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One Year, Open Label, Dose Escalation Long-term Safety Study in Multiple Sclerosis (MS) Subjects With Spasticity

Primary Purpose

Multiple Sclerosis, Spasticity

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
arbaclofen
Sponsored by
RVL Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Sclerosis focused on measuring Multiple sclerosis, spasticity, arbaclofen

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients (male or female) 18 to 70 years of age, inclusive, at the time of the first dose.
  • Have an established diagnosis (per McDonald 2005 Criteria, of Multiple Sclerosis Appendix C (either relapsing remitting or secondary progressive course), that manifests spasticity.
  • If receiving disease-modifying medications (immunomodulatory treatment), these must have been at a stable dose for at least one (1) months prior to screening, and the subject must be willing to maintain this treatment for the duration of the study.
  • If receiving botulinum toxin must be on a stable treatment regimen (e.g. every 12 weeks).
  • If receiving phenol or alcohol injections, should have been received 60 days before enrolment in the study.
  • Absence of infections and peripheral vascular disease.
  • Have a creatinine clearance, as calculated by Glomerular Filtration Rate using the Modification of Diet in Renal Disease (MDRD) formula , greater than 60 milliliters/minute.
  • Use of a medically highly effective form of birth control during the study and for 90 days thereafter for women of child-bearing potential (including female subjects and female partners of non-sterile male subjects. .
  • Willing to allow his or her general practitioner and consultant, if appropriate, to be notified of participation in the study

Exclusion Criteria:

  • Any concomitant disease or disorder that has symptoms of spasticity or that may influence the subject's level of spasticity.
  • Inability to rate their level of spasticity or distinguish it from other MS symptoms.
  • History of allergy to baclofen.
  • Concomitant use of medications that would potentially interfere with the actions of the study medication or outcome variables (Appendix D Prohibited Concomitant Medications)
  • Pregnancy, lactation or planned pregnancy during the course of the study and for three months thereafter. (Confirmation that the subject is not pregnant must be established by a negative serum pregnancy test at baseline).
  • History of, or current unstable psychiatric disease, or signs and symptoms of significant medical disorders such as severe, progressive, or uncontrolled renal, hepatic, gastrointestinal, hematological, endocrine, immunologic, pulmonary, cardiac or neurological disease which, in the opinion of the investigator, may; put the subject at risk because of participation, influence the result of the study, or affect the subject's ability to participate.
  • Seizures requiring medication.
  • Current significant cognitive deficit, severe or untreated anxiety, severe or untreated depression.
  • Subjects with abnormal micturition that requires indwelling or intermittent catheterization or with lower urinary tract symptoms (LUTS) that result in a score greater than twenty-six (>26) in the Baseline Urinary Symptom Profile© questionnaire.
  • Current malignancy or history of malignancy that has not been in remission for more than five years, except effectively treated basal cell skin carcinoma.
  • History of substance abuse within the past twelve (12) months.
  • Participation in another interventional research study within thirty (30) days of Screening except OS440-3002.
  • Patients who are uncooperative or unwilling to sign consent form.

Sites / Locations

  • Osmotica Study Site-154
  • Osmotica Study Site-158
  • Osmotica Study Site-165
  • Osmotica Study Site-164
  • Osomtica Study Site-164
  • Osmotica Study Site-173
  • Osmotica Study Site-178
  • Osmotica Study Site-170
  • Osmotica Study Site-179
  • Osmotica Study Site-174
  • Osmotica Study Site-175
  • Osmotica Study Site-161
  • Osmotica Study Site-151
  • Osmotica Study Site-157
  • Osmotica Study Site-155
  • Osmotica Study Site-152
  • Osmotica Study Site-156
  • Osmotica Study Site-163
  • Osmotica Study Site-162
  • Osmotica Study Site-171
  • Osmotica Study Site-166
  • Osmotica Study Site-554
  • Osmotica Study Site-552
  • Osmotica Study Site-557
  • Osmotica Study Site-556
  • Osmotica Study Site-553
  • Osmotica Study Site-560
  • Osmotica Study Site-551
  • Osmotica Study Site-555
  • Osmotica Study Site-653
  • Osmotica Study Site-655
  • Osmotica Study Site-651
  • Osmotica Study Site-654
  • Osmotica Study Site-656
  • Osmotica Study Site-657

