RC18 in Patients With Relapsing Remitting Multiple Sclerosis:a Phase II Trial
Primary Purpose
Multiple Sclerosis, Relapsing-Remitting
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
RC18 160mg
RC18 240mg
Sponsored by
About this trial
This is an interventional treatment trial for Multiple Sclerosis, Relapsing-Remitting
Eligibility Criteria
Inclusion Criteria:
- Patients with relapsing remitting multiple sclerosis meet the diagnostic criteria of McDonald 2017.
- 18-55 years old, male or female
- At least 2 recurrences (including clinical recurrence and imaging recurrence) were recorded within 1 year before randomization.
- Gadolinium enhanced T1 lesions (≥ 1) in the brain at the screening stage
- EDSS score ≤ 5.5
- Informed consent signed voluntarily
Exclusion Criteria:
- Patients with multiple sclerosis over 5 years
- Those who are unable to perform MRI or who are allergic to gadolinium contrast agent during the test
- In addition to multiple sclerosis, patients with chronic active immune system disease or stable condition but requiring immunotherapy (glucocorticoids and / or immunosuppressants) (such as rheumatoid arthritis, scleroderma, Sjogren's syndrome, Crohn's disease, ulcerative colitis, etc.) or known immune deficiency syndrome (AIDS, genetic immune deficiency and drug-induced immunity) Patients who used glucocorticoid maintenance therapy before randomization could participate in the trial after discontinuation of the drug
- Patients with Aquaporin 4 (AQP4) antibody positive and / or Myelin oligodendrocyte glycoprotein(MOG) antibody positive within 1 year before randomization
Patients who have received the following treatment:
- Interferon, pegylated interferon, galatirel acetate, dimethyl fumarate were used within 4 weeks before randomization.
- Fengomod, IV immunoglobulin or plasma exchange within 12 weeks before randomization.
- Alemtuzumab, daclizumab and ocrelizumab were used within 24 weeks before randomization.
- Before randomization, azathioprine (AZA, half-life t1/2 = 6hrs), mycophenolate mofetil (t1/2 = 16hrs), leflunomide (LEF, t1/2 = 14.7hrs), tacrolimus (t1/2 = 43hrs), teriflunomide (t1/2 = 18 days), cyclosporin, In addition to leflunomide and telifluoramine, immunosuppressants such as CSA, t1/2 = 27 hrs, methotrexate (MTX, t1/2 = 14 HRS), cyclophosphamide (CTX, t1/2 = 6 hrs) can be added to the group after the interval of withdrawal is more than 5 times of half-life. Leflunomide and tertiazem need to be eluted with coleridine. The drug can be stopped and the following measures can be taken: Take 8 g of coleridine three times a day for 11 days. If the dose of 8 g can not be tolerated, it can be changed to 4 g each time. The time and times are the same as before.
- Cladribine or mitoxantrone was used within 1 year before randomization.
- Lymphoid irradiation and bone marrow transplantation were received before randomization.
- Patients were participated in any clinical trial 28 days before randomization or within 5 times half-life of study drug participating in clinical trial (whichever is longer).
- Patients with any persistent or chronic active infection or serious infection history in the screening period, such as shingles; active tuberculosis (patients with latent tuberculosis can participate in the test if they are given isoniazid and / or rifampin at the same time); HIV infection; syphilis antibody positive; HCV antibody positive; HBsAg positive; HBsAg negative but HBcAb positive, the HBV-DNA quantitative test is needed. If the HBV-DNA is positive, the patient should be excluded. If the HBV-DNA is negative, the patient can not be excluded.
- The results of abnormal laboratory tests to be excluded include but are not limited to: Leukocyte count < 3 × 10~9 / L; neutrophil < 1.5 × 10~9 / L; hemoglobin < 85g / L; platelet count < 80 × 10~9 / L; serum creatinine > 1.5 × ULN, accompanied by creatinine clearance < 50ml / min (measured value, or calculated by Cockcroft Gault formula); total bilirubin > 1.5 × ULN; ALT > 3 × ULN; AST > 3 × ULN; alkaline phosphatase > 2 × ULN; IgG < lower limit of normal value; IgM < lower limit of normal value;
- Cancer patients
- Pregnant women, lactating women and patients with family planning during the trial
- Patients with other mental disorders
- Patients who experienced any of the following events within 12 weeks before randomization: myocardial infarction, unstable ischemic heart disease, stroke, or NYHA class IV heart failure
- The researchers believe that the patients are compliant insufficiently or not suitable to participate in this study.
