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 primary objective in this study is to investigate the effect of ocrelizumab given as two dose regimens of 600 or 1000 mg intravenously on the total number of gadolinium-enhancing T1 lesions observed on MRI scans of the brain at weeks 12, 16, 20 and 24 as compared with placebo. |
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E.2.2 | Secondary objectives of the trial |
- The annualized protocol defined relapse rate by Week 24; - Proportion of patients who remain relapse-free by Week 24; - The total number of gadolinium-enhancing T1 lesions observed on MRI scans of the brain at Weeks 4, 8, 12, 16, 20 and 24; - The total number of new and/or persisting gadolinium-enhancing T1 lesions on MRI scans of the brain at Weeks 4, 8, 12, 16, 20 and 24; - Change in total volume of T2 lesions on MRI scans of the brain from baseline to Week 24; - To evaluate the safety and tolerability of two dose regimens of ocrelizumab in patients with RRMS as compared with placebo and Avonex at Week 24 and the overall safety of ocrelizumab administered for up to 96 weeks; - To investigate the pharmacokinetics and other pharmacodynamic study endpoints of ocrelizumab.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Ability to provide written informed consent and to be compliant with the schedule of protocol assessments; 2. RRMS, as defined by the McDonald criteria (2005); 3. Ages 18-55 years, 4.At least two documented relapses within the last 3 years prior to screening, at least one of which occured within the last year prior to screening. 5. EDSS at baseline from 1.0 to 6.0 points; 6. Evidence of recent MS activity as defined below: a. At least six T2 lesions on an MRI scan done in the year prior to screening, based on local reading. Should an MRI scan be unavailable within the last year or showing less than six T2 lesions, a screening MRI scan with at least six T2 lesions is required for the patient to be eligible, or b. Patient had 2 documented relapses within the year prior to screening; 7. For sexually active female and male patients of reproductive potential, use of reliable means of contraception as described below: - Two methods of contraception throughout the trial, including the active treatment phase AND for 48 weeks after the last dose of ocrelizumab, or until their B-cells have repleted, whichever is the longer. - Acceptable methods of contraception include one primary (e.g. systemic hormonal contraception or tubal ligation of the female partner, vasectomy of the male partner) AND one secondary barrier method (e.g. latex condoms, spermicide) OR a double barrier method (e.g. latex condom, intrauterine device, vaginal ring or pessary plus spermicide (e.g. foam, vaginal suppository, gel, cream)) may be used. 8. For patients of non reproductive potential: a. Women may be enrolled if postmenopausal (i.e. spontaneous amenorrhea for the past year confirmed by an FSH level greater than 40 mIU/mL unless the patient is receiving a hormonal therapy for their menopause or surgically sterile (i.e. hysterectomy, complete bilateral oophorectomy); b. Men may be enrolled if they are surgically sterile. |
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E.4 | Principal exclusion criteria |
1. Secondary or primary progressive MS at screening 2. Disease duration > 15 years in patients with an EDSS ≤ 2.0 3. Incompatibility with MRI 4. Contra-indications to or intolerance of oral or i.v. corticosteroids, including methylprednisolone administered i.v., according to the country label 5. Known presence of other neurologic disorders, including but not limited to, the following: - History of ischemic cerebrovascular disorders or ischemia of the spinal cord - History or known presence of CNS or spinal cord tumor, potential metabolic causes of myelopathy, infectious causes of myelopathy, history of genetically inherited progressive CNS degenerative disorder, Neuromyelitis optica, history or known presence of systemic autoimmune disorders potentially causing progressive neurologic disease, history or known presence of sarcoidosis, history of severe, clinically significant brain or spinal cord trauma, history of progressive multifocal leukoencephalopathy
Exclusions Related to General Health: 1. Pregnancy or lactation 2. Lack of peripheral venous access 3. History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies 4. Significant, uncontrolled disease, such as cardiovascular, cardiac arrhythmia, pulmonary (including obstructive pulmonary disease), renal, hepatic, endocrine or gastrointestinal 5. Congestive heart failure NYHA III or IV functional severity 6. Known active bacterial, viral, fungal, mycobacterial infection or other infection [including tuberculosis [TB] or atypical mycobacterial disease (but excluding fungal infection of nail beds)] or any major episode of infection requiring hospitalization or treatment with i.v. antibiotics within 4 weeks prior to screening or oral antibiotics within 2 weeks prior to screening 7. History or known presence of recurrent or chronic infection (e.g., hepatitis B or C, HIV, syphilis, tuberculosis) 8. History of cancer, including solid tumors and hematological malignancies (except basal cell, in situ squamous cell carcinomas of the skin, and in situ carcinoma of the cervix of the uterus that have been excised and resolved) 9. History of alcohol or drug abuse within 24 weeks prior to randomization 10. History of or currently active primary or secondary immunodeficiency 11. History or laboratory evidence of coagulation disorders
Exclusions Related to Medications 1. Treatment with any investigational agent within 4 weeks of screening or five half-lives of the investigational drug (whichever is longer) 2. Receipt of a live vaccine within 6 weeks prior to randomization
Exclusions Related to Medications Potentially Used for the Treatment of MS 1. Incompatibility with Avonex use (see protocol) 2. Previous treatment with rituximab 3. Previous treatment with lymphocyte-depleting therapies (e.g., Campath, anti-CD4, cladribine, cyclophosphamide, total body irradiation, bone marrow transplantation) except mitoxantrone which should not be used within 48 weeks prior to randomization 4. Treatment with lymphocyte trafficking blockers (e.g. natalizumab, FTY720) within 24 weeks prior to randomization 5. Treatment with beta interferons, glatiramer acetate, i.v. Immunoglobulin (i.v. Ig), plasmapheresis, or immunosuppressive therapies (e.g., mycophenolate mofetil [MMF], cyclosporine or azathioprine) within 12 weeks prior to randomization 6. Systemic corticosteroid therapy within 4 weeks prior to randomization
Exclusions Related to Laboratory Findings Refer to the protocol for further information |
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E.5 End points |
E.5.1 | Primary end point(s) |
To investigate the effect of ocrelizumab given as two dose regimens of 600 or 1000 mg intravenously on the total number of gadolinium-enhancing T1 lesions observed on MRI scans of the brain at weeks 12, 16, 20 and 24 as compared to placebo. |
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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 | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | Yes |
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 | Yes |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| Information not present in EudraCT |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
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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The end of the study is the date of the last patient’s last visit |
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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 | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |