A Study Evaluating B Cell Levels In Infants Of Lactating Women With CIS Or MS Receiving Ocrelizumab (SOPRANINO)
Primary Purpose
Multiple Sclerosis, Clinically Isolated Syndrome
Status
Recruiting
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Ocrelizumab
Sponsored by
About this trial
This is an interventional other trial for Multiple Sclerosis focused on measuring ocrelizumab, OCREVUS, breastmilk transfer, breast milk transfer, lactation
Eligibility Criteria
Inclusion Criteria:
- Woman is willing to breastfeed for at least 60 days after the first post-partum ocrelizumab infusion (this decision is to be taken prior to and independent from study participation)
- Woman is willing to provide breastmilk samples
- Woman has a diagnosis of MS or CIS (in line with the locally approved indications)
- Woman has delivered a term singleton infant (≥37 weeks gestation)
- Infant is between 2-24 weeks of life
- For women who received commercial ocrelizumab (OCREVUS) before enrolment: documentation that last exposure to ocrelizumab occurred more than 3 months before the last menstrual period (LMP) and was given at the approved dose of 2 x 300 mg or 1 x 600 mg
- Woman agrees to use acceptable contraceptive methods during the study
Exclusion Criteria related to the Mother:
- Received last dose of ocrelizumab <3 months before the LMP or during pregnancy
- Active infections (may be included once the infection is treated and is resolved; women with bilateral mastitis infection should not have samples collected until the infection is completely resolved)
- Prior or current history of primary or secondary immunodeficiency, or woman in an otherwise severely immunocompromised state
- Known active malignancies, or being actively monitored for recurrence of malignancy
- History of breast implants, breast augmentation, breast reduction surgery or mastectomy
- Prior or current history of chronic alcohol abuse or drug abuse
- Any medical, obstetrical or psychiatric condition that, in the opinion of the Investigator, would compromise the woman's ability to participate in this study
- Positive screening tests for hepatitis B
- Treatment with a DMT for CIS or MS during pregnancy and/or first weeks post-partum, with the exception of formulations of interferon-beta, glatiramer acetate or pulsed corticosteroids
- Treatment with drugs known to transfer to the breastmilk and with established or potential deleterious effects for the infant
- Treatment with any investigational agent within 6 months or five half-lives of the investigational drug prior to the LMP
Exclusion Criteria related to the Infant:
- >24 weeks of life at the time of the mother's first dose of ocrelizumab
- Any abnormality that may interfere with breastfeeding or milk absorption
- Active infection (may be included once the infection resolves)
- Any other medical condition or abnormality that, in the opinion of the investigator, could compromise the infant's ability to participate in this study
- At least one documented brief resolved unexplained event (BRUE), as defined by the 2016 Guidelines of the American Academy of Pediatrics
Sites / Locations
- University of California San FranciscoRecruiting
- University Of ColoradoRecruiting
- Northwestern Memorial HospitalRecruiting
- Brigham and Womens HospitalRecruiting
- Memorial Healthcare Institute for Neurosciences and Multiple SclerosisRecruiting
- Hospital of the University of PennsylvaniaRecruiting
- St. Josef Hospital GmbHRecruiting
- Universitaetsklinikum Carl Gustav Carus an der TU DresdenRecruiting
- Hosp. Clinico San CarlosRecruiting
- Queen Mary University of LondonRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Women with CIS or MS
Arm Description
Lactating women with CIS or MS (in line with the locally approved indications) who decided together with their treating physician to continue on, or start treatment with, OCREVUS (ocrelizumab) post-partum. Women resuming treatment with ocrelizumab post-partum will be included only if the last exposure to ocrelizumab occurred more than 3 months before the last menstrual period to exclude any interference between fetal exposure and exposure via lactation.
