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 | 18.0 |
E.1.2 | Level | SOC |
E.1.2 | Classification code | 10029205 |
E.1.2 | Term | Nervous system disorders |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.0 |
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 this study is to evaluate the effect of BG00012 on brain MRI lesions in paediatric subjects with RRMS |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives of this study are as follows:
- To characterize the PK of BG00012 in paediatric subjects with RRMS
- To evaluate the safety and tolerability of BG00012 in paediatric subjects with RRMS |
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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 Screening or at the timepoint specified in the individual eligibility criterion listed:
1. Ability of parents or legal guardians to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information in accordance with national and local subject privacy regulations. Subjects will provide assent in addition to the parent or legal guardian, as appropriate, as per local regulations.
2. Male and female subjects aged 10 to 17 years old, inclusive, at the time of informed consent.
3. Must have a body weight of ≥30 kg at Screening and Day 1.
4. Must have a diagnosis of RRMS according to McDonald criteria for MS (2010) [Polman 2011] and International Pediatric Multiple Sclerosis Study Group criteria for pediatric MS (2013) [Krupp 2013].
5. Must be ambulatory, with a converted Kurtzke baseline EDSS score between 0 and 5.0, inclusive.
6. Must have experienced ≥1 relapse in the 12 months prior to Screening or ≥2 relapses in the 24 months prior to Screening.
7. Must agree to be without treatment for 8 weeks prior to Day 1.
8. Sexually active subjects of reproductive potential must practice effective contraception during the study and for at least 30 days after their last dose of study treatment. For further details of contraceptive requirements for this study, refer to 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 exist at Screening or at the timepoint specified in the individual criterion listed:
1. Primary progressive, secondary progressive, or progressive relapsing MS (as defined by [Lublin and Reingold 1996]). These conditions require the presence of continuous clinical disease worsening over a period of at least 3 months. Subjects with these conditions may also have superimposed relapses but are distinguished from relapsing-remitting subjects by the lack of clinically stable periods or clinical improvement.
2. Disorders mimicking MS, such as other demyelinating disorders (e.g., acute disseminated encephalomyelitis), systemic autoimmune disorders (e.g., Sjögren disease, lupus erythematosus, and neuromyelitis optica), metabolic disorders (e.g., dystrophies), and infectious disorders.
3. History of premalignant or malignant disease. Subjects with basal cell carcinoma that has been completely excised prior to Screening will remain eligible.
4. History of severe allergic or anaphylactic reactions or known drug hypersensitivity to DMF or fumaric acid esters.
5. History of any clinically significant cardiovascular, dermatologic, endocrinologic, GI, hematologic, immunologic, growth, developmental, pulmonary, psychiatric, neurologic (other than MS), renal, urologic, and/or other major disease that may confound safety or efficacy assessment.
6. History of drug or alcohol abuse (as defined by the Investigator) within the 2 years prior to Screening.
7. Any of the following abnormal blood tests at Screening:
- alanine transaminase (ALT)/serum glutamic pyruvic transaminase (SGPT), AST/serum glutamic oxaloacetic transaminase (SGOT), or gamma glutamyl transferase (GGT) ≥2 times the upper limit of normal
- leukocytes <3500/mm3
- absolute lymphocyte count <LLN
- eosinophils >0.7 × 103/μL or >0.7 GI/L
8. Any of the following abnormal urine tests at Screening confirmed by a second urinalysis 2 weeks later:
- proteinuria (1+ or greater) and/or spot protein/creatinine ratio (with AM void) >0.2 mg. Note: Documented benign proteinuria is not exclusionary.
- hematuria, without known etiology (e.g., urinary tract infection or menses)
- glycosuria, without known etiology (e.g., recent steroid use or elevated serum glucose)
9. History of or positive test result at Screening for human immunodeficiency virus.
10. History or positive test result at Screening for hepatitis C virus antibody or current hepatitis B infection (defined as positive for hepatitis B surface antigen [HBsAg] and/or hepatitis B core antibody [HBcAb]). Subjects with immunity to hepatitis B from previous natural infection (defined as negative HBsAg, positive hepatitis B surface antibody immunoglobulin G, and positive HBcAb) are eligible to participate in the study (US Centers for Disease Control and Prevention’s interpretation of the hepatitis B serology panel) [CDC 2007].