Sites / Locations
- the Third Affiliated Hospital,Sun Yat-Sen UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
RC18 160mg
RC18 240mg
Arm Description
RC18 160mg is injected subcutaneously once a week for 48 times.
RC18 240mg is injected subcutaneously once a week for 48 times.
Outcomes
Primary Outcome Measures
Number changes of gadolinium enhanced T1 lesions in the brain
Number changes of gadolinium enhanced T1 lesions in the brain at 12, 24, 36, and 48 weeks compared with baseline
Secondary Outcome Measures
Volume changes of gadolinium enhanced T1 lesions
Volume changes of gadolinium enhanced T1 lesions at 12, 24, 36 and 48 weeks compared with baseline
Number changes of new low signal T1 lesions
Number changes of new low signal T1 lesions at week 12, 24, 36, and 48 weeks compared with baseline
Number changes of new / increased T2 lesions in the brain
Number changes of new / increased T2 lesions in the brain at 12, 24, 36 and 48 weeks compared with baseline
Volume changes of T2 lesions in brain
Volume changes of T2 lesions in brain at 12, 24, 36 and 48 weeks compared with baseline
Proportion of patients who did not recur
Proportion of patients who did not recur between 0 and 48 weeks
Recurrence rate
Annual recurrence rate
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04625153
Brief Title
RC18 in Patients With Relapsing Remitting Multiple Sclerosis:a Phase II Trial
Official Title
RC18, a Recombinant Human B Lymphocyte Stimulator Receptor:Immunoglobulin G( IgG ) Fc Fusion Protein for Injection in Patients With Relapsing Remitting Multiple Sclerosis:a Phase II Trial
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 13, 2021 (Actual)
Primary Completion Date
October 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
RemeGen Co., Ltd.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
To observe the safety and effectivity of a Recombinant Human B Lymphocyte Stimulator Receptor : Immunoglobulin G( IgG ) Fc Fusion Protein for injection (RC18) in patients with relapsing remitting multiple sclerosis, analyze the dose-response relationship and provide a dose basis for follow-up clinical trials.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis, Relapsing-Remitting
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
18 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
RC18 160mg
Arm Type
Experimental
Arm Description
RC18 160mg is injected subcutaneously once a week for 48 times.
Arm Title
RC18 240mg
Arm Type
Experimental
Arm Description
RC18 240mg is injected subcutaneously once a week for 48 times.
Intervention Type
Biological
Intervention Name(s)
RC18 160mg
Other Intervention Name(s)
telitacicept
Intervention Description
RC18 160mg is injected subcutaneously once a week for 48 times.
Intervention Type
Biological
Intervention Name(s)
RC18 240mg
Other Intervention Name(s)
telitacicept
Intervention Description
RC18 240mg is injected subcutaneously once a week for 48 times.
Primary Outcome Measure Information:
Title
Number changes of gadolinium enhanced T1 lesions in the brain
Description
Number changes of gadolinium enhanced T1 lesions in the brain at 12, 24, 36, and 48 weeks compared with baseline
Time Frame
At 12, 24, 36, and 48 weeks
Secondary Outcome Measure Information:
Title
Volume changes of gadolinium enhanced T1 lesions
Description
Volume changes of gadolinium enhanced T1 lesions at 12, 24, 36 and 48 weeks compared with baseline
Time Frame
At 12, 24, 36 and 48 weeks
Title
Number changes of new low signal T1 lesions
Description
Number changes of new low signal T1 lesions at week 12, 24, 36, and 48 weeks compared with baseline
Time Frame
At week 12, 24, 36, and 48 weeks
Title
Number changes of new / increased T2 lesions in the brain
Description
Number changes of new / increased T2 lesions in the brain at 12, 24, 36 and 48 weeks compared with baseline
Time Frame
At 12, 24, 36 and 48 weeks
Title
Volume changes of T2 lesions in brain
Description
Volume changes of T2 lesions in brain at 12, 24, 36 and 48 weeks compared with baseline
Time Frame
At 12, 24, 36 and 48 weeks
Title
Proportion of patients who did not recur
Description
Proportion of patients who did not recur between 0 and 48 weeks
Time Frame
Between 0 and 48 weeks
Title
Recurrence rate
Description
Annual recurrence rate
Time Frame
0-48weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with relapsing remitting multiple sclerosis meet the diagnostic criteria of McDonald 2017.
