search
Back to results

Efficacy and Safety of Xacrel® (Ocrelizumab) in Participants With Relapsing Remitting Multiple Sclerosis

Primary Purpose

Multiple Sclerosis, Relapsing-Remitting

Status
Completed
Phase
Phase 3
Locations
Iran, Islamic Republic of
Study Type
Interventional
Intervention
Ocrelizumab (CinnaGen, Iran)
Ocrelizumab (Roche, Switzerland)
Sponsored by
Cinnagen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Sclerosis focused on measuring RRMS, Annualized Relapse Rate, Monoclonal, Humanized, Ocrelizumab

Eligibility Criteria

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

Inclusion Criteria:

  1. Ability to provide written, informed consent and to be compliant with the schedule of protocol assessments.
  2. Ages 18-55 years at screening, inclusive.
  3. Diagnosis of MS, in accordance with the revised McDonald criteria (2010).
  4. At least two relapses having occurred within the past 2 years or one relapse within the past 12 months prior to screening.
  5. Neurological stability for ≥ 30 days prior to both screening and baseline.
  6. EDSS, at screening, from 0 to 5.5 inclusive.
  7. Patients of reproductive potential must use reliable means of contraception.

Exclusion Criteria:

  1. Diagnosis of primary progressive MS.
  2. Disease duration of more than 10 years in patients with an EDSS ≤ 2.0 at screening.
  3. Inability to complete an MRI (contraindications for MRI include but are not restricted to claustrophobia, weight ≥ 140 kg, pacemaker, cochlear implants, presence of foreign substances in the eye, intracranial vascular clips, surgery within 6 weeks of entry into the study, coronary stent implanted within 8 weeks prior to the time of the intended MRI, etc).
  4. Known presence of other neurological disorders which may mimic MS including but not limited to: neuromeylitis optica, Lyme disease, untreated vitamin B12 deficiency, neurosarcoidosis and cerebrovascular disorders.
  5. Pregnancy or lactation.
  6. Any concomitant disease that may require chronic treatment with systemic corticosteroids or immunosuppressants during the course of the study.
  7. History or currently active primary or secondary immunodeficiency.
  8. Lack of peripheral venous access.
  9. History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies.
  10. Significant or uncontrolled somatic disease or any other significant disease that may preclude patient from participating in the study such as Congestive heart failure (NYHA III or IV functional severity).
  11. Known active bacterial, viral, fungal, mycobacterial infection or other infection, excluding fungal infection of nail beds.
  12. Infection requiring hospitalization or treatment with I.V. antibiotics within 4 weeks prior to baseline visit or oral antibiotics within 2 weeks prior to baseline visit.
  13. History or known presence of recurrent or chronic infection (e.g., hepatitis B or C, HIV).
  14. History of progressive multifocal leukoencephalopathy (PML)
  15. History of malignancy, including solid tumors and hematological malignancies, except basal cell carcinoma, in situ squamous cell carcinoma of the skin, and in situ carcinoma of the cervix of the uterus that have been previously completely excised with documented, clear margins.
  16. History of alcohol or drug abuse within 24 weeks prior to baseline.
  17. History or laboratory evidence of coagulation disorders.
  18. Receipt of a live vaccine (BCG, MMR, VZV, polio, yellow fever and some influenza vaccine) within 6 weeks prior to baseline. In rare cases when patient requires vaccination with a live vaccine, the screening period may be extended but cannot exceed 8 weeks.
  19. Treatment with any investigational agent within 24 weeks of screening (Visit 1) or five half-lives of the investigational drug (whichever is longer).
  20. Contraindications to or intolerance of oral or i.v. corticosteroids, including methylprednisolone administered i.v.
  21. Treatment with dalfampridine unless on stable dose for ≥ 30 days prior to screening. Patients should remain on stable doses throughout the 48 weeks' treatment period.
  22. Previous treatment with B-cell targeted therapies (i.e. rituximab, ocrelizumab, atacicept, belimumab or ofatumumab).
  23. Systemic corticosteroid therapy within 4 weeks prior to screening.
  24. Any previous treatment with anti-CD4, cladribine, mitoxantrone, daclizumab, teriflunomide, laquinimod, total body irradiation or bone marrow transplantation.
  25. Treatment with cyclophosphamide, azathioprine, mycophenolate mofetil (MMF), cyclosporine, methotrexate or natalizumab within 24 months prior to screening. Patients previously treated with natalizumab will be eligible for this study only if duration of treatment with natalizumab was < 1 year.
  26. Treatment with fingolimod or dimethyl fumarate (DMF) within 4 weeks prior to screening. Only patients with T lymphocyte count ≥ LLN will be eligible for this study.
  27. Treatment with I.V. immunoglobulin within 12 weeks prior to baseline.
  28. Positive serum β hCG measured at screening.
  29. Positive screening tests for hepatitis B
  30. CD4 count < 300/μL.
  31. AST/SGOT or ALT/SGPT ≥ 2.0 Upper Limit of Normal (ULN).
  32. Platelet count <100,000/μL (<100 x 109/L).
  33. Levels of serum IgG 18% below the LLN.
  34. Levels of serum IgM 8% below the LLN.
  35. Total neutrophil count <1.5 x 10^3/μL.

