Impact of Annual Versus Biannual Infusions of Ocrelizumab in Patients With Active MS,After 2 Years of Initial Treatment, on Freedom From Radiological Disease Activity at Two Years: a Multicenter Randomized Controlled Non-inferiority Trial: Autoimmune Diseases and Conditions - Multiple Sclerosis - Insurance News | InsuranceNewsNet

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September 5, 2023 Newswires
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Impact of Annual Versus Biannual Infusions of Ocrelizumab in Patients With Active MS,After 2 Years of Initial Treatment, on Freedom From Radiological Disease Activity at Two Years: a Multicenter Randomized Controlled Non-inferiority Trial: Autoimmune Diseases and Conditions – Multiple Sclerosis

Disease Prevention Daily

2023 SEP 05 (NewsRx) -- By a News Reporter-Staff News Editor at Disease Prevention Daily -- Staff editors report on the newly launched clinical trial, NCT05999604, which has the following summary description: “Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system and the leading cause of severe non-traumatic disability in young people, affecting 110,000 people in France. Ocrelizumab, a humanized anti-CD20 monoclonal antibody, has shown remarkable efficacy in Phase III trials on the inflammatory component of the disease, reducing the annualized relapse rate by 46% and the rate of new T2 lesions by 80% compared with interferon-b 1a. The use of anti-CD20 agents, including ocrelizumab, is associated with an infectious risk that increases with duration of exposure, part of which is due to the development of hypo-gammaglobulinemia in relation to cumulative dose. Several reports suggest a persistent effect of anti-CD20 drugs in MS, with no resumption of inflammatory activity after discontinuation: During the development of ocrelizumab, at the end of phase 2, after having received 3 or 4 semi-annual cycles of ocrelizumab, a safety period with a therapeutic window of 18 months was planned, before re-administration in the extension study. During this therapeutic window, the annualized relapse rate remained stable, and patients showed no radiological disease activity. Scandinavian observational studies of “off-label” use of anti-CD20 in MS provide real-life evidence of the absence of recovery of clinical and radiological activity after prolonged interruption of treatment. After 2 years of treatment, and with disease activity under control, spacing administration intervals could reduce the risk of infection without reducing treatment efficacy. This would facilitate the decision to maintain highly active immunotherapy over the long term. In addition, this therapeutic de-escalation, by reducing the frequency of infusions and associated day hospitalizations, would help to reduce treatment management costs. Our aim is to evaluate the non-inferiority of 12-monthly spacing of ocrelizumab infusions versus the conventional 6-monthly regimen, in a population of active MS patients over 18 years of age who have already received 4 or more semi-annual cycles of treatment for 2 years.”

As a matter of record, on August 22, 2023, NewsRx staff editors report that the available information provided by Fondation Ophtalmologique Adolphe de Rothschild on this trial include:

Tracking Information

Trial Identifier NCT05999604
First Submitted Date August 11, 2023
First Posted Date August 21, 2023
Results First Submitted Date Not Provided
Results First Posted Date Not Provided
Last Update Submitted Date August 11, 2023
Last Update Posted Date August 21, 2023
Primary Completion Date October 31, 2027
Start Date October 2023
Current Primary Outcome Measures •Absence of radiological disease activity at 2 years [ Time Frame: Months24 ] -- Percentage of patients with no new or enlarged T2 lesion >3mm on cerebrospinal MRI at 24 months compared with inclusion MRI. MRI readings at inclusion and M24 will be performed by an independent radiologist blinded to the treatment arm.
Current Secondary Outcome Measures Not Provided
Other Outcome Measures Not Provided
Change History Complete list of historical revisions of study NCT05999604

