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Safety and Efficacy of Monthly Long-acting IM Injection of 25mg or 40 mg GA Depot in Subjects With PPMS

Primary Purpose

Primary Progressive Multiple Sclerosis

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
GA Depot 40mg once monthly
GA Depot 25mg once monthly
Sponsored by
Mapi Pharma Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Progressive Multiple Sclerosis

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female subjects diagnosed with PPMS; Diagnosis of PPMS consistent with the McDonald Criteria (revisions of 2010).
  2. Age between 18 and 65 years (inclusive).
  3. Subjects diagnosed with PPMS for at least 1 year and with signs of disease progression in the year prior to screening, in a rate of ≥ 1 point increase / year in the EDSS score for EDSS between 2-5 and a rate of ≥0.5 point increase / year in the EDSS scores > 5.
  4. EDSS ≥2 and ≤ 6.5 (Pyramidal or Cerebellar FS ≥ 2).
  5. Documented history or the presence at screening of > 1 oligoclonal band (OCB) if quantitative testing was done, or OCB+ if not quantitative testing done and/or positive IgG index in the cerebrospinal fluid (CSF).
  6. Women of child bearing potential must have a negative urine pregnancy test at screening and use an adequate contraceptive method throughout the study.
  7. Ability to provide written informed consent.

Exclusion Criteria:

  1. Subjects with RRMS, SPMS, or PRMS.
  2. Subjects with a documented history of clinical relapse events.
  3. Any relevant medical, surgical, or psychiatric condition, laboratory value, or concomitant medication which, in the opinion of the investigator, makes the subject unsuitable for study entry or potentially unable to complete all aspects of the study.
  4. Contraindications or inability to successfully undergo magnetic resonance imaging (MRI) scanning.
  5. Subjects diagnosed with any other than MS systemic autoimmune disease that may impact the CNS with MS like lesions such as Sarcoidosis, Sjögren's syndrome, Systemic Lupus Erythematosus (SLE), Lyme disease, APLA syndrome, etc.. Subjects with stable local/organ autoimmune disease such as psoriasis, Cutaneous Lupus erythematosus, thyroiditis (Hashimoto, grave) etc. may be considered eligible upon the PI's discretion.
  6. Severe anemia (hemoglobin <10 g/dL).
  7. Abnormal renal function (serum creatinine >1.5xULN or creatinine clearance <30 ml/min).
  8. Abnormal liver function (transaminases >2xULN).
  9. Pregnant or breast-feeding women.
  10. Treatment with any kind of steroids during the last month prior to screening visit.
  11. History of any anaphylactic reaction and/or serious allergic reaction following a vaccination, a known hypersensitivity to any component of the study drug, e.g. glatiramer acetate (GA), polylactic-co-glycolic acid (PLGA), polyvinyl alcohol (PVA).
  12. Known or suspected history of drug or alcohol abuse.
  13. Known as positive for HIV, hepatitis, VDRL, or tuberculosis.
  14. Active malignant disease of any kind. However, a patient, who had a malignant disease in the past, was treated and is currently disease - free for at least 7 years, may be considered eligible, upon the PI and sponsor's discretion.
  15. Previous treatment with B-cell-targeting therapies (e.g. rituximab, ocrelizumab, atacicept, belimumab or ofatumumab) within 6 months prior to screening visit.
  16. Previous treatment with cladribine within 2 years prior to screening visit
  17. Previous treatment with azathioprine, mitoxantrone or methotrexate within 6 months prior to screening visit.
  18. Previous treatment with lymphocyte-trafficking modifiers (e.g. natalizumab, fingolimod) within 6 months prior to screening visit. Subjects should have a total lymphocyte count within normal range.
  19. Previous treatment with beta interferons, intravenous immunoglobulin, plasmapheresis within 2 months prior to screening visit.
  20. Previous treatment with any glatiramer acetate therapy within 3 months prior to screening visit.
  21. Uncontrolled diabetes.
  22. Participation in an investigational study drug within 30 days prior to study entry.

