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A Study to Evaluate 2 Doses Of Oral Administration Of Laquinimod Compared to Interferon ß-1a Administered by Injection in Participants With Relapsing Remitting Multiple Sclerosis (RRMS) (LIBRETTO)

Primary Purpose

Relapsing Remitting Multiple Sclerosis

Status
Withdrawn
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Laquinimod
Avonex®
Sponsored by
Teva Branded Pharmaceutical Products R&D, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsing Remitting Multiple Sclerosis focused on measuring RRMS

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Subjects must have a confirmed and documented RRMS diagnosis as defined by the Revised McDonald criteria, with relapse onset disease or a relapsing-remitting disease course.
  • Subjects must be ambulatory with an Kurtzke EDSS score of 0-5.5 at both Screening and Baseline (randomization) visits.
  • Subjects must be in a stable neurological condition, relapse-free and free of any corticosteroid treatment (intravenous [IV], IM and/or per os [PO]) or adrenocorticotrophic hormone (ACTH), 60 days prior to randomization.
  • Subjects must have experienced at least 1 documented relapse in the last year prior to randomization or 2 relapses in the last 3 years prior to randomization.
  • Subjects must be between 18 and 55 years of age at screening, inclusive.
  • Women of child-bearing potential must practice an acceptable method of birth control until 30 days after the last dose of treatment was administered (acceptable methods of birth control in this study include: surgical sterilization, intrauterine devices, oral contraceptive, contraceptive patch, long-acting injectable contraceptive or double-barrier method [condom or diaphragm with spermicide]).
  • Subjects must be able to sign and date a written informed consent prior to entering the study.
  • Subjects must be willing and able to comply with the protocol requirements for the duration of the study.

    • other criteria may apply, please contact the investigator for more information

Exclusion Criteria:

  • Subjects with progressive forms of MS.
  • Subjects with Neuromyelitis Optica (NMO).
  • Use of experimental or investigational drugs and/or participation in drug clinical studies within 6 months prior to Baseline visit (randomization).
  • Use of immunosuppressive agents, or cytotoxic agents, including cyclophosphamide and azatioprine within 12 months prior to Baseline.
  • Natalizumab (Tysabri®) if given more than 6 months prior to randomization AND the subject is John Cunningham (JC) virus antibody test negative at Screening.
  • Previous use of Rituximab, ocrelizumab, or ofatumumab is allowed if the B cell count (CD19) is higher than 80 cells /μL.
  • Previous treatment with glatiramer acetate (Copaxone®e), fingolimod (Gilenya®), BG-12 (Tecfidera), Teriflunomide (Aubagio®) or intravenous immunoglobulin (IVIG) within 2 months prior to Baseline.
  • Use of mitoxantrone (Novantrone) within 5 years prior to Screening. Use of mitoxantrone (Novantrone) >5 years before screening is allowed in subjects with normal ejection fraction and who did not exceed the total lifetime maximal dose.
  • Chronic (more than 30 consecutive days or monthly dosing, eg, with the intent of MS disease modification) systemic (IV, IM or PO) corticosteroid treatment within 2 months prior to Baseline.
  • Previous use of cladribine.
  • Previous use of laquinimod or Avonex® IM.
  • Treatment with other Interferon-β (either 1a subcutaneous [SC] or 1b SC) within 60 days before baseline (earlier treatment will be allowed if the reason for discontinuation was not treatment failure or for Interferon-β related safety reasons. This decision will be taken by the investigator).
  • Previous total body irradiation or total lymphoid irradiation.
  • Previous stem cell treatment, autologous bone marrow transplantation, or allogenic bone marrow transplantation.
  • Acute infection within 2 weeks prior to Baseline visit.
  • Major trauma or surgery within 2 weeks prior to Baseline visit.
  • Use of moderate/strong inhibitors of CYP3A4 within 2 weeks prior to Baseline.
  • Use of inducers of CYP3A4 within 2 weeks prior to Baseline
  • Pregnancy or breast feeding.
  • Serum levels ≥ 3 times (x) upper limit of normal (ULN) of either ALT or AST at Screening.
  • Serum direct bilirubin ≥ 2xULN at Screening.
  • Subjects with a clinically significant or unstable medical or surgical condition or any other condition that cannot be well-controlled by the allowed medications permitted in the study protocol that would preclude safe and complete study participation, as determined by medical history, physical examinations, ECG, laboratory tests MRI or chest X-ray
  • Any acute pulmonary disorder.
  • A central nervous system disorder other than MS that may jeopardize the participation in the study, including such disorders that are demonstrated on the baseline MRI.
  • A gastrointestinal disorder that may affect the absorption of study medication.
  • Renal disease.
  • Thyroid disease: hyperthyroidism, hypothyroidism.
  • Any form of acute or chronic liver disease.
  • Known human immunodeficiency virus positive status.
  • A clinical history of drug and/or alcohol abuse.
  • Unstable psychiatric disorder.
  • A history of seizure disorder, with the last convulsive episode within 12 months prior to Screening visit.
  • Any malignancies, excluding basal cell carcinoma, in the 5 years prior to randomization.
  • Twenty or more gadolinium - enhancing lesions on baseline MRI.
  • A known history of sensitivity to gadolinium (Gd).
  • GFR ≤ 60 mL/min at the screening visit.
  • Inability to successfully/safely undergo MRI scanning.
  • Subjects who underwent endovascular treatment for Chronic Cerebrospinal Venous Insufficiency (CCSVI).
  • Known hypersensitivity that would preclude administration of laquinimod capsule, such as hypersensitivity to: mannitol, meglumine, or sodium stearyl fumarate.
  • A known history of hypersensitivity to natural or recombinant interferon β, human albumin, or any other component of the formulation of Avonex®
  • Employees of the clinical study site or any other individuals involved with the conduct of the study, or immediate family members of such individuals