Outcomes
Primary Outcome Measures
Proportion of infants with B cell levels (CD19+ cells) below the lower limit of normal (LLN)
Estimated average oral daily infant dosage (ADID)
Secondary Outcome Measures
B cell levels (CD19+ cells) in the infant
Area under the milk concentration-time curve (AUC) of ocrelizumab in mature breastmilk
Average ocrelizumab milk concentration
Peak ocrelizumab milk concentration
Time to reach peak ocrelizumab milk concentration
Estimated maximum oral daily infant dosage (MDID)
Serum concentration of ocrelizumab in the infant
Mean titers of antibody immune responses to Mumps, Measles and Rubella vaccination
Proportion of infants with positive humoral response (seroprotective titers; as defined for the individual vaccine) to Measles, Mumps and Rubella vaccines
Mean titers of antibody immune responses to Diphtheria-Tetanus-Pertussis Vaccine
Proportion of infants with positive humoral response to Diphtheria-Tetanus-Pertussis Vaccine
Mean titers of antibody immune responses to Haemophilus influenzae type B Vaccine
Proportion of infants with positive humoral response to Haemophilus influenzae type B Vaccine
Mean titers of antibody immune responses to Hepatitis B Vaccine
Proportion of infants with positive humoral response to Hepatitis B Vaccine
Mean titers of antibody immune responses to Pneumococcal conjugate Vaccine
Proportion of infants with positive humoral response to Pneumococcal conjugate Vaccine
Rate and nature of adverse events in the infant
Rate and nature of adverse events in the mother
Full Information
NCT ID
NCT04998851
First Posted
August 6, 2021
Last Updated
September 28, 2023
Sponsor
Hoffmann-La Roche
Collaborators
PPD, Laboratory Corporation of America, Illingworth Research Group
1. Study Identification
Unique Protocol Identification Number
NCT04998851
Brief Title
A Study Evaluating B Cell Levels In Infants Of Lactating Women With CIS Or MS Receiving Ocrelizumab
Acronym
SOPRANINO
Official Title
A Phase IV Multicenter, Open-Label Study Evaluating B Cell Levels In Infants Of Lactating Women With CIS Or MS Receiving Ocrelizumab
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 16, 2021 (Actual)
Primary Completion Date
November 13, 2023 (Anticipated)
Study Completion Date
October 14, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche
Collaborators
PPD, Laboratory Corporation of America, Illingworth Research Group
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study will evaluate the pharmacokinetics of ocrelizumab in the breastmilk of lactating women with clinically isolated syndrome (CIS) or multiple sclerosis (MS) [in line with the locally approved indications] treated with ocrelizumab, by assessing the concentration of ocrelizumab in mature breastmilk, as well as the corresponding exposure and pharmacodynamic effects (blood B cell levels) in the infants.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis, Clinically Isolated Syndrome
Keywords
ocrelizumab, OCREVUS, breastmilk transfer, breast milk transfer, lactation
7. Study Design
Primary Purpose
Other
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Women with CIS or MS
Arm Type
Experimental
Arm Description
Lactating women with CIS or MS (in line with the locally approved indications) who decided together with their treating physician to continue on, or start treatment with, OCREVUS (ocrelizumab) post-partum. Women resuming treatment with ocrelizumab post-partum will be included only if the last exposure to ocrelizumab occurred more than 3 months before the last menstrual period to exclude any interference between fetal exposure and exposure via lactation.
Intervention Type
Drug
Intervention Name(s)
Ocrelizumab
Intervention Description
Women will receive the ocrelizumab dose regimen as per the locally-approved label. The ocrelizumab dose will be administered as an initial split dose of two 300 mg infusions separated by 14 days or a single 600 mg infusion according to the local prescribing information.
Primary Outcome Measure Information:
Title
Proportion of infants with B cell levels (CD19+ cells) below the lower limit of normal (LLN)
Time Frame
Day 30 after the mother's first post-partum ocrelizumab infusion
Title
Estimated average oral daily infant dosage (ADID)
Time Frame
Over 60 days after the mother's first post-partum ocrelizumab infusion
Secondary Outcome Measure Information:
Title
B cell levels (CD19+ cells) in the infant
Time Frame
Day 30 after the mother's first post-partum ocrelizumab infusion
Title
Area under the milk concentration-time curve (AUC) of ocrelizumab in mature breastmilk
Time Frame
Over 60 days after the mother's first post-partum ocrelizumab infusion
Title
Average ocrelizumab milk concentration
Time Frame
Over 60 days after the mother's first post-partum ocrelizumab infusion
Title
Peak ocrelizumab milk concentration
Time Frame
Over 60 days after the mother's first post-partum ocrelizumab infusion
Title
Time to reach peak ocrelizumab milk concentration
Time Frame
Over 60 days after the mother's first post-partum ocrelizumab infusion
Title
Estimated maximum oral daily infant dosage (MDID)
Time Frame
Over 60 days after the mother's first post-partum ocrelizumab infusion
Title
Serum concentration of ocrelizumab in the infant
Time Frame
Day 30 after the mother's first post-partum ocrelizumab infusion
Title
Mean titers of antibody immune responses to Mumps, Measles and Rubella vaccination
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Proportion of infants with positive humoral response (seroprotective titers; as defined for the individual vaccine) to Measles, Mumps and Rubella vaccines
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Mean titers of antibody immune responses to Diphtheria-Tetanus-Pertussis Vaccine
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Proportion of infants with positive humoral response to Diphtheria-Tetanus-Pertussis Vaccine
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Mean titers of antibody immune responses to Haemophilus influenzae type B Vaccine
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Proportion of infants with positive humoral response to Haemophilus influenzae type B Vaccine
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Mean titers of antibody immune responses to Hepatitis B Vaccine
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Proportion of infants with positive humoral response to Hepatitis B Vaccine
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Mean titers of antibody immune responses to Pneumococcal conjugate Vaccine
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Proportion of infants with positive humoral response to Pneumococcal conjugate Vaccine
Time Frame
1 month after the first or second dose of measles, mumps, and rubella (MMR) vaccine, or at Month 13, in case MMR vaccine is not planned to be administered
Title
Rate and nature of adverse events in the infant
Time Frame
Baseline up to 16 months
Title
Rate and nature of adverse events in the mother
Time Frame
Baseline up to 16 months
10. Eligibility
Sex
Female
Gender Based
Yes
Gender Eligibility Description
Lactating women with CIS or MS (in line with the locally approved indications) who decided together with their treating physician to continue on, or start treatment with, OCREVUS (ocrelizumab) post-partum. Women resuming treatment with ocrelizumab post-partum will be included only if the last exposure to ocrelizumab occurred more than 3 months before the last menstrual period to exclude any interference between fetal exposure and exposure via lactation.
