E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Relapsing Remitting Multiple Sclerosis (RRMS) |
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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 | 20.0 |
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 | 20.0 |
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 |
Part 1
- To evaluate the safety, tolerability, and descriptive efficacy of BIIB017 in pediatric subjects with RRMS
- To assess the PK of BIIB017 in pediatric subjects with RRMS
The primary objective of Part 2 of the study is to evaluate the long term safety of BIIB017 in subjects who completed the study treatment at Week 96 in Part 1 of the study. |
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E.2.2 | Secondary objectives of the trial |
The secondary objective of Part 2 of the study is to further describe safety and the long-term MS outcomes after BIIB017 treatment in subjects who completed the study treatment at Week 96 in Part 1 of the study. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Part 1
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 confidential health information in accordance with national and local subject privacy regulations. Subjects will provide assent in addition to the parent’s or guardian’s consent, as appropriate, per local regulations.
2. Age 10 to <18 years old at the time of informed consent. The minimum age can be older than 10 years, as required by country-specific regulations and/or local ethics committees.
3. Must have a diagnosis of RRMS as defined by the revised consensus definition for pediatric MS [Krupp 2013; Polman 2011].
4. Must have an EDSS score between 0.0 and 5.5.
5. Must have experienced ≥1 relapse in the 12 months prior to randomization (Day 1) or ≥2 relapses in the 24 months prior to randomization (Day 1) or have evidence of
asymptomatic disease activity (Gd-enhancing lesions) on brain MRI in the 6 months prior to randomization (Day 1). Relapse is defined as the occurrence of a clinical
demyelination event regardless of whether the event is a first (initial) or subsequent (recurrent) demyelinating event.
6. Female subjects of childbearing potential and all male subjects must practice effective contraception during the study and for 3 months after their last dose of study treatment, unless they agree to abstinence. For further details of contraceptive requirements for this
study, see Section 15.5.
Part 2
1. Subjects who completed the study treatment in Part 1 (Week 96 Visit), as per protocol.
2. Sexually active subjects of childbearing potential must continue to practice effective contraception during the study and for 3 months after their last dose of study treatment. |
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E.4 | Principal exclusion criteria |
PART 1
1. Primary progressive, secondary progressive, or progressive relapsing MS .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 subjects by the lack of clinically stable periods or clinical improvement.
2. History of seizure disorder or unexplained blackouts, or history of a seizure within 3 months prior to randomization (Day 1).
3. History of suicidal ideation within 3 months prior to randomization (Day 1) or an episode of severe depression within 3 months prior to randomization (Day 1). Severe depression is defined as an episode of depression that requires hospitalization or is otherwise regarded as severe by the Investigator.
4. Occurrence of an MS relapse that has occurred within 30 days prior to randomization (Day 1) and/or the subject has not stabilized from a previous relapse prior to randomization (Day 1).
5. History of any clinically significant cardiovascular, endocrinologic, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, neurologic (other than MS), dermatologic, psychiatric, renal, or other major disease, as determined by the Investigator that would preclude participation in the study.
6. Abnormal screening blood tests exceeding any of the following defined limits:
a. ALT >2 upper limit of normal (ULN)
b. AST >2 ULN
c. Gamma-glutamyl transferase (GGT) >2 ULN
d. Total bilirubin >1.5 ULN
e. Total WBC count <3700/mm3
• ANC 1500/mm3
f. Platelet count <150,000/mm3
g. Hemoglobin <10 g/dL in female subjects or <11 g/dL in male subjects
h. Serum creatinine >1 ULN
i. Prothrombin time or activated partial thromboplastin time >1.2 ULN
PART 2
1. Any significant changes in medical history occurring after enrollment in Part 1, including laboratory test abnormalities or current clinically significant conditions that, in the opinion of the Investigator, would have excluded the subject’s participation in Part 1.
The Investigator must re-assess the subject’s medical fitness for participation and consider any factors that would preclude treatment.
2. The subject could not tolerate BIIB017 in Part 1.
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E.5 End points |
E.5.1 | Primary end point(s) |
Part 1
- The primary endpoint is the annualized relapse rate (ARR) at Week 96.
Part 2
- The primary endpoint is the safety and tolerability of BIIB017 as assessed by the incidence of AEs, SAEs, and AEs leading to study treatment discontinuation. |
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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) |
PART 1:
The secondary endpoints related to efficacy:
• ARR at Week 48
• Proportion of subjects free of new or newly enlarging T2 hyperintense lesions on brain magnetic resonance imaging (MRI) scans at Weeks 24, 48, and 96
• Proportion of subjects free of new MRI activity in the brain (free of gadolinium [Gd]-enhancing lesions and new or newly enlarging T2 hyperintense lesions) at Weeks 24, 48, and 96
The secondary endpoints related to safety, tolerability, and PK are as follows:
• Incidence of adverse events (AEs), serious adverse events (SAEs), and AEs leading to study treatment discontinuation
• Change over time in growth parameters, including height, weight, and Tanner Score
PART 2
The secondary endpoints are as follows:
• ARR at Weeks 144 and 192
• Change from baseline in EDSS
• Change over time in growth parameters, including height, weight, and Tanner Score
• Immunogenicity as assessed by the development of binding and neutralizing antibodies to IFN β-1a and/or binding antibodies to PEG
• Change from baseline in vital signs, 12-lead ECG parameters, and depression as assessed by MINI-KID
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Part 1 - Week 48
Part 2 - Weeks 144 and 192 |
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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 | 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 | Yes |
E.8.1.1 | Randomised | Yes |
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 | Yes |
E.8.2.3.1 | Comparator description |
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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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 37 |
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 |
Belgium |
Bulgaria |
Croatia |
Czech Republic |
France |
Germany |
Greece |
Hungary |
Israel |
Italy |
Kuwait |
Mexico |
Portugal |
Russian Federation |
Saudi Arabia |
Serbia |
Slovakia |
Spain |
Tunisia |
Turkey |
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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The end of study is last subject, last visit for final collection of data. |
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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 | 10 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | 15 |
E.8.9.2 | In all countries concerned by the trial years | 10 |
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 | 15 |