Sites / Locations

  • Qaem International Hospital
  • Qaem Hospital
  • Golestan Hospital
  • Bouali Hospital, MS Clinic
  • Sina Hospital
  • Ayatollah Kashani Hospital, MS Clinic
  • Imam Reza Hospital
  • Shafa Hospital
  • Dr. Nikseresht's office
  • Namazi Hospital
  • Imam Reza Hospital Department of Neurology
  • Amir Alam Hospital
  • Imam Hossein Hospital, MS Clinic
  • Imam Khomeini Hospital
  • Sina Hospital, MS Research Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Ocrelizumab (CinnaGen, Iran)

Ocrelizumab (Roche, Switzerland)

Arm Description

Ocrelizumab (CinnaGen, Iran) 600 mg (given as dual infusions of ocrelizumab 300 mg on Days 1 and 15 of the first 24-week treatment cycle and as single infusions of 600 mg on Day 1 for each 24-week treatment cycle, thereafter) every 24 weeks.

Ocrelizumab (Roche, Switzerland) 600 mg (given as dual infusions of ocrelizumab 300 mg on Days 1 and 15 of the first 24-week treatment cycle and as single infusions of 600 mg on Day 1 for each 24-week treatment cycle, thereafter) every 24 weeks.

Outcomes

Primary Outcome Measures

Annualized Relapse Rate at 48 weeks
Total number of confirmed relapses divided by the total number of days on study A relapse is defined as the appearance of a new or worsening of a previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding relapse. The abnormality must be present for at least 24 hours and occur in the absence of fever or infection

Secondary Outcome Measures

Time to onset of sustained disability progression for at least 12 weeks
Disability progression is defined as an increase in the Expanded Disability Status Scale (EDSS) score of: A) At least a 1.5-point increase in patients with a baseline score of 0 B) At least a 1.0-point increase on the EDSS in patients with a baseline score of 0<EDSS≤5.5 C) At least a 0.5-point increase on the EDSS in patients with a baseline score of >5.5 The EDSS scale ranges from 0 (normal neurological exam) to 10 (death due to multiple sclerosis)
Time to onset of sustained disability progression for at least 24 weeks
Disability progression is defined as an increase in the Expanded Disability Status Scale (EDSS) score of: A) At least a 1.5-point increase in patients with a baseline score of 0 B) At least a 1.0-point increase on the EDSS in patients with a baseline score of 0<EDSS≤5.5 C) At least a 0.5-point increase on the EDSS in patients with a baseline score of >5.5 The EDSS scale ranges from 0 (normal neurological exam) to 10 (death due to multiple sclerosis)
Proportion of relapse-free patients by 96 weeks
A relapse is defined as the appearance of a new or worsening of a previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding relapse. The abnormality must be present for at least 24 hours and occur in the absence of fever or infection
Total number of new Gadolinium (Gd)-enhancing lesions as detected by brain MRI
Sum of the individual number of (Gd)-enhancing lesions at Weeks 24, 48, and 96
Total number of new, and/or enlarging T2 hyperintense lesions as detected by brain MRI
Sum of the individual number of new, and/or enlarging T2 hyperintense lesions at Weeks 24, 48, and 96
Change in total T2 lesion volume as detected by brain MRI from baseline to week 96
Number of Participants With Adverse Events (AEs)
Intensity, seriousness and causality assessment of observed AEs, and abnormal laboratory findings every 12 weeks.
Number of Participants With Infusion Related Reactions (IRRs)
Assessment of IRRs every 24 weeks
Immunogenicity Assessment
Number of participants positive for anti-drug antibodies at weeks 24, 48 and 96

Full Information

First Posted
June 27, 2021
Last Updated
October 16, 2022
Sponsor
Cinnagen
search

1. Study Identification

Unique Protocol Identification Number
NCT04966338
Brief Title
Efficacy and Safety of Xacrel® (Ocrelizumab) in Participants With Relapsing Remitting Multiple Sclerosis
Official Title
A Phase III, Randomized, Two-armed, Double-blind, Parallel, Active-controlled Clinical Trial to Evaluate Equivalency of the Efficacy and Safety of Ocrelizumab (CinnaGen, Iran) in Comparison to Reference Product, Ocrevus® (Roche, Switzerland) in Patients With Relapsing Multiple Sclerosis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Completed
Study Start Date
August 19, 2019 (Actual)
Primary Completion Date
November 9, 2020 (Actual)
Study Completion Date
October 1, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cinnagen

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the efficacy and safety of Ocrelizumab produced by CinnaGen compared with Ocrevus® (Roche, Switzerland) in subjects with relapsing remitting multiple sclerosis (RRMS). All the participants will receive one of the following regimens: Ocrelizumab (CinnaGen) or Ocrevus® (Roche, Switzerland) ,600 mg (given as dual infusions of ocrelizumab 300 mg on Days 1 and 15 of the first 24-week treatment cycle and as single infusions of 600 mg on Day 1 for each 24-week treatment cycle, thereafter) every 24 weeks. The primary objective of this study is to verify the equivalency of Ocrelizumab (CinnaGen) versus Ocrevus® (Roche, Switzerland) in reducing the annualized relapse rate (ARR) in participants with relapsing remitting multiple sclerosis (RRMS) at 2 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis, Relapsing-Remitting
Keywords
RRMS, Annualized Relapse Rate, Monoclonal, Humanized, Ocrelizumab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
170 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ocrelizumab (CinnaGen, Iran)
Arm Type
Experimental
Arm Description
Ocrelizumab (CinnaGen, Iran) 600 mg (given as dual infusions of ocrelizumab 300 mg on Days 1 and 15 of the first 24-week treatment cycle and as single infusions of 600 mg on Day 1 for each 24-week treatment cycle, thereafter) every 24 weeks.
Arm Title
Ocrelizumab (Roche, Switzerland)
Arm Type
Active Comparator
Arm Description
Ocrelizumab (Roche, Switzerland) 600 mg (given as dual infusions of ocrelizumab 300 mg on Days 1 and 15 of the first 24-week treatment cycle and as single infusions of 600 mg on Day 1 for each 24-week treatment cycle, thereafter) every 24 weeks.
Intervention Type
Biological
Intervention Name(s)
Ocrelizumab (CinnaGen, Iran)
Other Intervention Name(s)
Xacrel®
Intervention Description
Ocrelizumab (CinnaGen, Iran) will be administered via intravenous (IV) infusion.
Intervention Type
Biological
Intervention Name(s)
Ocrelizumab (Roche, Switzerland)
Other Intervention Name(s)
Ocrevus®
Intervention Description
Ocrelizumab (Roche, Switzerland) will be administered via intravenous (IV) infusion.
Primary Outcome Measure Information:
Title
Annualized Relapse Rate at 48 weeks
Description
Total number of confirmed relapses divided by the total number of days on study A relapse is defined as the appearance of a new or worsening of a previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding relapse. The abnormality must be present for at least 24 hours and occur in the absence of fever or infection
Time Frame
48 weeks
Secondary Outcome Measure Information:
Title
Time to onset of sustained disability progression for at least 12 weeks
Description
Disability progression is defined as an increase in the Expanded Disability Status Scale (EDSS) score of: A) At least a 1.5-point increase in patients with a baseline score of 0 B) At least a 1.0-point increase on the EDSS in patients with a baseline score of 0<EDSS≤5.5 C) At least a 0.5-point increase on the EDSS in patients with a baseline score of >5.5 The EDSS scale ranges from 0 (normal neurological exam) to 10 (death due to multiple sclerosis)
Time Frame
Baseline up to Week 96
Title
Time to onset of sustained disability progression for at least 24 weeks
Description
Disability progression is defined as an increase in the Expanded Disability Status Scale (EDSS) score of: A) At least a 1.5-point increase in patients with a baseline score of 0 B) At least a 1.0-point increase on the EDSS in patients with a baseline score of 0<EDSS≤5.5 C) At least a 0.5-point increase on the EDSS in patients with a baseline score of >5.5 The EDSS scale ranges from 0 (normal neurological exam) to 10 (death due to multiple sclerosis)
Time Frame
Baseline up to Week 96
Title
Proportion of relapse-free patients by 96 weeks
Description
A relapse is defined as the appearance of a new or worsening of a previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding relapse. The abnormality must be present for at least 24 hours and occur in the absence of fever or infection
Time Frame
Week 96
Title
Total number of new Gadolinium (Gd)-enhancing lesions as detected by brain MRI
Description
Sum of the individual number of (Gd)-enhancing lesions at Weeks 24, 48, and 96
Time Frame
Baseline up to Week 96
Title
Total number of new, and/or enlarging T2 hyperintense lesions as detected by brain MRI
Description
Sum of the individual number of new, and/or enlarging T2 hyperintense lesions at Weeks 24, 48, and 96
Time Frame
Baseline up to Week 96
Title
Change in total T2 lesion volume as detected by brain MRI from baseline to week 96
Time Frame
Baseline up to Week 96
Title
Number of Participants With Adverse Events (AEs)
Description
Intensity, seriousness and causality assessment of observed AEs, and abnormal laboratory findings every 12 weeks.
Time Frame
Baseline up to Week 96
Title
Number of Participants With Infusion Related Reactions (IRRs)
Description
Assessment of IRRs every 24 weeks
Time Frame
Baseline up to Week 96
Title
Immunogenicity Assessment
Description
Number of participants positive for anti-drug antibodies at weeks 24, 48 and 96
Time Frame
Baseline up to Week 96

