E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 15.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10028245 |
E.1.2 | Term | Multiple sclerosis |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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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 of the study is to assess the effect of long-term treatment with prolonged-release fampridine 10 mg twice daily on the physical component scale (PCS) of the Short Form (36) Health Status Questionnaire (SF-36) as reported by treatment responders. |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives of this study are as follows:
1) Compare the change in the PCS of the SF-36 between treatment responders and non-responders (treatment discontinued at Week 4).
2)Evaluate change from baseline in additional QoL measures among treatment responders as well as changes from baseline in treatment responders versus non-responders.
3)Assess the safety and tolerability of prolonged-release fampridine 10 mg twice daily. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
To be eligible to participate in this study, candidates must meet the following eligibility criteria at the Screening Visit or at the timepoint specified in the individual eligibility criterion listed:
1. Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (PHI) in accordance with national and local subject privacy regulations.
2. Male or female subjects, 18 to 75 years old, inclusive, at the time of informed consent.
3. Must have a diagnosis of primary-progressive, secondary-progressive, progressive-remitting, or relapsing-remitting MS per revised McDonald Committee criteria (Section 22.1 [Polman et al, 2011]) as defined by Lublin and Reingold [Lublin and Reingold 1996] of at least 3 months duration.
4. Have a walking impairment as determined by the Investigator.
5. Able to perform the T25FW (Section 22.2) test with or without a walking aid.
6. Female subjects of childbearing potential must practice effective contraception during the study and be willing and able to continue contraception for 30 days after their last dose of study treatment. For further details of contraceptive requirements for this study, please refer to Section 15.5.3.
7. Able to understand and comply with the requirements of the protocol. |
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E.4 | Principal exclusion criteria |
Candidates will be excluded from study entry if any of the following exclusion criteria are met at the Screening Visit or at any time during the screening period, or at the timepoint specified in the individual eligibility criterion listed:
Medical History
1. Known allergy to pyridine-containing substances or to any of the inactive ingredients (see Section 12.1) in the prolonged-release fampridine tablet.
2. Any history of seizure, epilepsy, or other convulsive disorder, with the exception of febrile seizures in childhood.
3. An estimated CrCl of <80 mL/minute.
4. Subject needs to take medicinal products that are inhibitors of organic cation transporter 2 (OCT2 [e.g., cimetidine]).
Miscellaneous
5. Female subjects who are currently pregnant or who are considering becoming pregnant while participating in the study. Female subjects of childbearing potential who have a positive pregnancy test at the Screening Visit may not participate in this study.
6. Female subjects who are currently breastfeeding.
7. Previous exposure to fampridine. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from baseline in the PCS of the SF-36 measured over Months 3, 6, 9, and 12 among subjects who respond to treatment with prolonged-release fampridine. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
baseline and week 12, 24, 36, 48 and 50 |
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E.5.2 | Secondary end point(s) |
1)Comparison of the change from baseline in the PCS of the SF-36 measured over Months 3, 6, 9, and 12 among subjects who respond to treatment with prolonged-release fampridine and those who do not.
2)Change from baseline in additional QoL measures over Months 3, 6, 9, and 12 among responders as well as comparisons in change from baseline between responders and non-responders:
-Individual components and mental component scale (MCS) of the SF-36
-Multiple Sclerosis Impact Scale (MSIS-29) Physical and Psychological Score
-Activities Limitation scale of the Patient-Reported Indices for Multiple Sclerorsis (PRIMUS)
-EuroQoL descriptive system of health-related quality of life states consisting of 5 dimensions (questionnaire; EQ-5D)
-Work Productivity and Activity Impairment (WPAI)-Specific Health Problem (SHP) questionnaire
3)Change in QoL measures among responders stratified by disease type.
4)Change in QoL measures between responders and non-responders not taking additional MS therapy.
5)Safety of prolonged-release fampridine will be assessed by:
-the number and proportion of subjects with adverse events (AEs) and serious adverse events (SAEs) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1)baseline and week 12, 24, 36, 48 and 50
2)baseline and week 12, 24, 36, 48 and 50
3)baseline and week 12, 24, 36, 48 and 50
4)baseline and week 12, 24, 36, 48 and 50
5)Throughout the study |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
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) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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) | No |
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 | 15 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 68 |
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 | No |
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 |
Australia |
Belgium |
Denmark |
France |
Germany |
Ireland |
Italy |
Netherlands |
Portugal |
Sweden |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | No |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 18 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |