E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Relapsing Remitting Multiple Sclerosis |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10063399 |
E.1.2 | Term | Relapsing-remitting multiple sclerosis |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The main objectives of study CAMMS324 is to compare the safety and efficacy of 2 annual cycles of either low- (12 mg/day) or high-dose (24 mg/day) intravenous (IV) alemtuzumab to 3-times weekly subcutaneous (SC) interferon beta-1a (Rebif) in patients with active relpasing-remitting multiple sclerosis (RRMS) who have experienced at least 1 relapse while on disease-modifying drug therapy for > 6 months.
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E.2.2 | Secondary objectives of the trial |
Secondary objectives of the CAMMS324 trial are: - Proportion of patients who are relapse free at Year 2 - Change from baseline in EDSS - Acquisition of disability as measured by change from baseline in MSFC - Percent change from baseline in MRI-T2-hyperintense lesion volume at Year 2 |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Four sub-studies are included in this protocol (same protocol version number and date) which will be conducted at selected centres on a subpopulation of patients: - Laboratory substudy. Additional testing for the following parameters: expanded hematology, expanded thyroid function monitoring, expanded lymphocyte phenotyping, peripheral blood mononuclear cell (PBMC) - Semen substudy. Semen analysis of sperm count and motility. If agglutination is present, subsequent testing for anti-sperm antibodies. - Expanded imaging substudy. Additional MTR (to measure abnormalities in normal-appearing white matter, which may be indicative of demyelination associated with the effects of MS) and/or MRS (thought to be a marker for axonal preservation and thus a useful counterpoint to MTR measurement of demyelination) and/or DWI (measuring diffusion of water in tissues, which can be adapted to reveal the state of white matter including demylenating MS lesions) - Pharmacokinetic substudy. PK samples drawn in two sub-cohorts (dense or sparse collection) |
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E.3 | Principal inclusion criteria |
• Signed, informed consent form • Age 18 to 50 years old (inclusive) as of signing informed consent form (ICF) • Diagnosis of MS per update of McDonald criteria • Onset of MS symptoms (as determined by a neurologist) within 5 years prior to screening • EDSS score 0.0 to 5.0 (inclusive) • >/= 2 MS attacks (first episode or relpases) occurring in the 2 years prior to screening, with >/= 1 attack prior to screening, with objective neurological signs confirmed by a physician • >/= 6 months continous treatment with beta interferon or glatiramer acetate during the past 5 years prior to screening • >/= 1 MS attack (replase) during treatment with interferon beta or glatiramer acetate after being on that therapy for at least 6 months; relapses that occur within 6 months of initiating treatment with interferon beta or glatiramer acetate do not qualify as a relapse during treatment • MRI scanning demonstrating white matter lesions attributable to MS and meeting at least one of the following criteria, as determined by the treating neurologist - >/= 9 TS lesions at least 3 mm in any axis - a gadolinium-enhancing lesion at least 3 mm in any axis plus >/= 1 brain T2 lesions - a spinal cord lesion consistent with MS plus >/= 1 brain T2 lesions
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E.4 | Principal exclusion criteria |
•Previous treatment with alemtuzumab or any other investigational drug for MS • Previous treatment with mitoxantrone or natalizumab • Exposure to azathioprine, cladiribine, cyclophosphamide, cyclosporine A, methotrexate, or any other immunosuppressive agent other than systemic corticosteroid treatment • Received treatment with a monoclonal antibody for any reason • Has any progressive form of MS • History of malignancy (except for basal cell skin carcinoma if disease-free for >/=5 years) • Any disability acquired from trauma or another illness that, in the opinion of the Investigator, could interfere with evaluation of disability due to MS • Previous hypersensitivity reaction to other immunoglobulin product • Known allergy or intolerance to interferon beta, human albumin, or mannitol • Intolerance of pulsed corticosteroids, especially a history of steroid psychosis • Inability to self-administer SC injections or receive SC injections from caregiver • Inability to undergo MRI with gadolinium administration • Documented CD4+ cell count <490/mm3 within the past year • Documented CD8+ cell count <200/mm3 within the past year • Seropositivity for human immunodeficiency virus (HIV) • Significant autoimmune disease (eg, immune cytopenias, rheumatoid arthritis, systemic lupus erythematosus, other connective tissue disorders; vasculitis; inflammatory bowel disease; severe psoriasis) • Presence of anti-TSH receptor antibodies • Active infection, eg, 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. More specific guidance on tuberculosis testing and patient eligibility is provided in the Study Operations Manual (SOM) • 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 (fertile patients only); reliable and effective contraceptive method(s) include: condoms (male or female) with or without a spermicidal agent, diaphragm with spermicide or cervical cap, intrauterine device [IUD], or hormonal-based contraception • 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 • Current participation in another clinical study or previous participation in CAMMS 323 • 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 <130,000/uL at Screening or documented at < 100,000/uL within the past year on a sample without platelet clumping • Prior history of invasive fungal infections • History of untreated cervical dysplasia or intraepithelial neoplasia (CIN) • Seropositive for Trypanosoma cruzi of Human T-lymphotropic virus type I or type II (HTLV-I/II) (testing in endemic regions only). Guidance on region-specific testing recomemndations and patient eligibility is provided in the SOM • Any other illness or infection (latent or active) that, in the Investigator's opinion, could be execerbated 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.
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E.5 End points |
E.5.1 | Primary end point(s) |
The study will be considered to have met its efficacy objectives if a statistically significant treatment effect of either alemtuzumab dose level over SC interferon beta-1a is demonstrated in either or both of the co-primary efficacy endpoints: time to SAD and relapse rate. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 9 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 41 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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End of trial = 2 years from the date the last patient is randomised to treatment. All patients will be invited to participate in a separate extention protocol to provide long-term follow up, including safety monitoring for at least 3 years following their last alemtuzumab treatment |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |