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Alemtuzumab on Surrogate Markers of Disease Activity and Repair Using Advanced MRI Measures in Subjects With Relapsing Remitting Multiple Sclerosis

Primary Purpose

Multiple Sclerosis

Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Alemtuzumab
Sponsored by
University of Chicago
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Sclerosis

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. Signed, informed consent form (ICF)
  2. Age 18 to 50 years old (inclusive) as of signing the ICF
  3. Diagnosis of MS per update of McDonald criteria, and cranial MRI scan demonstrating white matter lesions attributable to MS within 10 years of screening
  4. Onset of MS symptoms (as determined by a neurologist) within 15 years of screening
  5. EDSS score 0.0 to 5.0 (inclusive)
  6. >=2 MS attacks (first episode or relapse) occurring in the 24 months prior to screening, with >=1 attack in the 12 months prior to screening, with objective neurological signs confirmed by a physician
  7. Subjects previously enrolled and randomized to interferon beta 1a in the CARE-MS 323 and 324 studies, and who will be treated with Alemtuzumab through the CARE-MS extension study will be eligible to participate in the immunology and MRI studies of this protocol.

Exclusion Criteria

  1. Received prior therapy for MS other than corticosteroids within 28 days of screening; e.g., interferons, IV immunoglobulin, and glatiramer acetate
  2. Exposure to natalizumab within 6 months of screening
  3. Any prior exposure to mitoxantrone, mycophenolate mofetil, azathioprine, cladribine, cyclophosphamide, cyclosporine A, methotrexate, rituximab, or any other immunosuppressive agent other than systemic corticosteroid treatment
  4. Has any progressive form of MS
  5. History of malignancy (exception for basal cell skin carcinoma)
  6. Previous hypersensitivity reaction to other immunoglobulin product
  7. Intolerance of pulsed corticosteroids, especially a history of steroid psychosis
  8. CD4+, CD8+, or CD19+ (i.e., absolute CD3+CD4+, CD3+CD8+, or CD19+/mm3) count <LLN at Screening; if abnormal cell count(s) return to within normal limits, eligibility may be reassessed
  9. Seropositivity for human immunodeficiency virus (HIV)
  10. Significant autoimmune disease (e.g, immune cytopenias, rheumatoid arthritis, systemic lupus erythematosus, other connective tissue disorders; vasculitis; inflammatory bowel disease; severe psoriasis)
  11. Presence of anti-thyroid stimulating hormone (TSH) receptor (TSHR) antibodies
  12. Active infection, e.g, deep-tissue infection, that the Investigator considers sufficiently serious to preclude study participation
  13. Latent tuberculosis unless effective anti-tuberculosis therapy has been completed, or active tuberculosis. Patients will be assessed for this risk based on a screening questionnaire.
  14. Infection with hepatitis B virus or hepatitis C virus
  15. Of childbearing potential with a positive serum pregnancy test
  16. Unwilling to agree to use a reliable and acceptable contraceptive method throughout the study period
  17. Major psychiatric disorder that is not adequately controlled by treatment
  18. Epileptic seizures that are not adequately controlled by treatment
  19. Major systemic disease or other illness that would, in the opinion of the Investigator, compromise patient safety or interfere with the interpretation of study results
  20. Medical, psychiatric, cognitive, or other conditions that, in the Investigator's opinion, compromise the patient's ability to understand the patient information, to give informed consent, to comply with the trial protocol, or to complete the study
  21. Confirmed platelet count < the lower limit of normal (LLN) of the evaluating laboratory at Screening or documented at <100,000/uL within the past year on a sample without clumping
  22. Prior history of invasive fungal infections
  23. Cervical high risk human papillomavirus (HPV) positivity or abnormal cervical cytology other than abnormal squamous cells of undetermined significance (ASCUS). The patient may be eligible after the condition has been effectively treated (eg, follow-up HPV test is negative or cervical abnormality has been treated).
  24. Seropositive for Trypanosoma cruzi or the Human T-lymphotropic virus type I or type II (HTLV-I/II) (testing required in endemic regions only)
  25. Any other illness or infection (latent or active) that, in the Investigator's opinion, could be exacerbated by alemtuzumab treatment
  26. Any hepatic or renal function value grade 2 or higher at Screening, with the exception of hyperbilirubinemia due to Gilbert's syndrome. See Table below, drawn from the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events v3.0 (CTCAE), published 09 August 2006

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Alemtuzumab

    Arm Description

    Single arm, single cohort study, all subjects will be dosed with alemtuzumab.

    Outcomes

    Primary Outcome Measures

    Diffusion and Myelin Fraction Water Changes on Magnetic Resonance Imaging (MRI)
    Changes in normal appearing white matter from baseline through month 24. The MRI is designed to identify possible mechanisms by which alemtuzumab acts to protect the brain from inflammation and how it may enhance repair through remyelination.

    Secondary Outcome Measures

    Full Information

    First Posted
    July 13, 2011
    Last Updated
    November 13, 2018
    Sponsor
    University of Chicago
    Collaborators
    Genzyme, a Sanofi Company
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01395316
    Brief Title
    Alemtuzumab on Surrogate Markers of Disease Activity and Repair Using Advanced MRI Measures in Subjects With Relapsing Remitting Multiple Sclerosis
    Official Title
    Alemtuzumab on Surrogate Markers of Disease Activity and Repair Using Advanced MRI Measures in Subjects With Relapsing Remitting Multiple Sclerosis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    June 2011 (undefined)
    Primary Completion Date
    October 2015 (Actual)
    Study Completion Date
    July 2017 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    University of Chicago
    Collaborators
    Genzyme, a Sanofi Company

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The MRI study is designed to identify possible mechanisms by which alemtuzumab acts to protect the brain from inflammation and how it may enhance repair through remyelination.
    Detailed Description
    To identify specific changes in T cell subsets and functions in Relapsing Remitting Multiple Sclerosis.

