Phase 3
Completed N=200
Safety of Switching From Rituximab to Ocrelizumab in MS Patients
Source: ClinicalTrials.gov NCT02980042 ↗Enrolled (actual)
200
Serious AEs
4.0%
Results posted
Jan 2020
Primary outcomePrimary: Proportion of Infusions With >= 1 IRR Between the Switching and Comparator Groups — 10; 14 percentage of infusions with IRRs — p=0.1996
◆ Published Evidence
No publication linked
No peer-reviewed publication reporting this trial's results has been linked yet. This can indicate results are unpublished — a known publication-bias signal. We re-check periodically.
Summary
This is a prospective between and within group observational study to determine differences in tolerability, immunogenicity and safety related outcomes for 100 multiple sclerosis (MS) patients who have been administered at least two infusions of rituximab, six months apart and are willing to be switched to ocrelizumab compared to a 100 patients who are continuing on rituximab as a comparison cohort from the clinic population treated as part of clinical care.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Proportion of Infusions With >= 1 IRR Between the Switching and Comparator Groups |
10; 14 | 0.1996 |
| PRIMARY Difference in the Total Number of IRRs After Each Infusion of Ocrelizumab Compared to Rituximab Infusions in the Comparator Group. |
28; 14; 4; 12 | 1.0000 |
| PRIMARY Severity of IRRs Following the Day 1 Infusion of Ocrelizumab in the Switching and the Comparator Groups Infusions |
86; 172; 8; 3; 6; 25 | — |
| PRIMARY Severity of IRRs Following the Day 15 Infusion of Ocrelizumab in the Switching and the Comparator Groups Infusions |
96; 172; 0; 3; 4; 25 | — |
| PRIMARY Severity of IRRs Following the Week 24 Infusion of Ocrelizumab in the Switching and the Comparator Groups Infusions |
88; 172; 9; 3; 3; 25 | — |
| PRIMARY Proportion of Patients With an IRR at Day 1 Versus Day 15 and Week 24 Infusions |
14; 4; 12 | 0.0075 sig |
| SECONDARY Presence of Ocrelizumab Anti-drug Anti-bodies |
1.00; 1.00 | — |
| SECONDARY Presence of Rituximab Anti-drug Anti-bodies |
16.00; 7.00 | — |
| SECONDARY B Cell Depletion (CD19) |
57.14; 92.00; 90.32 | — |
| SECONDARY B Cell Depletion (CD20) |
56.70; 92.00; 88.64 | — |
| SECONDARY Cytokine: Eotaxin - Pre-Post Infusion - Day 1 |
117.44; 101.41 | 0.005 sig |
| SECONDARY Cytokine: IFN-gamma - Pre-Post Infusion - Day 1 |
2.03; 4.58 | <0.0001 sig |
| SECONDARY Cytokine: IL-10 - Pre-Post Infusion - Day 1 |
0.18; 8.75 | <0.0001 sig |
| SECONDARY Cytokine: IL-12/IL-23p40 - Pre-Post Infusion - Day 1 |
59.79; 52.42 | <0.0001 sig |
| SECONDARY Cytokine: IL-16 - Pre-Post Infusion - Day 1 |
85.48; 129.80 | <0.0001 sig |
| SECONDARY Cytokine: IL-1RA - Pre-Post Infusion - Day 1 |
196.71; 550.06 | 0.0002 sig |
| SECONDARY Cytokine: IL-27 - Pre-Post Infusion - Day 1 |
643.32; 820.23 | <0.0001 sig |
| SECONDARY Cytokine: IL-6 - Pre-Post Infusion - Day 1 |
0.29; 0.49 | 0.0020 sig |
| SECONDARY Cytokine: IL-7 - Pre-Post Infusion - Day 1 |
0.84; 1.38 | <0.0001 sig |
| SECONDARY Cytokine: IL-8(HA) - Pre-Post Infusion - Day 1 |
306.89; 260.73 | 0.0091 sig |
| SECONDARY Cytokine: MCP-1 - Pre-Post Infusion - Day 1 |
34.83; 90.09 | 0.0002 sig |
| SECONDARY Cytokine: MDC - Pre-Post Infusion - Day 1 |
468.96; 451.72 | 0.0044 sig |
| SECONDARY Cytokine: MIP-1alpha - Pre-Post Infusion - Day 1 |
29.50; 45.52 | <0.0001 sig |
| SECONDARY Cytokine: MIP-1beta - Pre-Post Infusion - Day 1 |
24.27; 453.35 | <0.0001 sig |
| SECONDARY Cytokine: MIP-3alpha - Pre-Post Infusion - Day 1 |
3.90; 5.13 | 0.0101 sig |
| SECONDARY Cytokine: TARC - Pre-Post Infusion - Day 1 |
24.02; 32.72 | <0.0001 sig |
| SECONDARY Cytokine: TNF-alpha - Pre-Post Infusion - Day 1 |
0.99; 2.53 | <0.0001 sig |
| SECONDARY Cytokine: Exotaxin - Pre-Post Infusion - Day 15 |
128.38; 95.79 | <0.0001 sig |
| SECONDARY Cytokine: IFN-gamma - Pre-Post Infusion - Day 15 |
2.02; 1.40 | 0.0008 sig |
