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    Summary
    EudraCT Number:2012-003627-38
    Sponsor's Protocol Code Number:H3M116477
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2012-10-02
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2012-003627-38
    A.3Full title of the trial
    Proof of Mechanism Study to Assess the Potential of GSK239512 to Remyelinate Lesions in Subjects with Relapsing Remitting Multiple Sclerosis.
    Estudio de mecanismo de acción para evaluar el efecto potencial de GSK239512 sobre la remielinización de las lesiones en sujetos con esclerosis múltiple remitente recurrente.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Assessing the Potential Ability of GSK239512 to Remyelinate Brain Lesions in Relapsing Remitting Multiple Sclerosis
    Valorar la capacidad de GSK239512 de remielinizar las lesiones cerebrales en sujetos con esclerosis múltiple remitente y recurrente
    A.4.1Sponsor's protocol code numberH3M116477
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorGlaxoSmithKline, S.A.
    B.1.3.4CountrySpain
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportGlaxoSmithKline, Research and Development
    B.4.2CountryChina
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGlaxoSmithKline Research & Development Ltd
    B.5.2Functional name of contact pointClincial Trials Helpdesk
    B.5.3 Address:
    B.5.3.1Street AddressIron Bridge Road, Stockley Park West
    B.5.3.2Town/ cityUxbridge, Middlesex
    B.5.3.3Post codeUB11 1BU
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number44208990 4466
    B.5.5Fax number44208990 4466
    B.5.6E-mailGSKClinicalSupportHD@gsk.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.2Product code GSK2395612
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNGSK239512
    D.3.9.2Current sponsor codeGSK239512
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.2Product code GSK239512
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNGSK239512
    D.3.9.2Current sponsor codeGSK239512
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.2Product code GSK239512
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNGSK239512
    D.3.9.2Current sponsor codeGSK239512
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.2Product code GSK239512
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNGSK239512
    D.3.9.2Current sponsor codeGSK239512
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number80
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Relapsing Remitting Multiple Sclerosis
    Esclerosis múltiple remitente recurrente.
    E.1.1.1Medical condition in easily understood language
    Relapsing Remitting Multiple Sclerosis
    Esclerosis múltiple remitente recurrente.
    E.1.1.2Therapeutic area Diseases [C] - Nervous System Diseases [C10]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.1
    E.1.2Level PT
    E.1.2Classification code 10048393
    E.1.2Term Multiple sclerosis relapse
    E.1.2System Organ Class 10029205 - Nervous system disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Estimation of the effects of GSK239512 on lesion remyelination in
    subjects with Relapsing Remitting Multiple Sclerosis on stable treatment
    with Avonex [interferon-beta1a] or Copaxone [glatiramer acetate].
    Estimación de los efectos de GSK239512 sobre la remielinización de las lesiones en sujetos con esclerosis múltiple remitente-recurrente en tratamiento estable con Avonex (interferón-beta1a) o Copaxone (acetato de glatirámero).
    E.2.2Secondary objectives of the trial
    Evaluate the effects of GSK239512 on alternate potential marker of remyelination of lesions.
    Evaluar los efectos de GSK239512 sobre posibles marcadores alternativos de remielinización de las lesiones.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Estudio Farmacogenético. La fecha y la versión coinciden con la del protocolo: 2012N133918_00 del 16 de julio de 2012. Los objetivos del estudio farmacogenético vienen especificados en el Apendice 1 del protocolo.
    E.3Principal inclusion criteria
    1. Age: 18 to 50 years of age, inclusive
    2. RRMS Diagnosis and Treatment:
    - Diagnosed with a relapsing-remitting course of multiple sclerosis as defined by the appropriate McDonald criteria at the time of diagnosis, most recently updated by Polman (2011) and:
    - Diagnosis made within approximately 10 years prior to the screening visit (as documented by year of diagnosis or duration of disease), and
    - No physical manifestations of other forms of MS including signs of progression to secondary progressive MS (SPMS).
    - Currently compliant with a stable dose regimen of Avonex [Interferon Beta1a] or Copaxone [Glatiramer Acetate] for management of MS for - 1 year prior to the screening visit.
    - The occurrence of at least one of the following (within the year preceding the screen visit AND after -2 months of stable treatment with Avonex OR Copaxone):
    - 1 reported and/or documented relapse, OR
    - 1 Gadolinium Enhanced (GdE) lesion on MRI,
    Example: If treatment with Avonex initiated at 12 months prior to screen the earliest a lesion or relapse could occur to qualify for the study would be 10 months prior to screen.
    - Currently neurologically stable, in the investigator-s judgment, and not actively experiencing or recovering from a recent relapse at the screening visit.
    3. MS Disability: A Kurtzke Expanded Disability Status Scale (EDSS) (Kurtzke 1983) score of 1 - 4.5 (inclusive) at the screening visit.
    4. Clinical Trial Commitment: Must agree not to participate in a clinical study involving another investigational drug or device throughout their participation in this study. Non-interventional study participation is allowed if the time involvement and scheduling will not interfere with compliance in this study in the opinion of the investigator.
    5. Female Reproduction and lactation: A female subject is eligible to enter the study if she is
    a. Not pregnant or nursing
    b. Of non-childbearing potential (i.e. women who have had a hysterectomy, are postmeznopausal, which is defined as >2 years without menses (female subjects who have been post-menopausal for <2 years must be confirmed with Follicle Stimulating Hormone (FSH) and estradiol levels), have both ovaries surgically removed or have current documented tubal ligation); or,
    c. Of childbearing potential (i.e. women with functional ovaries and no documented impairment of oviductal or uterine function that would cause sterility). This category includes women with oligomenorrhea [even severe], women who are perimenopausal or have just begun to menstruate. Subject has a negative serum pregnancy test at screening and agrees to one of the following:
    1. Complete abstinence from intercourse for one month prior to administration of the first dose of investigational product until 1 month
    after the last dose of investigational product; or,
    2. Consistent and correct use of one of the following acceptable methods of birth control for one month prior to the start of investigational product to 1 month after the last dose of investigational product
    - Intrauterine device (IUD) or intrauterine system (IUS) with a documented failure rate of <1% per year
    - Male partner sterilization (vasectomy with documentation of azoospermia) prior to the female subject-s entry into the study, and this male is the sole partner for the subject
    - Double barrier method: condom and an occlusive cap (diaphragm or cervical/vault caps) with a vaginal spermicidal agent(foam/gel/film/cream/suppository).
    - Consistent and correct use of one of the following acceptable methods of birth control WITH a single barrier method (condom, occlusive cap, or vaginal spermicidal agent) for one month prior to the start of investigational product to 1 month after the last dose of investigational product:
    - Oral contraceptives (either combined or progesterone only)
    - Injectable progesterone
    - Implants of levonorgestrel
    - Estrogenic vaginal ring
    - Percutaneous contraceptive patches
    6. Informed Consent: Must be competent to understand the information given in the Institutional Review Board (IRB) or Independent Ethics Committee (IEC) approved ICF and must sign the form prior to the initiation of any study procedures.
    1. Edad: 18 a 50 años de edad, ambos inclusive
    2. Diagnóstico y tratamiento de EMRR:
    - Diagnóstico de EM remitente-recurrente según los criterios apropiados de Mc Donald en el momento del diagnóstico, actualizados recientemente por Polman (2011) y:
    - Con diagnóstico aproximadamente realizado en los 10 años previos a la visita de selección (documentado por el año de diagnóstico o la duración de la enfermedad), y
    - Sin manifestaciones físicas de otras formas de EM, incluyendo signos de progresión a EM secundaria progresiva (EMSP).
    - Cumpliendo actualmente,con un régimen posológico estable de Avonex (interferón Beta1a) o Copaxone (acetato de glatirámero) para el tratamiento de la EM durante <1 año antes de la visita de selección.