Sites / Locations

  • Mapi Pharma Research site 09Recruiting
  • Mapi Pharma Research site 07Recruiting
  • Mapi Pharma Research site 08Recruiting
  • Mapi Pharma Research site 06Recruiting
  • Mapi Pharma Research site 01Recruiting
  • Mapi Pharma Research site 20Recruiting
  • Mapi Pharma Research site 22Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

GA Depot 40mg once monthly

GA Depot 25mg once monthly

Arm Description

Monthly IM injection

Monthly IM injection

Outcomes

Primary Outcome Measures

Safety (Adverse Events and Injection Site Reactions)
Assessment of Adverse events (AEs) & Injection Sites Reactions (ISRs)

Secondary Outcome Measures

Efficacy (Confirmed Disease Progression)
Time to onset of Confirmed Disease Progression (CDP) assessed by Expanded Disability Status Scale (EDSS). EDSS is a method of quantifying disability in people with MS. The EDSS scale ranges from 0 to 10 in 0.5 unit increments that represent higher levels of disability.
Efficacy (Whole brain volume change)
MRI assessment of percent of whole brain volume change.
Efficacy (Cortical volume change)
MRI assessment of percent of cortical volume change.

Full Information

First Posted
November 15, 2017
Last Updated
October 30, 2022
Sponsor
Mapi Pharma Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03362294
Brief Title
Safety and Efficacy of Monthly Long-acting IM Injection of 25mg or 40 mg GA Depot in Subjects With PPMS
Official Title
A Prospective, Multicenter, Two Arms, Open Label, Phase IIa Study to Assess the Safety and Efficacy of Once-a-month Long-acting Intramuscular Injection of 25 mg or 40mg Glatiramer Acetate (GA Depot) in Subjects With Primary Progressive Multiple Sclerosis (PPMS)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
December 11, 2017 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mapi Pharma Ltd.

4. Oversight

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

5. Study Description

Brief Summary
This is a phase IIa study with GA Depot in subjects with Primary Progressive MS. GA Depot will be administered intramuscularly (IM), once every four weeks for 148 weeks. The purpose of this study is to assess the safety and efficacy of GA Depot to slow the accumulation of disability progression in subjects with Primary Progressive MS.
Detailed Description
30 Subjects with a diagnosis of primary progressive multiple sclerosis (PPMS) who are not treated for PPMS at study entry (except for symptoms relief). Study product is GA long-acting injection (GA Depot) which is a combination of extended-release microspheres for injection and diluent (water for injection) for parenteral use. GA Depot will be administered intramuscularly (IM). The study duration for an individual subject in the core study will be 156 weeks, consisting of 4 weeks of screening evaluation (weeks -4 to 0), followed by a 148-week open-label treatment period, and a 4 weeks follow up period: through a total of 41 visits. Vital signs and safety assessment will be performed at each visit during the study. Physical examination will be performed at screening, baseline, 1 week after the second GA Depot treatment, 3 months after first GA Depot treatment and every 3 months thereafter. Last physical examination will be performed at FU visit. MRI will be performed at screenings and every 6 months thereafter until the end of the treatment period . Safety laboratory tests will be performed at screening, baseline, 1 month after first treatment, and every 3 months thereafter. Neurological assessment will be performed at screening, baseline, 3 months, and then every 3 months until end of treatment.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
The first 20 subjects are allocated to the 40mg arm and the last 10 subjects are allocated to the 25mg.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GA Depot 40mg once monthly
Arm Type
Experimental
Arm Description
Monthly IM injection
Arm Title
GA Depot 25mg once monthly
Arm Type
Experimental
Arm Description
Monthly IM injection
Intervention Type
Drug
Intervention Name(s)
GA Depot 40mg once monthly
Intervention Description
Once-a-month long-acting intramuscular injection of 40mg Glatiramer Acetate (GA Depot)
Intervention Type
Drug
Intervention Name(s)
GA Depot 25mg once monthly
Intervention Description
Once-a-month long-acting intramuscular injection of 25mg Glatiramer Acetate (GA Depot)
Primary Outcome Measure Information:
Title
Safety (Adverse Events and Injection Site Reactions)
Description
Assessment of Adverse events (AEs) & Injection Sites Reactions (ISRs)
Time Frame
152 weeks
Secondary Outcome Measure Information:
Title
Efficacy (Confirmed Disease Progression)
Description
Time to onset of Confirmed Disease Progression (CDP) assessed by Expanded Disability Status Scale (EDSS). EDSS is a method of quantifying disability in people with MS. The EDSS scale ranges from 0 to 10 in 0.5 unit increments that represent higher levels of disability.
Time Frame
148 weeks
Title
Efficacy (Whole brain volume change)
Description
MRI assessment of percent of whole brain volume change.
Time Frame
148 weeks
Title
Efficacy (Cortical volume change)
Description
MRI assessment of percent of cortical volume change.
Time Frame
148 weeks

