapsing-remitting MS, as defined by the revised McDonald criteria 1 through 4 (Polman et al, 2005). All other possible neurologic diagnoses must have been reasonably excluded by means of laboratory and/or imaging studies, in the opinion of the Investigator.
Japanese men and women aged 18 to 65, inclusive, at the time of informed consent.
All male subjects and female subjects of childbearing potential must practice effective contraception during the study and be able to continue contraception for 12 weeks after their last dose of study treatment.
Must have an Expanded Disability Status Scale (EDSS) score between 0.0 and 6.0, inclusive.
Must have experienced at least 1 medically documented clinical exacerbation within 12 months of enrollment.
Must be willing to remain free from concomitant immunosuppressive or immunomodulatory treatment (including interferon beta [IFNβ] and chronic systemic corticosteroids) for the duration of the study.
Must have a baseline MRI, conducted within 35 calendar days prior to enrollment.
Key Exclusion Criteria:
Diagnosis or history of neuromyelitis optica (NMO), e.g., a long spinal lesion extending over 3 or more vertebral bodies was detected, or the subject has a history of positive tests for anti-aquaporin-4 (anti-AQP4) antibodies.
The subject is considered by the Investigator to be immunocompromised, based on medical history, physical examination, laboratory testing, or prior immunosuppressive or immunomodulating treatment.
An MS exacerbation (relapse) within 30 days prior to enrollment or, in the opinion of the Investigator, the subject has not stabilized from a relapse prior to enrollment at Week 0.
History of malignancy.
Known history of, or positive test result for human immunodeficiency virus (HIV) infection.
Known history of or positive test result for hepatitis C virus or hepatitis B virus within the year prior to enrollment.
History of severe allergic or anaphylactic reactions or known drug hypersensitivity.
A clinically significant infectious illness within 30 days prior to enrollment.
Abnormal liver function test results at screening: alanine aminotransferase (ALT), or aspartate aminotransferase (AST) >2 times of the upper limit of normal (ULN) or bilirubin >1.5 times of the ULN during screening.
Previous treatment with natalizumab, any murine protein, or any other therapeutic monoclonal antibody.
Any prior treatment with any of the following medications: total lymphoid irradiation, cladribine, T-cell or T-cell receptor vaccination.
Treatment with immunosuppressant medications, e.g., azathioprine, cyclophosphamide, methotrexate, and fingolimod within 6 months prior to enrollment, or mitoxantrone and cyclosporine within 12 months prior to enrollment.
Treatment with any of the following medications or procedures within 6 months prior to enrollment: intravenous immunoglobulin (IVIg), plasmapheresis, or cytapheresis.
Treatment with immunomodulatory medications (including IFNβ and glatiramer acetate [GA]) within 2 weeks of enrollment.
Treatment with any of the following medications within 30 days of enrollment: intravenous corticosteroid treatment, systemic corticosteroid treatment, 4-aminopyridine or related products.
Participation in any other investigational treatment within the 6 months prior to enrollment or concurrent with this study.
Part B
Key Inclusion Criteria:
Must give written informed consent and any authorizations required by local law.
Must have a diagnosis of relapsing-remitting MS, as defined by the revised McDonald criteria 1 through 4 (Polman et al, 2005). All other possible neurologic diagnoses must have been reasonably excluded by means of laboratory and/or imaging studies, in the opinion of the Investigator.
Japanese men and women aged 18 to 65, inclusive, at the time of informed consent.
All male subjects and female subjects of childbearing potential must practice effective contraception during the study and be able to continue contraception for 12 weeks after their last dose of study treatment.
Must have an EDSS score between 0.0 and 5.5, inclusive.
Must have experienced at least 1 medically documented clinical exacerbation within 12 months of enrollment.
Must be willing to remain free from concomitant immunosuppressive or immunomodulatory treatment (including IFNβ and chronic systemic corticosteroids) for the duration of the study.
Prior to enrollment all subjects must have: a screening MRI, or documentation of an MRI within the subject's medical record within 1 year of the screening visit, which reveals 3 or more T2 hyperintense lesions consistent with MS, and a baseline MRI, conducted within 7 calendar days prior to enrollment, which reveals at least 1 MRI lesion consistent with MS.
Key Exclusion Criteria
Diagnosis or history of NMO, e.g., a long spinal lesion extending over 3 or more vertebral bodies was detected, or the subject has a history of positive tests for anti-AQP4 antibodies.
