A Study of Ocrelizumab in Participants With Relapsing Remitting Multiple Sclerosis (RRMS) Who Have Had a Suboptimal Response to an Adequate Course of Disease-Modifying Treatment (DMT)
- Registration Number
- NCT02637856
- Lead Sponsor
- Genentech, Inc.
- Brief Summary
This study will evaluate the efficacy and safety of ocrelizumab in participants with RRMS who have had a suboptimal response to an adequate course of DMT. Participants will receive ocrelizumab as an initial dose of two 300-milligrams (mg) intravenous (IV) infusions (600 mg total) separated by 14 days followed by one 600-mg IV infusion for a maximum of 4 doses (up to 96 weeks). Anticipated time on study treatment is 96 weeks.
- Detailed Description
Participants who complete their Week 72 ocrelizumab infusion and do not experience any serious infusion related reaction (IRR) throughout the main study will be eligible to enroll in an optional, open-label, non-randomized substudy to MN30035 and receive one additional shorter infusion of ocrelizumab at the Week 96 visit. This substudy will enroll approximately 100 patients from MN30035 main study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 608
- Diagnosis of multiple sclerosis (specifically RRMS), in accordance with the revised 2010 McDonald criteria
- Disease duration from first symptom of less than or equal to (</=) 12 years
- Treated with an adequate course of treatment with no more than three prior DMT regimens of greater than or equal to (>/=) 6 months, and the discontinuation of the most recent adequately used DMT was due to suboptimal response
- Suboptimal response while the participant was on his/her last adequately used DMT for >/=6 months (defined by having one of the following qualifying events despite being on a stable dose of the same DMT for at least 6 months: one or more clinically reported relapses, one or more T1 Gd-enhanced lesions, or two or more new or enlarging T2 lesions on MRI); these qualifying events must have occurred while on the last adequately used DMT. In participants receiving stable doses of the same approved DMT for more than a year, the event must have occurred within the last 12 months of treatment with this DMT from the date of screening
- History of primary progressive multiple sclerosis (PPMS), progressive relapsing multiple sclerosis (PRMS), or secondary progressive multiple sclerosis (SPMS)
- Contraindications for MRI
- Known presence of other neurological disorders that may mimic multiple sclerosis
- Pregnancy or lactation, or intention to become pregnant during the study
- Requirement for chronic treatment with systemic corticosteroids or immunosuppressants during the course of the study
- History of or currently active primary or secondary immunodeficiency
- Lack of peripheral venous access
- History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies
- Active infection, or history of or known presence of recurrent or chronic infection such as human immunodeficiency virus (HIV), syphilis, or tuberculosis
- History of progressive multifocal leukoencephalopathy
- Contraindications to or intolerance of oral or IV corticosteroids
- Previous treatment with fingolimod (Gilenya®) or dimethyl fumarate (Tecfidera®) in participants whose lymphocyte count is below the lower limit of normal (LLN)
- Treatment with alemtuzumab (Lemtrada®)
- Previous treatment with systemic cyclophosphamide, azathioprine, mycophenolate mofetil, cyclosporine, or methotrexate
- Previous treatment with natalizumab within 12 months prior to screening unless failure was due to confirmed, persistent anti-drug antibodies (ADAs). Participants previously treated with natalizumab will be eligible for this study only if duration of treatment with natalizumab was less than (<) 1 year and natalizumab was not used in the 12 months prior to screening. Anti-John Cunningham virus (JCV) antibody status (positive or negative) and titer (both assessed within the year of screening) must be documented prior to enrollment
- Treatment with dalfampridine (Ampyra®) unless on stable dose for >/=30 days prior to screening
- Treatment with a B-cell targeted therapies (e.g., rituximab, ocrelizumab, atacicept, belimumab, or ofatumumab)
- Treatment with a drug that is experimental (Exception: treatment with an experimental drug that was subsequently approved in the participant's country is allowed)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Ocrelizumab Ocrelizumab Participants will receive ocrelizumab as an initial dose of two 300-mg IV infusions (600 mg total) separated by 14 days (on Days 1 and 15) followed by one 600-mg IV infusion every 24 weeks for a maximum of 4 doses (up to 96 weeks). Ocrelizumab (substudy) Ocrelizumab Participants with no serious IRR throughout the main study will be eligible to enroll in an optional substudy and receive one additional shorter infusion of ocrelizumab at the Week 96 visit. Ocrelizumab will be administered IV as a single 600-mg dose at a shorter infusion rate (approximately 2 hours instead of 3.5 hours)
- Primary Outcome Measures
Name Time Method Percentage of Participants Without Any Protocol-Defined Events During 96-Week Period Baseline up to Week 96 Protocol-defined event is the occurrence of either protocol-defined relapse (occurrence of new or worsening neurological symptoms attributable to multiple sclerosis) or T1 gadolinium (Gd)-enhanced lesion on brain magnetic resonance imaging (MRI) or new and/or enlarging T2 lesion on brain MRI or confirmed disability progression at 24 weeks.