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Woman is between 18 and 40 years of age at screening
Woman is willing to breastfeed for at least 60 days after the first post-partum ocrelizumab infusion (this decision is to be taken prior to and independent from study participation)
Woman is willing to provide breastmilk samples
Woman has a diagnosis of MS or CIS (in line with the locally approved indications)
Woman has delivered a healthy term singleton infant (≥37 weeks gestation)
Infant is between 2-24 weeks of age at the time of the mother's first post-partum dose of ocrelizumab
For women who received commercial ocrelizumab (OCREVUS) before enrolment: documentation that last exposure to ocrelizumab occurred more than 3 months before the last menstrual period (LMP) and was given at the approved dose of 2 x 300 mg or 1 x 600 mg
Woman agrees to use acceptable contraceptive methods during the study
Exclusion Criteria related to the Mother:
Hypersensitivity to ocrelizumab or to any of its excipients
Received last dose of ocrelizumab <3 months before the LMP or during pregnancy
Active infections (may be included once the infection is treated and is resolved; women with bilateral mastitis infection should not have samples collected until the infection is completely resolved)
Prior or current history of primary or secondary immunodeficiency, or woman in an otherwise severely immunocompromised state
Known active malignancies, or being actively monitored for recurrence of malignancy
History of breast implants, breast augmentation, breast reduction surgery or mastectomy
Prior or current history of chronic alcohol abuse or drug abuse
Positive screening tests for hepatitis B
Treatment with a DMT for CIS or MS during pregnancy and/or first weeks post-partum, with the exception of formulations of interferon-beta, glatiramer acetate or pulsed corticosteroids
Treatment with drugs known to transfer to the breastmilk and with established or potential deleterious effects for the infant
Treatment with any investigational agent within 6 months or five half-lives of the investigational drug prior to the LMP
Exclusion Criteria related to the Infant:
>24 weeks of life at the time of the mother's first dose of ocrelizumab
Any abnormality that may interfere with breastfeeding or milk absorption
Active infection (may be included once the infection resolves)
Infant has any other medical condition or abnormality that, in the opinion of the investigator, could compromise the infant's ability to participate in this study, including interference with the interpretation of study results
At least one documented brief resolved unexplained event (BRUE), as defined by the 2016 Guidelines of the American Academy of Pediatrics
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Reference Study ID Number: MN42989 https://forpatients.roche.com/
Phone
888-662-6728 (U.S. and Canada)
Email
global-roche-genentech-trials@gene.com
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 California San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94117
Country
United States
Individual Site Status
Recruiting
Facility Name
University Of Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Recruiting
Facility Name
Northwestern Memorial Hospital
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Individual Site Status
Recruiting
Facility Name
Brigham and Womens Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Individual Site Status
Recruiting
Facility Name
Memorial Healthcare Institute for Neurosciences and Multiple Sclerosis
City
Owosso
State/Province
Michigan
ZIP/Postal Code
48867
Country
United States
Individual Site Status
Recruiting
Facility Name
Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Individual Site Status
Recruiting
Facility Name
St. Josef Hospital GmbH
City
Bochum
ZIP/Postal Code
44791
Country
Germany
Individual Site Status
Recruiting
Facility Name
Universitaetsklinikum Carl Gustav Carus an der TU Dresden
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Individual Site Status
Recruiting
Facility Name
Hosp. Clinico San Carlos
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Individual Site Status
Recruiting
Facility Name
Queen Mary University of London
City
London
ZIP/Postal Code
EC1M 6BQ
Country
United Kingdom
Individual Site Status
Recruiting
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.vivli.org). Further details on Roche's criteria for eligible studies are available here (https://vivli.org/members/ourmembers/). For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).
Learn more about this trial
A Study Evaluating B Cell Levels In Infants Of Lactating Women With CIS Or MS Receiving Ocrelizumab
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