    - La aparición de al menos uno de las siguientes condiciones (en el año anterior a la visita de selección Y después de ? 2 meses de tratamiento estable con Avonex O
    - 1 recidiva confirmada o documentada, O
    - 1 lesión realzada con gadolinio (RGd) en la RM,
    Ejemplo: Si el tratamiento con Avonex se inició 12 meses antes de la selección,la primera lesión o recidivaque se podría producirpara cumplir los criterios de participación en el estudio sería 10 meses antes de la selección.
    - Neurológicamente estable , a juicio del investigador, y sin experimentar activamente una recidiva o recuperándose de la mismaTabla en la visita de selección.
    3. Discapacidad por la EM: Una puntuación de 1-4,5 (inclusive) en la escala Kurtzke Expanded Disability Status Scale (EDSS) (Kurtzke1983) en la visita de selección.
    4. Compromiso con el estudio clínico: Debe estar de acuerdo en no participar en un ensayo clínico con otro fármaco o dispositivo en investigación durante toda su participación en este estudio. Se permite la participación en estudios no intervencionales siempre y cuadno el calendario y sus visitas programadas no interfieran con el cumplimiento de este estudio, en opinión del investigador.
    5. Embarazo y lactancia: Una mujer es elegible para participar en el estudio si
    a. No está embarazada o en período de lactancia
    b. No tiene capacidad de procrear (es decir, mujeres a las que se ha hecho una histerectomía, o son posmenopáusicas, lo cual se define como >2 años sin menstruación [en las mujeres que hayan estado posmenopáusicas durante <2 años se debe confirmar su situación con concentraciones de hormona estimulante de los folículos {FSH} y de estradiol]) o a las que se hayan extirpado quirúrgicamente los dos ovarios o en las que se haya documentado actualmente una ligadura de trompas); o
    c. Con capacidad de procrear (es decir, mujeres con ovarios funcionales y sin deterioro documentado del funcionamiento de los oviductos o de los ovarios que pudiera producir esterilidad). Esta categoría incluye a mujeres con oligomenorrea (incluso grave) y mujeres que están perimenopáusicas o que acaban de empezar a tener la menstruación. El sujeto que tenga una prueba de embarazo en suero negativa en la selección y da su conformidad a uno de los siguientes supuestos:
    c.1. Abstinencia completa de relaciones sexuales durante un mes antes de la administración de la primera dosis del producto en investigación hasta 1 mes después de la última dosis del producto en investigación; o
    c.2. Uso constante y correcto de uno de los siguientes métodos anticonceptivos aceptables desde 1 mes antes del inicio del producto en investigación hasta 1 mes después de la última dosis del producto en investigación
    - Dispositivo intrauterino (DIU) o sistema intrauterino (SIU), con una tasa de fracaso documentada de <1% al año
    - Esterilización de la pareja masculina (vasectomía con documentación de azoospermia) antes de la inclusión de El sujetoen el estudio, y siendo ésta la única pareja de el sujeto
    - Doble método de barrera: preservativo y dispositivo oclusivo (diafragma o dispositivo de oclusión cervical/de la bóveda vaginal) con un espermicida vaginal (espuma/gel/película/crema/óvulo vaginal).
    - Uso constante y correcto de uno de los siguientes métodos aceptables de control de natalidad CON un método de barrera único (preservativo, dispositivo grosor o espermicida vaginal) durante un mes antes del inicio del producto en investigación hasta 1 mes después de la última dosis del producwto en investigación:
    - Anticonceptivos orales (combinados o solo con progesterona)
    - Progesterona inyectable
    - Implantes de levonorgestrel
    - Anillo vaginal estrogénico
    - Parches anticonceptivos percutáneos
    6. Consentimiento informado: Debe ser competente para comprender la información que figure en el ICI aprobado por el Comité de revisión institucional (CRI) o el Comité ético independiente (CEI) y debe firmar el impreso antes del inicio de cualquier procedimiento del estudio.
    E.4Principal exclusion criteria
    1. MRI:
    - Unable to undergo MRI scans (e.g. due to pacemaker, severe claustrophobia, hypersensitivity to contrast media).
    - Lacks adequate venous access for administration of Gd-enhancing agent.
    - Findings on brain MRI scan indicating any clinically significant brain
    abnormality other than MS (e.g. damage associated with prior traumatic brain injury).