    • other criteria may apply, please contact the investigator for more information

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Active Comparator

    Arm Label

    Laquinimod 0.6 mg

    Laquinimod 1.2 mg

    Avonex®

    Arm Description

    Outcomes

    Primary Outcome Measures

    Brain Atrophyas observed by Magnetic Resonance Imaging (MRI)
    This is assessed by an MRI and is a measure of brain volume

    Secondary Outcome Measures

    The cumulative number of reported influenza-like symptoms
    Cumulative number of new T2 lesions observed by Magnetic Resonance Imaging (MRI) between the 2 laquinimod doses
    Summary of Participant with Adverse Events

    Full Information

    First Posted
    October 28, 2013
    Last Updated
    November 5, 2021
    Sponsor
    Teva Branded Pharmaceutical Products R&D, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01975298
    Brief Title
    A Study to Evaluate 2 Doses Of Oral Administration Of Laquinimod Compared to Interferon ß-1a Administered by Injection in Participants With Relapsing Remitting Multiple Sclerosis (RRMS)
    Acronym
    LIBRETTO
    Official Title
    A Multinational, Multicenter, Randomized, Double-Blind, Parallel-Group, Active-Control (Rater Blinded) Study, to Evaluate The Efficacy, Safety And Tolerability Of 2 Doses Of Oral Administration Of Laquinimod (0.6 mg/Day Or 1.2 mg/Day) Compared to Interferon ß-1a Administered Intra Muscular Once Weekly in Subjects With Relapsing Remitting Multiple Sclerosis (RRMS).
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Business Decision
    Study Start Date
    January 2014 (undefined)
    Primary Completion Date
    March 2014 (Actual)
    Study Completion Date
    March 2014 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Teva Branded Pharmaceutical Products R&D, Inc.

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of the study is to assess the efficacy, safety, and tolerability of two doses of laquinimod compared to Avonex®

