Phase 3
N=106
Natalizumab (BG00002, Tysabri) Study in Japanese Participants With Relapsing-Remitting Multiple Sclerosis (RRMS)
Multiple Sclerosis
Bottom Line
View on ClinicalTrials.gov: NCT01440101 ↗Enrolled (actual)
106
Serious AEs
18.9%
Results posted
Oct 2014
Primary outcome: Primary: Part A: Number of Participants With Adverse Events (AEs) — 8; 4; 1; 3 participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Natalizumab (BG00002) (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Biogen
- Primary completion
- Aug 2012
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Part A: Number of Participants With Adverse Events (AEs) |
8; 4; 1; 3; 2; 1 | — |
| PRIMARY Part B: Rate of Development of New Active Lesions Over 24 Weeks |
0.352; 0.058 | <0.001 sig |
| SECONDARY Part B: Cumulative Number of New Active Lesions Over 24 Weeks |
8.5; 1.5 | — |
| SECONDARY Part B: Adjusted Annualized Relapse Rate Over 24 Weeks |
1.727; 0.532 | — |
| SECONDARY Part B: Cumulative Number of Gd+ Lesions Over 24 Weeks |
7.4; 1.2 | <0.001 sig |
| SECONDARY Part B: Cumulative Number Of New Or Newly Enlarging, Non-Enhancing T2-Hyperintense Lesions Over 24 Weeks |
1.1; 0.3 | 0.006 sig |
| SECONDARY Part B: Number of Participants Who Were Relapse Free Over 24 Weeks |
18; 37; 27; 9; 2; 1 | <0.001 sig |
| SECONDARY Part B: Change From Baseline to Weeks 12 and 24 in the Global Assessment of Well-Being As Assessed by Participants Using a Visual Analog Scale (VAS) |
63.5; 69.6; -4.9; -5.3; -2.9; -4.8 | 0.729 |
| SECONDARY Part A: Concentration of Natalizumab in Serum |
NA; 119.4550; 111.8159; 100.5707; 92.5144; 73.2038 | — |
| SECONDARY Part B: Concentration of Natalizumab in Serum |
NA; 32.6475; 44.4830 | — |
| SECONDARY Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: Cmax |
119.58; 144.36 | — |
| SECONDARY Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: AUC(0-last) and (0-AUC∞) |
31574.6; 46094.8; 43172.6 | — |
| SECONDARY Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: Tmax and T1/2 |
1.49; 2.27; 344.9; 381.2 | — |
| SECONDARY Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: Vd |
3.422; 3.561 | — |
| SECONDARY Part A: Pharmacokinetic (PK) Profile of Natalizumab in Serum: CL |
6.9497 | — |
| SECONDARY Part B: Status of Serum Antibodies to Natalizumab |
47; 45; 0; 2; 0; 1 | — |
| SECONDARY Part B: Number of Participants With Adverse Events (AEs) |
41; 34; 30; 14; 5; 0 | — |
| SECONDARY Part A: Natalizumab Binding Saturation Of α4 Integrin Sites On Peripheral Blood Mononuclear Cells (PBMC) |
6.282; 88.371; 85.491; 77.929; 71.362; 69.742 | — |
| SECONDARY Part A: Summary of Lymphocyte Counts Over Time |
1708.3; 1775.0; 3016.7; 3018.2; 3340.0; 1550.0 | — |
Summary
The primary objective of Part A is to determine the safety and tolerability of natalizumab administered over 24 weeks in Japanese participants with relapsing-remitting multiple sclerosis (MS). The endpoints for this will include assessment of adverse evetns (AEs), changes in laboratory evaluations, vital signs, Expanded Disability Status Scale (EDSS) scores, and changes in physical and neurological examination findings. The secondary objectives of Part A are to characterize the pharmacokinetics (PK) profile and pharmacodynamics (PD) of natalizumab.
The primary objective of Part B is to determine if natalizumab, when compared to placebo, is effective in treating Japanese participants with relapsing-remitting MS, as measured by new active lesions on cranial magnetic resonance imaging (MRI) scans over 24 weeks. New active lesions are the sum of the gadolinium-enhancing (Gd+) lesions and any new or newly-enlarging T2-hyperintense lesions that do not enhance. The primary endpoint is the rate of development of new active lesions over 24 weeks.
