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Biological Activity and Safety of Low Dose IL2 in Relapsing Remitting Multiple Sclerosis (MS-IL2)

Primary Purpose

Relapsing Remitting Multiple Sclerosis

Status
Completed
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
IL2
Placebo
Sponsored by
Assistance Publique - Hôpitaux de Paris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsing Remitting Multiple Sclerosis focused on measuring Interleukin 2, IL2, Relapsing Remitting Multiple Sclerosis, Autoimmune diseases, Regulatory T cells, Tregs

Eligibility Criteria

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

Inclusion Criteria:

  • Age 18-65 years old ;
  • Male and Female;
  • Presenting relapsing remitting multiple sclerosis as determined by revised McDonald criteria (2010) ;
  • On MRI : 1) Presenting 1-2 lesions enhanced by gadolinium (Gd+) (T1) without clinical expression of the disease clinique upon inclusion or 6 months prior to inclusion or 2) presenting one new lesion T2
  • Expanded Disability Status Scale (EDSS) score comprised between 0 and 6;
  • No flare (with or without any corticosteroid therapy) for the past 2 months
  • Under β-Interferon treatment for ≥ 6 months ; or any other first-line treatment of the Relapsing-Remitting Multiple Sclerosis (RRMS): Dimethyl fumarate or teriflunomide treatment for ≥ 6 months or glatiramer acetate for ≥ 9 months
  • For women of childbearing age, contraception for more than 2 weeks upon confirmation of inclusion criteria and negative Beta HCG on inclusion visit (D-30 to D-7);
  • Patient informed consent should be signed by the patient and investigator before performing any clinical examination required for the study.
  • Affiliation to the French Social Security Regimen

Exclusion Criteria:

  • Number of lesions enhanced by gadolinium (Gd+) on MRI in T1 > 2 upon inclusion;
  • Known intolerance to IL2 (see SPC):

    • Hypersensibility to active substance or one of the excipients ;
    • Signs of evolving infection requiring treatment
    • Other clinically significant chronic disorders (beside RR-MS)
    • History of organ allograft
  • Administration of a non-authorized treatment; bolus of corticosteroids in the last 2 months, or treatment with cyclophosphamide, mitoxantrone, or rituximab in the last 6 months;
  • Heart failure (≥ grade III NYHA), renal insufficiency, or hepatic insufficiency (transaminase>5N), or lung failure
  • White blood cell count <3000 /mm3, lymphocytes< 1000 /mm3, platelets <150 000 /mm3
  • Poor venous access not allowing repeated blood tests
  • Vaccination with live attenuated virus in the months preceding the inclusion or planned during the study
  • Surgery with general anaesthesia during the last 2 months or surgery planned during the study
  • Participation in other biomedical research in the last one month or planned during the study
  • Concomitant psychiatric disease or any other chronic illness or drug-abuse that could interfere with the ability to comply with the protocol or to give informed consent
  • Cancer or history of cancer cured for less than five years (except in situ carcinoma of the cervix or basocellular carcinoma)
  • Pregnant or lactating women;
  • Men and women of childbearing potential without effective contraception for the duration of treatment
  • Patients under a measure of legal protection

Sites / Locations

  • Centre d'investigation Clinique - Pitié salpêtrière
  • Centre d'investigation clinique Biothérapie Immunologie (CIC-BTi) - Groupe Hospitalier Pitié-Salpêtrière - AP-HP
  • Département des maladies du système nerveux et Centre d'investigation clinique - Groupe Hospitalier Pitié-Salpêtrière - AP-HP

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

1 : IL2

2 : Placebo

Arm Description

Interleukin-2 (ILT-101)

Placebo

Outcomes

Primary Outcome Measures

Treg response to low dose IL2 induction course period, expressed as % of total CD4 cells

Secondary Outcome Measures

Change in Treg percentage on D15 after induction (D1-D5) compared to baseline
Change in Treg percentage from D15 to M6 compared to baseline
The cumulative number of new lesions enhanced by Gd+ (Sum of Gd + lesions on T1 MRI on M2, M4 and M6)
Frequency of patients free of Gd+ lesions at M6
The cumulative number of new T2 lesions
Annual relapse rate (number of relapses observed over a 6 month period)
% of patients with flare
% of disease free patient i.e % of patient with no clinical symptoms and no activity on MRI

Full Information

First Posted
April 20, 2015
Last Updated
November 6, 2020
Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Fondation ARSEP/AFM
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1. Study Identification

Unique Protocol Identification Number
NCT02424396
Brief Title
Biological Activity and Safety of Low Dose IL2 in Relapsing Remitting Multiple Sclerosis
Acronym
MS-IL2
Official Title
Biological Activity and Safety of Low Dose IL2 in Relapsing Remitting Multiple Sclerosis. Multicentric Randomized Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Completed
Study Start Date
June 13, 2016 (Actual)
Primary Completion Date
October 11, 2019 (Actual)
Study Completion Date
June 15, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Fondation ARSEP/AFM

