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A Phase III, Non-Inferiority, Randomized, Open-Label, Parallel Group, Multicenter Study To Investigate The Pharmacokinetics, Pharmacodynamics, Safety And Radiological And Clinical Effects Of Subcutaneous Ocrelizumab Versus Intravenous Ocrelizumab In Patients With Multiple Sclerosis (Ocarina II)

Primary Purpose

Relapsing Multiple Sclerosis, Primary Progressive Multiple Sclerosis

Status
Active
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Ocrelizumab IV
Ocrelizumab SC
Methylprednisolone IV
Diphenhydramine IV
Dexamethasone given orally
Desloratadine given orally
Sponsored by
Hoffmann-La Roche
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsing Multiple Sclerosis

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnosis of PPMS or RMS according to the revised McDonald 2017 criteria (Thompson et al. 2018)
  • EDSS score, 0-6.5, inclusive, at screening
  • Neurological stability for ≥30 days prior to both screening and baseline
  • Disease duration from onset of MS symptoms of less than 15 years for patients with EDSS score <2.0 at screening
  • For females participants, without reproductive potential may be enrolled if post-menopausal, unless receiving a hormonal therapy for menopause or if surgically sterile
  • For females of childbearing potential, agreement to remain abstinent or use adequate contraceptive methods

Exclusion Criteria:

  • Any known or suspected active infection at screening or baseline (except nailbed infections), or any major episode of infection requiring hospitalization or treatment with IV anti microbials within 8 weeks prior to and during screening or treatment with oral anti microbials within 2 weeks prior to and during screening
  • History of confirmed or suspected progressive multifocal leukoencephalopathy (PML)
  • History of cancer, including hematologic malignancy and solid tumors, within 10 years of screening
  • Immunocompromised state
  • Receipt of a live-attenuated vaccine within 6 weeks prior to randomization Influenza vaccination is permitted if the inactivated vaccine formulation is administered
  • Inability to complete an MRI or contraindication to gadolinium administration
  • Contraindications to mandatory premedications for IRRs, including closed-angle glaucoma for antihistamines
  • Known presence of other neurologic disorders
  • Any concomitant disease that may require chronic treatment with systemic corticosteroids or immunosuppressants during the course of the study
  • Significant, uncontrolled disease, such as cardiovascular, pulmonary, renal, hepatic, endocrine or gastrointestinal, or any other significant disease that may preclude patient from participating in the study
  • History of or currently active primary or secondary (non-drug-related) immunodeficiency
  • Pregnant or breastfeeding, or intending to become pregnant during the study and 6 or 12 months
  • Lack of peripheral venous access
  • History of alcohol or other drug abuse within 12 months prior to screening
  • Treatment with any investigational agent within 24 weeks prior to screening or 5 half-lives of the investigational drug (whichever is longer), or treatment with any experimental procedure for MS (e.g., treatment for chronic cerebrospinal venous insufficiency)
  • Participants who have previously received anti-CD20s if the last treatment was less than 2 years before screening, and/or if B-cell count is below lower limit of normal, and/or the discontinuation of the treatment was due to safety reasons or lack of efficacy
  • Previous treatment with cladribine, atacicept, and alemtuzumab
  • Previous treatment with fingolimod, siponimod, ponesimod, or ozanimod within 6 weeks of baseline
  • Previous treatment with interferons beta (1a or 1b), or glatiramer acetate within 2 weeks of baseline
  • Previous treatment with natalizumab within 4.5 months of baseline
  • Treatment with mitoxantrone within 2 years prior to baseline visit or evidence of cardiotoxicity following mitoxantrone use or a cumulative lifetime dose of more than 60 mg/m2
  • Previous treatment with any other immunomodulatory or immunosuppressive medication not already listed above without appropriate washout as described in the applicable local label.
  • If the washout requirements are not described in the applicable local label, then the wash out period must be 5 times the half-life of the medication. The PD effects of the previous medication must also be considered when determining the required time for washout.
  • Any previous treatment with bone marrow transplantation and hematopoietic stem cell transplantation
  • Any previous history of transplantation or anti-rejection therapy
  • Treatment with IV Ig or plasmapheresis within 12 weeks prior to randomization
  • Systemic corticosteroid therapy within 4 weeks prior to screening
  • Positive screening tests for active, latent, or inadequately treated hepatitis B
  • Sensitivity or intolerance to any ingredient (including excipients) of ocrelizumab
  • Any additional exclusionary criterion as per ocrelizumab (Ocrevus®) local label, if more stringent than the above