18-55 years old, male or female
At least 2 recurrences (including clinical recurrence and imaging recurrence) were recorded within 1 year before randomization.
Gadolinium enhanced T1 lesions (≥ 1) in the brain at the screening stage
EDSS score ≤ 5.5
Informed consent signed voluntarily
Exclusion Criteria:
Patients with multiple sclerosis over 5 years
Those who are unable to perform MRI or who are allergic to gadolinium contrast agent during the test
In addition to multiple sclerosis, patients with chronic active immune system disease or stable condition but requiring immunotherapy (glucocorticoids and / or immunosuppressants) (such as rheumatoid arthritis, scleroderma, Sjogren's syndrome, Crohn's disease, ulcerative colitis, etc.) or known immune deficiency syndrome (AIDS, genetic immune deficiency and drug-induced immunity) Patients who used glucocorticoid maintenance therapy before randomization could participate in the trial after discontinuation of the drug
Patients with Aquaporin 4 (AQP4) antibody positive and / or Myelin oligodendrocyte glycoprotein(MOG) antibody positive within 1 year before randomization
Patients who have received the following treatment:
Interferon, pegylated interferon, galatirel acetate, dimethyl fumarate were used within 4 weeks before randomization.
Fengomod, IV immunoglobulin or plasma exchange within 12 weeks before randomization.
Alemtuzumab, daclizumab and ocrelizumab were used within 24 weeks before randomization.
Before randomization, azathioprine (AZA, half-life t1/2 = 6hrs), mycophenolate mofetil (t1/2 = 16hrs), leflunomide (LEF, t1/2 = 14.7hrs), tacrolimus (t1/2 = 43hrs), teriflunomide (t1/2 = 18 days), cyclosporin, In addition to leflunomide and telifluoramine, immunosuppressants such as CSA, t1/2 = 27 hrs, methotrexate (MTX, t1/2 = 14 HRS), cyclophosphamide (CTX, t1/2 = 6 hrs) can be added to the group after the interval of withdrawal is more than 5 times of half-life. Leflunomide and tertiazem need to be eluted with coleridine. The drug can be stopped and the following measures can be taken: Take 8 g of coleridine three times a day for 11 days. If the dose of 8 g can not be tolerated, it can be changed to 4 g each time. The time and times are the same as before.
Cladribine or mitoxantrone was used within 1 year before randomization.
Lymphoid irradiation and bone marrow transplantation were received before randomization.
Patients were participated in any clinical trial 28 days before randomization or within 5 times half-life of study drug participating in clinical trial (whichever is longer).
Patients with any persistent or chronic active infection or serious infection history in the screening period, such as shingles; active tuberculosis (patients with latent tuberculosis can participate in the test if they are given isoniazid and / or rifampin at the same time); HIV infection; syphilis antibody positive; HCV antibody positive; HBsAg positive; HBsAg negative but HBcAb positive, the HBV-DNA quantitative test is needed. If the HBV-DNA is positive, the patient should be excluded. If the HBV-DNA is negative, the patient can not be excluded.
The results of abnormal laboratory tests to be excluded include but are not limited to: Leukocyte count < 3 × 10~9 / L; neutrophil < 1.5 × 10~9 / L; hemoglobin < 85g / L; platelet count < 80 × 10~9 / L; serum creatinine > 1.5 × ULN, accompanied by creatinine clearance < 50ml / min (measured value, or calculated by Cockcroft Gault formula); total bilirubin > 1.5 × ULN; ALT > 3 × ULN; AST > 3 × ULN; alkaline phosphatase > 2 × ULN; IgG < lower limit of normal value; IgM < lower limit of normal value;
Cancer patients
Pregnant women, lactating women and patients with family planning during the trial
Patients with other mental disorders
Patients who experienced any of the following events within 12 weeks before randomization: myocardial infarction, unstable ischemic heart disease, stroke, or NYHA class IV heart failure
The researchers believe that the patients are compliant insufficiently or not suitable to participate in this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Binghua Xiao
Phone
86-010-58076833
Email
Binghua.xiao@remegen.cn
Facility Information:
Facility Name
the Third Affiliated Hospital,Sun Yat-Sen University
City
Guangzhou
State/Province
Guangdong
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wei Qiu, MD
Phone
02085253032
Email
qiuwei120@vip.163.com
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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RC18 in Patients With Relapsing Remitting Multiple Sclerosis:a Phase II Trial
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