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Safety and Tolerability Study of MEDI-551, a B-cell Depleting Agent, to Treat Relapsing Forms of Multiple Sclerosis

Primary Purpose

Multiple Sclerosis, Relapsing Forms

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
MEDI-551 30 MG-IV
MEDI-551 60 MG-SC
PLACEBO-IV-SC
MEDI-551 100 MG-IV
MEDI-551 300 MG-SC
MEDI-551 600 MG-IV
Sponsored by
MedImmune LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Sclerosis, Relapsing Forms focused on measuring MAb, B cell, depletion, RMS

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Confirmed relapsing form of MS (ie, RRMS, SPMS, PRMS, or CIS) according to revised 2010 McDonald criteria and MRI brain lesions consistent with MS on screening
  • At least 1 documented relapse within the past 3 years prior to screening
  • EDSS between 0.0 and 6.5 at screening
  • Have no more than 20 Gd-enhancing T1 brain lesions detected by cranial MRI scan

Exclusion Criteria:

  • Subjects with impaired renal function
  • Major surgery within 8 weeks of the screening visit
  • Subjects who are unable to undergo cranial MRI scan
  • A history of hypersensitivity to Gd-containing MRI contrast agents
  • Has received within 1 year prior to screening: monoclonal antibodies, experimental B-cell depleting agents, or treatment with natalizumab (Tysabri) for greater than 3 months
  • Receiving monthly methylprednisone or equivalent glucocorticoid for disease modification of a relapsing form of MS
  • Known sensitivity to acetaminophen/paracetamol, diphenhydramine or equivalent antihistamine, methylprednisolone or equivalent glucocorticoid, or to any component of the investigational drug
  • Diagnosis of PPMS, neuromyelitis optica, or other non-MS variant of neuro-inflammatory or demyelinating diseases
  • Any history of opportunistic infection or the presence of active infection within two months prior to screening or any herpes zoster infection that has not resolved within 12 weeks prior to screening
  • Any clinically significant findings during the screening phase, including physical, neurological, laboratory, or ECG examination as per protocol

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

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

MEDI-551 30 MG-IV

MEDI-551 60 MG-SC

MEDI-551 100 MG-IV

MEDI-551 300 MG-SC

MEDI-551 600 MG-IV

PLACEBO-IV-SC

Arm Description

Participants received a fixed IV dose of 30 milligram (mg) MEDI-551 infused on Days 1 and 15.

Participants received SC injection of 60 mg MEDI-551 on Day 1.

Participants received a fixed IV dose of 100 mg MEDI-551 infused on Days 1 and 15.

Participants received SC injection of 300 mg MEDI-551 on Day 1.

Participants received a fixed IV dose of 600 mg MEDI-551 infused on Days 1 and 15.

Participants received either a fixed IV dose of placebo matching with MEDI- 551 on Days 1 and 15 or SC injection on Day 1.

Outcomes

Primary Outcome Measures

Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
An adverse event (AE) is any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of study drug, whether or not considered related to the study drug. A TEAE were the events between administration of study drug (Day 1) and Day 169 that were absent before treatment or that worsened relative to pre-treatment state. The AEs were summarized using Medical Dictionary for Regulatory Activities version 19.0
Number of Participants With Treatment-emergent Serious Adverse Events (TESAEs)
A serious adverse event (SAE) is an AE resulting in any of the following outcomes or deemed significant for any other reason: death, life-threatening, initial or prolonged inpatient hospitalization, persistent or significant disability or incapacity, congenital anomaly or birth defect in the offspring of a participant who received the study drug. The TESAEs were the events between administration of study drug (Day 1) and long term follow up period (up to 18 months after early discontinuation visit or 24-week treatment period) that were absent before treatment or that worsened relative to pre-treatment state. The AEs were summarized using Medical Dictionary for Regulatory Activities version 19.0
Number of Participants With Clinical Laboratory Abnormalities Reported as TEAEs
Any clinically significant change in laboratory evaluations were recorded as AEs. The following parameters were analyzed for laboratory evaluations: haematology, serum chemistry, and urinalysis. Number of participants with TEAEs related to laboratory evaluations were reported.
Number of Participants With Vital Sign Abnormalities Reported as TEAEs
Vital sign parameters included blood pressure, temperature, pulse rate, and respiratory rate. The number of participants with TEAEs related to vital signs in participants were reported.

