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A 3-year Multi-center Study to Describe Changes of OCT Parameters Under Treatment With Gilenya® (PASSOS)

Primary Purpose

Relapsing Remitting Multiple Sclerosis RRMS

Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Fingolimod
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Relapsing Remitting Multiple Sclerosis RRMS focused on measuring Multiple sclerosis (MS), MS

Eligibility Criteria

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

Inclusion Criteria

Patients eligible for inclusion in this study have to fulfill all of the following criteria:

  1. Written informed consent must be obtained before any assessment is performed.
  2. Male or female subjects aged 18-65 years.
  3. Subjects with relapsing remitting MS defined by 2010 revised McDonald criteria (see Appendix 4).
  4. Patients with Expanded Disability Status Scale (EDSS) score of 0-6.0 inclusive (see Appendix 6).
  5. Patients stable on immunomodulatory treatment with fingolimod for at least 1 month and at most 4 months prior to screening according to local label
  6. Neurologically stable with no evidence of relapse within 30 days prior to inclusion date
  7. Sufficient ability to read, write, communicate and understand

Exclusion Criteria

Patients fulfilling any of the following criteria are not eligible for inclusion in this study:

  1. Patients who have been treated with:

    • systemic corticosteroids or immunoglobulins within 1 month prior to screening;
    • immunosuppressive medications such as azathioprine, cyclophosphamide, or methotrexate within 3 months prior to screening;
    • monoclonal antibodies (including natalizumab) within 3 months prior to screening;
    • mitoxantrone within 6 months prior to screening
    • cladribine at any time.
  2. Patients with any medically unstable condition, as assessed by the primary treating physician at each site.
  3. Patients with any of the following cardiovascular conditions :

    • history of myocardial infarction or with current unstable ischemic heart disease;
    • Heart failure (NYHA III-IV) or any severe cardiac disease as determined by the Investigator (see Appendix 5);
    • history or presence of a second-degree AV block, Type II or a third-degree AV block
    • patients receiving Class Ia (ajmaline, disopyramide, procainamide, quinidine) or III antiarrhythmic drugs (e.g., amiodarone, bretylium, sotalol, ibulitide, azimilide, dofelitide);
    • proven history of sick sinus syndrome;
    • uncontrolled hypertension
  4. Patients with severe respiratory disease, pulmonary fibrosis, or chronic obstructive pulmonary disease (Class III-IV).
  5. Patients with history of specific MRI findings (tumor, subdural haematoma, post-contusional changes, territorial stroke, neurodegenerative disorders, aneurysm/arteriovenous malformation, evidence of past macroscopic haemorrhage, or other relevant MRI findings that would interfere with evaluation)
  6. Any severe disability or clinical impairment that can prevent the patient to meet all study requirements at the investigator's discretion
  7. History of malignancy of any organ system, treated or untreated, within the past 5 years whether or not there is evidence of local recurrence or metastases, with the exception of localized basal cell carcinoma of the skin
  8. Patients who have received an investigational drug (excluding fingolimod) or therapy within 90 days or 5 half-lives of screening, whichever is longer.
  9. Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG test (serum)
  10. Patients with any ophthalmologic reason for RNFL pathology other than MS, such as: optic neuropathy, active advanced glaucoma, injury of the optic nerve based on the ophthalmologist's clinical judgment
  11. history or presence of severe myopia

    1. in patients who have not had refractive surgery, a refractive error of greater than 6.00 diopters
    2. pathologic fundus changes of high myopia, such as retinal pigmentary atrophy, besides peripapillary atrophy (atrophy involving the macula) or a staphyloma
    3. in patients that have had previous refractive surgery, an axial eye length of greater than 26 mm
  12. Acute optic neuritis within the past 6 months before screening
  13. Evidence of advanced, non-proliferative or proliferative diabetic retinopathy
  14. Presence of retinal conditions associated with edema, subretinal fluid, cysts, etc.
  15. Concomitant use of drugs that may directly affect retinal structure and function (e.g.

chronic systemic corticosteroids [>30 consecutive days; doses higher than Cushing threshold e.g. prednisone 7.5mg/d], intraocular anti-angiogenic drugs [ranibizumab, bevacizumab], intraocular steroids etc.)

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Fingolimod - Longitudinal Assessment

Arm Description

No study drug was provided. Fingolimod was to be prescribed according to local label. The decision to prescribe fingolimod had to be made independent of this study.

Outcomes

Primary Outcome Measures

Change From Baseline to Month 36 in Average Retinal Nerve Fiber Layer Thickness (RNFLT)
The primary endpoint was the change, i.e. the absolute difference, in average RNFL thickness from baseline to month 36 (or last values in case of missing data) in the Full Analysis Set (FAS). Average RNFL thickness was the average of valid measurements of the right and left eye and assessed by optical coherence tomography (OCT).

