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Observational Registry of Acthar Gel for Participants With Multiple Sclerosis Relapse

Completed
Conditions
Multiple Sclerosis, Relapsing-Remitting
Registration Number
NCT02633033
Lead Sponsor
Mallinckrodt
Brief Summary

Acthar Gel was first approved by the Food and Drug Administration in 1952.

It has been used to treat many different illnesses, including multiple sclerosis.

This study will observe how treatment with Acthar affected the daily lives of patients who suffer with relapsing/remitting MS.

It will collect information on symptoms, recovery, treatment patterns and safety outcomes.

Detailed Description

Acthar Gel (repository corticotropin injection) contains a non-bovine analogue of adrenocorticotropic hormone (ACTH) for intramuscular or subcutaneous use.

It was initially approved by the FDA in 1952 and is used for multiple indications.

This registry will evaluate the use of Acthar Gel for the treatment of MS exacerbations in the United States.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
160
Inclusion Criteria
  1. Male or Female ≥ 18 years of age.
  2. Patient has a clinically definite relapsing form of Multiple Sclerosis according to McDonald Criteria (2010 revision).
  3. Patient with an acute MS exacerbation as determined by their treating clinician.
  4. Patient planning to initiate Acthar Gel for the treatment of an acute MS exacerbation.
  5. Patient capable of providing informed consent.
Exclusion Criteria
  1. Patients with a diagnosis of Progressive MS.
  2. Patients that require concomitant corticosteroid therapy.
  3. Patients receiving experimental drug therapy.
  4. Patients with a history of scleroderma, systemic fungal infections, ocular herpes simplex within prior 5 years.
  5. Patient has any solid tumor malignancy currently diagnosed or undergoing therapy, or has received therapy for any solid tumor malignancy in the 5 years prior to the Enrollment Visit, with the exception of treated and cured basal cell carcinoma, treated and cured squamous cell carcinoma of the skin, and treated and cured carcinoma in situ of the cervix.
  6. Patients who had recent surgery or have a history of or the presence of a peptic ulcer within 6 months prior to study entry, congestive heart failure, or sensitivity to proteins of porcine origin.
  7. If female, pregnant or breast-feeding; or, if of childbearing age, an unwillingness to use appropriate birth control.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Physical subscale score of the Multiple Sclerosis Impact Scale, v.1 (MSIS-29v1)at 2 months

Participants rate 20 physical symptoms of multiple sclerosis (MS) on a scale from 1=not at all to 5=extremely. The highest possible score is 100. Higher scores mean physical symptoms of MS have a higher impact on day-to-day life.

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Secondary Outcome Measures
NameTimeMethod
Physical subscale score of the MSIS-29v1 within 6 monthswithin 6 months

Participants rate 20 physical symptoms of MS on a scale from 1=not at all to 5=extremely. The highest possible score is 100. Higher scores mean physical symptoms of MS have a higher impact on day-to-day life.

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at 2 weeks, at 1 Month, at 3 Months, at 4 Months, at 5 Months, at 6 Months

Psychological subscale score of the MSIS-29v1 within 6 monthswithin 6 months

Participants rate 9 psychological symptoms of MS on a scale from 1=not at all to 5=extremely. The highest possible score is 45. Higher scores mean psychological symptoms of MS have a higher impact on day-to-day life.

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at 2 weeks, at 1 Month, at 2 months, at 3 Months, at 4 Months, at 5 Months, at 6 Months

Score on the Expanded Disability Status Scale/Functional System Score (EDSS/FSS)within 6 months

Treating clinicians trained in completing the EDSS/FSS (neurologist or other healthcare professional such as a nurse practitioner or physician assistant) complete the EDSS/FSS to evaluate patient neurologic impairment.

The EDSS is based on the standard neurological examination and is used by the clinician in conjunction with the Functional System Score (FSS) to produce a disability score. The FSS is a companion scale that is part of the EDSS

Expanded Disability Status Scale (EDSS) is a well validated 10 point ordinal clinical rating scale with scores ranging from 0 (normal neurological examination) to 10 (death due to MS) in 0.5 point increments. The highest possible score is 100. A higher score means more neurological disability.

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at Baseline, at 2 Months, at 6 Months

Clinical Global Impression of Improvement Scale (CGI-I)within 6 months

Treating clinicians complete the CGI-I. It is a scale that compares the overall condition of the patient to baseline. Scores range from 1 (very much improved) to 7 (very much worse). The highest possible score is 7. Lower scores mean improvement.

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at Baseline, at 2 Months, at 6 Months

Total score of the MSIS-29v1 within 6 monthswithin 6 months

Participants rate 29 psychological symptoms of MS on a scale from 1=not at all to 5=extremely. The highest possible score is 145. Higher scores mean total symptoms of MS have a higher impact on day-to-day life.

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at 2 weeks, at 1 Month, at 2 months, at 3 Months, at 4 Months, at 5 Months, at 6 Months

Number of participants with treatment response based on the MSIS-29v1 physical subscale scorewithin 6 months

Treatment response is defined as an 8-point improvement on the MSIS-29v1 physical subscale score at 2 weeks and 1, 2, 3, 4, 5 and 6 months.