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arbaclofen Extended Release (ER) Tablets

Arm Description

Arbaclofen Extended Release Tablets, 20 mg/day, 30 mg/day or 40 mg/day

Outcomes

Primary Outcome Measures

Assessment of Adverse Events
Determination of incidence and severity of Adverse Events (AEs), discontinuations due to AEs and discontinuations due to failure of AERT to alleviate spasticity

Secondary Outcome Measures

Determination of Change in Spasticity by Total Number-transformed Modified Ashworth Scale (TNmAS)
Change in the total Numeric-transformed Modified Ashworth Scale from baseline to the end of the study (Day 393)

Full Information

First Posted
April 24, 2013
Last Updated
April 21, 2022
Sponsor
RVL Pharmaceuticals, Inc.
Collaborators
Osmotica Pharmaceutical US LLC
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1. Study Identification

Unique Protocol Identification Number
NCT01844232
Brief Title
One Year, Open Label, Dose Escalation Long-term Safety Study in Multiple Sclerosis (MS) Subjects With Spasticity
Official Title
A One Year, Open Label, Dose Escalation Study To Evaluate the Long-Term Safety of Arbaclofen Extended Release Tablets (AERT) in Multiple Sclerosis Subjects With Spasticity
Study Type
Interventional

2. Study Status

Record Verification Date
May 2015
Overall Recruitment Status
Completed
Study Start Date
April 2013 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
January 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
RVL Pharmaceuticals, Inc.
Collaborators
Osmotica Pharmaceutical US LLC

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Clinical protocol OS440-3003 is a multicenter, open-label, non-randomized, uncontrolled, dose escalation study to evaluate the safety and tolerability of Arbaclofen Extended Release Tablets over 1 year in Multiple Sclerosis (MS) subjects with spasticity. All subjects in this study will receive arbaclofen in the extended release tablet formulation.
Detailed Description
Clinical protocol OS440-3003 is a multicenter, open-label, non-randomized, uncontrolled, dose escalation study to evaluate the safety and tolerability of Arbaclofen Extended Release Tablets (AERT) over 1 year in MS subjects with spasticity. All subjects in this study will receive arbaclofen in the extended release tablet formulation. All subjects will begin treatment with arbaclofen at 20 milligrams (mg) per day (2 X 10 mg) for two weeks, then increase to 30 mg per day (2 X 15 mg) for two weeks, and then increase to 40 mg per day (2 X 20 mg) based on the Dose Escalation Criteria. Once the subject reaches the Maintenance Dose, they will remain on that dose for approximately 1 year. The Maintenance Dose is the highest tolerated dose, not to exceed 40 mg per day. In this study, the Up Titration Period begins with Visit 2 and ends when the Maintenance Dose is determined. The Maintenance Period is the time from establishment of the Maintenance Dose until the down-titration visit. For subjects that complete the study, the Maintenance Period is for approximately 1 year in duration. The Down Titration Period will be 2 weeks for subjects on the maintenance dose of 40 mg per day and 1 week for subjects on the maintenance dose of 30 mg per day. There is no down titration phase for subjects on a 20 mg per day maintenance dose. Subjects for whom the Maintenance Dose is 20 mg per day (i.e., subjects who did not tolerate the 30 mg/ day dose) will begin the 1 year Maintenance Period at Visit 4 and complete the study at Visit 8. Subjects for whom the Maintenance Dose is either 30 mg or 40 mg per day will begin the Maintenance Period at Visit 5 and complete the maintenance portion of the study at Visit 9. The next portion of the study is down titration. The subjects on the 20 mg per day Maintenance Dose will not have a down-titration. For subjects on the 30 mg per day Maintenance Dose, down-titration will begin at Visit 9 and continue for 1 week. These subjects will return for Visit 10 after the 1 week down-titration. For subjects on the 40 mg per day Maintenance Dose, down titration will begin at Visit 9 and continue for 2 weeks. These subjects will return for Visit 10 after the 2 week down-titration. Study visits will occur every two weeks until the Maintenance Dose is reached and then study visits will occur every three months with telephone follow-up calls monthly in between visits

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis, Spasticity
Keywords
Multiple sclerosis, spasticity, arbaclofen

