Atacicept in Multiple Sclerosis Extension Study, Phase II

NCT00853762 | Terminated Phase 2 Results DMC

• 1 other identifier: 28851
• Study Type: interventional
• Target: 74
• Locations: 17 countries
• Sites: 47

Brief Summary

This study (28851) is a long-term follow-up study of subjects enrolled in ATAMS study 28063 (NCT00642902). The aim of this study is to monitor the safety and tolerability of atacicept administered for up to 5 years to subjects with relapsing multiple sclerosis (RMS). This extension study consists of two parts. Part A will be double blind and Part B will be open label. During Part A, subjects initially randomized to atacicept will continue to receive the atacicept dose to which they have been randomized in study 28063 (ATAMS) once a week subcutaneously (under the skin). Subjects randomized to placebo in ATAMS will receive atacicept at 150 mg once a week subcutaneously during Part A. Once the results of ATAMS are available and the atacicept dose with the best benefit / risk ratio has been identified, all subjects will be switched to this dose and will continue the extension study open-label (Part B). Throughout the study, subjects and investigators will remain blinded with respect to initial and part A treatment allocation/dose.

Conditions

Relapsing Multiple Sclerosis

Outcome Measures

Primary Outcomes (7)

• Number of Subjects With Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, Injection Site Reactions, Infections, and Malignancies by Severity

  TEAEs were defined as AEs with a start date after or on the date of the first DB treatment injection in ATAMS Extension and that occurred anytime after treatment discontinuation, or up to the day before first Rebif® rescue medication injection in ATAMS Extension. A serious TEAE was an AE that resulted in any of the following: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect. TEAE severity was graded as per Qualitative Toxicity Scale. Local injection site reactions (injection site: pain, redness, itching and swelling) throughout ATAMS Extension, starting after the first trial medication administration. If the subject experienced 1 or more of the above injection site symptoms, these were reported with the AE verbatim term "injection site reaction". For all randomized subjects, there was an option of rescue treatment with Rebif® for 1 year beginning with the first injection of Rebif®).

  From the first dose of study drug administration up to Week 24

• Change From Baseline in Vital Signs: Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP)

  Blood pressure (systolic and diastolic) was measured after at least 3 minutes resting, with the subject in the seated position.

  Baseline, Week 2, 4, 8, 12, 16, 20, 24 and 36

• Change From Baseline in Vital Signs: Pulse Rate

  Baseline, Week 2, 4, 8, 12, 16, 20, 24 and 36

• Change From Baseline in Vital Signs: Temperature

  Baseline, Week 2, 4, 8, 12, 16, 20, 24 and 36

• Change From Baseline in Electrocardiogram (ECGs)

  Baseline, Week 12 and 36

• Number of Subjects With Worsened Post Baseline Shift in Immunoglobulin A (IgA), IgG and IgM Levels

  Number of subjects with shifts from normal Grade (Grade 0) at Baseline to worse value at post-baseline (Grade 1 to Grade 4) according to the following criteria: IgA Grade 0: greater than or equal to (\>=) lower limit normal (LLN) 0.7 gram per liter (g/L); Grade 1: less than (\<) LLN - 0.5 g/L, Grade 2: \<0.5g/L -0.3 g/L, Grade 3: \<0.3 g/L -0.1 g/L, Grade 4: \< 0.1 g/L; IgG Grade 0: \>= LLN (7 g/L), Grade 1: \< LLN - 5 g/L, Grade 2: \<5g/L -4 g/L, Grade 3: \<4 g/L -3 g/L and Grade 4: \< 3 g/L; IgM Grade 0: \>= LLN (0.4 g/L), Grade 1: \< LLN - 0.3 g/L, Grade 2: \<0.3 g/L -0.2 g/L, Grade 3: \<0.2 g/L -0.1 g/L, and Grade 4: \< 0.1 g/L are presented in this outcome measure.