    2. Past and Concurrent Medical Conditions:
    - History of severe and clinically significant CNS trauma with current sequelae (e.g. traumatic brain injury, spinal cord compression)
    - Significant concurrent, uncontrolled medical condition or disease which in the opinion of the investigator could (e.g. significant psychiatric disorder, etc...):
    - affect the subject's safety,
    - impair the subject's reliable participation in the trial,
    - impair the evaluation of the endpoints
    OR
    - necessitate the use of medication not allowed by this protocol.
    - History or presence of myelopathy due to spinal cord compression by disk or vertebral disease or chronic progressive myelopathy
    - Diagnosis of any type epilepsy.
    - At risk of suicide, as indicated by:
    - A documented history of attempted suicide or significant suicidal
    ideation during the 6 months preceding the screening visit, OR
    - If in the investigator's judgment the subject is at risk of a suicide
    attempt based on the screen visit assessment, including the eC-SSRS
    - Presence of significant and routine sleep disturbance that has a negative
    impact on quality of life that, in the judgement of the investigator, may
    increase the risk of tolerability issues during dose escalation. Examples of significant sleep disturbances may be: severe insomnia, nocturnal wandering, confusion, disorientation, agitation, or vivid dreams.
    - Presence or history of hallucinations that, in the judgement of the investigator, may increase the safety risk to the subject.
    - Known diagnosis or history consistent with positive human immunodeficiency virus (HIV).
    3. Past and Current Medications and Therapies:
    - Have had treatment with the following to manage their MS within 1 or 2 years prior to the Screen Visit:
    - One year:
    - fingolimod [e.g. Gilenya],
    - Rebif (interferon beta1a),
    - interferon beta1b [e.g. Betaseron],
    - mycophenolate mofetil [e.g. CellCept], or
    - Recently approved medication or formulation indicated for the
    management of MS. Consult with GSK Medical Monitor if there are specific questions regarding eligible treatments.
    - Two years:
    - natalizumab [e.g. Tysabri]
    - alemtuzumab [e.g. Campath].
    - daclizumab [e.g. Zenapax],
    - rituximab [e.g. Rituxan].
    - mitoxantrone [e.g. Novantrone],
    - cladribine [e.g. Leustatin], or
    - azathioprine [e.g. Imuran].
    - Have used corticotropin to manage a relapse within 6 months prior to Screen Visit.
    - Have had treatment with the following and were unable to discontinue and refrain from treatment for the specified time period and are not able to discontinue use throughout participation in the clinical trial (see Section 5.10.2 for information regarding reason for exclusion):
    - dalfampridine /fampridine [e.g. Ampyra] - 1 month prior to Screen Visit,
    - nabiximols [e.g. Sativex] - 1 month prior to Screen Visit,
    - amantadine [e.g. Symmetrel] - 3 months prior to Screen Visit, or
    - leflunomide [e.g. Arava] - 1 year prior to Screen Visit.
    - Have used the following medications within the last 30 days or 5 half-lives (whichever is longer) prior to screening and are not able to discontinue use throughout participation in the clinical trial:
    - Any CNS stimulants (e.g., modafinil, dexamphetamine, methylphenidate).
    - Known potent P-glycoprotein inhibitors (e.g. itraconazole,
    ketoconazole, cyclosporin, loperamide, diltiazem, verapamil, spironolactone, quinidine, bepridil, quinine, carvedilol).
    - Known potent inhibitors or inducers of the CYP3A4 enzyme (e.g.,
    verapamil, ketoconazole, cimetidine, rifampin, modafinil).
    - CNS-penetrant antihistamines (e.g. bromopheniramine, chlorpheniramine, clemastine, diphenhydramine, hyrdoxyzine)
    - History of medically significant adverse effects (including allergic reactions and hypersensitivities) following treatment with:
    - Histamine H3 receptor antagonist or inverse agonist,
    - Gadolinium enhancing agent,
    - Relapse medication: glucocorticoids (e.g., methylprednisolone)
    OR
    - A known hypersensitivity to components of the investigational product [Clinical Investigator Brochure (GlaxoSmithKline Document Number HM2008/00498/06 2012), relapse medication, or Gadolinium enhancing agent.
    4. Cardiovascular Status at Screening: Electrocardiogram (ECG) showing a
    clinically significant abnormality at screening. Including a QTcB or QTcF interval of >=450 msec or >=480 msec for patients with a Bundle Branch Block.
    (For the full section on Exclusion criteria, please refer to the Protocol on Page 28-31)
    1. RM:
    - Incapaz de someterse la RM (p. ej., debido a marcapasos, claustrofobia grave, hipersensibilidad a los medios de contraste).
    - Carece de un acceso venoso adecuado para la administración de medio del contraste con Gd.
    - Hallazgos de la RM craneal indicativos de cualquier alteración cerebral clínicamente significativa distinta a EM (p. ej., daños asociados a lesión cerebral traumática previa).
    2. Enfermedades médicas previas y actuales:
    - Antecedentes de traumatismo grave y clínicamente significativo del SNC con secuelas actuales (p. ej., lesión cerebral traumática, compresión medular)
    - Trastorno o enfermedad médica concurrente significativa y no controlada que en opinión del investigador podría (p. ej., trastorno psiquiátrico significativo, etc.):
    - afectar a la seguridad de los sujetos,
    - afectar a la fiabilidad de la participación del sujeto en el ensayo,
    - afectar a la evaluación de las variables del estudio
    O
    - precisar el uso de medicación no permitida por el presente protocolo.
    - Historia o presencia de mielopatía por compresión medular por enfermedad discal o vertebral, o mielopatía progresiva crónica
    - Diagnóstico de cualquier tipo de epilepsia.
    - Riesgo de suicidio, como indican:
    - Antecedentes documentados de intento de suicidio o ideas suicidas importante durante los 6 meses anteriores a la visita de selección, O
    - Si a juicio del investigador el sujeto tiene riesgo de intento de suicidio en base a la evaluación en la visita de selección, incluyendo la escala eC-SSRS
    - Presencia de trastornos del sueño significativos y habituales que tienen efectos negativos sobre la calidad de vida que, a juicio del investigador, puedan aumentar el riesgo de problemas de tolerabilidad durante el aumento progresivo de la dosis.
    Ejemplos de trastornos del sueño significativos pueden ser: insomnio grave, sonambulismo, confusión, desorientación, agitación, o sueños vívidos.
    - Presencia o antecedente de alucinaciones que, a juicio del investigador, pueden aumentar el riesgo de seguridad para el sujeto.
    - Diagnóstico conocido o historia clínica compatible con seropositividad del virus de la inmunodeficiencia humana (VIH).
    3. Medicamentos y tratamientos pasados y actuales:
    - Haber recibido tratamiento para tratar la EM en los 1-2 años previos a la visita de selección, con los siguiente medicamentos:
    - UN AÑO:
    - fingolimod (p. ej., Gilenya)
    - Rebif (interferón beta1a),
    - interferón beta1b (p. ej., Betaferon)
    - micofenolato mofetilo (p. ej., CellCept), o
    - Medicamentos o formulaciones autorizados recientemente indicados para el tratamiento de la EM. Consulte con el monitor médico de GSK si tiene preguntas concretas sobre los tratamientos elegibles.
    - Dos años:
    - natalizumab (p. ej., Tysabri)
    - alemtuzumab (p. ej., Campath).
    - daclizumab (p. ej., Zenapax),
    - rituximab (p. ej., Mabthera).
    - mitoxantrona (p. ej., Novantrone)
    - cladribina (p. ej., Leustatin), o
    - azatioprina (p. ej., Imurel).
    Haber utilizado corticotropina para tratar una recidiva en los 6 meses previos a la visita de selección.
    - Haber recibido tratamiento con los siguientes fármacos y sin poder interrumpir y retirar el el tratamiento durante el período temporal especificado, y sin poder suspender su uso durante la participación en el ensayo clínico (véase Sección 5.10.2 para más información respecto al motivo de la exclusión):
    - dalfampridina/fampridina (p. ej., Fampyra): 1 mes antes de la visita de selección
    - nabiximoles (p. ej., Sativex): 1 mes antes de la visita de selección
    - amantadina: 3 meses antes de la visita de selección, o
    - leflunomida (p. ej., Arava): 1 año antes de la visita de selección.