Treatment History
11. Any previous treatment with Fumaderm® or BG00012.
12. Prior treatment with any of the following:
- total lymphoid irradiation
- cladribine
- T-cell or T-cell receptor vaccination
- any therapeutic monoclonal antibody, with the exception of rituximab or natalizumab
13. Prior treatment with any of the following medications within the 12 months prior to the Week -8 MRI:
- mitoxantrone
- cyclophosphamide
- rituximab
14. Prior treatment with any of the following medications or procedures within 6 months prior to the Week -8 MRI:
- fingolimod
- teriflunomide
- natalizumab
- cyclosporine
- azathioprine
- methotrexate
- mycophenolate mofetil
- laquinimod
- intravenous (IV) immunoglobulin
- plasmapheresis or cytapheresis
15. Prior treatment with any of the following within 28 days prior to the Week -8 MRI:
- glatiramer acetate
- interferon-β
- steroids (IV or oral corticosteroid treatment, including agents that may act through the corticosteroid pathway [e.g., low-dose naltrexone])
Miscellaneous
16. Current enrollment or a plan to enroll in any interventional clinical study in which an investigational treatment or approved therapy for investigational use is administered within 6 months prior to Day 1.
17. Female subjects considering becoming pregnant or breastfeeding while in the study or who are pregnant or breastfeeding.
18. Subjects for whom MRI was contraindicated, e.g., who had pacemakers or other contraindicated implanted metal devices or had claustrophobia that could not be medically managed.
19. Inability to comply with study requirements.
20. Other unspecified reasons that, in the opinion of the Investigator or Biogen Idec, make the subject unsuitable for enrollment. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from Baseline Period to On-Treatment Assessment Period in the number of new or newly enlarging T2 hyperintense lesions on brain MRI scans, where the Baseline Period is from Week -8 to Day 0 and the On-Treatment Assessment Period is from Week 16 to Week 24 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Baseline period (Week -8 to Day 0), weeks 16 & 24 |
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E.5.2 | Secondary end point(s) |
The secondary endpoints of this study are as follows:
- PK parameters: Cmax, time to reach maximum observed plasma concentration (Tmax), apparent clearance (CL/F), apparent volume of distribution (V/F), elimination half-life (t½), and area under the concentration-time curve from time 0 to infinity (AUC0-inf)
- Incidence of treatment-emergent adverse events (AEs) and serious adverse events (SAEs) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
PK Assessments:
Day 1 (within 2 hrs prior to dose, 2 hrs post-dose, 3 hrs post-dose).
Day 8 (within 2 hrs prior to dose, 30 mins post-dose and 1, 2, 3, 4, 5, 6, 8, 10 hrs post-dose).
AEs and SAEs:
For AEs monitoring is from Week -8 MRI Visit up to the Safety Follow-Up Visit, or from the Week -8 MRI Visit up to the Week 24 Visit for subjects enrolling in the extension study.
For SAEs monitoring is from the signing of ICF and assent up to the Safety Follow-Up Visit, or from the signing the ICF up to the Week 24 Visit for subjects enrolling in the extension study. Any SAE that is ongoing when the subject completes or discontinues the study will be followed by the Investigator until the event has resolved, stabilized, or returned to baseline status |
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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 | No |
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) | 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 | 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) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 14 |
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 |
Bulgaria |
Czech Republic |
Finland |
France |
Germany |
Israel |
Italy |
Kuwait |
Latvia |
Lebanon |
Lithuania |
Poland |
Turkey |
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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LVLS: The end of study is last subject, last visit |
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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 | 1 |
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 | 2 |
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 |