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A Study to Characterize Subcutaneous or Intravenous Alemtuzumab in Patients With Progressive Multiple Sclerosis (SCALA)

Primary Purpose

Progressive Multiple Sclerosis

Status
Completed
Phase
Phase 1
Locations
Spain
Study Type
Interventional
Intervention
Acyclovir
Methylprednisolone
alemtuzumab GZ402673
alemtuzumab GZ402673
Paracetamol
Loratadine
Ceterizine
Dexchlorpheniramine
Sponsored by
Genzyme, a Sanofi Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Progressive Multiple Sclerosis

Eligibility Criteria

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

Inclusion criteria:

  • Male or female adults with a diagnosis of Multiple Sclerosis (MS) based on 2010 revision of McDonald criteria.
  • Diagnosis of progressive MS including primary progressive MS and secondary progressive MS.
  • Age ≥18 years.
  • Signed informed consent form.
  • Covered by a health insurance system where applicable, and/or in compliance with the recommendations of the national laws in force relating to biomedical research.
  • Not under any administrative or legal supervision.

Exclusion criteria:

  • Patients with relapsing remitting MS.
  • Any prior treatment with alemtuzumab or other anti-CD52 antibodies.
  • Treatment with natalizumab in the 4 months prior to Study Visit 1.
  • Progressive multifocal leukoencephalopathy (PML), or any clinical or imaging signs possibly indicative of undiagnosed PML. Particular vigilance is needed for patients with prior natalizumab exposure, even if the last exposure was more than 4 months prior to Study Visit 1.
  • Treatment with methotrexate, azathioprine, or cyclosporine in the past 6 months.
  • Treatment with mitoxantrone, cyclophosphamide, cladribine, rituximab, or any other immunosuppressant or cytotoxic therapy (other than steroids) in the last 12 months, or determined by the treating physician to have residual immune suppression from these treatments.
  • Treatment with glatiramer acetate or interferon beta in the past 4 weeks.
  • Treatment with fingolimod within the past 2 months.
  • Treatment with dimethyl fumarate in the past 4 weeks.
  • Treatment with teriflunomide within the past 12 months unless the patient has completed an accelerated clearance with cholestyramine or activated charcoal.
  • Any known contraindications to the symptomatic therapy used in the infusion management guidance for this study.
  • Hypersensitivity or contraindication to acyclovir.
  • History of a hypersensitivity reaction other than localized injection site reaction to any biological molecule.
  • If female, pregnancy (defined as positive β-HCG blood test) or lactating or breast-feeding.
  • Current participation in another investigational interventional study.
  • Any significant change in chronic treatment medication (ie, new chronic medication) within 14 days before inclusion.
  • An investigational medicinal product within 3 months or 5 half-lives, whichever is longer, before study inclusion.
  • Total lymphocyte or CD3+ counts are below normal limits at screening. If abnormal cell count(s) return to within normal limits, eligibility may be reassessed.
  • Live, attenuated vaccine within 3 months prior to the randomization (Day 1) visit, such as varicella-zoster, oral polio, rubella vaccines.
  • Any clinically relevant findings in the physical examination, medical history, or laboratory assessments which would compromise the safety of the patient.
  • Women of childbearing potential not protected by highly-effective method(s) of birth control and/or who are unwilling or unable to be tested for pregnancy.
  • Latent or active tuberculosis infection, verified by testing as per local practice.
  • Infection with human immunodeficiency virus (HIV).
  • Known Hepatitis B (HBV) or Hepatitis C (HCV) infection.
  • Active infection, eg, deep tissue infection, that the Investigator considers sufficiently serious to preclude study participation.
  • Prior history of invasive fungal infections.
  • Any patient who, in the judgment of the Investigator, is likely to be noncompliant during the study, or unable to cooperate because of a language problem or poor mental development.
  • Any patient in the exclusion period of a previous study according to applicable regulations.
  • Any patient who cannot be contacted in case of emergency.
  • Any patient who is the Investigator or any subinvestigator, research assistant, pharmacist, study coordinator, other staff or relative thereof directly involved in the conduct of the protocol.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sites / Locations

  • Investigational Site Number 724001

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

alemtuzumab (subcutaneous injection)

alemtuzumab (intravenous infusion)

Arm Description

Dose 1 (initial course) of alemtuzumab will be administered subcutaneously on 5 consecutive days, followed by Dose 2 (second course) on 3 consecutive days administered 12 months after initial course. Pre-medications (methylprednisolone, antihistamine [loratadine, cetirizine, dexchlorpheniramine], paracetamol, acyclovir) will be administered prior alemtuzumab administration.

Dose 1 (initial course) of alemtuzumab will be administered intravenously on 5 consecutive days, followed by Dose 2 (second course) on 3 consecutive days administered 12 months after initial course. Pre-medications (methylprednisolone, antihistamine [loratadine, cetirizine, dexchlorpheniramine], paracetamol, acyclovir) will be administered prior alemtuzumab administration.

