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A Study of Mitoxantrone Hydrochloride Liposome Injection for Relapsing Multiple Sclerosis

Primary Purpose

Relapsing Multiple Sclerosis

Status
Withdrawn
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Mitoxantrone Hydrochloride Liposome Injection
Sponsored by
CSPC Zhongnuo Pharmaceutical (Shijiazhuang) Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsing Multiple Sclerosis

Eligibility Criteria

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

Inclusion Criteria:

  • 18 to 55 years of age (inclusive);
  • Diagnosis of relapsing multiple sclerosis (RMS);
  • Disease duration of secondary progressive multiple sclerosis (SPMS) with superimposed relapses ≤ 5 years;
  • Expanded disability status scale (EDSS) score of 3 to 8;
  • Participants who have received disease-modifying therapy still relapse or aggravate; or participants who, in the opinion of the investigator, are suitable for treatment with Mitoxantrone Hydrochloride Liposome Injection;
  • Participants voluntarily sign informed consent, and complete the study according to the protocol.

Exclusion Criteria:

  • Pregnant or lactating female participants or participants planning to have a child during the study;
  • History of severe drug allergy, or allergy or intolerance to gadolinium, anthracyclines or liposome drugs;
  • History of vitamin B12 deficiency;
  • Participants with malignant tumor diagnosed within 5 years before the screening phase, except the skin basal cell carcinoma under effective control, and Stage I Squamous Cell Carcinoma);
  • Participants with history of interstitial lung disease or with pneumonia according to chest X-ray in the screening phase;
  • Participants with serious or active skin diseases, or clinically significant skin abnormalities in physical examination in the screening phase;
  • History of severe immunodeficiency;
  • History of drug and/or alcohol abuse, or mental disorder;
  • Participants has a progressive neurological disorder or optic neuritis other than MS; or has other disease that should be treated more preferentially than MS, or that could interfere with the study or compromise participants compliance with treatment;
  • MRI before randomization shows cervical spinal cord compression or lesions in non-MS characteristic areas of the brain, and the lesions can explain the changes in clinical symptoms and signs;
  • MS relapse in the screening phase;
  • Participated in other drug clinical studies and received investigational product within 3 months before screening or within 5 half-lives of the investigational product (whichever was longer), or participated in medical device clinical studies which is judged by the investigator to have a possible impact on the results of this study;
  • Participants who have received disease-modifying therapy or immunosuppressive agents or systemic corticosteroids within the washout period before the first dose (e.g., 4 weeks for interferon, PEGylated interferon, glatiramer acetate, dimethyl fumarate and 12 weeks for fingolimod, siponimod, intravenous immunoglobulin or plasma exchange, etc.)
  • Participants who have received anthracyclines or cardiotoxic drugs before screening;
  • Participants who previously received total body irradiation or total lymphatic irradiation, or received stem cell therapy or any type of bone marrow transplantation, or received solid organ transplantation;
  • Presence of the following clinically significant diseases: myocardial infarction, acute coronary syndrome, viral myocarditis, pulmonary embolism within 6 months; coronary revascularization within 6 months; arrhythmia requiring Class Ia or Ш antiarrhythmic drugs;
  • Laboratory tests in screening phase, such as white blood cell count, neutrophil count, platelet count, hemoglobin, creatinine clearance, etc., are abnormal with clinical significance (according to the judgment of the investigator); positive results for Hepatitis B Surface Antigen (HBsAg), Hepatitis C Antibody (HCVAb), syphilis antibody test; total bilirubin > 1.5x ULN, or alanine aminotransferase or aspartate aminotransferase > 3x ULN;
  • Participants could not complete MRI scan before randomization, such as participants with claustrophobia;
  • Participants with active or uncontrolled infection (defined as requiring systemic anti-infective therapy and the temperature ≥ 38℃ (axillary temperature) before receiving drugs and unexplainable);
  • Investigator believe that participants have other disease that are not suitable for participating in this study.

Sites / Locations

  • Xuanwu Hospital Capital Medical University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Mitoxantrone Hydrochloride Liposome Injection 4 mg/m^2 group

Mitoxantrone Hydrochloride Liposome Injection 8 mg/m^2 group

Mitoxantrone Hydrochloride Liposome Injection 12 mg/m^2 group

Arm Description

Participants will receive Mitoxantrone Hydrochloride Liposome Injection 4 mg/m^2 every 3 months (Q3M).

Participants will receive Mitoxantrone Hydrochloride Liposome Injection 8 mg/m^2 every 3 months (Q3M).

Participants will receive Mitoxantrone Hydrochloride Liposome Injection 12 mg/m^2 every 3 months (Q3M).

Outcomes

Primary Outcome Measures

The cumulative number of new Gadolinium (Gd)-enhancing lesions at the end of 48 weeks of Mitoxantrone Hydrochloride Liposome Injection treatment in brain MRI.

Secondary Outcome Measures

Annualized Relapse Rate (ARR)
ARR at Week 48 is calculated as the ratio of the sum of all participants confirmed relapse counts divided by the sum of all participants treatment duration (in years).
Number of Relapses
Time to Onset of Confirmed Disability Progression for at least 6 Months
Time to Onset of Confirmed Disability Progression for at least 3 Months
Proportion of participants with ≥ 20% improvement from baseline in T25FW walking speed.
Change from baseline to Week 48 in T25FW walking speed.
Number of new or enlarged T2 lesions.
Change from baseline in brain MRI Gd-enhancing T1 lesion volume at Weeks 12、24、36、48.
Change from baseline in brain MRI T2 lesion volume at Weeks 12、24、36、48.
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Plasma concentration of Mitoxantrone Hydrochloride Liposome Injection.
Descriptive analysis of the rate of change in the number or proportion of B cells from baseline to different time points in different dose groups.
Descriptive analysis of the rate of change in the number or proportion of T cells from baseline to different time points in different dose groups.
Descriptive analysis of the rate of change in the number or proportion of NK cells from baseline to different time points in different dose groups.

Full Information

First Posted
July 28, 2022
Last Updated
December 13, 2022
Sponsor
CSPC Zhongnuo Pharmaceutical (Shijiazhuang) Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05496894
Brief Title
A Study of Mitoxantrone Hydrochloride Liposome Injection for Relapsing Multiple Sclerosis
Official Title
A Phase Ⅱ Study to Evaluate the Safety and Efficacy of Mitoxantrone Hydrochloride Liposome Injection for Relapsing Multiple Sclerosis
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Withdrawn
Why Stopped
Due to the company's project adjustment, decided to stop this study
Study Start Date
August 2022 (Anticipated)
Primary Completion Date
November 8, 2022 (Actual)
Study Completion Date
November 8, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CSPC Zhongnuo Pharmaceutical (Shijiazhuang) Co., Ltd.

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
This is a multicenter, randomized, single-arm, open-label Phase II study to evaluate the efficacy and safety of Mitoxantrone Hydrochloride Liposome Injection with different doses in participants with Relapsing Multiple Sclerosis. Participants will be randomly enrolled into three treatment groups: Mitoxantrone Hydrochloride Liposome Injection 4 mg/m^2 group, Mitoxantrone Hydrochloride Liposome Injection 8 mg/m^2 group, and Mitoxantrone Hydrochloride Liposome Injection 12 mg/m^2 group. The primary outcome measure is the cumulative number of new Gd-enhancing lesions at the end of 48 weeks of Mitoxantrone Hydrochloride Liposome Injection treatment in brain MRI.
Detailed Description
Multiple sclerosis is a chronic, inflammatory, demyelinating disease of the central nervous system (CNS) and is one of the most common causes of neurological disability in young adults. It is characterised by multi-focal recurrent attacks of neurological symptoms and signs with variable recovery.This is a multicenter, randomized, single-arm, open-label Phase II study to evaluate the efficacy and safety of Mitoxantrone Hydrochloride Liposome Injection with different doses in participants with Relapsing Multiple Sclerosis. Participants will be randomly enrolled into three treatment groups: Mitoxantrone Hydrochloride Liposome Injection 4 mg/m^2 group, Mitoxantrone Hydrochloride Liposome Injection 8 mg/m^2 group, and Mitoxantrone Hydrochloride Liposome Injection 12 mg/m^2 group. The primary outcome measure is the cumulative number of new Gd-enhancing lesions at the end of 48 weeks of Mitoxantrone Hydrochloride Liposome Injection treatment in brain MRI.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Mitoxantrone Hydrochloride Liposome Injection 4 mg/m^2 group
Arm Type
Experimental
Arm Description
Participants will receive Mitoxantrone Hydrochloride Liposome Injection 4 mg/m^2 every 3 months (Q3M).
Arm Title
Mitoxantrone Hydrochloride Liposome Injection 8 mg/m^2 group
Arm Type
Experimental
Arm Description
Participants will receive Mitoxantrone Hydrochloride Liposome Injection 8 mg/m^2 every 3 months (Q3M).
Arm Title
Mitoxantrone Hydrochloride Liposome Injection 12 mg/m^2 group
Arm Type
Experimental
Arm Description
Participants will receive Mitoxantrone Hydrochloride Liposome Injection 12 mg/m^2 every 3 months (Q3M).
Intervention Type
Drug
Intervention Name(s)
Mitoxantrone Hydrochloride Liposome Injection
Intervention Description
IV, once every 3 months (Q3M)
Primary Outcome Measure Information:
Title
The cumulative number of new Gadolinium (Gd)-enhancing lesions at the end of 48 weeks of Mitoxantrone Hydrochloride Liposome Injection treatment in brain MRI.
Time Frame
Week 48
Secondary Outcome Measure Information:
Title
Annualized Relapse Rate (ARR)
Description
ARR at Week 48 is calculated as the ratio of the sum of all participants confirmed relapse counts divided by the sum of all participants treatment duration (in years).
Time Frame
Week 48
Title
Number of Relapses
Time Frame
Week 48
Title
Time to Onset of Confirmed Disability Progression for at least 6 Months
Time Frame
Week 48
Title
Time to Onset of Confirmed Disability Progression for at least 3 Months
Time Frame
Week 48
Title
Proportion of participants with ≥ 20% improvement from baseline in T25FW walking speed.
Time Frame
Week 48
Title
Change from baseline to Week 48 in T25FW walking speed.
Time Frame
Week 48
Title
Number of new or enlarged T2 lesions.
Time Frame
Week 48
Title
Change from baseline in brain MRI Gd-enhancing T1 lesion volume at Weeks 12、24、36、48.
Time Frame
Week 12、24、36、48
Title
Change from baseline in brain MRI T2 lesion volume at Weeks 12、24、36、48.
Time Frame
Week 12、24、36、48
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Time Frame
Week 56
Title
Plasma concentration of Mitoxantrone Hydrochloride Liposome Injection.
Time Frame
Week 12
Title
Descriptive analysis of the rate of change in the number or proportion of B cells from baseline to different time points in different dose groups.
Time Frame
Week 36
Title
Descriptive analysis of the rate of change in the number or proportion of T cells from baseline to different time points in different dose groups.
Time Frame
Week 36
Title
Descriptive analysis of the rate of change in the number or proportion of NK cells from baseline to different time points in different dose groups.
Time Frame
Week 36

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: 18 to 55 years of age (inclusive); Diagnosis of relapsing multiple sclerosis (RMS); Disease duration of secondary progressive multiple sclerosis (SPMS) with superimposed relapses ≤ 5 years; Expanded disability status scale (EDSS) score of 3 to 8; Participants who have received disease-modifying therapy still relapse or aggravate; or participants who, in the opinion of the investigator, are suitable for treatment with Mitoxantrone Hydrochloride Liposome Injection; Participants voluntarily sign informed consent, and complete the study according to the protocol. Exclusion Criteria: Pregnant or lactating female participants or participants planning to have a child during the study; History of severe drug allergy, or allergy or intolerance to gadolinium, anthracyclines or liposome drugs; History of vitamin B12 deficiency; Participants with malignant tumor diagnosed within 5 years before the screening phase, except the skin basal cell carcinoma under effective control, and Stage I Squamous Cell Carcinoma); Participants with history of interstitial lung disease or with pneumonia according to chest X-ray in the screening phase; Participants with serious or active skin diseases, or clinically significant skin abnormalities in physical examination in the screening phase; History of severe immunodeficiency; History of drug and/or alcohol abuse, or mental disorder; Participants has a progressive neurological disorder or optic neuritis other than MS; or has other disease that should be treated more preferentially than MS, or that could interfere with the study or compromise participants compliance with treatment; MRI before randomization shows cervical spinal cord compression or lesions in non-MS characteristic areas of the brain, and the lesions can explain the changes in clinical symptoms and signs; MS relapse in the screening phase; Participated in other drug clinical studies and received investigational product within 3 months before screening or within 5 half-lives of the investigational product (whichever was longer), or participated in medical device clinical studies which is judged by the investigator to have a possible impact on the results of this study; Participants who have received disease-modifying therapy or immunosuppressive agents or systemic corticosteroids within the washout period before the first dose (e.g., 4 weeks for interferon, PEGylated interferon, glatiramer acetate, dimethyl fumarate and 12 weeks for fingolimod, siponimod, intravenous immunoglobulin or plasma exchange, etc.) Participants who have received anthracyclines or cardiotoxic drugs before screening; Participants who previously received total body irradiation or total lymphatic irradiation, or received stem cell therapy or any type of bone marrow transplantation, or received solid organ transplantation; Presence of the following clinically significant diseases: myocardial infarction, acute coronary syndrome, viral myocarditis, pulmonary embolism within 6 months; coronary revascularization within 6 months; arrhythmia requiring Class Ia or Ш antiarrhythmic drugs; Laboratory tests in screening phase, such as white blood cell count, neutrophil count, platelet count, hemoglobin, creatinine clearance, etc., are abnormal with clinical significance (according to the judgment of the investigator); positive results for Hepatitis B Surface Antigen (HBsAg), Hepatitis C Antibody (HCVAb), syphilis antibody test; total bilirubin > 1.5x ULN, or alanine aminotransferase or aspartate aminotransferase > 3x ULN; Participants could not complete MRI scan before randomization, such as participants with claustrophobia; Participants with active or uncontrolled infection (defined as requiring systemic anti-infective therapy and the temperature ≥ 38℃ (axillary temperature) before receiving drugs and unexplainable); Investigator believe that participants have other disease that are not suitable for participating in this study.
Facility Information:
Facility Name
Xuanwu Hospital Capital Medical University
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100000
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study of Mitoxantrone Hydrochloride Liposome Injection for Relapsing Multiple Sclerosis

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