| SECONDARY Cytokine: IL-10 - Pre-Post Infusion - Day 15 |
0.12; 2.12 | <0.0001 sig |
| SECONDARY Cytokine: IL-12/IL-23p40 - Pre-Post Infusion - Day 15 |
49.36; 41.31 | <0.0001 sig |
| SECONDARY Cytokine: IL-16 - Pre-Post Infusion - Day 15 |
90.35; 76.62 | 0.0022 sig |
| SECONDARY Cytokine: IL-1beta - Pre-Post Infusion - Day 15 |
0.65; 0.95 | <0.0001 sig |
| SECONDARY Cytokine: IL-7 - Pre-Post Infusion - Day 15 |
0.88; 1.29 | <0.0001 sig |
| SECONDARY Cytokine: IL-8 - Pre-Post Infusion - Day 15 |
1.82; 1.09 | <0.0001 sig |
| SECONDARY Cytokine: MCP-1 - Pre-Post Infusion - Day 15 |
35.57; 16.33 | <0.0001 sig |
| SECONDARY Cytokine: MCP-4 - Pre-Post Infusion - Day 15 |
37.38; 30.38 | <0.0001 sig |
| SECONDARY Cytokine: MDC - Pre-Post Infusion - Day 15 |
458.13; 435.00 | 0.0061 sig |
| SECONDARY Cytokine: MIP-1beta - Pre-Post Infusion - Day 15 |
23.09; 17.23 | <0.0001 sig |
| SECONDARY Cytokine: MIP-3alpha - Pre-Post Infusion - Day 15 |
4.15; 3.31 | 0.0077 sig |
| SECONDARY Cytokine: TNF-alpha - Pre-Post Infusion - Day 15 |
1.14; 0.81 | <0.0001 sig |
Eligibility Criteria
Inclusion Criteria
Switching group:
- Current active patient of RMMSC
- 18-65 years
- Diagnosis of relapsing forms of MS
- Completed ≥ two doses of rituximab with the last dose having been administered:
- Within 12 months of screening and
- At least 6 months prior to the first planned infusion of study drug
- Are receiving their current infusions of rituximab at the University of Colorado Outpatient Infusion Center
- Have discussed the possibility of switching to ocrelizumab with their MS provider
- Screened for Hepatitis B and C and TB within 2 years of first dose of ocrelizumab
- A negative serum pregnancy test must be available for premenopausal women and for women <12 months after the onset of menopause, unless they have undergone surgical sterilization.
- Women of childbearing potential must agree to use a "highly effective", hormonal form of contraception or two "effective" forms of non-hormonal contraception. Contraception must continue for the duration of study treatment and for at least three months after the last dose of study treatment
- Are able to complete patient reported outcomes developed as English written scales.
- Must be able and willing to give meaningful, written informed consent prior to participation in the trial, in accordance with local regulatory requirements
Comparator group:
- Current active patient of RMMSC
- 18-65 years
- Diagnosis of relapsing forms of MS
- Completed ≥ two doses of rituximab with the last dose having been administered within 12 months of screening as standard of care
- Are receiving their current infusions of rituximab as standard of care at the University of Colorado Outpatient Infusion Center and will continue to do so
- Are willing to be followed for up to two additional rituximab infusions during the study period as standard of care
- Must be able and willing to give meaningful, written informed consent prior to participation in the trial, in accordance with local regulatory requirements
Exclusion Criteria
Both groups:
- Pregnant or lactating women
- Hypersensitivity to trial medications
- Hepatic Dysfunction (liver enzymes are 5 times greater than normal)
- History of Congestive Heart Failure
- Any history of a positive blood assay for Hepatitis B or C
- Any history of TB or a positive Quantiferon Gold Assay
- Concurrent use of immunosuppressant medications
- Any history of immunodeficiency or other medical condition increasing risk of anti-CD 20 therapy.
- No serious infection at the time of a scheduled study infusion.
- Any medical, psychiatric or other condition that could result in the patient not being able to give fully informed consent, or to comply with the protocol requirements as determined by the investigator
Data sourced from ClinicalTrials.gov (NCT02980042). 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. Informational only — not medical advice.