The subject is considered by the Investigator to be immunocompromised, based on medical history, physical examination, laboratory testing, or prior immunosuppressive or immunomodulating treatment.
An MS exacerbation (relapse) within 30 days prior to enrollment or, in the opinion of the Investigator, the subject has not stabilized from a relapse prior to enrollment at Week 0.
History of malignancy.
Known history, or positive test result of HIV infection.
Known history of or positive test result for hepatitis C virus or hepatitis B virus within the year prior to Enrollment.
History of severe allergic or anaphylactic reactions or known drug hypersensitivity.
A clinically significant infectious illness within 30 days prior to Enrollment.
Abnormal liver function test results at screening: ALT or AST >2 times of the ULN or bilirubin >1.5 times of the ULN during screening.
Previous treatment with natalizumab, any murine protein, or any other therapeutic monoclonal antibody.
Any prior treatment with any of the following medications: total lymphoid irradiation, cladribine, T-cell or T-cell receptor vaccination.
Treatment with immunosuppressant medications, e.g., azathioprine, cyclophosphamide, methotrexate, and fingolimod within 6 months prior to enrollment, or mitoxantrone and cyclosporine within 12 months prior to enrollment.
Treatment with any of the following medications or procedures within 6 months prior to enrollment: IVIg, plasmapheresis, or cytapheresis.
Treatment with immunomodulatory medications (including IFNβ and GA) within 2 weeks of enrollment.
Treatment with any of the following medications within 30 days of enrollment: intravenous corticosteroid treatment, systemic corticosteroid treatment, 4-aminopyridine or related products.
Participation in any other investigational treatment within the 6 months prior to enrollment or concurrent with this study.
NOTE: Other protocol defined inclusion/exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Biogen
Official's Role
Study Director
Facility Information:
Facility Name
Research Site
City
Chiba
Country
Japan
Facility Name
Research Site
City
Fukuoka
Country
Japan
Facility Name
Research Site
City
Hiroshima
Country
Japan
Facility Name
Research Site
City
Kawagoe
Country
Japan
Facility Name
Research Site
City
Kyoto
Country
Japan
Facility Name
Research Site
City
Morioka
Country
Japan
Facility Name
Research Site
City
Niigata
Country
Japan
Facility Name
Research Site
City
Osaka
Country
Japan
Facility Name
Research Site
City
Otaku
Country
Japan
Facility Name
Research Site
City
Sapporo
Country
Japan
Facility Name
Research Site
City
Sendai
Country
Japan
Facility Name
Research Site
City
Suita
Country
Japan
Facility Name
Research Site
City
Tokorozawa
Country
Japan
Facility Name
Research Site
City
Tokyo
Country
Japan
Facility Name
Research Site
City
Tsukuba
Country
Japan
Facility Name
Research Site
City
Ube
Country
Japan
Facility Name
Research Site
City
Yokohama
Country
Japan
12. IPD Sharing Statement
Citations:
PubMed Identifier
28104251
Citation
Saida T, Kira JI, Kishida S, Yamamura T, Sudo Y, Ogiwara K, Tibung JT, Lucas N, Subramanyam M; Natalizumab Trial Principal Investigators. Efficacy, safety, and pharmacokinetics of natalizumab in Japanese multiple sclerosis patients: A double-blind, randomized controlled trial and open-label pharmacokinetic study. Mult Scler Relat Disord. 2017 Jan;11:25-31. doi: 10.1016/j.msard.2016.11.002. Epub 2016 Nov 11.
Results Reference
derived
PubMed Identifier
28078634
Citation
Saida T, Kira JI, Kishida S, Yamamura T, Ohtsuka N, Dong Q, Tibung JT. Natalizumab for Achieving Relapse-Free, T1 Gadolinium-Enhancing-Lesion-Free, and T2 Lesion-Free Status in Japanese Multiple Sclerosis Patients: A Phase 2 Trial Subanalysis. Neurol Ther. 2017 Jun;6(1):153-159. doi: 10.1007/s40120-016-0062-4. Epub 2017 Jan 11.
Results Reference
derived
Learn more about this trial
Natalizumab (BG00002, Tysabri) Study in Japanese Participants With Relapsing-Remitting Multiple Sclerosis (RRMS)
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