An Open Label Extension Trial of Eculizumab in Relapsing NMO Patients

Phase 3

Completed

Conditions: Neuromyelitis Optica Spectrum Disorder
Neuromyelitis Optica

Interventions: Biological: eculizumab

Registration Number: NCT02003144

Lead Sponsor: Alexion Pharmaceuticals, Inc.

Brief Summary: The purpose of this study is to determine whether eculizumab long-term use is safe and effective in patients with relapsing NMO.

Detailed Description: This study is an open label extension study to confirm the long term safety and efficacy of eculizumab in subjects with relapsing NMO who have completed the initial double-blind, randomized, placebo-controlled trial ECU-NMO-301.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 119

Inclusion Criteria

Patient completed the ECU-NMO-301 trial
Patient has given written informed consent

Key

Exclusion Criteria

Patients who have withdrawn from the ECU-NMO-301 trial as a result of an AE related to trial drug
Female patients who are pregnant, breastfeeding, or intend to conceive during the course of the trial

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Eculizumab	eculizumab	Eculizumab intravenous infusion every two weeks.

Primary Outcome Measures

Name	Time	Method
Number of Participants With An On-trial Relapse as Determined by The Treating Physician	Baseline up to end of study (up to 6.5 years)	An On-trial Relapse was defined as a new onset of neurologic symptoms or worsening of existing neurologic symptoms with an objective change (clinical sign) on neurologic examination that persisted for more than 24 hours as confirmed by the treating physician.
Number of Participants With Treatment Emergent Adverse Events and Serious Adverse Events	Baseline up to end of study (up to 6.5 years)	An adverse event (AE) was defined as any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Treatment-emergent adverse events (TEAEs) were defined as an AE with onset on or after the first study drug dose in Study ECU-NMO-302. A serious adverse event (SAE) was defined as an untoward medical occurrence that at any dose either results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, or is an important medical event. A summary of serious and all other non-serious adverse events, regardless of causality, is located in the Reported Adverse Events module.
Number of Participants With At Least 1 Post Baseline Columbia-Suicide Severity Rating Scale (C-SSRS) Assessment (Suicide-Related Thoughts or Behaviours) Abnormality	Baseline up to end of study (up to 6.5 years)	The C-SSRS is a validated questionnaire to capture occurrence, severity, and frequency of suicide-related thoughts and behaviours, and has a binary response (yes/no). Suicidal Ideation: a "yes" answer to any one of 5 suicidal ideation questions: Wish to be Dead; Non-specific Active Suicidal Thoughts; Active Suicidal Ideation with Any Methods (Not Planned) without Intent to Act; Active Suicidal Ideation with Some Intent to Act, without Specific Plan; and Active Suicidal Ideation with Specific Plan and Intent. Suicidal Behaviour: a "yes" answer to any of 5 suicidal behaviour questions: Preparatory Acts or Behaviour, Aborted Attempt, Interrupted Attempt, Actual Attempt (non-fatal), and Completed Suicide. Suicidal Ideation or Behaviour: a "yes" answer to the following question: Self-injurious behaviour without suicidal intent.
On-Trial Annualized Relapse Rate (ARR) as Determined by The Treating Physician	Baseline up to end of study (up to 6.5 years)	The On-trial ARR was computed as the total number of relapses divided by the total number of participant years in the study period.

Secondary Outcome Measures

Name	Time	Method
Change From Baseline in Modified Rankin Scale (mRS) Score	Baseline, Weeks 52, 104 and 156	Disease-related disability was measured by the mRS score. The mRS is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people who have suffered from a neurological disability. The scale ranges from 0 (no symptoms at all) to 6 (death) in whole-point increments. A decrease in score indicates improvement. Baseline was defined as the last available assessment prior to the first study drug infusion in Study ECU-NMO-302.
Change From Baseline in Hauser Ambulation Index (HAI) in Participants With Abnormal Baseline Ambulatory Function	Baseline, Weeks 52, 104 and 156	The HAI evaluates gait and was used to assess the time and effort used by the participant to walk 25 feet (8 meters). The scale ranges from 0 to 9, with 0 being the best score (asymptomatic; fully active) and 9 being the worst (restricted to wheelchair; unable to transfer self independently). A decrease in score indicates improvement. Baseline is defined as the last available assessment prior to the first study drug infusion in Study ECU-NMO-302.
Change From Baseline in European Quality of Life (EuroQoL) 5-Dimension Visual Analog Scale (EQ-5D VAS) Health Status Score	Baseline, Weeks 52, 104 and 156	The EQ-5D is a generic, standardized participant self-administered health status instrument. EQ-5D general health status can also be measured by a visual analog scale (EQ-5D VAS). EQ-5D-VAS recorded the participant's self-rated health on a vertical visual analog scale (VAS) that allowed the participants to indicate their health state that ranged from 0 (worst imaginable) to 100 (best imaginable). Baseline is defined as the last available assessment prior to the first study drug infusion in Study ECU-NMO-302.
Change From Baseline in Kurtzke Visual Functional System Scores (FSS) in Participants With Abnormal Baseline Visual Function	Baseline, Weeks 52, 104 and 156	The EDSS assesses multiple Kurtzke functional systems in the context of a standard neurological exam, including visual function. The visual score ranges from 0 to 6. A score of 0 implies the participant has normal visual function. Higher scores represent worse disability. Baseline is defined as the last available assessment prior to the first study drug infusion in Study EC-NMO-302.
Change From Baseline in Expanded Disability Status Scale (EDSS) Score	Baseline, Weeks 52, 104 and 156	Disease-related disability was measured by the EDSS. The EDSS quantifies disability in 8 Functional Systems (FS) and allows neurologists to assign a Functional System Score (FSS) in each of these. The Functional Systems are pyramidal, cerebellar, brainstem, sensory, bowel and bladder, visual, cerebral, and other. The EDSS is an ordinal clinical rating scale that ranges from 0 (normal neurologic examination) to 10 (death) in half-point increments. A decrease in score indicates improvement. Baseline was defined as the last available assessment prior to the first study drug infusion in Study ECU-NMO-302.