Secondary objectives of Part B are to determine over 24 weeks whether natalizumab, when compared to placebo, is effective in reducing the frequency of clinical exacerbations, reducing the number of Gd+ lesions, reducing the number of new or newly-enlarging T2-hyperintense lesions on brain MRI scans, increasing the proportion of relapse-free participants, and improving outcomes on visual analog scale (VAS) assessing the participant's global impression of his/her well-being. Additional objectives are to assess the safety and tolerability, the incidence of serum antibodies to natalizumab and the PK profile of natalizumab.
Eligibility Criteria
Part A
Key Inclusion Criteria
- Must give written informed consent and any authorizations required by local law.
- Must have a diagnosis of relapsing-remitting MS, as defined by the revised McDonald criteria 1 through 4 (Polman et al, 2005). All other possible neurologic diagnoses must have been reasonably excluded by means of laboratory and/or imaging studies, in the opinion of the Investigator.
- Japanese men and women aged 18 to 65, inclusive, at the time of informed consent.
- All male subjects and female subjects of childbearing potential must practice effective contraception during the study and be able to continue contraception for 12 weeks after their last dose of study treatment.
- Must have an Expanded Disability Status Scale (EDSS) score between 0.0 and 6.0, inclusive.
- Must have experienced at least 1 medically documented clinical exacerbation within 12 months of enrollment.
- Must be willing to remain free from concomitant immunosuppressive or immunomodulatory treatment (including interferon beta [IFNβ] and chronic systemic corticosteroids) for the duration of the study.
- Must have a baseline MRI, conducted within 35 calendar days prior to enrollment.
Key Exclusion Criteria
- Diagnosis or history of neuromyelitis optica (NMO), e.g., a long spinal lesion extending over 3 or more vertebral bodies was detected, or the subject has a history of positive tests for anti-aquaporin-4 (anti-AQP4) antibodies.
- The subject is considered by the Investigator to be immunocompromised, based on medical history, physical examination, laboratory testing, or prior immunosuppressive or immunomodulating treatment.
- An MS exacerbation (relapse) within 30 days prior to enrollment or, in the opinion of the Investigator, the subject has not stabilized from a relapse prior to enrollment at Week 0.
- History of malignancy.
- Known history of, or positive test result for human immunodeficiency virus (HIV) infection.
- Known history of or positive test result for hepatitis C virus or hepatitis B virus within the year prior to enrollment.
- History of severe allergic or anaphylactic reactions or known drug hypersensitivity.
- A clinically significant infectious illness within 30 days prior to enrollment.
- Abnormal liver function test results at screening: alanine aminotransferase (ALT), or aspartate aminotransferase (AST) >2 times of the upper limit of normal (ULN) or bilirubin >1.5 times of the ULN during screening.
- Previous treatment with natalizumab, any murine protein, or any other therapeutic monoclonal antibody.
- Any prior treatment with any of the following medications: total lymphoid irradiation, cladribine, T-cell or T-cell receptor vaccination.
- Treatment with immunosuppressant medications, e.g., azathioprine, cyclophosphamide, methotrexate, and fingolimod within 6 months prior to enrollment, or mitoxantrone and cyclosporine within 12 months prior to enrollment.
- Treatment with any of the following medications or procedures within 6 months prior to enrollment: intravenous immunoglobulin (IVIg), plasmapheresis, or cytapheresis.
- Treatment with immunomodulatory medications (including IFNβ and glatiramer acetate [GA]) within 2 weeks of enrollment.
- Treatment with any of the following medications within 30 days of enrollment: intravenous corticosteroid treatment, systemic corticosteroid treatment, 4-aminopyridine or related products.
- Participation in any other investigational treatment within the 6 months prior to enrollment or concurrent with this study.
Part B
Key Inclusion Criteria
- Must give written informed consent and any authorizations required by local law.
- Must have a diagnosis of relapsing-remitting MS, as defined by the revised McDonald criteria 1 through 4 (Polman et al, 2005). All other possible neurologic diagnoses must have been reasonably excluded by means of laboratory and/or imaging studies, in the opinion of the Investigator.
- Japanese men and women aged 18 to 65, inclusive, at the time of in
Data sourced from ClinicalTrials.gov (NCT01440101). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.