Descriptive Information

Brief Title Impact of Annual Versus Biannual Infusions of Ocrelizumab in Patients With Active MS,After 2 Years of Initial Treatment, on Freedom From Radiological Disease Activity at Two Years: a Multicenter Randomized Controlled Non-inferiority Trial
Official Title Impact of Annual Versus Biannual Infusions of Ocrelizumab in Patients With Active MS,After 2 Years of Initial Treatment, on Freedom From Radiological Disease Activity at Two Years: a Multicenter Randomized Controlled Non-inferiority Trial
Brief Summary Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system and the leading cause of severe non-traumatic disability in young people, affecting 110,000 people in France. Ocrelizumab, a humanized anti-CD20 monoclonal antibody, has shown remarkable efficacy in Phase III trials on the inflammatory component of the disease, reducing the annualized relapse rate by 46% and the rate of new T2 lesions by 80% compared with interferon-b 1a. The use of anti-CD20 agents, including ocrelizumab, is associated with an infectious risk that increases with duration of exposure, part of which is due to the development of hypo-gammaglobulinemia in relation to cumulative dose. Several reports suggest a persistent effect of anti-CD20 drugs in MS, with no resumption of inflammatory activity after discontinuation: During the development of ocrelizumab, at the end of phase 2, after having received 3 or 4 semi-annual cycles of ocrelizumab, a safety period with a therapeutic window of 18 months was planned, before re-administration in the extension study. During this therapeutic window, the annualized relapse rate remained stable, and patients showed no radiological disease activity. Scandinavian observational studies of “off-label” use of anti-CD20 in MS provide real-life evidence of the absence of recovery of clinical and radiological activity after prolonged interruption of treatment. After 2 years of treatment, and with disease activity under control, spacing administration intervals could reduce the risk of infection without reducing treatment efficacy. This would facilitate the decision to maintain highly active immunotherapy over the long term. In addition, this therapeutic de-escalation, by reducing the frequency of infusions and associated day hospitalizations, would help to reduce treatment management costs. Our aim is to evaluate the non-inferiority of 12-monthly spacing of ocrelizumab infusions versus the conventional 6-monthly regimen, in a population of active MS patients over 18 years of age who have already received 4 or more semi-annual cycles of treatment for 2 years.
Detailed Description Not Provided
Study Type Interventional
Study Phase Phase 3
Study Design Allocation: Randomized
Intervention Model: Parallel Assignment
Primary Purpose: Treatment
Masking: Single
Condition Multiple Sclerosis
Intervention •Drug: Ocrelizumab Injection [Ocrevus]
spacinf of the injections from semestrial to annual administration
Study Arms •Experimental: annual ocrelizumab infusions
Interventions:
⚬Drug: Ocrelizumab Injection [Ocrevus]
•Other: semestrial ocrelizumab infusions
Interventions:
⚬Drug: Ocrelizumab Injection [Ocrevus]

Recruitment Information

Recruitment Status Not yet recruiting
Estimated Enrollment 244
Estimated Completion Date October 2027
Primary Completion Date October 31, 2027 (Final data collection date for primary outcome measure)
Eligibility Inclusion Criteria: Patient 18 years of age or older Presenting for a 4th semi-annual cycle of ocrelizumab (minimum) Requires follow-up MRI as part of treatment. Initial indication for ocrelizumab according to the marketing authorization (active MS, RR or SP form) Absence of relapse for at least 18 months (a relapse being defined as the appearance of new symptoms or worsening of existing symptoms, lasting more than 24 hours and outside a period of fever or an infectious episode; notified as a validated relapse by the neurologist in the patient’s file, treated or not with boluses of Solu-Medrol). EDSS between 0 and 6 inclusive Having received informed information about the study and having signed a consent to participate in the study French language proficiency Affiliated or beneficiary of a social insurance scheme Exclusion Criteria: Clinical forms of primary progressive MS Patients already receiving systematically spaced doses of ocrelizumab ≥ 9 months apart Contraindication to continued treatment with ocrelizumab (hypersensitivity reaction, ongoing active infection, development of malignancy since previous injection, development of severe immune deficiency) Planned pregnancy within 3 years Contraindication to MRI Contraindication to injection of contrast media Subject with severe or uncontrolled symptoms of renal, hepatic, hematological, gastrointestinal, pulmonary, psychiatric or cardiac disease, or any uncontrolled intercurrent pathology. Patient under legal protection Patients of childbearing age who do not wish to use effective contraception Pregnant or breast-feeding women
Sex/Gender Sexes Eligible for Study: All
Ages 18 years and older
Accepts Healthy Volunteers No
Contacts Contact information is only displayed when the study is recruiting subjects
Listed Location Countries Not Provided
Removed Location Countries

Administrative Information

NCT Number NCT05999604
Other Study ID Numbers CBR_2022_13
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product Not Provided
Plan to Share Data No
Plan to Share Data (IPD) Description Not Provided
Responsible Party Fondation Ophtalmologique Adolphe de Rothschild
Collaborators Not Provided
Investigators Not Provided
Information Provided By Fondation Ophtalmologique Adolphe de Rothschild
Verification Date August 2023

(Our reports deliver fact-based news of research and discoveries from around the world.)

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