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Interleukin-2 (IL-2) was initially discovered and used as a stimulator of effector T lymphocytes (Teffs), but is now viewed as a very promising immunoregulatory drug having the capacity to stimulate regulatory T cells (Tregs). At low dose, Il-2 tips the Treg/Teff balance towards Tregs. Recently, it has been shown that Tregs of MS patients have reduced proliferative potential. MS-IL2 will assess the safety and biological efficacy of low-dose IL2 as a Treg inducer in a Relapsing-Remitting Multiple Sclerosis (RRMS), with the aim to stimulate Treg and define potential clinical benefits
Detailed Description
In MS-IL2, 30 RRMS patients will be treated in a randomized, double-blind, placebo controlled clinical trial. IL-2 will be administered first as an induction course of IL-2 or placebo each day for 5 days, followed by a maintenance course at the same dose or placebo every two weeks over 6 months. The primary efficacy criteria will be the % change from baseline in Treg at day-5, which is indicative of the biological response to IL-2. The secondary efficacy criteria will be (i) the maintenance of regulatory T cells during the 6 months of treatment with IL-2 vs. placebo and (ii) the stabilization or regression of the disease as determined by disease activity parameters assessed by MRI (cumulative number of new lesions in T1 enhanced by gadolinium after 6 months) in the groups treated with IL-2 compared to placebo. Expected impact: MS-IL2 will define which patient respond to IL2 and which doses prevent relapses in RRMS. In addition, the deep phenomics studies will further provide the foundation for a clinical phase II to define clinical efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsing Remitting Multiple Sclerosis
Keywords
Interleukin 2, IL2, Relapsing Remitting Multiple Sclerosis, Autoimmune diseases, Regulatory T cells, Tregs

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1 : IL2
Arm Type
Experimental
Arm Description
Interleukin-2 (ILT-101)
Arm Title
2 : Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
IL2
Intervention Description
Induction period: repeated administration of low-dose IL-2 Maintenance period: treatment with IL-2
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Treg response to low dose IL2 induction course period, expressed as % of total CD4 cells
Time Frame
at day5
Secondary Outcome Measure Information:
Title
Change in Treg percentage on D15 after induction (D1-D5) compared to baseline
Time Frame
at day15
Title
Change in Treg percentage from D15 to M6 compared to baseline
Time Frame
Day 15 to Day 169
Title
The cumulative number of new lesions enhanced by Gd+ (Sum of Gd + lesions on T1 MRI on M2, M4 and M6)
Time Frame
Day 57, Day 113 and Day 169
Title
Frequency of patients free of Gd+ lesions at M6
Time Frame
Day 169
Title
The cumulative number of new T2 lesions
Time Frame
Day 169
Title
Annual relapse rate (number of relapses observed over a 6 month period)
Time Frame
Day 169
Title
% of patients with flare
Time Frame
Day 169
Title
% of disease free patient i.e % of patient with no clinical symptoms and no activity on MRI
Time Frame
Day 169

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: Age 18-65 years old ; Male and Female; Presenting relapsing remitting multiple sclerosis as determined by revised McDonald criteria (2010) ; On MRI : 1) Presenting 1-2 lesions enhanced by gadolinium (Gd+) (T1) without clinical expression of the disease clinique upon inclusion or 6 months prior to inclusion or 2) presenting one new lesion T2 Expanded Disability Status Scale (EDSS) score comprised between 0 and 6; No flare (with or without any corticosteroid therapy) for the past 2 months Under β-Interferon treatment for ≥ 6 months ; or any other first-line treatment of the Relapsing-Remitting Multiple Sclerosis (RRMS): Dimethyl fumarate or teriflunomide treatment for ≥ 6 months or glatiramer acetate for ≥ 9 months For women of childbearing age, contraception for more than 2 weeks upon confirmation of inclusion criteria and negative Beta HCG on inclusion visit (D-30 to D-7); Patient informed consent should be signed by the patient and investigator before performing any clinical examination required for the study. Affiliation to the French Social Security Regimen Exclusion Criteria: Number of lesions enhanced by gadolinium (Gd+) on MRI in T1 > 2 upon inclusion; Known intolerance to IL2 (see SPC): Hypersensibility to active substance or one of the excipients ; Signs of evolving infection requiring treatment Other clinically significant chronic disorders (beside RR-MS) History of organ allograft Administration of a non-authorized treatment; bolus of corticosteroids in the last 2 months, or treatment with cyclophosphamide, mitoxantrone, or rituximab in the last 6 months; Heart failure (≥ grade III NYHA), renal insufficiency, or hepatic insufficiency (transaminase>5N), or lung failure White blood cell count <3000 /mm3, lymphocytes< 1000 /mm3, platelets <150 000 /mm3 Poor venous access not allowing repeated blood tests Vaccination with live attenuated virus in the months preceding the inclusion or planned during the study Surgery with general anaesthesia during the last 2 months or surgery planned during the study Participation in other biomedical research in the last one month or planned during the study Concomitant psychiatric disease or any other chronic illness or drug-abuse that could interfere with the ability to comply with the protocol or to give informed consent Cancer or history of cancer cured for less than five years (except in situ carcinoma of the cervix or basocellular carcinoma) Pregnant or lactating women; Men and women of childbearing potential without effective contraception for the duration of treatment Patients under a measure of legal protection
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Klatzmann
Organizational Affiliation
Assistance Publique - Hôpitaux de Paris
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centre d'investigation Clinique - Pitié salpêtrière
City
Paris
ZIP/Postal Code
75013
Country
France
Facility Name
Centre d'investigation clinique Biothérapie Immunologie (CIC-BTi) - Groupe Hospitalier Pitié-Salpêtrière - AP-HP
City
Paris
ZIP/Postal Code
75013
Country
France
Facility Name
Département des maladies du système nerveux et Centre d'investigation clinique - Groupe Hospitalier Pitié-Salpêtrière - AP-HP
City
Paris
ZIP/Postal Code
75013
Country
France

12. IPD Sharing Statement

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Biological Activity and Safety of Low Dose IL2 in Relapsing Remitting Multiple Sclerosis

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