Sites / Locations

  • University of South Florida
  • Johns Hopkins Hospital; Neurology
  • Memorial Healthcare Institute for Neurosciences and Multiple Sclerosis
  • Neurology Associates PA
  • UC Health Neurology
  • Premier Neurology
  • Neurology Clinic PC
  • Clinica Amo - Assistencia Medica Em Oncologia
  • CEDOES - Diagnóstico e Pesquisa
  • Fakultni nemocnice u sv. Anny; Neurologicka klinika
  • Charles University, Medical faculty, Hradec Kralove ;Department of Neurology
  • Nemocnice Jihlava; NEU-Neurologicke oddeleni
  • Fakultni nemocnice Ostrava; MS centrum
  • Pardubicka Krajska Nemocnice; Department of Neurology
  • Fakultni poliklinika VFN; RS centrum
  • Fakultni nemocnice Motol; Neurologicka klinika
  • Krajska zdravotni a.s Nemocnice Teplice o.z.; RS centrum
  • A. O. U. Federico II; Dip Neuroscienze, Scienze Riproduttive ed Odontostomatologiche
  • Policlinico Tor Vergata Dip. Neuroscienze-Clinica Neurologica-UOSD Sclerosi Multipla
  • Azienda Ospedaliera Sant'Andrea; UOC Neurologia
  • Irccs A.O.U.San Martino Ist; Dinogmi
  • IRCCS Ospedale San Raffaele; Neurologia Neurofisiologia Neuroriabilitazione-Centro Sclerosi Multipla
  • Ospedale Civile di Montichiari; Centro Sclerosi Multipla
  • IRCCS Istituto Neurologico Neuromed; Centro per lo Studio e la Cura della Sclerosi Multipla
  • Optimal Clinical Trials
  • Hawkes Bay Hospital
  • Neurocentrum Bydgoszcz sp. z o.o
  • Care Clinic
  • Centrum Neurologii Krzysztof Selmaj
  • Przychodnia EuroMediCare
  • Hospital Universitario Puerta de Hierro Majadahonda
  • Hospital Universitario Virgen Macarena
  • Complejo Hospitalario Nuestra Señora de la Candelaria; Servicio de Neurologia
  • Hospital Universitari Vall d'Hebron
  • Hospital Universitario Reina Sofia; Servicio de Neurologia
  • Bakirkoy State Mental Hospital
  • Istanbul Universitesi - Cerrahpasa Cerrahpasa Tip Fakultesi; Noroloji Anabilim Dali
  • Katip Celebi University Ataturk Training and Research Hospital; Neurology
  • Kocaeli University Hospital; Department of Neurology
  • Namik Kemal Universitesi Sagli Uygulama ve Arastirma Hastanesi; Noroloji

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Ocrelizumab: Intravenous (IV) formulation

Ocrelizumab: Subcutaneous (SC) formulation

Arm Description

Participants will receive the first dose of ocrelizumab IV as two IV infusions given 14 days apart. The subsequent doses of study drug will be administered as SC injections. A minimum of 22 weeks should be kept between SC doses. Participants will undergo 96 weeks of study treatment.

Participants will receive the first dose of ocrelizumab SC as one SC injection at a dose which is expected to result in non-inferior exposure to ocrelizumab IV. The subsequent doses of study drug will be administered as SC injections. A minimum of 22 weeks should be kept between the first and second SC doses, and between subsequent SC doses. Participants will undergo 96 weeks of study treatment.

Outcomes

Primary Outcome Measures

Serum ocrelizumab area under the concentration-time curve (AUCW1-12)

Secondary Outcome Measures

Maximum serum concentration (Cmax) of ocrelizumab SC in patients with MS
Total number of T1Gd+ lesions as detected by brain MRI
Total number of new or enlarging T2 lesions as detected by brain MRI
Percentage of participants with Adverse Events
Incidence of treatment-emergent antidrug antibodies to ocrelizumab after SC or IV administration
Incidence of treatment-emergent antibodies to rHuPH20
Proportion of participants achieving CD19+ B cell level ≤5 cells/uL

Full Information

First Posted
January 27, 2022
Last Updated
September 29, 2023
Sponsor
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT05232825
Brief Title
A Phase III, Non-Inferiority, Randomized, Open-Label, Parallel Group, Multicenter Study To Investigate The Pharmacokinetics, Pharmacodynamics, Safety And Radiological And Clinical Effects Of Subcutaneous Ocrelizumab Versus Intravenous Ocrelizumab In Patients With Multiple Sclerosis
Acronym
Ocarina II
Official Title
A Study To Investigate The Pharmacokinetics, Pharmacodynamics, Safety And Radiological And Clinical Effects Of Subcutaneous Ocrelizumab Versus Intravenous Ocrelizumab In Patients With Multiple Sclerosis
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 3, 2022 (Actual)
Primary Completion Date
March 10, 2023 (Actual)
Study Completion Date
April 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche

4. Oversight

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

5. Study Description

Brief Summary
This study will evaluate the pharmacokinetics, pharmacodynamics, safety, immunogenicity, and radiological and clinical effects of subcutaneous (SC) administration of ocrelizumab compared with the intravenous (IV) infusion of ocrelizumab in patients with either relapsing multiple sclerosis (RMS) or primary progressive multiple sclerosis (PPMS).