Outcomes

Primary Outcome Measures

Change from baseline in the CD3+ lymphocyte subset after alemtuzumab administration

Secondary Outcome Measures

Change from baseline in lymphocyte subsets after alemtuzumab administration
Change from baseline in total lymphocyte count after alemtuzumab administration
Change from baseline in helper/suppressor ratio after alemtuzumab administration
Assessment of pharmacokinetic parameter after alemtuzumab administration: maximum plasma concentration observed (Cmax)
Assessment of pharmacokinetic parameter after alemtuzumab administration: time to reach Cmax (Tmax)
Assessment of pharmacokinetic parameter after alemtuzumab administration: area under plasma concentration versus time curve from time zero until the last measurable concentration (AUClast)
Assessment of pharmacokinetic parameter after alemtuzumab administration: area under plasma concentration (AUC)
Assessment of pharmacokinetic parameter after alemtuzumab administration: terminal half-life (t1/2z)
Number of patients with adverse events
Number of patients with adverse events of special interest
Number of patients with injection site reactions

Full Information

First Posted
October 16, 2015
Last Updated
March 8, 2021
Sponsor
Genzyme, a Sanofi Company
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1. Study Identification

Unique Protocol Identification Number
NCT02583594
Brief Title
A Study to Characterize Subcutaneous or Intravenous Alemtuzumab in Patients With Progressive Multiple Sclerosis
Acronym
SCALA
Official Title
A Phase 1, Exploratory, Randomized, Open-label, 2-Arm Study to Characterize the Pharmacodynamics, Pharmacokinetics, Safety, and Tolerability of Alemtuzumab 12mg Administered Subcutaneously or Intravenously in Patients With Progressive Multiple Sclerosis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2021
Overall Recruitment Status
Completed
Study Start Date
December 6, 2015 (Actual)
Primary Completion Date
March 2016 (Actual)
Study Completion Date
March 1, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genzyme, a Sanofi Company

