E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Relapsing-Remitting Multiple Sclerosis |
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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 | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10063399 |
E.1.2 | Term | Relapsing-remitting 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 |
To evaluate the safety, tolerability and effects of three oral doses of MT-1303 compared to placebo given for a period of 24 weeks in subjects with relapsing-remitting multiple sclerosis (RRMS) on MRI parameters.
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E.2.2 | Secondary objectives of the trial |
• To evaluate the effects of MT-1303 compared to placebo on clinical outcomes
• To explore the dose-response relationship of three dose levels of MT-1303 in subjects with RRMS
• To evaluate the pharmacokinetics (PK) and pharmacodynamics (PD) of MT-1303 and its phosphorylated metabolite (MT-1303-P) in subjects with RRMS
• To evaluate the effects of MT-1303 compared to placebo on quality of life as measured by the Multiple Sclerosis Quality of Life-54 (MSQOL-54)
• To obtain deoxyribonucleic acid (DNA) for exploratory purposes (optional). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. RRMS as defined by the revised McDonald criteria
2. Evidence of recent MS activity defined as either:
• at least one documented relapse in the previous 12 months, OR
• a positive gadolinium (Gd)-enhanced MRI scan within 3 months prior to screening, OR
• at least two documented relapses in the previous 24 months with a positive Gd-enhanced MRI scan within the previous 12 months
3. Expanded Disability Status Score (EDSS) score ≥0.0 and
≤5.5 points. |
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E.4 | Principal exclusion criteria |
1. Primary progressive, secondary progressive or progressive relapsing MS at screening
2. Disease duration >15 years combined with an EDSS score ≤2.0
3. Relapse of MS during the Screening Period
4. History or known presence of other neurological disorders likely to render the subject unsuitable for the study
5. History of any of a list of pre-defined cardiovascular diseases
6. History or known presence of any significant central nervous system, infectious, metabolic, oncological, ophthalmological or respiratory system disease or illness likely to render the subject unsuitable for the study
7. Previous exposure to any sphingosine 1-phosphate receptor modulator
8. Receipt of a live vaccine or systemic corticosteroid use within 28 days prior to randomisation
9. Previous treatment with beta-interferons or glatiramer acetate within 14 days prior to randomisation
10. Previous treatment with intravenous immunoglobulin, plasmapheresis, certain immunosuppressants, lymphocyte-depleting therapy, total body irradiation or bone marrow transplantation
11. Need, or likely need for, treatment with Class I or III
anti-arrhythmic drugs or with heart-rate-lowering beta-blockers or calcium-channel blockers, or with any other drugs which can reduce the heart rate
12. Evidence of significant anaemia, thrombocytopenia, leucopoenia or lymphocytopenia, renal or hepatic impairment
13. Clinically significant electrocardiogram (ECG) findings. |
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E.5 End points |
E.5.1 | Primary end point(s) |
• Total number of monthly MRI Gd-enhanced T1-weighted lesions observed across post-baseline visits (Weeks 8-24) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Various timepoints throughout the study - please refer to the detailed Time and Events Schedule in the protocol for full details |
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E.5.2 | Secondary end point(s) |
• Total number of monthly MRI Gd-enhanced T1-weighted lesions observed across all scheduled post-baseline visits (Weeks 4-24)
• Total number of and volume of new or enlarged T2-weighted lesions observed across all scheduled post-baseline visits (Weeks 4-24)
• Change from baseline in brain volume at Week 24
• Exploratory Magnetisation Transfer Ratio (MTR)
endpoints detailed in Statistical Analysis Plan (SAP) (selected centres only)
• Clinical endpoints
o Annualised Relapse Rate (ARR) at Week 24
o Change from baseline in total EDSS score and total Multiple Sclerosis Functional Composite (MSFC) score at Week 24
Pharmacodynamic endpoints:
• Lymphocyte counts
• Lymphocyte subsets (selected centres only)
Safety Endpoints:
• Adverse events (AEs)
• Vital signs
• 12-lead ECG
• 3-lead Holter ECG monitoring
• Routine safety laboratory assessments
• Physical examination
• Optical coherence tomography (OCT)
Pharmacokinetic Endpoint:
• MT-1303 and MT-1303-P concentrations
Subject-reported Outcome:
• Change from baseline in MSQOL-54 at Week 24. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Various timepoints throughout the study - please refer to the detailed Time and Events Schedule in the protocol for full details |
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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 | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
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 | 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 | No |
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) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 4 |
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 | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 77 |
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 |
Belgium |
Bosnia and Herzegovina |
Bulgaria |
Canada |
Croatia |
Czech Republic |
Finland |
Germany |
Hungary |
Italy |
Latvia |
Lithuania |
Poland |
Russian Federation |
Serbia |
Spain |
Sweden |
Switzerland |
Turkey |
Ukraine |
United Kingdom |
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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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 6 |