  Baseline up to Week 36

• Number of Subjects With Positive Neutralizing Antibody (NAb)

  Baseline, Week 12 and 36

Secondary Outcomes (8)

• Number of Subjects With Clinical Attacks/Relapses

  Baseline up to Week 24

• Change From Baseline in Expanded Disability Status Scale (EDSS) Scores at Week 12

  Baseline, Week 12

• Change in Multiple Sclerosis Functional Composite (MSFC) Score at Week 12

  Week 12

• Magnetic Resonance Imaging (MRI) Parameters: Number of T1 Gadolinium (Gd)-Enhancing Lesions Per Subject

  Baseline, Week 12 and 24

• Magnetic Resonance Imaging (MRI) Parameters: Volume of T2 Lesions (New or Enlarging T2 Lesions) Per Subject

  Baseline, Week 12 and Week 24

Study Arms (4)

Atacicept 25 mg (With Loading)

EXPERIMENTAL

Drug: Atacicept 25 mg

Atacicept 75 mg (With Loading)

EXPERIMENTAL

Drug: Atacicept 75 mg

Atacicept 150 mg (With Loading)

EXPERIMENTAL

Drug: Atacicept 150 mg

Atacicept 150 mg (Without Loading)

EXPERIMENTAL

Drug: Atacicept 150 mg

Interventions

Atacicept 25 mg DRUG

Subjects who received atacicept 25 milligram (mg) subcutaneously (SC) as loading dose twice weekly for first 4 weeks, followed by atacicept 25 mg SC for 32 weeks, in 28063 study will continue with atacicept 25 mg SC once weekly up to 5 years or up to early termination of treatment or early termination of the study.

Atacicept 25 mg (With Loading)

Atacicept 75 mg DRUG

Subjects who received atacicept 75 mg SC as loading dose twice weekly for first 4 weeks, followed by atacicept 75 mg SC for 32 weeks, in 28063 study will continued with atacicept 75 mg SC once weekly up to 5 years or up to early termination of treatment or early termination of the study.

Atacicept 75 mg (With Loading)

Atacicept 150 mg DRUG

Subjects who received atacicept 150 mg SC as loading dose twice weekly for first 4 weeks, followed by atacicept 150 mg SC for 32 weeks, in 28063 study will continue with atacicept 150 mg SC once weekly up to 5 years or up to early termination of treatment or early termination of the study.

Atacicept 150 mg (With Loading)

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participation in study 28063.
• Completion of Week 36 visit of the core study 28063.
• Willingness and ability to comply with study procedures for the duration of the study.
• Voluntary provision of written informed consent (including, for the USA, subject authorization under the Health Insurance Portability and Accountability Act (HIPAA)), given before any study-related procedure that is not part of normal medical care and with the understanding that the subject may withdraw consent at any time without prejudice to his or her future medical care.

You may not qualify if:

• Premature discontinuation of core study 28063.
• Subjects who meet criteria listed below will receive IMP in study 28851:
• Subjects who are eligible for participation in extension study 28851 but do not meet these criteria will not be treated with IMP but will undergo scheduled visits, irrespective of their treatment.
• All subjects must satisfy the following criteria before Extension Study Day 1 (D1-EXT; defined as the first day of dosing in the extension study) to be eligible for treatment with IMP:
• Eligibility for participation in extension study 28851.
• For women of childbearing potential, a negative urine pregnancy test at eligibility assessment.
• Female subjects of childbearing potential must be willing to avoid pregnancy by using an adequate method of contraception for four (4) weeks before the first dose administered within the extension study, during the study and for twelve (12) weeks after the last dose of trial medication. Adequate contraception is defined as two barrier methods, or one barrier method with spermicide, or an intrauterine device, or use of a combined oral female hormonal contraceptive (or the definitions requested by health authorities and locally amended in the core study 28063). For the purposes of this trial, women of childbearing potential are defined as: "All female subjects after puberty unless they are post-menopausal for at least two years or are surgically sterile" (For Germany Only: Female subjects of childbearing potential must be willing to avoid pregnancy by using highly effective methods of contraception for approximately four (4) weeks prior to D1-EXT, during and for twelve (12) weeks after the last dose of trial medication. This requirement does not apply to surgically sterile subjects or to subjects who are postmenopausal for at least 2 years. Highly effective contraception is defined as any method or combination of methods which result in a low failure rate (i.e. less than (\<) 1% per year) when used consistently and correctly, such as implants, injectables, combined oral contraceptives, sexual abstinence, vasectomized partner, 2 barrier methods, or 1 barrier method with spermicide)
• Willingness and ability to comply with study procedures for the duration of the study.
• To be eligible for treatment with investigational medicinal product (IMP) in study 28851, the subjects must not meet any of the following criteria:
• Non-eligibility for participation in extension study 28851 (premature discontinuation of core study 28063).
• Major protocol violation or non-compliance in the core study.
• Use of prohibited immunomodulatory / immunosuppressive therapies
• Serum immunoglobulin G (IgG) level \<3 gram per liter (g/L) if the subject received atacicept in the core study, or serum IgG level \<6 g/L if the subject received placebo in the core study (to protect the blinding of the core study, the IgG level will be communicated to the treating physician only if it is too low for extension study participation and only after all Week 36 assessments performed within the core study have been completed).
• Any condition, including laboratory findings that, in the opinion of the Investigator, constitutes a risk or a contraindication for participation in the extension study, or that could interfere with the study objectives, conduct or evaluation.
• Known active clinically significant acute or chronic infection, or any major episode of infection requiring hospitalization or treatment with parenteral anti-infectives.