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Laquinimod 0.6 mg
    Arm Type
    Experimental
    Arm Title
    Laquinimod 1.2 mg
    Arm Type
    Experimental
    Arm Title
    Avonex®
    Arm Type
    Active Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    Laquinimod
    Other Intervention Name(s)
    TV-5600
    Intervention Description
    Oral Administration
    Intervention Type
    Drug
    Intervention Name(s)
    Avonex®
    Other Intervention Name(s)
    Interferon β1A
    Intervention Description
    Interferon β1A 30 μg/0.5mL administered Intra Muscular
    Primary Outcome Measure Information:
    Title
    Brain Atrophyas observed by Magnetic Resonance Imaging (MRI)
    Description
    This is assessed by an MRI and is a measure of brain volume
    Time Frame
    Baseline and Month 12.
    Secondary Outcome Measure Information:
    Title
    The cumulative number of reported influenza-like symptoms
    Time Frame
    Baseline to Month 3
    Title
    Cumulative number of new T2 lesions observed by Magnetic Resonance Imaging (MRI) between the 2 laquinimod doses
    Time Frame
    Baseline, Month 6 and Month 12
    Title
    Summary of Participant with Adverse Events
    Time Frame
    12 Months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    55 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria Subjects must have a confirmed and documented RRMS diagnosis as defined by the Revised McDonald criteria, with relapse onset disease or a relapsing-remitting disease course. Subjects must be ambulatory with an Kurtzke EDSS score of 0-5.5 at both Screening and Baseline (randomization) visits. Subjects must be in a stable neurological condition, relapse-free and free of any corticosteroid treatment (intravenous [IV], IM and/or per os [PO]) or adrenocorticotrophic hormone (ACTH), 60 days prior to randomization. Subjects must have experienced at least 1 documented relapse in the last year prior to randomization or 2 relapses in the last 3 years prior to randomization. Subjects must be between 18 and 55 years of age at screening, inclusive. Women of child-bearing potential must practice an acceptable method of birth control until 30 days after the last dose of treatment was administered (acceptable methods of birth control in this study include: surgical sterilization, intrauterine devices, oral contraceptive, contraceptive patch, long-acting injectable contraceptive or double-barrier method [condom or diaphragm with spermicide]). Subjects must be able to sign and date a written informed consent prior to entering the study. Subjects must be willing and able to comply with the protocol requirements for the duration of the study. other criteria may apply, please contact the investigator for more information Exclusion Criteria: Subjects with progressive forms of MS. Subjects with Neuromyelitis Optica (NMO). Use of experimental or investigational drugs and/or participation in drug clinical studies within 6 months prior to Baseline visit (randomization). Use of immunosuppressive agents, or cytotoxic agents, including cyclophosphamide and azatioprine within 12 months prior to Baseline. Natalizumab (Tysabri®) if given more than 6 months prior to randomization AND the subject is John Cunningham (JC) virus antibody test negative at Screening. Previous use of Rituximab, ocrelizumab, or ofatumumab is allowed if the B cell count (CD19) is higher than 80 cells /μL. Previous treatment with glatiramer acetate (Copaxone®e), fingolimod (Gilenya®), BG-12 (Tecfidera), Teriflunomide (Aubagio®) or intravenous immunoglobulin (IVIG) within 2 months prior to Baseline. Use of mitoxantrone (Novantrone) within 5 years prior to Screening. Use of mitoxantrone (Novantrone) >5 years before screening is allowed in subjects with normal ejection fraction and who did not exceed the total lifetime maximal dose. Chronic (more than 30 consecutive days or monthly dosing, eg, with the intent of MS disease modification) systemic (IV, IM or PO) corticosteroid treatment within 2 months prior to Baseline. Previous use of cladribine. Previous use of laquinimod or Avonex® IM. Treatment with other Interferon-β (either 1a subcutaneous [SC] or 1b SC) within 60 days before baseline (earlier treatment will be allowed if the reason for discontinuation was not treatment failure or for Interferon-β related safety reasons. This decision will be taken by the investigator). Previous total body irradiation or total lymphoid irradiation. Previous stem cell treatment, autologous bone marrow transplantation, or allogenic bone marrow transplantation. Acute infection within 2 weeks prior to Baseline visit. Major trauma or surgery within 2 weeks prior to Baseline visit. Use of moderate/strong inhibitors of CYP3A4 within 2 weeks prior to Baseline. Use of inducers of CYP3A4 within 2 weeks prior to Baseline Pregnancy or breast feeding. Serum levels ≥ 3 times (x) upper limit of normal (ULN) of either ALT or AST at Screening. Serum direct bilirubin ≥ 2xULN at Screening. Subjects with a clinically significant or unstable medical or surgical condition or any other condition that cannot be well-controlled by the allowed medications permitted in the study protocol that would preclude safe and complete study participation, as determined by medical history, physical examinations, ECG, laboratory tests MRI or chest X-ray Any acute pulmonary disorder. A central nervous system disorder other than MS that may jeopardize the participation in the study, including such disorders that are demonstrated on the baseline MRI. A gastrointestinal disorder that may affect the absorption of study medication. Renal disease. Thyroid disease: hyperthyroidism, hypothyroidism. Any form of acute or chronic liver disease. Known human immunodeficiency virus positive status. A clinical history of drug and/or alcohol abuse. Unstable psychiatric disorder. A history of seizure disorder, with the last convulsive episode within 12 months prior to Screening visit. Any malignancies, excluding basal cell carcinoma, in the 5 years prior to randomization. Twenty or more gadolinium - enhancing lesions on baseline MRI. A known history of sensitivity to gadolinium (Gd). GFR ≤ 60 mL/min at the screening visit. Inability to successfully/safely undergo MRI scanning. Subjects who underwent endovascular treatment for Chronic Cerebrospinal Venous Insufficiency (CCSVI). Known hypersensitivity that would preclude administration of laquinimod capsule, such as hypersensitivity to: mannitol, meglumine, or sodium stearyl fumarate. A known history of hypersensitivity to natural or recombinant interferon β, human albumin, or any other component of the formulation of Avonex® Employees of the clinical study site or any other individuals involved with the conduct of the study, or immediate family members of such individuals other criteria may apply, please contact the investigator for more information
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Medical Director, MD
    Organizational Affiliation
    Teva Branded Pharmaceutical Products R&D, Inc.
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    A Study to Evaluate 2 Doses Of Oral Administration Of Laquinimod Compared to Interferon ß-1a Administered by Injection in Participants With Relapsing Remitting Multiple Sclerosis (RRMS)

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