E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Relapsing remitting multiple sclerosis (RRMS) |
esclerosis múltiple remitente-recidivante (EMRR) |
|
E.1.1.1 | Medical condition in easily understood language |
Multiple sclerosis is a disabling disease of brain and spinal cord that disrupts flow of information within brain, characterized by flare-ups with periods of remission in between (relapsing remitting) |
Esclerosis múltiple es una enfermedad incapacitante en cerebro y médula espinal que interrumpe el flujo de info en cerebro, con ataques de asma con períodos de remisión en medio(recaídas y remisiones) |
|
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 | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10028245 |
E.1.2 | Term | Multiple sclerosis |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
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 |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10048393 |
E.1.2 | Term | Multiple sclerosis relapse |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10039720 |
E.1.2 | Term | Sclerosis multiple |
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 |
? To assess the efficacy of ocrelizumab 600 mg intravenous (IV) given every 24 weeks on the basis of the following endpoint - Proportion of patients who have no evidence of disease activity |
Evaluar la eficacia de ocrelizumab 600 mg por vía intravenosa (IV) administrado cada 24 semanas basándose en el criterio de valoración siguiente: - Porcentaje de pacientes sin signos de actividad de la enfermedad |
|
E.2.2 | Secondary objectives of the trial |
? To evaluate the efficacy of ocrelizumab 600 mg IV given every 24 weeks on the basis of the following endpoints - Proportions of patients free from a protocol-defined event of disease activity - Time to first protocol-defined event of disease activity - Change in Expanded Disability Status Scale (EDSS) - Proportion of patients who have Confirmed Disability Improvement (CDI), Confirmed Disability Progression (CDP) or stable disability - Annualized rate of protocol-defined relapses - Time to onset of first protocol-defined relapse, 24 weeks CDP, first new and/or enlarging T2 lesion - Total number of T1 Gd-enhanced lesions detected by brain MRI - Change in total T2 lesion volume detected by brain MRI - Change in T1 hypointense lesions - Change in brain volume - Change in cognitive performance as measured by the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) ? To evaluate the safety and tolerability of ocrelizumab 600 mg IV given every 24 weeks |
Evaluar eficacia de ocrelizumab 600 mg por vía intravenosa (IV) administrado cada 24 semanas: -% de pacientes sin signos de actividad de la enfermedad conforme episodios definidos en protocolo -Tiempo transcurrido hasta primer episodio de actividad de la enfermedad definido en protocolo - Variación de la EDSS - % pacientes con mejoría confirmada de discapacidad (MCD), progresión confirmada de discapacidad (PCD) o discapacidad estable -Tasa anualizada de recidivas definidas en protocolo -Tiempo transcurrido hasta comienzo de primera recidiva definida en protocolo, PCD 24 semanas, primera lesión en T2 nueva o aumentada de tamaño -Num total de lesiones en T1 realzadas con Gd, detectadas mediante RM cerebral -Variación vol total de lesiones en T2 detectadas mediante RM cerebral -Variación lesiones hipointensas en T1 -Variación volumen cerebral -Variación rendimiento cognitivo según BICAMS -Evaluar eficacia y tolerabilidad de ocrelizumab 600 mg IV administrado cada 24 semanas |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Age 18-55 years - Have a definite diagnosis of RRMS, confirmed as per the revised McDonald 2010 criteria of <= 5 years - Have a length of disease duration, from first symptom, of < 10 years - Have received no more than two prior disease modifying treatments (DMTs), and the discontinuation of the most recent DMT was due to lack of efficacy - Suboptimal disease control while on a DMT - EDSS of 0.0 to 4.0, inclusive, at screening - For women of childbearing potential: agreement to use an acceptable birth control method during the treatment period and for at least 6 months after the last dose of study drug |
? 18 a 55 años de edad ? Diagnóstico evidente de EMRR, confirmado según los criterios de McDonald modificados de 2010, desde hace ? 5 años ? Enfermedad de < 10 años de duración desde el primer síntoma ? Recepción de no más de dos TME previos y suspensión del TME más reciente por falta de eficacia ? Control subóptimo de la enfermedad con un TME ? EDSS de 0,0 a 4,0, inclusive, en la selección ? Mujeres en edad fértil: aceptación del uso de un método anticonceptivo aceptable durante el periodo de tratamiento y durante al menos 6 meses después de la última dosis del fármaco del estudio. |
|
E.4 | Principal exclusion criteria |
- Secondary progressive multiple sclerosis (SPMS) or history of primary progressive or progressive relapsing MS - Inability to complete an MRI - Known presence of other neurological disorders Exclusions Related to General Health - Any concomitant disease that may require chronic treatment with systemic corticosteroids or immunosuppressants during the course of the study - History or currently active primary or secondary immunodeficiency - History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies - History of opportunistic infections - History or known presence of recurrent or chronic infection - History of malignancy - Congestive heart failure - Known active bacterial, viral, fungal, mycobacterial infection or other infection, excluding fungal infection of nail beds Exclusions Related to Medications - Receipt of a live vaccine or attenuated live vaccine within 6 weeks prior to the baseline visit - Treatment with any investigational agent within 24 weeks of screening (Visit 1) or five half-lives of the investigational drug (whichever is longer) or treatment with any experimental procedures for MS - Contraindications to or intolerance of oral or IV corticosteroids, according to the country label, including a) Psychosis not yet controlled by a treatment; b) Hypersensitivity to any of the constituents - Previous treatment with B-cell targeted therapies (i.e., rituximab, ocrelizumab, atacicept, belimumab, or ofatumumab) - Systemic corticosteroid therapy within 4 weeks prior to screening - Any previous treatment with alemtuzumab (Campath/Mabcampath/Lemtrada), cladribine, mitoxantrone, daclizumab, laquinimod, total body irradiation, or bone marrow transplantation - Treatment with cyclophosphamide, azathioprine, mycophenolate mofetil, cyclosporine or methotrexate - Previous treatment with natalizumab unless natalizumab was discontinued because of persistent anti-natalizumab antibodies - Treatment with IV immunoglobulin (Ig) within 12 weeks prior to baseline - Treatment with investigational DMT Exclusions Related to Laboratory Findings - Positive serum ? human chorionic gonadotropin (hCG) measured at screening - Positive screening tests for hepatitis B (hepatitis B surface antigen [HBsAg] positive, or positive hepatitis B core antibody [total HBcAb] confirmed by a positive viral DNA polymerase chain reaction [PCR]) or hepatitis C (HepCAb) - Lymphocyte count below lower limit of normal (LLN) - CD4 count<250/mcL - Aspartate aminotransferase (AST)/ serum glutamic oxaloacetic transaminase (SGOT) or alanine aminotransferase (ALT) /serum glutamic pyruvic transaminase (SGPT)=> 3.0 × the upper limit of normal (ULN) - Platelet count <100,000/µL (<100 × 109/L) - Absolute neutrophil count <1.0 × 103/mcL |
? Esclerosis múltiple progresiva secundaria (EMPS) o antecedente de EM progresiva primaria o progresiva recidivante ? Incapacidad para someterse a una RM ? Presencia conocida de otros trastornos neurológicos
Exclusiones relacionadas con la salud general ? Cualquier enfermedad concomitante que requiera tratamiento crónico con corticosteroides o inmunodepresores sistémicos durante el estudio ? Inmunodeficiencia primaria o secundaria ? Antecedentes de reacciones alérgicas o anafilácticas intensas a anticuerpos monoclonales humanizados o murinos. ? Antecedentes de infecciones oportunistas importantes ? Antecedente o presencia conocida de infección recurrente o crónica ? Antecedente de malignidad ? Insuficiencia cardíaca congestiva ? Infección bacteriana, viral, fúngica o micobacteriana activa confirmada u otra infección, excluida la infección fúngica de los lechos ungueales
Exclusiones relacionadas con medicamentos ? Recepción de una vacuna de microbios vivos o microbios vivos atenuados en las 6 semanas previas a la visita basal. ? Tratamiento con cualquier fármaco en investigación en las 24 semanas previas a la selección (visita 1) o cinco semividas del medicamento en investigación (lo que sea más largo) o tratamiento con cualquier procedimiento experimental para la EM (p. ej., tratamiento para la insuficiencia venosa cefalorraquídea crónica) ? Intolerancia a los corticosteroides orales o IV o contraindicaciones para recibirlos, según la ficha técnica del país, como: a) Psicosis no controlada todavía con un tratamiento; b) Hipersensibilidad a cualquiera de los componentes ? Administración previa de tratamientos dirigidos a los linfocitos B (es decir, rituximab, ocrelizumab, atacicept, belimumab o ofatumumab) ? Tratamiento con corticosteroides sistémicos en las 4 semanas previas a la selección ? Cualquier tratamiento previo con alemtuzumab (Campath/Mabcampath/Lemtrada), cladribina, mitoxantrona, daclizumab, laquinimod, irradiación corporal total o trasplante de médula ósea. ? Tratamiento con ciclofosfamida, azatioprina, micofenolato mofetilo, ciclosporina o metotrexato ? Tratamiento previo con natalizumab a menos que se haya suspendido por anticuerpos persistentes contra este medicamento ? Tratamiento con inmunoglobulina (Ig) IV en las 12 semanas previas al momento basal ? Tratamiento con TME en investigación
Exclusiones relacionadas con resultados analíticos ? Positividad de la gonadotropina coriónica humana ß (hCG) en suero en la selección ? Positividad de las pruebas de detección de la hepatitis B (positividad del antígeno de superficie de la hepatitis B [HBsAg] o del anticuerpo central de la hepatitis B [HBcAb total] confirmada mediante una reacción en cadena de la polimerasa [PCR]) positiva del ADN viral o hepatitis C (HepCAb) ? Recuento de linfocitos menor que el LIN ? Recuento de CD4 < 250/?l. ? Aspartato aminotransferasa (AST)/ transaminasa glutamicooxaloacética (SGOT) en suero o alanina aminotransferasa (ALT) /transaminasa glutamicopirúvica (SGPT) en suero ? 3,0 × límite superior de la normalidad (LSN) ? Recuento de plaquetas < 100.000/?l (< 100 × 10^9/l) ? Recuento absoluto de neutrófilos < 1,0 × 10^3/?l |
|
E.5 End points |
E.5.1 | Primary end point(s) |
1. Proportion of patients who have no evidence of disease activity (NEDA), as per protocol defined events during a 96-week period |
1. Porcentaje de pacientes sin episodios definidos en el protocolo hasta la semana 96 (es decir, pacientes sin SSAE) |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. Up to 96 weeks |
1. Hasta la semana 96 |
|
E.5.2 | Secondary end point(s) |
1. Proportions of patients free from a protocol-defined event of disease activity during a 24-week period and a 48-week period 2. Time to first protocol-defined event of disease activity 3. Change in EDSS from Baseline to Week 96 4. Proportion of patients who, over a 96-week period, have CDI, CDP or stable disability 5. Annualized rate of protocol-defined relapses at Week 96 6. Time to onset of first protocol-defined relapse 7. Time to onset of 24 weeks CDP 8. Time to onset of first new and/or enlarging T2 lesion 9. Total number of T1 Gd-enhanced lesions detected by brain MRI at Weeks 24, 48 and 96 10. Change in total T2 lesion volume detected by brain MRI from Baseline to Weeks 24, 48 and 96 11. Change in T1 hypointense lesions (volume and number) from Baseline to Weeks 24, 48 and 96 12. Change in brain volume from baseline measured at Weeks 24, 48 and 96 13. Change from Baseline in cognitive performance at Week 48 and Week 96 as measured by the BICAMS 14. Incidence of adverse events 15. Changes in vital signs, physical and neurological examinations, clinical laboratory results, locally reviewed MRI for safety and concomitant medications |
1. Porcentajes de pacientes sin un episodio de actividad de la enfermedad definido en el protocolo durante 24 semanas y 48 semanas 2. Tiempo transcurrido hasta el primer episodio de actividad de la enfermedad definido en el protocolo 3. Variación de la EDSS entre el momento basal y la semana 96 4. Porcentaje de pacientes con mejoría confirmada de la discapacidad (MCD), progresión confirmada de la discapacidad (PCD) o discapacidad estable (es decir, ni MCD ni PCD) durante 96 semanas 5. Tasa anualizada de recidivas definidas en el protocolo en la semana 96 6. Tiempo transcurrido hasta el comienzo de la primera recidiva definida en el protocolo 7. Tiempo transcurrido hasta el comienzo de la PCD a las 24 semanas 8. Tiempo transcurrido hasta el comienzo de la primera lesión en T2 nueva o aumentada de tamaño 9. Número total de lesiones en T1 realzadas con Gd, detectadas mediante RM cerebral en las semanas 24, 48 y 96 10. Variación del volumen total de lesiones en T2 detectadas mediante RM cerebral entre el momento basal y las semanas 24, 48 y 96 11. Variación de las lesiones hipointensas en T1 (volumen y número) entre el momento basal y las semanas 24, 48 y 96 12. Variación del volumen cerebral entre el momento basal y las semanas 24, 48 y 96 13. Variación del rendimiento cognitivo entre el momento basal y las semanas 48 y 96, según la BICAMS (Breve evaluación cognitiva internacional de la esclerosis múltiple) 14. Incidencia de los acontecimientos adversos 15. Variaciones de las constantes vitales, las exploraciones físicas y neurológicas, los resultados de los análisis clínicos, la RM revisada localmente para la seguridad y los fármacos concomitantes. |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. at Weeks 24 and 48 2. Up to 96 weeks 3. Baseline and Week 96 4. Up to 96 weeks 5. at Week 96 6-8. Up to 96 weeks 9. at Weeks 24, 48 and 96 10-12. Baseline, Weeks 24, 48, and 96 13. Baseline, Weeks 48, and 96 14-15. Up to Week 192 |
1. En semanas 24 y 48 2. Hasta 96 semanas 3. Basal y semana 96 4. Hasta 96 semanas 5. En semana 96 6-8. Hasta 96 semanas 9. en semanas 24, 48 y 96 10-12. Basal, semanas 24, 48, y 96 13. Basal, semanas 48, y 96 14-15. Hasta semana 192 |
|
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 | No |
E.6.7 | Pharmacodynamic | No |
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) | 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 | No |
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.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 23 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 220 |
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 |
Czech Republic |
Denmark |
Estonia |
Finland |
France |
Germany |
Greece |
Ireland |
Italy |
Netherlands |
Norway |
Spain |
Sweden |
Switzerland |
Turkey |
United Kingdom |
|
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
|
Last patient last visit in the B-cell monitoring of the Follow-up Period. |
Ultima visita del último paciente en la vigilancia de los linfocitos B del periodo de seguimiento. |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
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 |