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: Male or female subjects diagnosed with PPMS; Diagnosis of PPMS consistent with the McDonald Criteria (revisions of 2010). Age between 18 and 65 years (inclusive). Subjects diagnosed with PPMS for at least 1 year and with signs of disease progression in the year prior to screening, in a rate of ≥ 1 point increase / year in the EDSS score for EDSS between 2-5 and a rate of ≥0.5 point increase / year in the EDSS scores > 5. EDSS ≥2 and ≤ 6.5 (Pyramidal or Cerebellar FS ≥ 2). Documented history or the presence at screening of > 1 oligoclonal band (OCB) if quantitative testing was done, or OCB+ if not quantitative testing done and/or positive IgG index in the cerebrospinal fluid (CSF). Women of child bearing potential must have a negative urine pregnancy test at screening and use an adequate contraceptive method throughout the study. Ability to provide written informed consent. Exclusion Criteria: Subjects with RRMS, SPMS, or PRMS. Subjects with a documented history of clinical relapse events. Any relevant medical, surgical, or psychiatric condition, laboratory value, or concomitant medication which, in the opinion of the investigator, makes the subject unsuitable for study entry or potentially unable to complete all aspects of the study. Contraindications or inability to successfully undergo magnetic resonance imaging (MRI) scanning. Subjects diagnosed with any other than MS systemic autoimmune disease that may impact the CNS with MS like lesions such as Sarcoidosis, Sjögren's syndrome, Systemic Lupus Erythematosus (SLE), Lyme disease, APLA syndrome, etc.. Subjects with stable local/organ autoimmune disease such as psoriasis, Cutaneous Lupus erythematosus, thyroiditis (Hashimoto, grave) etc. may be considered eligible upon the PI's discretion. Severe anemia (hemoglobin <10 g/dL). Abnormal renal function (serum creatinine >1.5xULN or creatinine clearance <30 ml/min). Abnormal liver function (transaminases >2xULN). Pregnant or breast-feeding women. Treatment with any kind of steroids during the last month prior to screening visit. History of any anaphylactic reaction and/or serious allergic reaction following a vaccination, a known hypersensitivity to any component of the study drug, e.g. glatiramer acetate (GA), polylactic-co-glycolic acid (PLGA), polyvinyl alcohol (PVA). Known or suspected history of drug or alcohol abuse. Known as positive for HIV, hepatitis, VDRL, or tuberculosis. Active malignant disease of any kind. However, a patient, who had a malignant disease in the past, was treated and is currently disease - free for at least 7 years, may be considered eligible, upon the PI and sponsor's discretion. Previous treatment with B-cell-targeting therapies (e.g. rituximab, ocrelizumab, atacicept, belimumab or ofatumumab) within 6 months prior to screening visit. Previous treatment with cladribine within 2 years prior to screening visit Previous treatment with azathioprine, mitoxantrone or methotrexate within 6 months prior to screening visit. Previous treatment with lymphocyte-trafficking modifiers (e.g. natalizumab, fingolimod) within 6 months prior to screening visit. Subjects should have a total lymphocyte count within normal range. Previous treatment with beta interferons, intravenous immunoglobulin, plasmapheresis within 2 months prior to screening visit. Previous treatment with any glatiramer acetate therapy within 3 months prior to screening visit. Uncontrolled diabetes. Participation in an investigational study drug within 30 days prior to study entry.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Arnon Karni, MD
Organizational Affiliation
Coordinating PI
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mapi Pharma Research site 09
City
Haifa
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Svetlana Afanasiev
Phone
+972 4 7771926
Email
s_afanasiev@rmc.gov.il
Facility Name
Mapi Pharma Research site 07
City
Jerusalem
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Keren Dambinsky
Phone
02-6777716
Email
keidy@hadassah.org.il
Facility Name
Mapi Pharma Research site 08
City
Petah tikva
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yaniv Rodity
Phone
03-6528734
Email
yar@clalait.org.il
Facility Name
Mapi Pharma Research site 06
City
Rehovot
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shiran Rogof
Phone
08-9441364
Email
shiranro1@clalit.org.il
Facility Name
Mapi Pharma Research site 01
City
Tel Aviv
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Irina Komarov
Phone
03-6974380
Email
irinako@tlvmc.gov.il
Facility Name
Mapi Pharma Research site 20
City
Chisinau
Country
Moldova, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mihail Gavriliuc, MD
Phone
+37322205383
Email
mgavriliuc@gmail.com
Facility Name
Mapi Pharma Research site 22
City
Chisinau
Country
Moldova, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Olesea Odainic, MD
Phone
+37379443354
Email
oodainic@mail.ru

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety and Efficacy of Monthly Long-acting IM Injection of 25mg or 40 mg GA Depot in Subjects With PPMS

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