Secondary Outcome Measures

Change From Baseline to Month 12 and 24 in Average Retinal Nerve Fiber Layer Thickness (RNFLT)
Change from baseline in average RNFL thickness to months 12 and 24 (or last values in case of missing data) in the Full Analysis Set (FAS). Average RNFL thickness was the average of valid measurements of the right and left eye and assessed by optical coherence tomography (OCT).
Change From Baseline to Month 12, 24 and 36 in Average Quadrant Retinal Nerve Fiber Layer Thickness (RNFLT)
Change from baseline in average quadrant RNFL thickness to months 12, 24 and 36 (or last values in case of missing data) in the Full Analysis Set (FAS). Average quadrant RNFL thickness was the average of valid measurements of the right and left eye and assessed by optical coherence tomography (OCT). Quadrant RNFL thickness were: Nasal-inferior; nasal-superior; temporal-inferior; temporal-superior.
Change From Baseline to Month 12, 24 and 36 in Total Macular Volume (TMV)
Change from baseline in TMV to months 12, 24 and 36 (or last values in case of missing data) in the Full Analysis Set (FAS).
Change From Baseline to Month 12, 24 and 36 in Ganglion Cell Inner Plexiform (GCIP)
Change from baseline in GCIP to months 12, 24 and 36 (or last values in case of missing data) in the Full Analysis Set (FAS). The change in Ganglion cell layer thickness (GCLT) had been defined as secondary endpoint in the protocol, but OCT measured the GCIP instead. This was done because both layers were not clearly separable by OCT. GCIP was calculated as mean of the inner sectors (nasal, superior, temporal, and inferior) and declared as usual parameter instead. This change was introduced prior to data base lock, but the derivation of GCIP was corrected after data base lock.
Number of Participants With Adverse Events
Number of participants with adverse events and specifically macular edema.

Full Information

First Posted
August 13, 2012
Last Updated
February 14, 2020
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01705236
Brief Title
A 3-year Multi-center Study to Describe Changes of OCT Parameters Under Treatment With Gilenya®
Acronym
PASSOS
Official Title
A 3-year Multi-center Study to Describe the Long Term Changes of Optical Coherence Tomography (OCT) Parameters in Patients Under Treatment With Gilenya®
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
August 20, 2012 (Actual)
Primary Completion Date
February 18, 2019 (Actual)
Study Completion Date
February 18, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

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 was a 3-year, prospective, multi-center, open-label study to describe the long term changes of optical coherence tomography (OCT) parameters in RRMS patients under treatment with Fingolimod. It was designed to longitudinally study the degeneration of retinal axons by measuring change in RNFL thickness by latest OCT-technology.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
87 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Fingolimod - Longitudinal Assessment
Arm Type
Experimental
Arm Description
No study drug was provided. Fingolimod was to be prescribed according to local label. The decision to prescribe fingolimod had to be made independent of this study.
Intervention Type
Drug
Intervention Name(s)
Fingolimod
Other Intervention Name(s)
FTY720
Intervention Description
All subjects received an oral dose of 0.5 mg fingolimod (FTY720) per capsule (hard gelatin capsules) once daily according to local label for the treatment of their MS.
Primary Outcome Measure Information:
Title
Change From Baseline to Month 36 in Average Retinal Nerve Fiber Layer Thickness (RNFLT)
Description
The primary endpoint was the change, i.e. the absolute difference, in average RNFL thickness from baseline to month 36 (or last values in case of missing data) in the Full Analysis Set (FAS). Average RNFL thickness was the average of valid measurements of the right and left eye and assessed by optical coherence tomography (OCT).
Time Frame
Baseline, month 36
Secondary Outcome Measure Information:
Title
Change From Baseline to Month 12 and 24 in Average Retinal Nerve Fiber Layer Thickness (RNFLT)
Description
Change from baseline in average RNFL thickness to months 12 and 24 (or last values in case of missing data) in the Full Analysis Set (FAS). Average RNFL thickness was the average of valid measurements of the right and left eye and assessed by optical coherence tomography (OCT).
Time Frame
Baseline, month 12, month 24
Title
Change From Baseline to Month 12, 24 and 36 in Average Quadrant Retinal Nerve Fiber Layer Thickness (RNFLT)
Description
Change from baseline in average quadrant RNFL thickness to months 12, 24 and 36 (or last values in case of missing data) in the Full Analysis Set (FAS). Average quadrant RNFL thickness was the average of valid measurements of the right and left eye and assessed by optical coherence tomography (OCT). Quadrant RNFL thickness were: Nasal-inferior; nasal-superior; temporal-inferior; temporal-superior.
Time Frame
Baseline, month 12, month 24, month 36
Title
Change From Baseline to Month 12, 24 and 36 in Total Macular Volume (TMV)
Description
Change from baseline in TMV to months 12, 24 and 36 (or last values in case of missing data) in the Full Analysis Set (FAS).
Time Frame
12, 24 and 36 months
Title
Change From Baseline to Month 12, 24 and 36 in Ganglion Cell Inner Plexiform (GCIP)
Description
Change from baseline in GCIP to months 12, 24 and 36 (or last values in case of missing data) in the Full Analysis Set (FAS). The change in Ganglion cell layer thickness (GCLT) had been defined as secondary endpoint in the protocol, but OCT measured the GCIP instead. This was done because both layers were not clearly separable by OCT. GCIP was calculated as mean of the inner sectors (nasal, superior, temporal, and inferior) and declared as usual parameter instead. This change was introduced prior to data base lock, but the derivation of GCIP was corrected after data base lock.
Time Frame
Baseline, month 12, month 24, month 36
Title
Number of Participants With Adverse Events
Description
Number of participants with adverse events and specifically macular edema.
Time Frame
36 months