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
236 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ocrelizumab: Intravenous (IV) formulation
Arm Type
Active Comparator
Arm Description
Participants will receive the first dose of ocrelizumab IV as two IV infusions given 14 days apart. The subsequent doses of study drug will be administered as SC injections. A minimum of 22 weeks should be kept between SC doses. Participants will undergo 96 weeks of study treatment.
Arm Title
Ocrelizumab: Subcutaneous (SC) formulation
Arm Type
Experimental
Arm Description
Participants will receive the first dose of ocrelizumab SC as one SC injection at a dose which is expected to result in non-inferior exposure to ocrelizumab IV. The subsequent doses of study drug will be administered as SC injections. A minimum of 22 weeks should be kept between the first and second SC doses, and between subsequent SC doses. Participants will undergo 96 weeks of study treatment.
Intervention Type
Drug
Intervention Name(s)
Ocrelizumab IV
Other Intervention Name(s)
RO4964913
Intervention Description
IV Injection
Intervention Type
Drug
Intervention Name(s)
Ocrelizumab SC
Other Intervention Name(s)
RO4964913
Intervention Description
SC Injection
Intervention Type
Drug
Intervention Name(s)
Methylprednisolone IV
Intervention Description
Participants will receive mandatory (corticosteroids and antihistamine) and optional (analgesic) prophylactic treatment before the start of each ocrelizumab infusion
Intervention Type
Drug
Intervention Name(s)
Diphenhydramine IV
Intervention Description
Participants will receive mandatory (corticosteroids and antihistamine) and optional (analgesic) prophylactic treatment before the start of each ocrelizumab infusion
Intervention Type
Drug
Intervention Name(s)
Dexamethasone given orally
Intervention Description
Participants will receive mandatory (corticosteroids and antihistamine) and optional (analgesic) prophylactic treatment before the start of each ocrelizumab injection
Intervention Type
Drug
Intervention Name(s)
Desloratadine given orally
Intervention Description
Participants will receive mandatory (corticosteroids and antihistamine) and optional (analgesic) prophylactic treatment before the start of each ocrelizumab injection
Primary Outcome Measure Information:
Title
Serum ocrelizumab area under the concentration-time curve (AUCW1-12)
Time Frame
Day 1 to Week 12
Secondary Outcome Measure Information:
Title
Maximum serum concentration (Cmax) of ocrelizumab SC in patients with MS
Time Frame
Day 1 to Week 12
Title
Total number of T1Gd+ lesions as detected by brain MRI
Time Frame
Weeks 8 and 24
Title
Total number of new or enlarging T2 lesions as detected by brain MRI
Time Frame
Weeks 12 and 24
Title
Percentage of participants with Adverse Events
Time Frame
Day 1 to Week 48
Title
Incidence of treatment-emergent antidrug antibodies to ocrelizumab after SC or IV administration
Time Frame
Day 1 to Week 48
Title
Incidence of treatment-emergent antibodies to rHuPH20
Time Frame
Day 1 to Week 48
Title
Proportion of participants achieving CD19+ B cell level ≤5 cells/uL
Time Frame
Day 1 to Week 48