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Number of participants with treatment response based on the EDSSwithin 6 months

Treatment response is defined as a 0.5 point improvement on the EDSS at 2 and 6 months.

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at 2 Months, at 6 Months

Percent of normal work hours missed (absenteeism) due to MS exacerbationwithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at 2 weeks, at 1 Month, at 2 Months, at 3 Months, at 4 Months, at 5 Months, at 6 Months

Number of participants with impairment at work and/or reduced on-the-job effectiveness (presenteeism) due to MS exacerbationwithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at 1 Week, at 2 Weeks, at 3 Weeks, at 4 Weeks, at 6 Weeks, at 2 Months, at 3 Months, at 4 Months, at 5 Months, at 6 Months

Number of participants with overall Impairment at Work (absenteeism + presenteeism) due to MS exacerbationwithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at 1 Week, at 2 Weeks, at 3 Weeks, at 4 Weeks, at 6 Weeks, at 2 Months, at 3 Months, at 4 Months, at 5 Months, at 6 Months

Number of days per month an unpaid caregiver missed work due to the patient's MSwithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Number of participants with Impairment in activities other than work due to MS exacerbationwithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Rows: at 1 Week, at 2 Weeks, at 3 Weeks, at 4 Weeks, at 6 Weeks, at 2 Months, at 3 Months, at 4 Months, at 5 Months, at 6 Months

Number of MS-related emergency department visitswithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Number of MS-related off-site clinical/office visits with a specialist or a general practitionerwithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Number of MS-related healthcare professional visits at homewithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Number of MS-related hospitalizationswithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Number of MS-related MRIswithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Number of days per month of MS-related paid and unpaid caregiver assistancewithin 6 months

For patients having a relapse during the study period, the schedule of assessments restarts at the time of relapse(s).

Trial Locations

Locations (38)

Cordova Research Institute

🇺🇸

Miami, Florida, United States

Colorado Springs Neurological Associates

🇺🇸

Colorado Springs, Colorado, United States

Associated Neurologists of Southern Connecticut

🇺🇸

Fairfield, Connecticut, United States

Neurology Associates of Ormond Beach

🇺🇸

Ormond Beach, Florida, United States

Advanced Neurosciences Research

🇺🇸

Fort Collins, Colorado, United States

Neurology and Stroke Associates

🇺🇸

Lititz, Pennsylvania, United States

Oak Clinic for Multiple Sclerosis

🇺🇸

Uniontown, Ohio, United States

Columbus Research & Wellness Institute

🇺🇸

Columbus, Georgia, United States

Braunstein Neurology

🇺🇸

Mooresville, North Carolina, United States

MedStar Health

🇺🇸

Washington, District of Columbia, United States

Five Towns Neurology

🇺🇸

Woodmere, New York, United States

The Toledo Clinic

🇺🇸

Toledo, Ohio, United States

Neurology of Central Georgia

🇺🇸

Macon, Georgia, United States

Meridian Clinical Research

🇺🇸

Savannah, Georgia, United States

College Park Family Care Center

🇺🇸

Overland Park, Kansas, United States

Optimum Neurology

🇺🇸

Bala-Cynwyd, Pennsylvania, United States

Alpha Neurology

🇺🇸

Staten Island, New York, United States

Irene Greenhouse MD

🇺🇸

Jamison, Pennsylvania, United States

Dominion Neurological Services

🇺🇸

Richmond, Virginia, United States

Alabama Neurology Associates

🇺🇸

Homewood, Alabama, United States

Strotira, Inc.

🇺🇸

New York, New York, United States

D. Gary Kolva, MD, Neurology

🇺🇸

West Reading, Pennsylvania, United States

Neurological Services of Orlando

🇺🇸

Orlando, Florida, United States

Negroski, Sutherland and Hanes Neurology

🇺🇸

Sarasota, Florida, United States

Territory Neurology & Research Institute

🇺🇸

Tucson, Arizona, United States

Neurology Center of New England

🇺🇸

Foxboro, Massachusetts, United States

Emery Neuroscience Center

🇺🇸

Lighthouse Point, Florida, United States

Neurology Associates

🇺🇸

Maitland, Florida, United States

Infinity Clinical Research

🇺🇸

Sunrise, Florida, United States

University System of Maryland

🇺🇸

Baltimore, Maryland, United States

Ogden Clinic

🇺🇸

Ogden, Utah, United States

Colonial Healthcare

🇺🇸

Sumter, South Carolina, United States

Detroit Clinical Research Center

🇺🇸

Farmington Hills, Michigan, United States

CentraState Medical Center

🇺🇸

Freehold, New Jersey, United States

Milford Regional Medical Center

🇺🇸

Hopedale, Massachusetts, United States

International Neurorehabilitation Institute

🇺🇸

Lutherville, Maryland, United States

Collier Neurologic Specialists

🇺🇸

Naples, Florida, United States

Florida Neurological Center

🇺🇸

Ocala, Florida, United States

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