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 Patients eligible for inclusion in this study have to fulfill all of the following criteria: Written informed consent must be obtained before any assessment is performed. Male or female subjects aged 18-65 years. Subjects with relapsing remitting MS defined by 2010 revised McDonald criteria (see Appendix 4). Patients with Expanded Disability Status Scale (EDSS) score of 0-6.0 inclusive (see Appendix 6). Patients stable on immunomodulatory treatment with fingolimod for at least 1 month and at most 4 months prior to screening according to local label Neurologically stable with no evidence of relapse within 30 days prior to inclusion date Sufficient ability to read, write, communicate and understand Exclusion Criteria Patients fulfilling any of the following criteria are not eligible for inclusion in this study: Patients who have been treated with: systemic corticosteroids or immunoglobulins within 1 month prior to screening; immunosuppressive medications such as azathioprine, cyclophosphamide, or methotrexate within 3 months prior to screening; monoclonal antibodies (including natalizumab) within 3 months prior to screening; mitoxantrone within 6 months prior to screening cladribine at any time. Patients with any medically unstable condition, as assessed by the primary treating physician at each site. Patients with any of the following cardiovascular conditions : history of myocardial infarction or with current unstable ischemic heart disease; Heart failure (NYHA III-IV) or any severe cardiac disease as determined by the Investigator (see Appendix 5); history or presence of a second-degree AV block, Type II or a third-degree AV block patients receiving Class Ia (ajmaline, disopyramide, procainamide, quinidine) or III antiarrhythmic drugs (e.g., amiodarone, bretylium, sotalol, ibulitide, azimilide, dofelitide); proven history of sick sinus syndrome; uncontrolled hypertension Patients with severe respiratory disease, pulmonary fibrosis, or chronic obstructive pulmonary disease (Class III-IV). Patients with history of specific MRI findings (tumor, subdural haematoma, post-contusional changes, territorial stroke, neurodegenerative disorders, aneurysm/arteriovenous malformation, evidence of past macroscopic haemorrhage, or other relevant MRI findings that would interfere with evaluation) Any severe disability or clinical impairment that can prevent the patient to meet all study requirements at the investigator's discretion History of malignancy of any organ system, treated or untreated, within the past 5 years whether or not there is evidence of local recurrence or metastases, with the exception of localized basal cell carcinoma of the skin Patients who have received an investigational drug (excluding fingolimod) or therapy within 90 days or 5 half-lives of screening, whichever is longer. Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG test (serum) Patients with any ophthalmologic reason for RNFL pathology other than MS, such as: optic neuropathy, active advanced glaucoma, injury of the optic nerve based on the ophthalmologist's clinical judgment history or presence of severe myopia in patients who have not had refractive surgery, a refractive error of greater than 6.00 diopters pathologic fundus changes of high myopia, such as retinal pigmentary atrophy, besides peripapillary atrophy (atrophy involving the macula) or a staphyloma in patients that have had previous refractive surgery, an axial eye length of greater than 26 mm Acute optic neuritis within the past 6 months before screening Evidence of advanced, non-proliferative or proliferative diabetic retinopathy Presence of retinal conditions associated with edema, subretinal fluid, cysts, etc. Concomitant use of drugs that may directly affect retinal structure and function (e.g. chronic systemic corticosteroids [>30 consecutive days; doses higher than Cushing threshold e.g. prednisone 7.5mg/d], intraocular anti-angiogenic drugs [ranibizumab, bevacizumab], intraocular steroids etc.)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Novartis Investigative Site
City
Bochum
ZIP/Postal Code
44791
Country
Germany
Facility Name
Novartis Investigative Site
City
Bonn
ZIP/Postal Code
53105
Country
Germany
Facility Name
Novartis Investigative Site
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Novartis Investigative Site
City
Duesseldorf
ZIP/Postal Code
40225
Country
Germany
Facility Name
Novartis Investigative Site
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Novartis Investigative Site
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Novartis Investigative Site
City
Leipzig
ZIP/Postal Code
04103
Country
Germany
Facility Name
Novartis Investigative Site
City
Rostock
ZIP/Postal Code
18057
Country
Germany
Facility Name
Novartis Investigative Site
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
Novartis Investigative Site
City
Zuerich
ZIP/Postal Code
8091
Country
Switzerland

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.

Learn more about this trial

A 3-year Multi-center Study to Describe Changes of OCT Parameters Under Treatment With Gilenya®

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