    6. Conditions and Keywords

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

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Alemtuzumab
    Arm Type
    Experimental
    Arm Description
    Single arm, single cohort study, all subjects will be dosed with alemtuzumab.
    Intervention Type
    Drug
    Intervention Name(s)
    Alemtuzumab
    Other Intervention Name(s)
    CamPath, MabPath
    Intervention Description
    10 mg/ml alemtuzumab intravenous infusion, sterile clear, colorless solution. dosage: 2 cycles. Month 0 dosed over 5 consecutive days: month 12 dosed over 3 consecutive days.
    Primary Outcome Measure Information:
    Title
    Diffusion and Myelin Fraction Water Changes on Magnetic Resonance Imaging (MRI)
    Description
    Changes in normal appearing white matter from baseline through month 24. The MRI is designed to identify possible mechanisms by which alemtuzumab acts to protect the brain from inflammation and how it may enhance repair through remyelination.
    Time Frame
    Baseline to Month 24

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    50 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria Signed, informed consent form (ICF) Age 18 to 50 years old (inclusive) as of signing the ICF Diagnosis of MS per update of McDonald criteria, and cranial MRI scan demonstrating white matter lesions attributable to MS within 10 years of screening Onset of MS symptoms (as determined by a neurologist) within 15 years of screening EDSS score 0.0 to 5.0 (inclusive) >=2 MS attacks (first episode or relapse) occurring in the 24 months prior to screening, with >=1 attack in the 12 months prior to screening, with objective neurological signs confirmed by a physician Subjects previously enrolled and randomized to interferon beta 1a in the CARE-MS 323 and 324 studies, and who will be treated with Alemtuzumab through the CARE-MS extension study will be eligible to participate in the immunology and MRI studies of this protocol. Exclusion Criteria Received prior therapy for MS other than corticosteroids within 28 days of screening; e.g., interferons, IV immunoglobulin, and glatiramer acetate Exposure to natalizumab within 6 months of screening Any prior exposure to mitoxantrone, mycophenolate mofetil, azathioprine, cladribine, cyclophosphamide, cyclosporine A, methotrexate, rituximab, or any other immunosuppressive agent other than systemic corticosteroid treatment Has any progressive form of MS History of malignancy (exception for basal cell skin carcinoma) Previous hypersensitivity reaction to other immunoglobulin product Intolerance of pulsed corticosteroids, especially a history of steroid psychosis CD4+, CD8+, or CD19+ (i.e., absolute CD3+CD4+, CD3+CD8+, or CD19+/mm3) count <LLN at Screening; if abnormal cell count(s) return to within normal limits, eligibility may be reassessed Seropositivity for human immunodeficiency virus (HIV) Significant autoimmune disease (e.g, immune cytopenias, rheumatoid arthritis, systemic lupus erythematosus, other connective tissue disorders; vasculitis; inflammatory bowel disease; severe psoriasis) Presence of anti-thyroid stimulating hormone (TSH) receptor (TSHR) antibodies Active infection, e.g, deep-tissue infection, that the Investigator considers sufficiently serious to preclude study participation Latent tuberculosis unless effective anti-tuberculosis therapy has been completed, or active tuberculosis. Patients will be assessed for this risk based on a screening questionnaire. Infection with hepatitis B virus or hepatitis C virus Of childbearing potential with a positive serum pregnancy test Unwilling to agree to use a reliable and acceptable contraceptive method throughout the study period Major psychiatric disorder that is not adequately controlled by treatment Epileptic seizures that are not adequately controlled by treatment Major systemic disease or other illness that would, in the opinion of the Investigator, compromise patient safety or interfere with the interpretation of study results Medical, psychiatric, cognitive, or other conditions that, in the Investigator's opinion, compromise the patient's ability to understand the patient information, to give informed consent, to comply with the trial protocol, or to complete the study Confirmed platelet count < the lower limit of normal (LLN) of the evaluating laboratory at Screening or documented at <100,000/uL within the past year on a sample without clumping Prior history of invasive fungal infections Cervical high risk human papillomavirus (HPV) positivity or abnormal cervical cytology other than abnormal squamous cells of undetermined significance (ASCUS). The patient may be eligible after the condition has been effectively treated (eg, follow-up HPV test is negative or cervical abnormality has been treated). Seropositive for Trypanosoma cruzi or the Human T-lymphotropic virus type I or type II (HTLV-I/II) (testing required in endemic regions only) Any other illness or infection (latent or active) that, in the Investigator's opinion, could be exacerbated by alemtuzumab treatment Any hepatic or renal function value grade 2 or higher at Screening, with the exception of hyperbilirubinemia due to Gilbert's syndrome. See Table below, drawn from the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events v3.0 (CTCAE), published 09 August 2006
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Adil Javed, MD
    Organizational Affiliation
    University of Chicago
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Alemtuzumab on Surrogate Markers of Disease Activity and Repair Using Advanced MRI Measures in Subjects With Relapsing Remitting Multiple Sclerosis

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