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: Diagnosis of PPMS or RMS according to the revised McDonald 2017 criteria (Thompson et al. 2018) EDSS score, 0-6.5, inclusive, at screening Neurological stability for ≥30 days prior to both screening and baseline Disease duration from onset of MS symptoms of less than 15 years for patients with EDSS score <2.0 at screening For females participants, without reproductive potential may be enrolled if post-menopausal, unless receiving a hormonal therapy for menopause or if surgically sterile For females of childbearing potential, agreement to remain abstinent or use adequate contraceptive methods Exclusion Criteria: Any known or suspected active infection at screening or baseline (except nailbed infections), or any major episode of infection requiring hospitalization or treatment with IV anti microbials within 8 weeks prior to and during screening or treatment with oral anti microbials within 2 weeks prior to and during screening History of confirmed or suspected progressive multifocal leukoencephalopathy (PML) History of cancer, including hematologic malignancy and solid tumors, within 10 years of screening Immunocompromised state Receipt of a live-attenuated vaccine within 6 weeks prior to randomization Influenza vaccination is permitted if the inactivated vaccine formulation is administered Inability to complete an MRI or contraindication to gadolinium administration Contraindications to mandatory premedications for IRRs, including closed-angle glaucoma for antihistamines Known presence of other neurologic disorders Any concomitant disease that may require chronic treatment with systemic corticosteroids or immunosuppressants during the course of the study Significant, uncontrolled disease, such as cardiovascular, pulmonary, renal, hepatic, endocrine or gastrointestinal, or any other significant disease that may preclude patient from participating in the study History of or currently active primary or secondary (non-drug-related) immunodeficiency Pregnant or breastfeeding, or intending to become pregnant during the study and 6 or 12 months Lack of peripheral venous access History of alcohol or other drug abuse within 12 months prior to screening Treatment with any investigational agent within 24 weeks prior to screening or 5 half-lives of the investigational drug (whichever is longer), or treatment with any experimental procedure for MS (e.g., treatment for chronic cerebrospinal venous insufficiency) Participants who have previously received anti-CD20s if the last treatment was less than 2 years before screening, and/or if B-cell count is below lower limit of normal, and/or the discontinuation of the treatment was due to safety reasons or lack of efficacy Previous treatment with cladribine, atacicept, and alemtuzumab Previous treatment with fingolimod, siponimod, ponesimod, or ozanimod within 6 weeks of baseline Previous treatment with interferons beta (1a or 1b), or glatiramer acetate within 2 weeks of baseline Previous treatment with natalizumab within 4.5 months of baseline Treatment with mitoxantrone within 2 years prior to baseline visit or evidence of cardiotoxicity following mitoxantrone use or a cumulative lifetime dose of more than 60 mg/m2 Previous treatment with any other immunomodulatory or immunosuppressive medication not already listed above without appropriate washout as described in the applicable local label. If the washout requirements are not described in the applicable local label, then the wash out period must be 5 times the half-life of the medication. The PD effects of the previous medication must also be considered when determining the required time for washout. Any previous treatment with bone marrow transplantation and hematopoietic stem cell transplantation Any previous history of transplantation or anti-rejection therapy Treatment with IV Ig or plasmapheresis within 12 weeks prior to randomization Systemic corticosteroid therapy within 4 weeks prior to screening Positive screening tests for active, latent, or inadequately treated hepatitis B Sensitivity or intolerance to any ingredient (including excipients) of ocrelizumab Any additional exclusionary criterion as per ocrelizumab (Ocrevus®) local label, if more stringent than the above
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
Facility Name
University of South Florida
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Johns Hopkins Hospital; Neurology
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
Memorial Healthcare Institute for Neurosciences and Multiple Sclerosis
City
Owosso
State/Province
Michigan
ZIP/Postal Code
48867
Country
United States
Facility Name
Neurology Associates PA
City
Hickory
State/Province
North Carolina
ZIP/Postal Code
28602
Country
United States
Facility Name
UC Health Neurology