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: Ability to provide written, informed consent and to be compliant with the schedule of protocol assessments. Ages 18-55 years at screening, inclusive. Diagnosis of MS, in accordance with the revised McDonald criteria (2010). At least two relapses having occurred within the past 2 years or one relapse within the past 12 months prior to screening. Neurological stability for ≥ 30 days prior to both screening and baseline. EDSS, at screening, from 0 to 5.5 inclusive. Patients of reproductive potential must use reliable means of contraception. Exclusion Criteria: Diagnosis of primary progressive MS. Disease duration of more than 10 years in patients with an EDSS ≤ 2.0 at screening. Inability to complete an MRI (contraindications for MRI include but are not restricted to claustrophobia, weight ≥ 140 kg, pacemaker, cochlear implants, presence of foreign substances in the eye, intracranial vascular clips, surgery within 6 weeks of entry into the study, coronary stent implanted within 8 weeks prior to the time of the intended MRI, etc). Known presence of other neurological disorders which may mimic MS including but not limited to: neuromeylitis optica, Lyme disease, untreated vitamin B12 deficiency, neurosarcoidosis and cerebrovascular disorders. Pregnancy or lactation. Any concomitant disease that may require chronic treatment with systemic corticosteroids or immunosuppressants during the course of the study. History or currently active primary or secondary immunodeficiency. Lack of peripheral venous access. History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies. Significant or uncontrolled somatic disease or any other significant disease that may preclude patient from participating in the study such as Congestive heart failure (NYHA III or IV functional severity). Known active bacterial, viral, fungal, mycobacterial infection or other infection, excluding fungal infection of nail beds. Infection requiring hospitalization or treatment with I.V. antibiotics within 4 weeks prior to baseline visit or oral antibiotics within 2 weeks prior to baseline visit. History or known presence of recurrent or chronic infection (e.g., hepatitis B or C, HIV). History of progressive multifocal leukoencephalopathy (PML) History of malignancy, including solid tumors and hematological malignancies, except basal cell carcinoma, in situ squamous cell carcinoma of the skin, and in situ carcinoma of the cervix of the uterus that have been previously completely excised with documented, clear margins. History of alcohol or drug abuse within 24 weeks prior to baseline. History or laboratory evidence of coagulation disorders. Receipt of a live vaccine (BCG, MMR, VZV, polio, yellow fever and some influenza vaccine) within 6 weeks prior to baseline. In rare cases when patient requires vaccination with a live vaccine, the screening period may be extended but cannot exceed 8 weeks. Treatment with any investigational agent within 24 weeks of screening (Visit 1) or five half-lives of the investigational drug (whichever is longer). Contraindications to or intolerance of oral or i.v. corticosteroids, including methylprednisolone administered i.v. Treatment with dalfampridine unless on stable dose for ≥ 30 days prior to screening. Patients should remain on stable doses throughout the 48 weeks' treatment period. Previous treatment with B-cell targeted therapies (i.e. rituximab, ocrelizumab, atacicept, belimumab or ofatumumab). Systemic corticosteroid therapy within 4 weeks prior to screening. Any previous treatment with anti-CD4, cladribine, mitoxantrone, daclizumab, teriflunomide, laquinimod, total body irradiation or bone marrow transplantation. Treatment with cyclophosphamide, azathioprine, mycophenolate mofetil (MMF), cyclosporine, methotrexate or natalizumab within 24 months prior to screening. Patients previously treated with natalizumab will be eligible for this study only if duration of treatment with natalizumab was < 1 year. Treatment with fingolimod or dimethyl fumarate (DMF) within 4 weeks prior to screening. Only patients with T lymphocyte count ≥ LLN will be eligible for this study. Treatment with I.V. immunoglobulin within 12 weeks prior to baseline. Positive serum β hCG measured at screening. Positive screening tests for hepatitis B CD4 count < 300/μL. AST/SGOT or ALT/SGPT ≥ 2.0 Upper Limit of Normal (ULN). Platelet count <100,000/μL (<100 x 109/L). Levels of serum IgG 18% below the LLN. Levels of serum IgM 8% below the LLN. Total neutrophil count <1.5 x 10^3/μL.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mohammad Ali Sahraian, professor
Organizational Affiliation
Neurologist/MS Research Center, Neuroscience Institute ,Tehran University of Medical Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Qaem International Hospital
City
Rasht
State/Province
Guilan
Country
Iran, Islamic Republic of
Facility Name
Qaem Hospital
City
Mashhad
State/Province
Khorasan Razavi
Country
Iran, Islamic Republic of
Facility Name
Golestan Hospital
City
Ahvaz
State/Province
Khozestan
Country
Iran, Islamic Republic of
Facility Name
Bouali Hospital, MS Clinic
City
Sari
State/Province
Mazandaran
Country
Iran, Islamic Republic of
Facility Name
Sina Hospital
City
Hamadān
Country
Iran, Islamic Republic of
Facility Name
Ayatollah Kashani Hospital, MS Clinic
City
Isfahan
Country
Iran, Islamic Republic of
Facility Name
Imam Reza Hospital
City
Kermanshah
Country
Iran, Islamic Republic of
Facility Name
Shafa Hospital
City
Kerman
Country
Iran, Islamic Republic of
Facility Name
Dr. Nikseresht's office
City
Shiraz
Country
Iran, Islamic Republic of
Facility Name
Namazi Hospital
City
Shiraz
Country
Iran, Islamic Republic of
Facility Name
Imam Reza Hospital Department of Neurology
City
Tabriz
Country
Iran, Islamic Republic of
Facility Name
Amir Alam Hospital
City
Tehran
Country
Iran, Islamic Republic of
Facility Name
Imam Hossein Hospital, MS Clinic
City
Tehran
Country
Iran, Islamic Republic of
Facility Name
Imam Khomeini Hospital
City
Tehran
Country
Iran, Islamic Republic of
Facility Name
Sina Hospital, MS Research Center
City
Tehran
Country
Iran, Islamic Republic of

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Efficacy and Safety of Xacrel® (Ocrelizumab) in Participants With Relapsing Remitting Multiple Sclerosis

We'll reach out to this number within 24 hrs