NCT00241254

Brief Summary

Preliminary not-controlled clinical studies of the efficacy of monthly intravenous cyclophosphamide administration in secondary progressive multiple sclerosis reported encouraging results, but no randomized controlled trial has been conducted so far. The primary objective of this trial is to evaluate the efficacy of IV cyclophosphamide as compared to IV methylprednisolone administered every 4 weeks during 1 year and every 8 weeks during 1 year, on the delay to confirmed disability deterioration as assessed by the Expanded Disability Status Scale (EDSS) in patients with secondary progressive multiple sclerosis. The secondary objectives are to evaluate safety, tolerability and efficacy at 2 years on the Multiple Sclerosis Functional Composite (MSFC), the percentage of patients with disability deterioration (EDSS) and the number of relapses. An intention-to-treat statistical analysis will be carried out.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
138

participants targeted

Target at P25-P50 for phase_3

Timeline
Completed

Started Dec 2005

Longer than P75 for phase_3

Geographic Reach
1 country

26 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 17, 2005

Completed
1 day until next milestone

First Posted

Study publicly available on registry

October 18, 2005

Completed
1 month until next milestone

Study Start

First participant enrolled

December 1, 2005

Completed
4.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2010

Completed
2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2012

Completed
Last Updated

March 15, 2012

Status Verified

March 1, 2012

Enrollment Period

4.2 years

First QC Date

October 17, 2005

Last Update Submit

March 14, 2012

Conditions

Keywords

Multiple Sclerosis, Chronic ProgressiveCyclophosphamideMethylprednisoloneRandomized Controlled TrialsDouble-Blind Study

Outcome Measures

Primary Outcomes (1)

  • Delay to disability deterioration as assessed by the Expanded Disability Status Scale (EDSS: 0.5 or 1 point increase, depending on baseline score)

    every 4 weeks for one year, then every 8 weeks for one year

Secondary Outcomes (6)

  • Proportion of patients with disability deterioration (EDSS: 0.5 or 1 point increase, depending on baseline score)

    every month during one year then every two months during the 2nd year

  • Multiple Sclerosis Functional Composite (MSFC) and the Z scores of MSFC three components

    Visit number 1, 2, 13(at one year),19 (at two years) and 20 (last visit)

  • Number of MS relapses

    all along the follow up period

  • Proportion of patients with adverse events and delay of occurrence of adverse events

    all along the follow up period

  • Quality of life questionnaires

    visit 2, 13(at one year) and 19 (at two years)

  • +1 more secondary outcomes

Study Arms (2)

1

EXPERIMENTAL

Cyclophosphamide

Drug: Cyclophosphamide (drug)

2

ACTIVE COMPARATOR

Methylprednisolone

Drug: Methylprednisolone (drug)

Interventions

IV cyclophosphamide infusion administered every 4 weeks during 1 year and every 8 weeks during 1 year.

1

Control group : IV methylprednisolone infusion administered every 4 weeks during 1 year and every 8 weeks during 1 year.

2

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Multiple sclerosis (MS) subjects (Mc Donald et al criteria),
  • Aged 18 to 65
  • Diagnosis of secondary progressive MS ( Lublin and Reingold criteria)
  • Progressive deterioration phase of at least 6 months and less than 4 years.
  • Reduction of walking capacity and increase EDSS not ascribed to consequence of relapses (at least 0.5 point) in the last 12 months
  • EDSS between 4.0 and 6.5 included
  • Female participating must use contraceptives while on study drug
  • Written informed consent
  • Patient protected by French social security system

You may not qualify if:

  • Others diseases interfering with MS or treatment
  • Recent history (within the previous 2 years) of drug or alcohol abuse.
  • Patients with psychiatric illnesses who are unable to provide written, informed consent prior to any testing under this protocol
  • Hemorrhagic cystitis
  • Pregnant or lactating women
  • Known allergy at cyclophosphamide, corticoids and in particular methylprednisolone
  • Persistent infectious diseases
  • Patients with bladder permanent catheterization
  • Known history of cardiac arrhythmia after methylprednisolone intravenous treatment
  • Abnormal screening/baseline blood tests exceeding any of the limits defined below : Hb \< 9g/dl or Total white blood cell count less than 3 000/mm3 or lymphocytes count less than 900/ mm3 or Platelet count less than 125 000/mm3
  • Gastric or duodenal ulcer in evolution
  • Gut diverticulosis
  • Diabetes mellitus
  • Known history of active hepatitis (ASAT \>3 X ULN)
  • Known history of renal failure (creatinine level \> 180 µmol/L)
  • +7 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (26)

CH de la Cote Basque

Bayonne, 64109, France

Location

CHU Besançon

Besançon, 25030, France

Location

Hôpital Pellegrin, Département de neurologie

Bordeaux, 33076, France

Location

CHU Caen

Caen, 14033, France

Location

Hôpital Gabriel Montpied

Clermont-Ferrand, 63003, France

Location

AP HP Henri Mondor

Créteil, 94010, France

Location

CHU Dijon

Dijon, 21033, France

Location

CHU Lille Hôpital Salengro

Lille, 59037, France

Location

CHU Limoges

Limoges, 87042, France

Location

GHICL Hôpital St. Philibert

Lomme, 59462, France

Location

(CHU Lyon) Hôpital neurologique

Lyon, 69394, France

Location

Hôpital La Timone

Marseille, 13385, France

Location

(CHR Metz-Thionville) Hôpital Notre Dame de Bon Secours

Metz, 57038, France

Location

(CHU Montpellier), Hôpital de Gui de Chauliac

Montpellier, 34295, France

Location

CHU Nancy Hôpital central

Nancy, 54035, France

Location

Hôpital Guillaume et René Laënnec

Nantes, 44093, France

Location

CHU Nice Hôpital Pasteur

Nice, 06002, France

Location

(CHU Nîmes) Hôpital Caremeau

Nîmes, 30029, France

Location

Fondation Rothschild

Paris, 75019, France

Location

(AP HP) Hôpital Tenon

Paris, 75970, France

Location

Centre Hospitalier de Pau

Pau, 64046, France

Location

CHU de POISSY

Poissy, 78300, France

Location

(CHU Reims) Hôpital Robert Debré

Reims, 51092, France

Location

CHU Ponchaillou

Rennes, 35033, France

Location

CH d'Angoulême Girac

Saint-Michel, 16470, France

Location

(CHRU Starsbourg) Hôpital civil

Strasbourg, 67091, France

Location

Related Publications (1)

  • Brochet B, Deloire MS, Perez P, Loock T, Baschet L, Debouverie M, Pittion S, Ouallet JC, Clavelou P, de Seze J, Collongues N, Vermersch P, Zephir H, Castelnovo G, Labauge P, Lebrun C, Cohen M, Ruet A; PROMESS study investigators. Double-Blind Controlled Randomized Trial of Cyclophosphamide versus Methylprednisolone in Secondary Progressive Multiple Sclerosis. PLoS One. 2017 Jan 3;12(1):e0168834. doi: 10.1371/journal.pone.0168834. eCollection 2017.

MeSH Terms

Conditions

Multiple Sclerosis, Chronic Progressive

Interventions

CyclophosphamidePharmaceutical PreparationsMethylprednisolone

Condition Hierarchy (Ancestors)

Multiple SclerosisDemyelinating Autoimmune Diseases, CNSAutoimmune Diseases of the Nervous SystemNervous System DiseasesDemyelinating DiseasesAutoimmune DiseasesImmune System DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Phosphoramide MustardsNitrogen Mustard CompoundsMustard CompoundsHydrocarbons, HalogenatedHydrocarbonsOrganic ChemicalsPhosphoramidesOrganophosphorus CompoundsPrednisolonePregnadienetriolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic Compounds

Study Officials

  • Bruno Brochet, Professor

    University Hospital, Bordeaux, France

    PRINCIPAL INVESTIGATOR
  • Paul Perez, Dr

    University Hospital, Bordeaux, France

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 17, 2005

First Posted

October 18, 2005

Study Start

December 1, 2005

Primary Completion

March 1, 2010

Study Completion

March 1, 2012

Last Updated

March 15, 2012

Record last verified: 2012-03

Locations