City
Dayton
State/Province
Ohio
ZIP/Postal Code
45417
Country
United States
Facility Name
Premier Neurology
City
Greer
State/Province
South Carolina
ZIP/Postal Code
29650
Country
United States
Facility Name
Neurology Clinic PC
City
Cordova
State/Province
Tennessee
ZIP/Postal Code
38018
Country
United States
Facility Name
Clinica Amo - Assistencia Medica Em Oncologia
City
Salvador
State/Province
BA
ZIP/Postal Code
41950640
Country
Brazil
Facility Name
CEDOES - Diagnóstico e Pesquisa
City
Vitoria
State/Province
ES
ZIP/Postal Code
29055-450
Country
Brazil
Facility Name
Fakultni nemocnice u sv. Anny; Neurologicka klinika
City
Brno
ZIP/Postal Code
656 91
Country
Czechia
Facility Name
Charles University, Medical faculty, Hradec Kralove ;Department of Neurology
City
Hradec Králové
ZIP/Postal Code
500 05
Country
Czechia
Facility Name
Nemocnice Jihlava; NEU-Neurologicke oddeleni
City
Jihlava
ZIP/Postal Code
58633
Country
Czechia
Facility Name
Fakultni nemocnice Ostrava; MS centrum
City
Ostrava-Poruba
ZIP/Postal Code
708 52
Country
Czechia
Facility Name
Pardubicka Krajska Nemocnice; Department of Neurology
City
Pardubice
ZIP/Postal Code
532 03
Country
Czechia
Facility Name
Fakultni poliklinika VFN; RS centrum
City
Praha 2
ZIP/Postal Code
128 08
Country
Czechia
Facility Name
Fakultni nemocnice Motol; Neurologicka klinika
City
Praha
ZIP/Postal Code
150 06
Country
Czechia
Facility Name
Krajska zdravotni a.s Nemocnice Teplice o.z.; RS centrum
City
Teplice
ZIP/Postal Code
415 01
Country
Czechia
Facility Name
A. O. U. Federico II; Dip Neuroscienze, Scienze Riproduttive ed Odontostomatologiche
City
Napoli
State/Province
Campania
ZIP/Postal Code
80131
Country
Italy
Facility Name
Policlinico Tor Vergata Dip. Neuroscienze-Clinica Neurologica-UOSD Sclerosi Multipla
City
Roma
State/Province
Lazio
ZIP/Postal Code
00133
Country
Italy
Facility Name
Azienda Ospedaliera Sant'Andrea; UOC Neurologia
City
Roma
State/Province
Lazio
ZIP/Postal Code
00189
Country
Italy
Facility Name
Irccs A.O.U.San Martino Ist; Dinogmi
City
Genova
State/Province
Liguria
ZIP/Postal Code
16132
Country
Italy
Facility Name
IRCCS Ospedale San Raffaele; Neurologia Neurofisiologia Neuroriabilitazione-Centro Sclerosi Multipla
City
Milano
State/Province
Lombardia
ZIP/Postal Code
20132
Country
Italy
Facility Name
Ospedale Civile di Montichiari; Centro Sclerosi Multipla
City
Montichiari
State/Province
Lombardia
ZIP/Postal Code
25018
Country
Italy
Facility Name
IRCCS Istituto Neurologico Neuromed; Centro per lo Studio e la Cura della Sclerosi Multipla
City
Pozzilli
State/Province
Molise
ZIP/Postal Code
86077
Country
Italy
Facility Name
Optimal Clinical Trials
City
Auckland
ZIP/Postal Code
1010
Country
New Zealand
Facility Name
Hawkes Bay Hospital
City
Hastings
ZIP/Postal Code
4120
Country
New Zealand
Facility Name
Neurocentrum Bydgoszcz sp. z o.o
City
Bydgoszcz
ZIP/Postal Code
85-796
Country
Poland
Facility Name
Care Clinic
City
Katowice
ZIP/Postal Code
40-568
Country
Poland
Facility Name
Centrum Neurologii Krzysztof Selmaj
City
Lodz
ZIP/Postal Code
90-324
Country
Poland
Facility Name
Przychodnia EuroMediCare
City
Wroc?aw
ZIP/Postal Code
50-220
Country
Poland
Facility Name
Hospital Universitario Puerta de Hierro Majadahonda
City
Majadahonda
State/Province
Madrid
ZIP/Postal Code
28222
Country
Spain
Facility Name
Hospital Universitario Virgen Macarena
City
Seville
State/Province
Sevilla
ZIP/Postal Code
41071
Country
Spain
Facility Name
Complejo Hospitalario Nuestra Señora de la Candelaria; Servicio de Neurologia
City
Santa Cruz De Tenerife
State/Province
Tenerife
ZIP/Postal Code
38010
Country
Spain
Facility Name
Hospital Universitari Vall d'Hebron
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital Universitario Reina Sofia; Servicio de Neurologia
City
Cordoba
ZIP/Postal Code
14004
Country
Spain
Facility Name
Bakirkoy State Mental Hospital
City
Istanbul
ZIP/Postal Code
34000
Country
Turkey
Facility Name
Istanbul Universitesi - Cerrahpasa Cerrahpasa Tip Fakultesi; Noroloji Anabilim Dali
City
Istanbul
ZIP/Postal Code
34098
Country
Turkey
Facility Name
Katip Celebi University Ataturk Training and Research Hospital; Neurology
City
Izmir
ZIP/Postal Code
35360
Country
Turkey
Facility Name
Kocaeli University Hospital; Department of Neurology
City
Kocaeli
ZIP/Postal Code
41380
Country
Turkey
Facility Name
Namik Kemal Universitesi Sagli Uygulama ve Arastirma Hastanesi; Noroloji
City
Süleymanpa?a
ZIP/Postal Code
59100
Country
Turkey

12. IPD Sharing Statement

Learn more about this trial

A Phase III, Non-Inferiority, Randomized, Open-Label, Parallel Group, Multicenter Study To Investigate The Pharmacokinetics, Pharmacodynamics, Safety And Radiological And Clinical Effects Of Subcutaneous Ocrelizumab Versus Intravenous Ocrelizumab In Patients With Multiple Sclerosis

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