Percentage of Participants With Infusion Related Reactions (IRRs) in Optional Substudy Week 96 to Week 100 Rate and frequency of Grade 3 or 4 IRRs with onset on or after the shorter ocrelizumab infusion
- Secondary Outcome Measures
Name Time Method Percentage of Participants Without Any Protocol-Defined Events During 24-Week and 48-Week Period Baseline up to Weeks 24 and 48 Protocol-defined event is the occurrence of either protocol-defined relapse (occurrence of new or worsening neurological symptoms attributable to multiple sclerosis) or T1 Gd-enhanced lesion on brain MRI or new and/or enlarging T2 lesion on brain MRI or confirmed disability progression at 24 weeks.
Time to Protocol-Defined Event Baseline up to Week 96 Protocol-defined event is the occurrence of either protocol-defined relapse (occurrence of new or worsening neurological symptoms attributable to multiple sclerosis) or T1 Gd-enhanced lesion on brain MRI or new and/or enlarging T2 lesion on brain MRI or confirmed disability progression at 24 weeks.
Time to Onset of First T1 Gd-Enhanced Lesion as Detected by Brain MRI Baseline up to Week 96 Time to Onset of First Protocol-Defined Relapse Baseline up to Week 96 Protocol-defined relapse is an occurrence of new or worsening neurological symptoms attributable to multiple sclerosis which must persist for \>24 hours and should not be attributable to confounding clinical factors (e.g., fever, infection, injury, adverse reactions to medications) and immediately preceded by a stable or improving neurological state for least 30 days.
Total Number of Protocol-Defined Relapses Per Participant Year During 96-week Period Baseline up to Week 96 Protocol-defined relapse is an occurrence of new or worsening neurological symptoms attributable to multiple sclerosis which must persist for greater than (\>) 24 hours and should not be attributable to confounding clinical factors (e.g., fever, infection, injury, adverse reactions to medications) and immediately preceded by a stable or improving neurological state for least 30 days. The Adjusted Annualized Relapse Rate was adjusted by baseline Expanded Disability Status Scale (EDSS \<2.5 vs. \>=2.5) and number of previous disease-modifying treatments (DMTs =1 vs. \>1)
Time to Onset of Confirmed Disability Progression (CDP) for at Least 24 Weeks According to Expanded Disability Status Scale (EDSS) Score Baseline up to Week 96 Total Number of T1 Gd-Enhancing Lesions as Detected by Brain MRI Weeks 24, 48, and 96 The analyses included participants who had an interpretable MRI at the time point of interest. Participants having 0, 1, 2, 3, and greater than 3 lesions at weeks 24, 48, and 96 were included in the analysis.
Time to Onset of First New and/or Enlarging T2 Lesion as Detected by Brain MRI Baseline up to Week 96 Change From Baseline in Total T2 Lesion Volume as Detected by Brain MRI Baseline, Weeks 24, 48, and 96 Baseline data is represented as mean; post-Baseline date are represented as mean changes.
Total Number of New and/or Enlarging T2 Lesions as Detected by Brain MRI Weeks 24, 48, and 96 Percentage of Participants With Adverse Events Baseline up to 100 weeks An adverse event is any untoward medical occurrence in a subject administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.
Trial Locations
- Locations (82)
The Ohio State University Wexner Medical Center; Department of Neurology
🇺🇸Columbus, Ohio, United States
Allegheny Neurological Associates
🇺🇸Pittsburgh, Pennsylvania, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Beth Israel Deaconess Med Ctr; Neurology/MS Center
🇺🇸Boston, Massachusetts, United States
Josephson Wallack Munshower Neurology PC
🇺🇸Indianapolis, Indiana, United States
Cleveland Clinic Lou Ruvo; Center for Brain Research
🇺🇸Las Vegas, Nevada, United States
Swedish Neuroscience Institute
🇺🇸Seattle, Washington, United States
Mercy Medical Group; MS Centre Nurse
🇺🇸Carmichael, California, United States
IMMUNOe Research Centers
🇺🇸Centennial, Colorado, United States
Territory Neurology and Research Institute
🇺🇸Tucson, Arizona, United States
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
🇺🇸Torrance, California, United States
Colorado Neurological Institute
🇺🇸Englewood, Colorado, United States
North Central Neurology Associates
🇺🇸Cullman, Alabama, United States
The Research Center of Southern California, LLC
🇺🇸Carlsbad, California, United States
John Hopkins University School of Medicine
🇺🇸Baltimore, Maryland, United States
MS Clinic Mauricie Bois Francs
🇨🇦Trois Rivieres, Quebec, Canada
University of Miami Miller School of Medicine; Clinical Reseach Building
🇺🇸Miami, Florida, United States
Neurology Associates PA
🇺🇸Maitland, Florida, United States
Consultants in Neurology Ltd
🇺🇸Northbrook, Illinois, United States
American Health Network Institute, LLC
🇺🇸Avon, Indiana, United States
Horizon Health Network - Multiple Sclerosis Clinic
🇨🇦Saint John, New Brunswick, Canada
University of Chicago Hospital
🇺🇸Chicago, Illinois, United States
Columbia University Medical Center
🇺🇸New York, New York, United States
University of Maryland Medical Center; Department of Neurology
🇺🇸Baltimore, Maryland, United States
Ochsner Clinic Foundation
🇺🇸New Orleans, Louisiana, United States
Dragonfly Research, LLC
🇺🇸Wellesley, Massachusetts, United States
Minneapolis Clinic of Neurology
🇺🇸Golden Valley, Minnesota, United States
Recherche Sepmus, Inc.
🇨🇦Greenfield Park, Quebec, Canada
CHU De Quebec Universite Laval
🇨🇦Quebec, Canada
Cleveland Clinic Foundation; Cleveland Clinic Cancer Center/I40
🇺🇸Cleveland, Ohio, United States
Uni of Texas Health Science Center At Houston
🇺🇸Houston, Texas, United States
Hopital Hotel Dieu de Levis
🇨🇦Levis, Quebec, Canada
Island Neurological Associates, P.C.
🇺🇸Plainview, New York, United States
Neurology Clinic PC
🇺🇸Cordova, Tennessee, United States
Neurology Specialists, Inc
🇺🇸Dayton, Ohio, United States
Foothills Medical Centre; Centre Dept of Medical Clinical Neuroscience
🇨🇦Calgary, Alberta, Canada
Chum Campus Notre Dame
🇨🇦Montreal, Quebec, Canada
Rocky Mountain MS Clinic
🇺🇸Salt Lake City, Utah, United States
Neurology Center of San Antonio
🇺🇸San Antonio, Texas, United States
UCSF- Multiple Sclerosis Centre; Department of Neurology
🇺🇸San Francisco, California, United States
Rutgers New Jersey Medical School
🇺🇸Newark, New Jersey, United States
Raleigh Neurology Associates
🇺🇸Raleigh, North Carolina, United States
MultiCare Health System Institute for Research and Innovation
🇺🇸Tacoma, Washington, United States
McGill University; Montreal Neurological Institute; Neurological and Psychiatric
🇨🇦Montreal, Quebec, Canada
Neurostudies Inc
🇺🇸Port Charlotte, Florida, United States
Ms Center Of Atlanta
🇺🇸Atlanta, Georgia, United States
Scripps Health
🇺🇸La Jolla, California, United States
Fullerton Neurology and Headache Center
🇺🇸Fullerton, California, United States
Advanced Neurology of Colorado, LLC
🇺🇸Fort Collins, Colorado, United States
Mountain Neurological Research Center; Roaring Fork Neurologt, P.C.
🇺🇸Basalt, Colorado, United States
KI Health Partners, LLC; New England Institute for Clinical Research
🇺🇸Stamford, Connecticut, United States
Associated Neurologists of Southern CT PC
🇺🇸Fairfield, Connecticut, United States
Hope Neurology
🇺🇸Knoxville, Tennessee, United States
Lahey Clinic Med Ctr
🇺🇸Lexington, Kentucky, United States
UC Health Clinical Trials Office
🇺🇸Cincinnati, Ohio, United States
Infinity Clinical Research, LLC
🇺🇸Sunrise, Florida, United States
Hamilton General Hospital
🇨🇦Hamilton, Ontario, Canada
Associates in Neurology PSC
🇺🇸Lexington, Kentucky, United States
UMASS Memorial Medical Center
🇺🇸Worcester, Massachusetts, United States
University of Kansas Medical Center; Division of Nuclear Medicine
🇺🇸Kansas City, Kansas, United States
Holy Name Hospital; Institute For Clinical Research
🇺🇸Teaneck, New Jersey, United States
The MS Center of Northeastern New York
🇺🇸Latham, New York, United States
Washington University School of Medicine; Department of Neurology
🇺🇸Saint Louis, Missouri, United States
Jacobs Neurological Institute
🇺🇸Buffalo, New York, United States
South Shore Neurologic Associates P.C.
🇺🇸Patchogue, New York, United States
Neurology and Neuroscience Assoc., Inc.
🇺🇸Westerville, Ohio, United States
Fraser Health Multiple Sclerosis Clinic; Burnaby Hospital Pharmacy
🇨🇦Burnaby, British Columbia, Canada
Bhupesh Dihenia M.D. P.A.
🇺🇸Lubbock, Texas, United States
Dalhousie Multiple Sclerosis Research Unit
🇨🇦Halifax, Nova Scotia, Canada
Central Texas Neurology Consultants
🇺🇸Round Rock, Texas, United States
University of Alberta; Divison of Pulmonary Medicine, Dept. of Medicine,
🇨🇦Edmonton, Alberta, Canada
Clinique NeuroOutaouais
🇨🇦Gatineau, Quebec, Canada
St. Michael's Hospital MS Clinic, MS Research Centre
🇨🇦Toronto, Ontario, Canada
The Ottawa Hospital - General Campus; Department of Neurology - Multiple Sclerosis
🇨🇦Ottawa, Ontario, Canada
Phoenix Neurological Associates Ltd
🇺🇸Phoenix, Arizona, United States
Barrow Neurological Institute
🇺🇸Phoenix, Arizona, United States
University of South Florida - Bradenton
🇺🇸Tampa, Florida, United States
Oklahoma Medical Research Foundation
🇺🇸Oklahoma City, Oklahoma, United States
Providence Multiple Sclerosis Center
🇺🇸Portland, Oregon, United States
Axiom Clinical Research of Florida
🇺🇸Tampa, Florida, United States
Community Medical Associates Inc.; d.b.a. Norton Neurology Services MS Services
🇺🇸Louisville, Kentucky, United States
Wayne State University; Department of Neurology
🇺🇸Detroit, Michigan, United States