Secondary Outcome Measures

Time to Reach Maximum Observed Serum Concentration (Tmax) of MEDI-551
The time to reach the maximum observed serum concentration of MEDI-551.
Maximum Observed Serum Concentration (Cmax) of MEDI-551
The maximum observed serum concentration (Cmax) of MEDI-551.
Area Under the Plasma Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUC 0-last) of MEDI-551
The area under the concentration time curve from time 0 (dosing time) to the last measurable concentration (AUC 0-last) of MEDI-551.
Area Under the Plasma Concentration-time Curve From Zero to Infinity (AUC 0-infinity) of MEDI-551
The area under the concentration-time curve from dosing extrapolated to infinity (AUC 0-infinity) of MEDI-551.
Dose Normalized Area Under the Plasma Concentration-time Curve From Zero to Infinity (AUC 0-infinity/D) of MEDI-551
The AUC (0-infinity)/D is the area under concentration-time curve extrapolated to infinity post dose normalized by MEDI-551.
Clearance of MEDI-551
Systemic clearance (CL) for MEDI-551 IV cohorts and apparent clearance (CL/F) for MEDI-551 SC cohorts were calculated
Terminal Elimination Half-life (t1/2) of MEDI-551
The terminal elimination half-life (t1/2) was estimated based on the plasma concentrations of MEDI-551.
Absolute Subcutaneous Bioavailability (F%) of MEDI-551
Bioavailability (F%) is the fraction of the study drug absorbed through non-intravenous administration compared with the corresponding intravenous administration of the same drug.
Absolute CD20 B-cell Count at Baseline
Baseline absolute CD20 count is measured as the average between screening and predose on Day 1.
Time to 90 Percent (%) CD20 B-cell Depletion
Time in days of first observation where CD20 counts fall to or below 10 percent (%) of baseline.
Duration of Suppression Greater Than or Equal to 90 % of CD20 B-cell Count
Time in days of last observation where CD20 counts remain at or below 10% of baseline. Participants whose samples are available were analyzed for this outcome measure.
Maximum Change From Baseline in Absolute CD20 of Peripheral Blood B-cell Count to LTFU
The maximum degree of depletion (intensity) measured during the course of the study for each participant by subtracting 100 from the lowest observed percent of baseline value.
Number of Participants Positive for Anti-Drug Antibodies to MEDI-551
A participant was considered anti-drug antibody positive across the study if they had a positive reading at any time point during the study.

Full Information

First Posted
April 9, 2012
Last Updated
February 8, 2018
Sponsor
MedImmune LLC
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1. Study Identification

Unique Protocol Identification Number
NCT01585766
Brief Title
Safety and Tolerability Study of MEDI-551, a B-cell Depleting Agent, to Treat Relapsing Forms of Multiple Sclerosis
Official Title
A Phase 1 Randomized Study of MEDI-551 in Subjects With Relapsing Forms of Multiple Sclerosis
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
April 24, 2012 (Actual)
Primary Completion Date
January 2, 2015 (Actual)
Study Completion Date
June 20, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MedImmune LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and tolerability of ascending intravenous (IV) and subcutaneous (SC) doses of MEDI-551 in adult subjects with relapsing forms of multiple sclerosis (MS).
Detailed Description
This is a Phase 1, multicenter, multinational, randomized, blinded, placebo-controlled, dose-escalation study to evaluate the safety and tolerability of IV and SC doses of MEDI-551 in adult subjects with relapsing forms of MS.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis, Relapsing Forms
Keywords
MAb, B cell, depletion, RMS

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
56 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MEDI-551 30 MG-IV
Arm Type
Experimental
Arm Description
Participants received a fixed IV dose of 30 milligram (mg) MEDI-551 infused on Days 1 and 15.
Arm Title
MEDI-551 60 MG-SC
Arm Type
Experimental
Arm Description
Participants received SC injection of 60 mg MEDI-551 on Day 1.
Arm Title
MEDI-551 100 MG-IV
Arm Type
Experimental
Arm Description
Participants received a fixed IV dose of 100 mg MEDI-551 infused on Days 1 and 15.
Arm Title
MEDI-551 300 MG-SC
Arm Type
Experimental
Arm Description
Participants received SC injection of 300 mg MEDI-551 on Day 1.
Arm Title
MEDI-551 600 MG-IV
Arm Type
Experimental
Arm Description
Participants received a fixed IV dose of 600 mg MEDI-551 infused on Days 1 and 15.
Arm Title
PLACEBO-IV-SC
Arm Type
Placebo Comparator
Arm Description
Participants received either a fixed IV dose of placebo matching with MEDI- 551 on Days 1 and 15 or SC injection on Day 1.
Intervention Type
Drug
Intervention Name(s)
MEDI-551 30 MG-IV
Intervention Description
Participants received a fixed IV dose of 30 milligram (mg) MEDI-551 infused on Days 1 and 15.
Intervention Type
Drug
Intervention Name(s)
MEDI-551 60 MG-SC
Intervention Description
Participants received SC injection of 60 mg MEDI-551 on Day 1.
Intervention Type
Drug
Intervention Name(s)
PLACEBO-IV-SC
Intervention Description
Participants received either a fixed IV dose of placebo matching with MEDI- 551 on Days 1 and 15 or SC injection on Day 1
Intervention Type
Drug
Intervention Name(s)
MEDI-551 100 MG-IV
Intervention Description
Participants received a fixed IV dose of 100 mg MEDI-551 infused on Days 1 and 15.
Intervention Type
Drug
Intervention Name(s)
MEDI-551 300 MG-SC
Intervention Description
Participants received SC injection of 300 mg MEDI-551 on Day 1.
Intervention Type
Drug
Intervention Name(s)
MEDI-551 600 MG-IV
Intervention Description
Participants received a fixed IV dose of 600 mg MEDI-551 infused on Days 1 and 15.
Primary Outcome Measure Information:
Title
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Description
An adverse event (AE) is any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of study drug, whether or not considered related to the study drug. A TEAE were the events between administration of study drug (Day 1) and Day 169 that were absent before treatment or that worsened relative to pre-treatment state. The AEs were summarized using Medical Dictionary for Regulatory Activities version 19.0
Time Frame
From study drug administration (Day 1) through the end of treatment period (Day 169)
Title
Number of Participants With Treatment-emergent Serious Adverse Events (TESAEs)
Description
A serious adverse event (SAE) is an AE resulting in any of the following outcomes or deemed significant for any other reason: death, life-threatening, initial or prolonged inpatient hospitalization, persistent or significant disability or incapacity, congenital anomaly or birth defect in the offspring of a participant who received the study drug. The TESAEs were the events between administration of study drug (Day 1) and long term follow up period (up to 18 months after early discontinuation visit or 24-week treatment period) that were absent before treatment or that worsened relative to pre-treatment state. The AEs were summarized using Medical Dictionary for Regulatory Activities version 19.0
Time Frame
From study drug administration (Day 1) through the long term follow up period (up to 18 months after early discontinuation visit or 24 week treatment period).
Title
Number of Participants With Clinical Laboratory Abnormalities Reported as TEAEs
Description
Any clinically significant change in laboratory evaluations were recorded as AEs. The following parameters were analyzed for laboratory evaluations: haematology, serum chemistry, and urinalysis. Number of participants with TEAEs related to laboratory evaluations were reported.
Time Frame
From study drug administration (Day 1) through the end of treatment period (Day 169)
Title
Number of Participants With Vital Sign Abnormalities Reported as TEAEs
Description
Vital sign parameters included blood pressure, temperature, pulse rate, and respiratory rate. The number of participants with TEAEs related to vital signs in participants were reported.
Time Frame
From study drug administration (Day 1) through the end of treatment period (Day 169)
Secondary Outcome Measure Information:
Title
Time to Reach Maximum Observed Serum Concentration (Tmax) of MEDI-551
Description
The time to reach the maximum observed serum concentration of MEDI-551.
Time Frame
Predose (Day 1) and Postdose (IV Cohorts only), Days 4 (SC Cohorts only), 8, 15 Predose and Postdose (IV Cohorts only), 29, 57, 85, 113, 141, and 169
Title
Maximum Observed Serum Concentration (Cmax) of MEDI-551
Description
The maximum observed serum concentration (Cmax) of MEDI-551.
Time Frame
Predose (Day 1) and Postdose (IV Cohorts only), Days 4 (SC Cohorts only), 8, 15 Predose and Postdose (IV Cohorts only), 29, 57, 85, 113, 141, and 169
Title
Area Under the Plasma Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUC 0-last) of MEDI-551
Description
The area under the concentration time curve from time 0 (dosing time) to the last measurable concentration (AUC 0-last) of MEDI-551.
Time Frame
Predose (Day 1) and Postdose (IV Cohorts only), Days 4 (SC Cohorts only), 8, 15 Predose and Postdose (IV Cohorts only), 29, 57, 85, 113, 141, and 169
Title
Area Under the Plasma Concentration-time Curve From Zero to Infinity (AUC 0-infinity) of MEDI-551
Description
The area under the concentration-time curve from dosing extrapolated to infinity (AUC 0-infinity) of MEDI-551.
Time Frame
Predose (Day 1) and Postdose (IV Cohorts only), Days 4 (SC Cohorts only), 8, 15 Predose and Postdose (IV Cohorts only), 29, 57, 85, 113, 141, and 169
Title
Dose Normalized Area Under the Plasma Concentration-time Curve From Zero to Infinity (AUC 0-infinity/D) of MEDI-551
Description
The AUC (0-infinity)/D is the area under concentration-time curve extrapolated to infinity post dose normalized by MEDI-551.
Time Frame
Predose (Day 1) and Postdose (IV Cohorts only), Days 4 (SC Cohorts only), 8, 15 Predose and Postdose (IV Cohorts only), 29, 57, 85, 113, 141, and 169
Title
Clearance of MEDI-551
Description
Systemic clearance (CL) for MEDI-551 IV cohorts and apparent clearance (CL/F) for MEDI-551 SC cohorts were calculated
Time Frame
Predose (Day 1) and Postdose (IV Cohorts only), Days 4 (SC Cohorts only), 8, 15 Predose and Postdose (IV Cohorts only), 29, 57, 85, 113, 141, and 169
Title
Terminal Elimination Half-life (t1/2) of MEDI-551
Description
The terminal elimination half-life (t1/2) was estimated based on the plasma concentrations of MEDI-551.
Time Frame
Predose (Day 1) and Postdose (IV Cohorts only), Days 4 (SC Cohorts only), 8, 15 Predose and Postdose (IV Cohorts only), 29, 57, 85, 113, 141, and 169
Title
Absolute Subcutaneous Bioavailability (F%) of MEDI-551
Description
Bioavailability (F%) is the fraction of the study drug absorbed through non-intravenous administration compared with the corresponding intravenous administration of the same drug.
Time Frame
Predose (Day 1) and Days 4, 8, 15, 29, 57, 85, 113, 141, and 169
Title
Absolute CD20 B-cell Count at Baseline
Description
Baseline absolute CD20 count is measured as the average between screening and predose on Day 1.
Time Frame
Baseline (Days -28 to -1)
Title
Time to 90 Percent (%) CD20 B-cell Depletion
Description
Time in days of first observation where CD20 counts fall to or below 10 percent (%) of baseline.
Time Frame
Baseline (Days -28 to -1) to long-term follow-up (LTFU) (Up to 18 months after EDV or 24 Week treatment period)
Title
Duration of Suppression Greater Than or Equal to 90 % of CD20 B-cell Count
Description
Time in days of last observation where CD20 counts remain at or below 10% of baseline. Participants whose samples are available were analyzed for this outcome measure.
Time Frame
Baseline (Days -28 to -1) to LTFU (Up to 18 months after EDV or 24 Week treatment period)
Title
Maximum Change From Baseline in Absolute CD20 of Peripheral Blood B-cell Count to LTFU
Description
The maximum degree of depletion (intensity) measured during the course of the study for each participant by subtracting 100 from the lowest observed percent of baseline value.
Time Frame
Baseline (Days -28 to -1) to LTFU (Up to 18 months after EDV or 24 Week treatment period)
Title
Number of Participants Positive for Anti-Drug Antibodies to MEDI-551
Description
A participant was considered anti-drug antibody positive across the study if they had a positive reading at any time point during the study.
Time Frame
Days 1, 29, 85 and 169

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Confirmed relapsing form of MS (ie, RRMS, SPMS, PRMS, or CIS) according to revised 2010 McDonald criteria and MRI brain lesions consistent with MS on screening At least 1 documented relapse within the past 3 years prior to screening EDSS between 0.0 and 6.5 at screening Have no more than 20 Gd-enhancing T1 brain lesions detected by cranial MRI scan Exclusion Criteria: Subjects with impaired renal function Major surgery within 8 weeks of the screening visit Subjects who are unable to undergo cranial MRI scan A history of hypersensitivity to Gd-containing MRI contrast agents Has received within 1 year prior to screening: monoclonal antibodies, experimental B-cell depleting agents, or treatment with natalizumab (Tysabri) for greater than 3 months Receiving monthly methylprednisone or equivalent glucocorticoid for disease modification of a relapsing form of MS Known sensitivity to acetaminophen/paracetamol, diphenhydramine or equivalent antihistamine, methylprednisolone or equivalent glucocorticoid, or to any component of the investigational drug Diagnosis of PPMS, neuromyelitis optica, or other non-MS variant of neuro-inflammatory or demyelinating diseases Any history of opportunistic infection or the presence of active infection within two months prior to screening or any herpes zoster infection that has not resolved within 12 weeks prior to screening Any clinically significant findings during the screening phase, including physical, neurological, laboratory, or ECG examination as per protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Armando Flor
Organizational Affiliation
MedImmune LLC
Official's Role
Study Director
Facility Information:
Facility Name
Research Site
City
Scottsdale
State/Province
Arizona
Country
United States
Facility Name
Research Site
City
Long Beach
State/Province
California
Country
United States
Facility Name
Research Site
City
Sacramento
State/Province
California
Country
United States
Facility Name
Research Site
City
Denver
State/Province
Colorado
Country
United States
Facility Name
Research Site
City
Tampa
State/Province
Florida
Country
United States
Facility Name
Research Site
City
Marlton
State/Province
New Jersey
Country
United States
Facility Name
Research Site
City
Winston-Salem
State/Province
North Carolina
Country
United States
Facility Name
Research Site
City
Cordova
State/Province
Tennessee
Country
United States
Facility Name
Research Site
City
Houston
State/Province
Texas
Country
United States
Facility Name
Research Site
City
Katowice
Country
Poland
Facility Name
Research Site
City
Szczecin
Country
Poland
Facility Name
Research Site
City
Barcelona
Country
Spain
Facility Name
Research Site
City
Girona
Country
Spain
Facility Name
Research Site
City
Sevilla
Country
Spain
Facility Name
Research Site
City
Donetsk
Country
Ukraine
Facility Name
Research Site
City
Kyiv
Country
Ukraine

12. IPD Sharing Statement

Learn more about this trial

Safety and Tolerability Study of MEDI-551, a B-cell Depleting Agent, to Treat Relapsing Forms of Multiple Sclerosis

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