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A Multicenter, Observational, Open-Label, Single-Arm Study of Tysabri in Early Relapsing-Remitting Multiple Sclerosis in Anti-JCV Antibody Negative Patients

Description

Multiple studies have demonstrated the positive effect of early therapy on patients who were in the earliest stages of relapsing-remitting multiple sclerosis (RRMS; having 1 clinical event clinically isolated syndrome [CIS] and magnetic resonance images [MRIs] suggestive of MS). These studies involved partially effective medications, all with approximately a 30% reduction in relapse rate.Tysabri is a monoclonal antibody that binds and interferes with the action of 41 integrin which results in reducing certain cells of the immune system transmigration across the blood brain barrier.In the recently presented Tysabri Observational Program (TOP) data, early treatment was most effective in treatment-nave patients and patients with lower Expanded Disability Status Scale (EDSS) scores. Thus, use of an effective agent (Tysabri) in the early stages of MS (when immune cell collections have not yet developed behind the blood-brain barrier [BBB]) may be beneficial, and has not been systematically studied.Study population includes RRMS patients diagnosed with Mc Donald's Criteria, Age 18 to 45 years old, Anti-JCV antibody negative test within 6 months of Screening Visit or negative test for anti-JCV antibody at Baseline Visit.Methodology:This is a Phase 4, single-country, multicenter, open-label, prospective, observational study.The primary objective of the study is to determine which baseline and yearly response factors (clinical and para clinical) predict overall disease-free status at Month 12 and Month 24, and clinical disease-free status in subsequent Months 36 and 48. The response factors include clinical assessments of sustained EDSS progression, relapse status, and MRI measures, and patient reported outcomes (PROs) of cognition, capacity to work, quality of life (QoL), and visual function assessments.In general, continuous variables will be presented with summary statistics (mean, standard deviation, median, range), and categorical variables will be presented with frequency distributions. All analyses will be conducted using 2-sided tests at the type I error rate (alpha level) of 0.05 unless otherwise stated.There will be up to 10 clinic visits included in this protocol. A patients participation in the study will last up to 48 months.

Phase

Phase 4 - refines the treatment to become part of standard care.

Inclusion and Exclusion Criteria

  • Key Inclusion Criteria:
  • 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 patient privacy regulations.
  • Documented diagnosis of Relapsing Multiple Sclerosis (McDonald 2010 Criteria ).
  • <3 year disease duration.
  • Must have an Expanded Disability Status Scale (EDSS) score from 0 to 4.0, inclusive.
  • Anti-JCV antibody negative test at Screening Visit
  • Must satisfy the approved therapeutic indications for Tysabri®.
  • Must be treatment-naïve to disease-modifying therapy (DMT) or have been treated with a single DMT (including Avonex, Betaseron, Rebif, Copaxone, Extavia, or Gilenya) for ≤12 months total prior to date of informed consent.
  • Decision to treat with Tysabri® must precede enrollment. Key Exclusion Criteria:
  • Any prior treatment with Tysabri®.
  • Anti-JCV antibody positive at any timepoint prior to the Screening Visit.
  • Contraindications to treatment with Tysabri® as described in the US Prescribing Information.
  • History of progressive multifocal leukoencephalopathy (PML) or other opportunistic infections, or an increased risk for such infections.
  • History of diagnosis of Primary Progressive Multiple Sclerosis (PPM) and/or Secondary Progressive Multiple Sclerosis (SPMS).
  • Receiving immunomodulatory or immunosuppressive therapy.
  • Prior history of immunosuppressive use (mitoxantrone, azathioprine, methotrexate, cyclophosphamide, mycophenolate, cladribine, rituximab).
  • Immunocompromised at the time of enrollment.
  • Known active malignancies (subjects with cutaneous basal cell carcinoma that has been completely excised prior to study entry remain eligible).
  • Women breastfeeding, pregnant, or planning to become pregnant; women who are not post-menopausal or surgically sterile who are unwilling to practice contraception.
  • Inability to comply with study requirements. NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

Sites

Please contact Jose Aparicio to learn more about where you can participate in this trial. Please use the contact form on the right side.

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