Sponsors & Collaborators

• EMD Serono: lead
• Merck KGaA, Darmstadt, Germany: collaborator

Study Sites (47)

Research Site

Phoenix, Arizona, United States

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Northbrook, Illinois, United States

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East Lansing, Michigan, United States

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Cleveland, Ohio, United States

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Philadelphia, Pennsylvania, United States

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Nashville, Tennessee, United States

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Box Hill VIC, Australia

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Fitzroy, Australia

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New Lambton, Australia

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Woodville, Australia

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Diepenbeek, Belgium

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Sijsele, Belgium

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Calgary, Alberta, Canada

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Ottawa, Ontario, Canada

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Brno, Czechia

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Hradec Králové, Czechia

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Caen, France

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Saint-Herblain, France

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Bochum, Germany

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Düsseldorf, Germany

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Beirut, Lebanon

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Kaunas, Lithuania

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Breda, Netherlands

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Nieuwegein, Netherlands

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Rotterdam, Netherlands

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Winston Salem, New Caledonia

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Moscow, Russia

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Novosibirsk, Russia

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Saint Petersburg, Russia

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Samara, Russia

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Vladimir, Russia

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Yaroslavl, Russia

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Yekaterinburg, Russia

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Barcelona, Spain

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Madrid, Spain

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Málaga, Spain

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Stockholm, Sweden

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Basel, Switzerland

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Innsbruck, Switzerland

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Zurich, Switzerland

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Kharkiv, Ukraine

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Kyiv, Ukraine

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Odesa, Ukraine

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Uzhhorod, Ukraine

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London, United Kingdom

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Sheffield, United Kingdom

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Stoke-on-Trent, United Kingdom

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Related Publications (1)

• Kappos L, Hartung HP, Freedman MS, Boyko A, Radu EW, Mikol DD, Lamarine M, Hyvert Y, Freudensprung U, Plitz T, van Beek J; ATAMS Study Group. Atacicept in multiple sclerosis (ATAMS): a randomised, placebo-controlled, double-blind, phase 2 trial. Lancet Neurol. 2014 Apr;13(4):353-63. doi: 10.1016/S1474-4422(14)70028-6. Epub 2014 Mar 6.

  PMID: 24613349 DERIVED

MeSH Terms

Interventions

TACI receptor-IgG Fc fragment fusion protein

Limitations and Caveats

Sponsor voluntarily decided to terminate this trial after observing increased MS disease activity in trial 28063 ATAMS.

Results Point of Contact

• Title: Merck KGaA Communication Center
• Organization: Merck Serono, a division of Merck KGaA

service@merckgroup.com

+49-6151-72-5200

Study Officials

• Daniel Mikol, MD, PhD

  EMD Serono

  STUDY DIRECTOR

Publication Agreements

• PI is Sponsor Employee: No
• Restriction Type: OTHER
• Restrictive Agreement: Yes

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 26, 2009
• First Posted: March 2, 2009
• Study Start: March 1, 2009
• Primary Completion: September 1, 2009
• Study Completion: February 1, 2011
• Last Updated: March 20, 2017
• Results First Posted: May 24, 2016

Record last verified: 2017-02

Locations

GB (3); ES (3); FR (2); NL (3); DE (2); NE (1); SE (1); UA (4); CA (2); CZ (2); RU (7); AU (4); LE (1); US (6); LI (1); BE (2); CH (3)