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 | 16.0 |
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 |
The primary objective of the study is to assess the safety and tolerability of long-term treatment with DAC HYP monotherapy in subjects who completed Study 205MS301. |
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E.2.2 | Secondary objectives of the trial |
Secondary objectives of this study are as follows:
• To assess the long-term immunogenicity of DAC HYP administered by PFS
• To describe MS-related outcomes, including MS relapse, disability progression, MS lesion formation, and patient-reported impact of MS, following long-term treatment with DAC HYP
• To assess the safety, tolerability, and efficacy of switching to DAC HYP in subjects previously on long-term treatment with interferon β 1a in Study 205MS301
• To evaluate PD parameters that may be associated with treatment response
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
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. Must be a subject currently participating in Study 205MS301 who has completed either the Week 144 Visit or the End of Study Visit (Week 96).
Note: Subjects who are not able to enroll into 205MS303 at the time of their Week 144/End of Study Visit may be eligible to enroll into 205MS303 at a later time if they are still participating in the 6-month follow-up period of 205MS301 at the time of expected rollover into 205MS303.
3. Women of childbearing potential must practice effective contraception during the study and be willing and able to continue contraception for 4 months after their last dose of study treatment.
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E.4 | Principal exclusion criteria |
Medical History
1. Any subject who permanently discontinued study treatment in Study 205MS301 prior to the end of the study treatment period, or had an Early Termination visit in Study 205MS301.
Note: Subjects for whom dosing was temporarily suspended in Study 205MS301 are not excluded from participation in this extension study if the criteria for resuming DAC HYP treatment under the Study 205MS301 protocol have been met at the time of enrollment into Study 205MS303.
2. Any significant change in the subject’s medical history that would preclude administration of DAC HYP, including laboratory tests or a current clinically significant condition that, in the opinion of the Investigator, would have excluded the subject’s participation in Study 205MS301. The Investigator must re review the subject’s medical fitness for participation and consider any factors that would preclude treatment in Study 205MS303, including:
• History of any significant cardiac, endocrine, hematological, hepatic, immunologic, metabolic, urologic, pulmonary, gastrointestinal, dermatologic, psychiatric, renal, neurological (other than MS), and/or other major disease (e.g., malignancy) that would preclude administration of DAC HYP.
• Clinically significant laboratory abnormalities (hematology and blood chemistry) from the most recently available test in Study 205MS301, as determined by the Investigator. Laboratory findings mandating discontinuation of study treatment as defined in Protocol 205MS301 are exclusionary.
3. Any of the following abnormal blood tests within the 7 days prior to Day 1:
• alanine aminotransferase/serum glutamate pyruvate transaminase (ALT/SGPT), aspartate aminotransferase/serum glutamic oxaloacetic transaminase (AST/SGOT), or gamma-glutamyl-transferase (GGT) >3 the upper limit of normal (ULN)
Note: Subjects ending 205MS301 on a treatment suspension may not enroll into 205MS303 until ALT/SGPT and AST/SGOT are 2 ULN.
• total bilirubin >2 ULN (subjects with an established diagnosis of Gilbert's syndrome are excluded if total bilirubin is >2.5 ULN)
Note: Subjects ending 205MS301 on a treatment suspension may not enroll into 205MS303 until total bilirubin 1 ULN (subjects with an established diagnosis of Gilbert's syndrome may not enroll into 205MS303 until total bilirubin is 1.5 ULN).
4. Other medical reasons that, in the opinion of the Investigator and/or Biogen Idec, make the subject unsuitable for enrollment.
Treatment History
5. Treatment with any prohibited concomitant medication during Study 205MS301.
Note: Subjects who start an approved, open-label IFN β preparation after completion of dosing in Study 205MS301 are not excluded, but IFN β treatment must be discontinued before the first dose of DAC HYP in Study 205MS303 is given.
Miscellaneous
6. Female subjects who are currently pregnant or breastfeeding, or considering becoming pregnant while in the study.
7. Previous participation in Study 205MS303.
8. History of drug or alcohol abuse (as defined by the Investigator) at any time after the start of Study 205MS301.
9. Unwillingness or inability to comply with the requirements of the protocol, including the presence of any condition (physical, mental, or social) that is likely to affect the subject’s ability to comply with the protocol.
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary End Points include incidence of AEs including serious AEs (SAEs), discontinuation of DAC HYP due to AEs, and withdrawals due to AEs |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
• Shifts in clinical laboratory assessments (hematology and blood chemistry)
• Incidence of depression as assessed by the Beck Depression Inventory, Second Edition (BDI-II)
• Incidence of anti-DAC binding antibodies (ADAbs) over time
• Incidence of anti-DAC HYP neutralizing antibodies (NAbs) over time
• Relapse outcomes: annualized relapse rate (ARR), and proportion of subjects who relapse
• Sustained disability progression defined by at least a 1.0 point increase on the Expanded Disability Status Scale (EDSS) score from a baseline EDSS ≥1.0 that is sustained for 12 weeks, or at least a 1.5-point increase on the EDSS from a baseline EDSS <1.0 that is sustained for 12 weeks
• Magnetic Resonance Imaging (MRI) outcomes: total number and volume of new or newly enlarging T2 hyperintense lesions, Gd-enhancing lesions, T1 hypointense lesions, and brain atrophy on brain MRI (Note: The decision to collect and analyze brain atrophy data will be made after the analysis of Study 205MS301 is complete. Brain atrophy analysis may be omitted.)
• Change in Multiple Sclerosis Functional Composite (MSFC) score
• Change in EDSS score
• Proportion of subjects who are free from disease activity.
• Proportion of subjects with sustained improvement in disability as defined by the number of subjects with baseline EDSS of at least 2.0 who experience ≥1.0 decrease in EDSS that is sustained for 24 weeks.
• Change in Multiple Sclerosis Impact Scale-29 (MSIS-29) physical and psychological scores
• Change in quality of life as assessed by the European Quality of Life, 5 dimensions (EQ-5D and EQ VAS)
• Change in direct HRU (hospitalizations, emergency room visits, and unscheduled neurologist visits)
• Change in treatment satisfaction as assessed by the subject
• Change in subject productivity as assessed by the HRPQ
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Throughout the course of 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 | Yes |
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 | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
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 | No |
E.8.1.1 | Randomised | No |
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 | 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 | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 120 |
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 |
Brazil |
Canada |
Czech Republic |
Denmark |
Finland |
France |
Georgia |
Germany |
Greece |
Hungary |
India |
Ireland |
Israel |
Italy |
Mexico |
Moldova, Republic of |
Poland |
Romania |
Russian Federation |
Serbia |
Spain |
Sweden |
Switzerland |
Ukraine |
United Kingdom |
United States |
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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 | 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 |