A Study to Evaluate the Safety and Efficacy of Satralizumab in Participants With Neuromyelitis Optica Spectrum Disorder (NMOSD)
- Conditions
- Neuromyelitis Optica Spectrum Disorder
- Interventions
- Drug: oral corticosteroids
- Registration Number
- NCT04660539
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This multicenter, single-arm, open-label study will evaluate the long-term safety and efficacy of satralizumab in participants with neuromyelitis optica spectrum disorder (NMOSD) who completed open-label extension (OLE) period of studies BN40898 and BN40900. Participants will receive satralizumab as monotherapy or in combination with one of the following background immunosuppressive treatments: azathioprine (AZA), mycophenolate mofetil (MMF), or oral corticosteroids.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 119
- Participants aged less than 18 years at the time of informed consent for Study BN40898 can continue treatment with a combination of oral corticosteroids and either AZA or MMF
- Participated in Study BN40898 or Study BN40900 with satralizumab in NMOSD, are on ongoing satralizumab treatment and were anti-aquaporin-4 IgG antibody (AQP4-IgG) seropositive at screening in these studies. Participants with NMOSD who were AQP4-IgG seronegative at screening in Study BN40898 or Study BN40900 can be enrolled if the investigator considers the continued treatment with satralizumab to be beneficial for the participant
- For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use adequate contraception during the treatment period and for 3 months after the final dose of satralizumab.
- Pregnant or breastfeeding, or intending to become pregnant during the study or within 3 months after the final dose of study drug. Women of childbearing potential must have a negative urine pregnancy test result on the baseline visit prior to initiation of study drug
- Evidence of any serious uncontrolled concomitant diseases that may preclude participation including nervous system disease, cardiovascular disease, hematologic/hematopoiesis disease, respiratory disease, muscular disease, endocrine disease, renal/urologic disease, digestive system disease, congenital or acquired severe immunodeficiency
- Known active infection that requires delaying the next satralizumab dose at the time of enrollment
- NMOSD relapse at the time of enrollment
- Laboratory abnormalities at the last assessment in Study BN40898 or Study BN40900 that preclude re-treatment with satralizumab
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Satralizumab Treatment mycophenolate mofetil (MMF) Participants will receive satralizumab subcutaneously (SC) every 4 weeks (Q4W) Satralizumab Treatment satralizumab Participants will receive satralizumab subcutaneously (SC) every 4 weeks (Q4W) Satralizumab Treatment azathioprine (AZA) Participants will receive satralizumab subcutaneously (SC) every 4 weeks (Q4W) Satralizumab Treatment oral corticosteroids Participants will receive satralizumab subcutaneously (SC) every 4 weeks (Q4W)
- Primary Outcome Measures
Name Time Method Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) Baseline up to 523 weeks AE=any untoward medical occurrence in a participant administered a pharmaceutical product, regardless of causal relationship with it. AE can therefore be any unfavorable \& unintended sign, symptoms/disease temporally associated with use of a medicinal (investigational) product, whether or not considered related to it. SAE is any significant hazard, contraindication, or side effect that is fatal or life-threatening, requires hospitalization or prolongation of an existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, is medically significant or requires intervention. The first dosing visit in the current study or randomization visit in the parent studies (NCT02028884/NCT02073279) was considered as baseline for this outcome measure. All AEs from the time of randomization in the parent studies for satralizumab-treated participants are reported here.
Number of Participants With Adverse Events of Special Interest (AESIs) and Selected AEs Baseline up to 523 weeks An AESIs included potential drug induced liver injury and suspected transmission of an infectious agent by study drug defined as any organism, virus, or infectious particle (e.g., prion protein transmitting transmissible spongiform encephalopathy), pathogenic or non-pathogenic causing clinical symptoms or laboratory findings that indicate an infection in a participant exposed to a medicinal product. Selected AEs included infections that required treatments with IV antibiotics, antifungals, or antivirals; opportunistic infections that required treatment with oral antibiotics, antifungals, or antivirals and injection related reaction. The first dosing visit in the current study or randomization visit in the parent studies (NCT02028884/NCT02073279) was considered as baseline for this outcome measure. All AEs from the time of randomization in the parent studies for satralizumab-treated participants are reported here.
- Secondary Outcome Measures
Name Time Method Number of Participants With Suicidality Assessed Using Columbia-Suicide Severity Rating Scale (C-SSRS) Baseline up to 523 weeks C-SSRS=assessment tool used to assess lifetime suicidality of a participant (at baseline) as well as any new instances of suicidality (since last visit). Structured interview prompts recollection of suicidal ideation, including intensity of ideation, behavior \& attempts with actual/potential lethality. Categories have binary responses (yes/no) \& include a-Wish to be Dead; b-Non-specific Active Suicidal Thoughts; c-Active Suicidal Ideation with Any Methods(Not Plan) without Intent to Act; d-Active Suicidal Ideation with Some Intent to Act, without Specific Plan; e-Active Suicidal Ideation with Specific Plan \& Intent, f-Preparatory Acts \& Behavior; g-Aborted Attempt; h-Interrupted Attempt; i-Actual Attempt(non-fatal); j-Completed Suicide. Suicidal ideation/behavior is indicated by a "yes" answer to any of listed categories. Score of 0 is assigned if no suicide risk is present. Score of 1 or higher= suicidal ideation or behavior. Categories with non-zero values are only reported here.
Number of Participants With Serious Infections and Hepatotoxicity Baseline up to 523 weeks Hepatotoxicity was defined using the following Medical Dictionary for Regulatory Activities Standardised MedDRA Queries (MedDRA SMQs) - Cholestasis and jaundice of hepatic origin (SMQ narrow) and Drug related hepatic disorders - severe events only (SMQ narrow). The first dosing visit in the current study or randomization visit in the parent studies (NCT02028884/NCT02073279 ) was considered as baseline for this outcome measure. Data for all serious infections and hepatotoxicity from the time of randomization in the parent studies for satralizumab-treated participants are reported here.
Time to First Protocol-defined Relapse (PDR) as Assessed by Investigator (iPDR) Baseline up to 528 weeks Time to first relapse (TFR) was defined as the time from randomization in parent studies to the first occurrence of the first iPDR. PDR=occurrence of new or worsening neurological symptoms attributable to neurological neuromyelitis optica (NMO) or NMOSD. New or worsening neurological symptoms that occur \< 31 days following onset of PDR were considered part of same relapse. The time point of relapse onset=time at which the participant experienced any new or worsening neurological symptoms representing NMOSD clinical relapse(s). For participants who did not relapse at the time of analysis, TFR was censored at the clinical cutoff date (CCOD) or at the time of withdrawal from study. The first dosing visit in current study or randomization visit in the parent studies (NCT02028884/NCT02073279) was considered as baseline. All TFR data from the time of randomization in the parent studies up to the end of study WN42349 for satralizumab-treated participants are reported here.
iPDR-free Rate up to Week 456 Baseline up to Week 456 iPDR free rate was defined as the percentage of participants who did not experience a protocol-defined relapse as assessed by the investigator. Protocol-defined relapse was the occurrence of new or worsening neurological symptoms attributable to NMOSD. New or worsening neurological symptoms that occur \< 31 days following the onset of a PDR were considered part of the same relapse. The first dosing visit in the current study or randomization visit in the parent studies (NCT02028884/NCT0207327) was considered as baseline for this outcome measure. All data from the time of randomization in the parent studies up to Week 456 for satralizumab-treated participants are reported here. Percentages have been rounded off to the nearest decimal point. Kaplan-Meier method was used to estimate the iPDR-free rates.
Percentage of Relapse-Free Participants Baseline up to 528 weeks Protocol-defined relapse was the occurrence of new or worsening neurological symptoms attributable to NMOSD. New or worsening neurological symptoms that occur \< 31 days following the onset of a PDR were considered part of the same relapse. The first dosing visit in the current study or randomization visit in the parent studies (NCT02028884/NCT0207327) was considered as baseline for this outcome measure. All data from the time of randomization in the parent studies up to end of study WN42349 for satralizumab-treated participants are reported here. Participants who did not experience any relapse events are reported here. Percentages have been rounded off to the nearest decimal point.
Annualized Relapse Rate (ARR) Baseline up to 528 weeks ARR was calculated as total number of relapses experienced divided by the participant-years of the whole study period. Adjusted ARR was calculated using Poisson regression model adjusted by study identifier (BN40898, BN40900). ARR was assessed from randomization in parent studies to the first occurrence of the iPDR. PDR=occurrence of new/worsening neurological symptoms attributable to NMO/NMOSD. New or worsening neurological symptoms that occur \< 31 days following onset of a PDR were considered part of the same relapse. Time point of relapse onset=the time at which the participant experienced any new or worsening neurological symptoms representing NMOSD clinical relapse(s). First dosing visit in the current study or randomization visit in the parent studies (NCT02028884/NCT02073279) was considered as baseline for this outcome measure. All ARR data from time of randomization in the parent studies up to the end of study WN42349 for satralizumab-treated participants are reported here.
Concentrations of Soluble IL-6 Receptor (sIL-6R) in Blood Baseline, every two weeks from Weeks 2 to 8; every 4 weeks from Weeks 12 to 192; every 24 weeks from Weeks 216 to 528 Baseline was defined as last observation collected on or before day of first study drug administration in parent studies (NCT02028884/NCT02073279). All data from the time of randomization in the parent studies up to the end of study WN42349 for satralizumab-treated participants are reported here.
Change in Expanded Disability Status Scale (EDSS) Score Baseline and every 24 weeks (up to 528 weeks) EDSS was a quantitative measure of disability and for assessment of severity of relapse for participants with NMOSD. Values from 0 points (normal neurological examination) up to 10 points (death), increasing in increments of 0.5 points. Higher scores represent increased disability. Baseline is the last observation on or before the day of first study drug administration in the current study or the parent studies (NCT02028884/NCT02073279). All EDSS data from the time of randomization in the parent studies up to the end of study WN42349 for satralizumab-treated participants are reported here.
Time to First EDSS Scores Worsening Baseline up to 528 weeks EDSS=quantitative measure of disability \& for assessment of severity of relapse for participants with NMOSD. Values from 0 points (normal neurological examination) up to 10 points (death), increasing in increments of 0.5 points. Higher scores=increased disability. EDSS worsening=(a) worsening of 2/more points in EDSS score for participants with a baseline score (BS) of 0, (b) worsening of 1/more points in EDSS score for participants with a BS of 1 to 5, or (c) worsening of 0.5 points/more in EDSS score for participants with a BS of 5.5/more. Participants were censored at date of last EDSS assessment or if no EDSS assessment was performed at randomization date. Baseline=last observation on/before day of first study drug administration in current study/parent studies (NCT02028884/NCT02073279). All EDSS data from time of randomization in parent studies up to end of study WN42349 for satralizumab-treated participants are reported here.
Event-free Rate for EDSS Score Worsening up to Week 456 Baseline up to Week 456 Event-free rate for EDSS score worsening was defined as the percentage of participants who did not experience worsening in their EDSS score from baseline. EDSS=quantitative measure of disability \& for assessment of severity of relapse for participants with NMOSD. Values from 0 points (normal neurological examination) up to 10 points (death), increasing in increments of 0.5 points. Higher scores=increased disability. Participants were censored at the date of the last EDSS assessment or if no EDSS assessment was performed at the randomization date. Baseline is defined as the last observation on/before the day of the first study drug administration in current study/parent studies (NCT02028884/NCT02073279). All EDSS data from the time of randomization in the parent studies up to Week 456 for satralizumab-treated participants are reported here. Kaplan-Meier method was used to estimate the event-free rates.
Percentage of Participants Without EDSS Worsening Baseline up to 528 weeks EDSS=quantitative measure of disability \& for assessment of severity of relapse for participants with NMOSD. Values from 0 points (normal neurological examination) up to 10 points (death), increasing in increments of 0.5 points. Higher scores=increased disability. EDSS worsening=(a) worsening of 2/more points in EDSS score for participants with a BS of 0, (b) worsening of 1/more points in EDSS score for participants with a BS of 1 to 5, or (c) worsening of 0.5 points/more in EDSS score for participants with a BS of 5.5/more. Baseline=last observation on/before day of first study drug administration in current study/parent studies (NCT02028884/NCT02073279). All EDSS data from time of randomization in parent studies up to end of study WN42349 for satralizumab-treated participants are reported here. Participants who did not experience any EDDS worsening events are reported here. Percentages have been rounded off to the nearest decimal point.