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Primary Objective: To characterize the pharmacodynamic profile of 2 treatment courses of alemtuzumab administered by subcutaneous injection and 2 treatment courses of alemtuzumab administered by intravenous infusion in patients with progressive multiple sclerosis. Secondary Objectives: To characterize the pharmacokinetic profiles of alemtuzumab administered by subcutaneous injection or intravenous infusion to patients with progressive multiple sclerosis. To characterize the safety and tolerability of alemtuzumab administered by subcutaneous injection or intravenous infusion to patients with progressive multiple sclerosis.
Detailed Description
The duration of study per patient will be approximately 61 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Progressive Multiple Sclerosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
alemtuzumab (subcutaneous injection)
Arm Type
Experimental
Arm Description
Dose 1 (initial course) of alemtuzumab will be administered subcutaneously on 5 consecutive days, followed by Dose 2 (second course) on 3 consecutive days administered 12 months after initial course. Pre-medications (methylprednisolone, antihistamine [loratadine, cetirizine, dexchlorpheniramine], paracetamol, acyclovir) will be administered prior alemtuzumab administration.
Arm Title
alemtuzumab (intravenous infusion)
Arm Type
Experimental
Arm Description
Dose 1 (initial course) of alemtuzumab will be administered intravenously on 5 consecutive days, followed by Dose 2 (second course) on 3 consecutive days administered 12 months after initial course. Pre-medications (methylprednisolone, antihistamine [loratadine, cetirizine, dexchlorpheniramine], paracetamol, acyclovir) will be administered prior alemtuzumab administration.
Intervention Type
Drug
Intervention Name(s)
Acyclovir
Intervention Description
Pharmaceutical form:tablet Route of administration: oral
Intervention Type
Drug
Intervention Name(s)
Methylprednisolone
Intervention Description
Pharmaceutical form:tablet Route of administration: oral
Intervention Type
Drug
Intervention Name(s)
alemtuzumab GZ402673
Intervention Description
Pharmaceutical form:solution for infusion Route of administration: intravenous
Intervention Type
Drug
Intervention Name(s)
alemtuzumab GZ402673
Intervention Description
Pharmaceutical form:injection Route of administration: subcutaneous
Intervention Type
Drug
Intervention Name(s)
Paracetamol
Intervention Description
Pharmaceutical form:tablet Route of administration: oral
Intervention Type
Drug
Intervention Name(s)
Loratadine
Intervention Description
Pharmaceutical form:tablet Route of administration: oral
Intervention Type
Drug
Intervention Name(s)
Ceterizine
Intervention Description
Pharmaceutical form:tablet Route of administration: oral
Intervention Type
Drug
Intervention Name(s)
Dexchlorpheniramine
Intervention Description
Pharmaceutical form:tablet Route of administration: oral
Primary Outcome Measure Information:
Title
Change from baseline in the CD3+ lymphocyte subset after alemtuzumab administration
Time Frame
Baseline, 30 days after each treatment course
Secondary Outcome Measure Information:
Title
Change from baseline in lymphocyte subsets after alemtuzumab administration
Time Frame
Baseline, 30 days after each treatment course
Title
Change from baseline in total lymphocyte count after alemtuzumab administration
Time Frame
Baseline, 30 days after each treatment course
Title
Change from baseline in helper/suppressor ratio after alemtuzumab administration
Time Frame
Baseline, 30 days after each treatment course
Title
Assessment of pharmacokinetic parameter after alemtuzumab administration: maximum plasma concentration observed (Cmax)
Time Frame
30 days after each treatment course
Title
Assessment of pharmacokinetic parameter after alemtuzumab administration: time to reach Cmax (Tmax)
Time Frame
30 days after each treatment course
Title
Assessment of pharmacokinetic parameter after alemtuzumab administration: area under plasma concentration versus time curve from time zero until the last measurable concentration (AUClast)
Time Frame
30 days after each treatment course
Title
Assessment of pharmacokinetic parameter after alemtuzumab administration: area under plasma concentration (AUC)
Time Frame
30 days after each treatment course
Title
Assessment of pharmacokinetic parameter after alemtuzumab administration: terminal half-life (t1/2z)
Time Frame
30 days after each treatment course
Title
Number of patients with adverse events
Time Frame
4 years
Title
Number of patients with adverse events of special interest
Time Frame
4 years
Title
Number of patients with injection site reactions
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Male or female adults with a diagnosis of Multiple Sclerosis (MS) based on 2010 revision of McDonald criteria. Diagnosis of progressive MS including primary progressive MS and secondary progressive MS. Age ≥18 years. Signed informed consent form. Covered by a health insurance system where applicable, and/or in compliance with the recommendations of the national laws in force relating to biomedical research. Not under any administrative or legal supervision. Exclusion criteria: Patients with relapsing remitting MS. Any prior treatment with alemtuzumab or other anti-CD52 antibodies. Treatment with natalizumab in the 4 months prior to Study Visit 1. Progressive multifocal leukoencephalopathy (PML), or any clinical or imaging signs possibly indicative of undiagnosed PML. Particular vigilance is needed for patients with prior natalizumab exposure, even if the last exposure was more than 4 months prior to Study Visit 1. Treatment with methotrexate, azathioprine, or cyclosporine in the past 6 months. Treatment with mitoxantrone, cyclophosphamide, cladribine, rituximab, or any other immunosuppressant or cytotoxic therapy (other than steroids) in the last 12 months, or determined by the treating physician to have residual immune suppression from these treatments. Treatment with glatiramer acetate or interferon beta in the past 4 weeks. Treatment with fingolimod within the past 2 months. Treatment with dimethyl fumarate in the past 4 weeks. Treatment with teriflunomide within the past 12 months unless the patient has completed an accelerated clearance with cholestyramine or activated charcoal. Any known contraindications to the symptomatic therapy used in the infusion management guidance for this study. Hypersensitivity or contraindication to acyclovir. History of a hypersensitivity reaction other than localized injection site reaction to any biological molecule. If female, pregnancy (defined as positive β-HCG blood test) or lactating or breast-feeding. Current participation in another investigational interventional study. Any significant change in chronic treatment medication (ie, new chronic medication) within 14 days before inclusion. An investigational medicinal product within 3 months or 5 half-lives, whichever is longer, before study inclusion. Total lymphocyte or CD3+ counts are below normal limits at screening. If abnormal cell count(s) return to within normal limits, eligibility may be reassessed. Live, attenuated vaccine within 3 months prior to the randomization (Day 1) visit, such as varicella-zoster, oral polio, rubella vaccines. Any clinically relevant findings in the physical examination, medical history, or laboratory assessments which would compromise the safety of the patient. Women of childbearing potential not protected by highly-effective method(s) of birth control and/or who are unwilling or unable to be tested for pregnancy. Latent or active tuberculosis infection, verified by testing as per local practice. Infection with human immunodeficiency virus (HIV). Known Hepatitis B (HBV) or Hepatitis C (HCV) infection. Active infection, eg, deep tissue infection, that the Investigator considers sufficiently serious to preclude study participation. Prior history of invasive fungal infections. Any patient who, in the judgment of the Investigator, is likely to be noncompliant during the study, or unable to cooperate because of a language problem or poor mental development. Any patient in the exclusion period of a previous study according to applicable regulations. Any patient who cannot be contacted in case of emergency. Any patient who is the Investigator or any subinvestigator, research assistant, pharmacist, study coordinator, other staff or relative thereof directly involved in the conduct of the protocol. The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Sciences & Operations
Organizational Affiliation
Sanofi
Official's Role
Study Director
Facility Information:
Facility Name
Investigational Site Number 724001
City
Barcelona
ZIP/Postal Code
08035
Country
Spain

12. IPD Sharing Statement

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A Study to Characterize Subcutaneous or Intravenous Alemtuzumab in Patients With Progressive Multiple Sclerosis

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