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Sequential Assignment
Model Description
All subjects will begin treatment with arbaclofen at 20 milligrams (mg) per day (2 X 10 mg) for two weeks, then increase to 30 mg per day (2 X 15 mg) for two weeks, and then increase to 40 mg per day (2 X 20 mg) based on the Dose Escalation Criteria. Once the subject reaches the Maintenance Dose, they will remain on that dose for approximately 1 year. The Maintenance Dose is the highest tolerated dose, not to exceed 40 mg per day.
Masking
None (Open Label)
Allocation
N/A
Enrollment
150 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arbaclofen Extended Release (ER) Tablets
Arm Type
Experimental
Arm Description
Arbaclofen Extended Release Tablets, 20 mg/day, 30 mg/day or 40 mg/day
Intervention Type
Drug
Intervention Name(s)
arbaclofen
Other Intervention Name(s)
OS440
Intervention Description
Arbaclofen ER tablets, 20 mg, 30 mg and 40 mg
Primary Outcome Measure Information:
Title
Assessment of Adverse Events
Description
Determination of incidence and severity of Adverse Events (AEs), discontinuations due to AEs and discontinuations due to failure of AERT to alleviate spasticity
Time Frame
From the beginning of dose titration to end of study (day 393 of dosing)
Secondary Outcome Measure Information:
Title
Determination of Change in Spasticity by Total Number-transformed Modified Ashworth Scale (TNmAS)
Description
Change in the total Numeric-transformed Modified Ashworth Scale from baseline to the end of the study (Day 393)
Time Frame
From baseline (Day1, Visit 2) to end of treatment (Day 393)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients (male or female) 18 to 70 years of age, inclusive, at the time of the first dose. Have an established diagnosis (per McDonald 2005 Criteria, of Multiple Sclerosis Appendix C (either relapsing remitting or secondary progressive course), that manifests spasticity. If receiving disease-modifying medications (immunomodulatory treatment), these must have been at a stable dose for at least one (1) months prior to screening, and the subject must be willing to maintain this treatment for the duration of the study. If receiving botulinum toxin must be on a stable treatment regimen (e.g. every 12 weeks). If receiving phenol or alcohol injections, should have been received 60 days before enrolment in the study. Absence of infections and peripheral vascular disease. Have a creatinine clearance, as calculated by Glomerular Filtration Rate using the Modification of Diet in Renal Disease (MDRD) formula , greater than 60 milliliters/minute. Use of a medically highly effective form of birth control during the study and for 90 days thereafter for women of child-bearing potential (including female subjects and female partners of non-sterile male subjects. . Willing to allow his or her general practitioner and consultant, if appropriate, to be notified of participation in the study Exclusion Criteria: Any concomitant disease or disorder that has symptoms of spasticity or that may influence the subject's level of spasticity. Inability to rate their level of spasticity or distinguish it from other MS symptoms. History of allergy to baclofen. Concomitant use of medications that would potentially interfere with the actions of the study medication or outcome variables (Appendix D Prohibited Concomitant Medications) Pregnancy, lactation or planned pregnancy during the course of the study and for three months thereafter. (Confirmation that the subject is not pregnant must be established by a negative serum pregnancy test at baseline). History of, or current unstable psychiatric disease, or signs and symptoms of significant medical disorders such as severe, progressive, or uncontrolled renal, hepatic, gastrointestinal, hematological, endocrine, immunologic, pulmonary, cardiac or neurological disease which, in the opinion of the investigator, may; put the subject at risk because of participation, influence the result of the study, or affect the subject's ability to participate. Seizures requiring medication. Current significant cognitive deficit, severe or untreated anxiety, severe or untreated depression. Subjects with abnormal micturition that requires indwelling or intermittent catheterization or with lower urinary tract symptoms (LUTS) that result in a score greater than twenty-six (>26) in the Baseline Urinary Symptom Profile© questionnaire. Current malignancy or history of malignancy that has not been in remission for more than five years, except effectively treated basal cell skin carcinoma. History of substance abuse within the past twelve (12) months. Participation in another interventional research study within thirty (30) days of Screening except OS440-3002. Patients who are uncooperative or unwilling to sign consent form.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Praveen Tyle, Ph.D.