Change in Visual Acuity (VA) Assessed by a Snellen 20-Foot Wall Chart Baseline and every 24 weeks (up to 528 weeks) Visual acuity is measured using Snellen 20-foot wall chart and then converted to logMAR visual acuity scoring. Lower values indicate better visual acuity. Data are reported for right eye (OD) and left eye (OS). Visual acuity scores (Snellen chart) worse than 20/200 \[i.e. CF (counting fingers), HM (hand movement), LP (light perception), or NLP (no LP)\] are converted to logMAR 1.85, logMAR 2.00, logMAR 2.70, and logMAR 3.00 respectively. LogMAR \>= 1 is equivalent to Physically blind. A negative change from baseline indicates an improvement. The first dosing visit in the current study or randomization visit in the parent studies (NCT02028884/NCT02073279) was considered as baseline for this outcome measure. All VA data from the time of randomization in the parent studies up to the end of study WN42349 for satralizumab-treated participants are reported here.
Concentrations of Interleukin-6 (IL-6) in Blood Baseline, every two weeks from Weeks 2 to 8; every 4 weeks from Weeks 12 to 192; every 24 weeks from Weeks 216 to 528 Baseline was defined as last observation collected on or before day of first study drug administration in parent studies (NCT02028884/NCT02073279). All data from the time of randomization in the parent studies up to the end of study WN42349 for satralizumab-treated participants are reported here.
Concentration of C-Reactive Protein (CRP) in Blood Baseline, every two weeks from Weeks 2 to 8; every 4 weeks from Weeks 12 to 192; every 24 weeks from Weeks 216 to 528 Baseline was defined as last observation collected on or before day of first study drug administration in parent studies (NCT02028884/NCT02073279). All data from the time of randomization in the parent studies up to the end of study WN42349 for satralizumab-treated participants are reported here.
Serum Concentration of Satralizumab at Specified Timepoints Baseline, Week 2, Week 4, Week 5, Week 6; every 4 weeks from Weeks 8 to 192; every 24 weeks from Weeks 216 to 528 Baseline was defined as last observation collected on or before day of first study drug administration in parent studies (NCT02028884/NCT02073279). All data from the time of randomization in the parent studies up to the end of study WN42349 for satralizumab-treated participants are reported here.
Number of Participants With Anti-Drug Antibodies (ADAs) From the First Dose of Satralizumab in Studies NCT02028884 or NCT02073279 First dose of satralizumab in parent studies up to end of study WN42349 (up to 523 weeks) The number and percentage of ADA-positive participants and ADA-negative participants at baseline (baseline prevalence) and after drug administration (post-baseline incidence) were summarized. Baseline evaluable participants were participants with an ADA assay result at baseline. Post-baseline evaluable participants were participants with an ADA assay from at least one post-baseline sample. Participants positive for ADA= number of participants with positive ADA result. Participants negative for ADA=number of participants with negative or missing baseline ADA result(s) and all negative post-baseline results. Baseline was defined as last observation collected on or before day of first study drug administration in parent studies. All data from the time of randomization in the parent studies up to the end of study WN42349 for satralizumab-treated participants are reported here.
