| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
| Secondary progressive multiple sclerosis |
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| E.1.1.1 | Medical condition in easily understood language |
| Secondary progressive multiple sclerosis |
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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 | 16.0 |
| E.1.2 | Level | PT |
| E.1.2 | Classification code | 10063400 |
| E.1.2 | Term | Secondary progressive multiple sclerosis |
| E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
|
| 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 |
Primary objective: To demonstrate the efficacy of Siponimod (BAF312) relative to placebo in delaying the time to 3-month confirmed disability progression in patients with secondary progressive multiple sclerosis (SPMS) as measured by expanded disability status scale (EDSS)
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| E.2.2 | Secondary objectives of the trial |
First key secondary objective: To demonstrate the efficacy of Siponimod relative to placebo in delaying the time to 3-month confirmed worsening of at least 20% from Baseline in the timed 25-foot walk test (T25W)
Second key secondary objective: To demonstrate the efficacy of Siponimod relative to placebo in reducing the increase in T2 lesion volume from Baseline to the end of the study
For further secondary objectives please see protocol
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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 |
1. Exploratory blood and CSF biomarker sub-study
(2012-7-12, Original Version)
- Characterization of changes in biomarker levels in the CSF and peripheral blood during study course
2. Exploratory cognitive sub-study
(2012-7-12, Original Version)
- Exploration of cognitive impairment in SPMS patients
- Investigation of relationship between cognitive test performance and certain brain imaging findings
3. Exploratory optical coherence tomography (OCT) sub-study
(2012-7-12, Original Version)
-Exploration of the utility of retinal layer thickness as a marker of axonal degeneration and disability progression in SPMS
4. Magnetic resonance imaging (MRI) sub-study
(2012-07-12, Original Version)
-Exploration of the use of MRI techniques that may provide additional information about the extent and nature of structural damage due to demyelination or axonal loss, in patients with SPMS treated with Siponimod and placebo, respectively
-In addition to the conventional MRI, MTR (magnetization transfer ratio) and high resolution structural imaging will be implemented at centers meeting pre-specified technical requirements to evaluate structural integrity of the brain lesions visible on conventional MRI and in the normal appearing brain tissue as well as the grey matter volume of the patients participating in the CBAF312A2304 study
5. Exploratory fluorescence-activated cell sorting (FACS) sub-study
(2012-07-12, Original Version)
-Investigation of the influence of pre-treatment peripheral lymphocyte composition on the on-treatment absolute lymphocyte count (ALC)
-Increase understanding of the effect of Siponimod on different lymphocyte subpopulations, follow their longitudinal changes on treatment and relate these changes to the clinical and MR outcomes |
|
| E.3 | Principal inclusion criteria |
Prior history of relapsing remitting MS
Secondary progressive multiple sclerosis (SPMS) defined as progressive increase of disability in at least 6 months
EDSS score of 3.0 to 6.5
No relapse or corticosteroid treatment within 3 months
Other protocol-defined inclusion criteria may apply
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|
| E.4 | Principal exclusion criteria |
Women of child bearing potential must use reliable forms of contraception.
Diagnosis of Macular edema during screening period
Any medically unstable condition determined by investigator
Unable to undergo MRI scans
Hypersensitivity to any study drugs or drugs of similar class
Other protocol-defined inclusion criteria may apply
|
|
| E.5 End points |
| E.5.1 | Primary end point(s) |
The delay in time to 3-month confirmed disability progression by Siponimod (BAF312) relative to placebo as measured by expanded disability status scale (EDSS)
Confirmed disability is defined as an increase of score of 1 point in patients with baseline score of 3.0-5.0 and 0.5 point increase with baseline score of 5.5 to 6.5. |
|
| E.5.1.1 | Timepoint(s) of evaluation of this end point |
| baseline, every three months |
|
| E.5.2 | Secondary end point(s) |
The first key secondary endpoint is the delay in time to 3-month confirmed worsening of at least 20% from Baseline in the timed 25-foot walk test (T25W) by Siponimod (BAF312) compared to placebo.
The second key secondary endpoint is the efficacy of Siponimod (BAF312) relative to placebo in reducing the increase in T2 lesion volume from Baseline to the end of the study. |
|
| E.5.2.1 | Timepoint(s) of evaluation of this end point |
1.) baseline, every three months
2.) baseline, every year |
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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 | Yes |
| E.6.11 | Pharmacogenomic | Yes |
| E.6.12 | Pharmacoeconomic | No |
| E.6.13 | Others | Yes |
| E.6.13.1 | Other scope of the trial description |
| Exploratory biomarkers in blood, serum, plasma and CSF |
|
| 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 | 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 | 2 |
| 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 | 11 |
| E.8.5 | The trial involves multiple Member States | Yes |
| E.8.5.1 | Number of sites anticipated in the EEA | 173 |
| 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 |
| Argentina |
| Australia |
| Austria |
| Belgium |
| Bulgaria |
| Canada |
| Czech Republic |
| Egypt |
| Estonia |
| France |
| Germany |
| Greece |
| Hungary |
| Ireland |
| Israel |
| Italy |
| Latvia |
| Lithuania |
| Netherlands |
| Poland |
| Portugal |
| Romania |
| Russian Federation |
| Slovakia |
| Spain |
| Sweden |
| Switzerland |
| Turkey |
| United Kingdom |
| United States |
|
| 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 | 5 |
| E.8.9.1 | In the Member State concerned months | 0 |
| E.8.9.1 | In the Member State concerned days | 0 |
| E.8.9.2 | In all countries concerned by the trial years | 5 |
| 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 |