Organizational Affiliation
Osmotica Pharmaceutical
Official's Role
Study Chair
Facility Information:
Facility Name
Osmotica Study Site-154
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85234
Country
United States
Facility Name
Osmotica Study Site-158
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85032
Country
United States
Facility Name
Osmotica Study Site-165
City
Pasadena
State/Province
California
ZIP/Postal Code
91105
Country
United States
Facility Name
Osmotica Study Site-164
City
Torrance
State/Province
California
ZIP/Postal Code
90505
Country
United States
Facility Name
Osomtica Study Site-164
City
Torrance
State/Province
California
ZIP/Postal Code
90505
Country
United States
Facility Name
Osmotica Study Site-173
City
Bradenton
State/Province
Florida
ZIP/Postal Code
34205
Country
United States
Facility Name
Osmotica Study Site-178
City
Pompano Beach
State/Province
Florida
ZIP/Postal Code
33060
Country
United States
Facility Name
Osmotica Study Site-170
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Osmotica Study Site-179
City
Northbrook
State/Province
Illinois
ZIP/Postal Code
60096
Country
United States
Facility Name
Osmotica Study Site-174
City
Lenexa
State/Province
Kansas
ZIP/Postal Code
66214
Country
United States
Facility Name
Osmotica Study Site-175
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48104
Country
United States
Facility Name
Osmotica Study Site-161
City
Plainview
State/Province
New York
ZIP/Postal Code
11803
Country
United States
Facility Name
Osmotica Study Site-151
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Facility Name
Osmotica Study Site-157
City
High Point
State/Province
North Carolina
ZIP/Postal Code
27262
Country
United States
Facility Name
Osmotica Study Site-155
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Osmotica Study Site-152
City
Wilmington
State/Province
North Carolina
ZIP/Postal Code
28401
Country
United States
Facility Name
Osmotica Study Site-156
City
Dayton
State/Province
Ohio
ZIP/Postal Code
45417
Country
United States
Facility Name
Osmotica Study Site-163
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Osmotica Study Site-162
City
Franklin
State/Province
Tennessee
ZIP/Postal Code
37064
Country
United States
Facility Name
Osmotica Study Site-171
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Osmotica Study Site-166
City
Vienna
State/Province
Virginia
ZIP/Postal Code
22182
Country
United States
Facility Name
Osmotica Study Site-554
City
Krasnoyarsk
ZIP/Postal Code
660022
Country
Russian Federation
Facility Name
Osmotica Study Site-552
City
Krasnoyarsk
Country
Russian Federation
Facility Name
Osmotica Study Site-557
City
Moscow
ZIP/Postal Code
107150
Country
Russian Federation
Facility Name
Osmotica Study Site-556
City
Moscow
ZIP/Postal Code
127018
Country
Russian Federation
Facility Name
Osmotica Study Site-553
City
Pyatigorsk
Country
Russian Federation
Facility Name
Osmotica Study Site-560
City
Sestroretsk
ZIP/Postal Code
197706
Country
Russian Federation
Facility Name
Osmotica Study Site-551
City
St. Petersburg
ZIP/Postal Code
190000
Country
Russian Federation
Facility Name
Osmotica Study Site-555
City
Tonnel'nyy
ZIP/Postal Code
357034
Country
Russian Federation
Facility Name
Osmotica Study Site-653
City
Dnipropetrovsk
ZIP/Postal Code
49022
Country
Ukraine
Facility Name
Osmotica Study Site-655
City
Dnipropetrovsk
ZIP/Postal Code
53012
Country
Ukraine
Facility Name
Osmotica Study Site-651
City
Donetsk
ZIP/Postal Code
83003
Country
Ukraine
Facility Name
Osmotica Study Site-654
City
Kharkov
ZIP/Postal Code
61103
Country
Ukraine
Facility Name
Osmotica Study Site-656
City
Lviv
ZIP/Postal Code
79010
Country
Ukraine
Facility Name
Osmotica Study Site-657
City
Poltava
ZIP/Postal Code
36011
Country
Ukraine

12. IPD Sharing Statement

Learn more about this trial

One Year, Open Label, Dose Escalation Long-term Safety Study in Multiple Sclerosis (MS) Subjects With Spasticity

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