Trial Locations
- Locations (53)
Jefferson Hospital For Neuroscience; Jefferson Neurology Associates
🇺🇸Philadelphia, Pennsylvania, United States
University of Texas Southwestern Medical Center
🇺🇸Dallas, Texas, United States
University of Chicago
🇺🇸Chicago, Illinois, United States
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan
Consultants in Neurology Ltd
🇺🇸Northbrook, Illinois, United States
M.A. - LEK A. M. Maciejowscy SC. Centrum Terapii SM
🇵🇱Katowice, Poland
Tohoku University Hospital
🇯🇵Miyagi, Japan
Multiprofile Hospital for Active Treatment of Neurology and Psychiatry Sv. Naum EAD
🇧🇬Sofia, Bulgaria
Children's Hospital of Alabama
🇺🇸Birmingham, Alabama, United States
University of Miami
🇺🇸Miami, Florida, United States
Centre hospitalier de l'Universite de Montreal (CHUM)
🇨🇦Montreal, Quebec, Canada
Wayne State University; UHC-4H
🇺🇸Detroit, Michigan, United States
Columbus Research and Wellness
🇺🇸Columbus, Georgia, United States
UMHAT 'Dr. Georgi Stranski', EAD
🇧🇬Pleven, Bulgaria
Hospital Kuala Lumpur
🇲🇾Kuala Lumpur, FED. Territory OF Kuala Lumpur, Malaysia
China Medical University Hospital
🇨🇳North Dist., Taiwan
Communal Nonprofit enterprise Ternopil Regional Clinical Psychoneurological Hospital of TRC
🇺🇦Ternopil, Volhynian Governorate, Ukraine
OhioHealth Research Institute
🇺🇸Columbus, Ohio, United States
Central Texas Neurology Consultants
🇺🇸Round Rock, Texas, United States
University Multiprofile Hospital for Active Treatment Aleksandrovska EAD
🇧🇬Sofia, Bulgaria
Samodzielny Publiczny Szpital Kliniczny Nr 4 w Lublinie; Klinika Neurologii
🇵🇱Lublin, Poland
Uniwersyteckie Centrum Kliniczne WUM, Centralny Szpital Kliniczny; Klinika Neurologii
🇵🇱Warszawa, Poland
Hosp. Clinico San Carlos
🇪🇸Madrid, Spain
Jahn Ferenc Del-Pesti Korhaz es Rendelointezet
ðŸ‡ðŸ‡ºBudapest, Hungary
Asan Medical Center - PPDS
🇰🇷Seoul, Korea, Republic of
Clinical Hospital Centre Osijek
ðŸ‡ðŸ‡·Osijek, Croatia
Azienda Ospedaliera Sant'Andrea
🇮🇹Roma, Lazio, Italy
NZOZ Wielospecjalistyczna Poradnia Lekarska SYNAPSIS
🇵🇱Katowice, Poland
Miedzyleski Szpital Specjalistyczny w Warszawie
🇵🇱Warszawa, Poland
Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele
🇮🇹Catania, Sicilia, Italy
Kyushu University Hospital
🇯🇵Fukuoka, Japan
Osaka University Hospital
🇯🇵Osaka, Japan
Instytut Psychiatrii i Neurologii
🇵🇱Warszawa, Poland
San Juan MS Center
🇵🇷Guaynabo, Puerto Rico
Bilim University Medical Faculty Florence Nightingale Hospital
🇹🇷Istanbul, Turkey
National Center of Neurology and Psychiatry
🇯🇵Tokyo, Japan
Korea University Anam Hospital
🇰🇷Seoul, Korea, Republic of
Taipei Veterans General Hospital
🇨🇳Taipei City, Taiwan
Communal NPE Vinnytsia Reg. Clin. Psychoneurolog. Hosp. n.a. O.I. Yushchenko of Vinnytsia RC
🇺🇦Vinnytsia, Podolia Governorate, Ukraine
National Hospital For Neurology and Neurosurgery
🇬🇧London, United Kingdom
Tokyo Women's Medical University Hospital
🇯🇵Tokyo, Japan
Hospital Clinic de Barcelona
🇪🇸Barcelona, Spain
Kindai University Hospital
🇯🇵Osaka, Japan
Niigata University Medical & Dental Hospital
🇯🇵Niigata, Japan
The Neurological Institute PA
🇺🇸Charlotte, North Carolina, United States
Ruhr Universitat Bochum
🇩🇪Bochum, Germany
Municipal Non-Commercial Enterprise Odesa RMC for Mental Health of Odessa Regional Council
🇺🇦Odesa, Kherson Governorate, Ukraine
MS Clinical Trials Group
🇨🇦Vancouver, British Columbia, Canada
SC Clubul Sanatatii SRL
🇷🇴Campulung, Romania
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Municipal Non-Profit Enterprise City Clinical Hospital #16 of Dnipro City Council
🇺🇦Dnipro, Katerynoslav Governorate, Ukraine
OSF Saint Francis Medical Center
🇺🇸Peoria, Illinois, United States
University of Kansas Medical Center
🇺🇸Kansas City, Kansas, United States