    - Haber utilizado los siguientes fármacos en los últimos 30 días o 5 semividas (lo que sea más largo) antes de la visita de selección, y sin poder suspender el tratamiento durante la participación en el ensayo clínico:
    - Cualquier estimulante del SNC (p. ej., modafinilo, dexanfetamina, metilfenidato).
    - Inhibidores potentes de la glucoproteína P (p. ej., itraconazol, ketoconazol, ciclosporina, loperamida, diltiazem, verapamilo, espironolactona, quinidina, bepridilo, quinina, carvedilol).
    - Inhibidores o inductores potentes de la enzima CYP3A4 (p. ej., verapamilo, ketoconazol, cimetidina, rifampicina, modafinilo).
    - Antihistamínicos con penetración en el SNC (p. ej., bromofeniramina, clorfeniramina, clemastina, difenhidramina, hidroxicina)
    - Antecedente de efectos adversos médicos significativos (incluyendo reacciones alérgicas e hipersensibilidad) después del tratamiento con:
    - Antagonistas o agonistas inversos del receptor histamínico H3,
    - Contraste con gadolinio,
    - Medicamento para la recidiva: glucocorticoesteroides
    O
    - Hipersensibilidad conocida a los componentes del producto en investigación, medicamento para la recidiva o medios de contraste con gadolinio.
    (Para un listado completo de los Criterios de Exclusión, ver Sección 4.2.2 del Protocolo)
    E.5 End points
    E.5.1Primary end point(s)
    Changes in lesion myelination using two exploratory
    magnetization transfer ratio (MTR) endpoints comparing
    placebo to GSK239512 treated subjects in:
    1) Mean change in gadolinium (Gd) enhanced
    (GdE) lesion MTR differences (calibrated to reference scan [Section 6.3.1.1]) from before enhancement to stable recovery (>=3 months post new GdE lesion), and
    2) Mean change in Delta MTR lesion MTR differences (calibrated to reference scan) from before lesion appearance to stable recovery (>=3 months post lesion appearance)
    Cambios en la mielinización de las lesiones utilizando dos variable exploratorias del cociente de transferencia de la magnetización (MTR) comparando los sujetos tratados con placebo con los que reciben GSK239512 en:
    1) Cambio medio de las diferencias de MTR en lesiones realzadas con gadolinio (Gd) (RGd) (calibrado respecto la exploración de referencia [Sección 6.3.1.1]) desde antes del realce hasta la recuperación estable (>= 3 meses después de la nueva lesión de RGd), y
    2) Cambio medio de las diferencias del MTR de las lesiones delta (calibrado respecto la exploración de referencia) desde antes de la aparición de la lesión hasta la recuperación estable (>=3 meses después de la aparición de la lesión).
    E.5.1.1Timepoint(s) of evaluation of this end point
    Every 6 weeks for MRI assessment, with a minimum of 5 MRI scans required to assess the endpoints.
    Cada 6 semanas evaluación mediante RM, se requiere un un mínimo de 5 RM para evaluación de las variables.
    E.5.2Secondary end point(s)
    Change from baseline in T2 lesion MTR at Week 48. Cumulative new and enlarging Gd enhancing, T2 and Combined Unique Active lesions comparing placebo to GSK239512 treated subjects.
    Change from baseline at Week 48 in total brain volume, white matter volume and grey matter volume comparing placebo to GSK239512 treated subjects.
    Cumulative number of persistent black holes and new, unenhancing T1 lesion counts comparing placebo to GSK239512 treated subjects over treatment duration up to Week 48.
    Proportion of new GdE lesions evolving into chronic (unenhancing) T1 lesions (black holes) comparing placebo to GSK239512 treated subjects over treatment duration up to Week 48.
    Mean change from baseline in overall Cognitive impairment and cognitive domains comparing placebo to GSK239512 treated subjects.
    Comparison of Relapse Rates between placebo and GSK239512 treated subjects.
    Comparison of Time to First Relapse between placebo and GSK239512 treated subjects.
    Comparison of the proportion of subjects Relapse Free between placebo and GSK239512 treated subjects.
    Proportion of subjects with sustained worsening of Expanded Disability Severity Scale (EDSS) over 3 months comparing placebo to GSK239512 treated subjects.
    Mean change from baseline in the EDSS functional systems and a subset of component assessments comparing placebo to GSK239512 treated subjects.
    Cambio del MTR de la lesión en T2 desde la situación basal hasta la semana 48.
    En lesiones acumuladas realzadas con Gadolinio nuevas, su aumento de tamaño y T2 lesiones activas únicas/combinadas, comparando sujetos tratados con placebo frente a GSK.

    Cambio desde el valor basal hasta la semana 48 del volumen cerebral total, el volumen de la sustancia blanca y el volumen la sustancia gris, comparando los sujetos tratados con placebo con los que recibieron GSK239512.
    Número acumulado de agujeros negros persistente y recuento de nuevas lesiones sin realce en T1, comparando los sujetos tratados con placebo con los que reciben GSK239512 durante todo el estudio hasta la semana 48.
    Proporción de los nuevas lesiones RGd que evolucionan hacia lesiones crónicas (sin realce) en T1 (agujeros negros) comparando los sujetos tratados con placebo con los que reciben GSK239512 durante todo el tratamiento hasta la semana 48.
    Cambio medio desde la situación basal del deterioro cognitivo global y los dominios cognitivos, comparando los sujetos tratados con placebo con los que reciben GSK239512.
    Comparación de la tasa de recidivas entre los sujetos tratados con placebo y los que reciben GSK239512.
    Comparación del tiempo hasta la primera recidiva entre los sujetos tratados con placebo y los que reciben GSK239512.
    Comparación de la proporción de sujetos libres de recidivas entre los sujetos tratados con placebo y los que reciben GSK239512
    Proporción de sujetos con empeoramiento mantenido de la puntuación de la escala Expanded Disability Severity Scale (EDSS) durante 3 meses, comparando los sujetos tratados con placebo con los que reciben GSK239512.
    Cambio medio desde la situación basal de los sistemas funcionales de la escala EDSS y un subgrupo de evaluaciones de componentes, comparando los sujetos tratados con placebo con los que reciben GSK239512.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Imaging endpoints are assessed every 6 weeks, relapse is assessed every 4 weeks, cognition is assessed at 3 and 6 month intervals, and disability progression is assessed every 12 weeks.
    Las variables de imagen seran evaluadas cada 6 semanas, los brotes se evaluaran cada 4 semanas, las evaluaciones cognitivas en intervalos de 3 y 6 meses y la progresión de la discapacidad sera valorada cada 12 semanas.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis Yes
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised No
    E.8.1.2Open No
    E.8.1.3Single blind Yes
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned7
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA40
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Bulgaria
    Canada
    Czech Republic
    Germany
    Spain
    Sweden
    Ukraine
    United Kingdom
    E.8.7Trial 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
    LSLV
    Última visita de último paciente.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years0
    E.8.9.1In the Member State concerned months21
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years0
    E.8.9.2In all countries concerned by the trial months21
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 114
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state10
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 84
    F.4.2.2In the whole clinical trial 114
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    If an extension study is available for subjects completing participation in this study, they will be eligible for enrolment, as appropriate. The investigator is responsible for ensuring that consideration has been given to the poststudy care of the patient's medical condition whether or not GSK is providing specific post study treatment.
    Si se dispone de un estudio de extensión para los sujetos que completen la participación en este estudio, serán elegibles para su inclusión, cuando proceda. El investigador es responsable de garantizar que se ha tenido en consideración la asistencia de la enfermedad médica de los sujetos después del estudio, independientemente de que GSK suministre un tratamiento específico después del estudio
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2012-12-17
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2012-11-08
    P. End of Trial
    P.End of Trial StatusCompleted
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