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Safety and Efficacy of Fingolimod in Pediatric Patients With Multiple Sclerosis

Phase 3
Active, not recruiting
Conditions
Multiple Sclerosis
Interventions
Drug: Placebo capsule
Drug: Placebo i.m. injection
Registration Number
NCT01892722
Lead Sponsor
Novartis Pharmaceuticals
Brief Summary

To evaluate the safety and efficacy of fingolimod vs. interferon beta-1a i.m. in pediatric patients with multiple sclerosis (MS)

Detailed Description

The study is divided into a Core Phase, which includes the Double-Blind Treatment Period, and an Extension Phase in which all patients will be treated with fingolimod. The Core Phase is a 24-month, double-blind, randomized, active-controlled, parallel-group multicenter study phase to evaluate the efficacy and safety of fingolimod compared to IFN β-1a in children/adolescent patients aged 10-17 years old with MS. The Extension Phase is a 60-month (5 year) study phase for patients who complete the Core Phase of the study and meet all inclusion/exclusion criteria and for patients who will be recruited in the younger cohort to participate in the Extension Phase. The 'younger cohort' refers to the population of pediatric patients fulfilling any single one or a combination of the following criteria: being ≤12 years of age, or weighing ≤40 kg, or being prepubertal (i.e. pubertal status of Tanner stage \<2). The recruitment of the younger cohort (up to 25 patients) was requested as a post- approval health authority commitment

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
240
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
FingolimodFingolimodFingolimod was administered orally once daily at a dose of either 0.5 mg or 0.25 mg (depending on patient's body weight) with the aim to achieve systemic exposure in range of that in adults at the licensed 0.5 mg dose. Participants in this arm during core continued into extension and received open-label treatment
FingolimodPlacebo capsuleFingolimod was administered orally once daily at a dose of either 0.5 mg or 0.25 mg (depending on patient's body weight) with the aim to achieve systemic exposure in range of that in adults at the licensed 0.5 mg dose. Participants in this arm during core continued into extension and received open-label treatment
Interferon beta-1aInterferon beta-1aAn intramuscular (IM) injection of Interferon beta-1a was administered once weekly during core phase. Participants switched to receive open-label fingolimod in extension phase
Interferon beta-1aPlacebo i.m. injectionAn intramuscular (IM) injection of Interferon beta-1a was administered once weekly during core phase. Participants switched to receive open-label fingolimod in extension phase
Fingolimod-Younger CohortFingolimodThe 'younger cohort' refers to the new pediatric patients to be recruited in the extension phase who fulfill any single one or a combination of the following criteria: being ≤12 years of age, or weighing ≤40 kg, or being prepubertal (i.e. pubertal status of Tanner stage \<2)
Primary Outcome Measures
NameTimeMethod
Frequency of Relapses in Patients Treated for up to 24 Months24 months

Frequency of relapses assessed by the annualized relapse rate (ARR). The ARR is defined as the average number of confirmed relapses per year (total number of confirmed relapses divided by the total days in the study multiplied by 365.25).

Secondary Outcome Measures
NameTimeMethod
Time to First Relapse24 months

Time to first relapse was determined.

T1 Gd- Enhancing Lesions24 months

Number of T1 Gd-enhancing lesions per scan up to Month 24

Proportion of Patients Relapse-free24 months

Proportion of patients relapse-free was determined

Pharmacokinetics (Cavg) of Fingolimod-P24 months

Cavg (average drug concentration over the dose interval) will be evaluated.

New/Newly Enlarged T2 Lesions24 months

Annualized rate of the number of new/newly enlarged T2 lesions up to Month 24

Pharmacokinetic/Pharmacodynamic Relationship for Fingolimod-P to Lymphocyte Levels24 months

Population PK/PD modeling approaches were used to relate the individual fingolimod-P concentrations to lymphocyte counts.

Trial Locations

Locations (12)

AMO Corporation

🇺🇸

Tallahassee, Florida, United States

UAB Childrens Hospital Harbor Center Neurology Dept

🇺🇸

Birmingham, Alabama, United States

Childrens Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

UCSF

🇺🇸

San Francisco, California, United States

University of Miami

🇺🇸

Miami, Florida, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Wayne State University

🇺🇸

Detroit, Michigan, United States

Robert Wood Johnson Medical School

🇺🇸

New Brunswick, New Jersey, United States

Childrens Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

University of Utah Clinical Trials Office

🇺🇸

Salt Lake City, Utah, United States

Novartis Investigative Site

🇬🇧

London, United Kingdom

San Jorge Childrens Hospital

🇵🇷

Santurce, Puerto Rico

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