Trial Locations

Locations (69): Mayo Clinic Arizona
🇺🇸
Scottsdale, Arizona, United States
The Research Center of Southern California
🇺🇸
Oceanside, California, United States
Georgetown University Hospital
🇺🇸
Washington, District of Columbia, United States
Neurological Services of Orlando
🇺🇸
Orlando, Florida, United States
Baptist Health Lexington
🇺🇸
Nicholasville, Kentucky, United States
Washington University School of Medicine
🇺🇸
Saint Louis, Missouri, United States
Mayo Clinic - Rochester
🇺🇸
Rochester, Minnesota, United States
Multiple Sclerosis Comprehensive Care Center NYU Langone Medical Center
🇺🇸
New York, New York, United States
Mount Sinai School of Medicine
🇺🇸
New York, New York, United States
University of Utah
🇺🇸
Salt Lake City, Utah, United States
Hospital Universitario Austral
🇦🇷
Pilar, Buenos Aires, Argentina
Hospital General de Agudos Dr. J. M. Ramos Mejia
🇦🇷
Ciudad Autonoma, Buenos Aires,, Argentina
Hospital General de Agudos Juan Antonio Fernandez
🇦🇷
Ciudad Autonoma, Buenos Aires, Argentina
VFN v Praze
🇨🇿
Praha, Czechia
The Ottawa Hospital
🇨🇦
Ottawa, Ontario, Canada
University Hospital Heidelberg
🇩🇪
Heidelberg, Baden Wuerttemberg, Germany
Århus Universitetshospital
🇩🇰
Arhus, Denmark
University Hospital Heinrich Heine University
🇩🇪
Dusseldorf, Nordrhein Westfalen, Germany
Neurologische Klinik und Poliklinik
🇩🇪
Munich, Bayern, Germany
Universitaetsmedizin Rostock
🇩🇪
Rostock, Germany
Policlinico di Catania
🇮🇹
Catania, Italy
Azienda Ospedaliera Universitaria
🇮🇹
Napoli, Italy
Azienda Ospedaliera di Padova
🇮🇹
Padova, Italy
Azienda Ospedaliera Sant'Andrea-Università di Roma La Sapienza
🇮🇹
Rome, Italy
Chiba University Hospital
🇯🇵
Chiba-shi, Chiba-Ken, Japan
Hyogo College of Medicine Hospital
🇯🇵
Nishinomiya-shi, HyogoKen, Japan
Yamaguchi University Hospital
🇯🇵
Ube-shi, Yamaguchi-Ken, Japan
Kyoto Min-iren Chuo Hospital
🇯🇵
Kyoto-shi, Kyoto-Fu, Japan
Tohoku University Hospital
🇯🇵
Sendai-shi, Miyagi-Ken, Japan
National Center Hospital, NCNP
🇯🇵
Tokio, Japan
Kyushu University Hospital
🇯🇵
Fukuoka, Japan
Korea University Anam Hospital
🇰🇷
Seoul, Korea, Republic of
Samsung Medical Center
🇰🇷
Seoul, Korea, Republic of
Seoul University National Hospital
🇰🇷
Seoul, Korea, Republic of
Severance Hospital, Yonsei University
🇰🇷
Seoul, Korea, Republic of
Hospital Kuala Lumpur
🇲🇾
Kuala Lumpur, Malaysia
Federal State Budget Institution of Healthcare - Siberian District Medical Center of FMBA of Russia
🇷🇺
Novosibirsk, Russian Federation
Republican Clinical Hospital for Rehabilitation of Healthcare Ministry of Republic of Tatarstan
🇷🇺
Kazan, Russian Federation
SBEI "Krasnoyarsk SMU n.a. Prof. V.F. Voyno-Yasenetsky"
🇷🇺
Krasnoyarsk, Russian Federation
Hospital Universitario Reina Sofia
🇪🇸
Cordoba, Spain
SEIHPE "Rostov SMU of MoH of RF"
🇷🇺
Rostov-on Don, Russian Federation
Hospital Universitario Clinico San Carlos
🇪🇸
Madrid, Spain
Ondokuz Mayis Univ. Med. Fac.
🇹🇷
Samsun, Turkey
Cheng Hsin General Hospital
🇨🇳
Taipei, Taiwan
Hacettepe University Medical Faculty
🇹🇷
Ankara, Turkey
Trakya University Medical Faculty
🇹🇷
Edirne, Turkey
Dokuz Eylul University Medicine Faculty
🇹🇷
Izmir, Turkey
The Walton Centre
🇬🇧
Liverpool, United Kingdom
Kocaeli University Medical Faculty
🇹🇷
Kocaeli, Turkey
University of Miami McKnight Brain Institute
🇺🇸
Miami, Florida, United States
University of Pennsylvania School of Medicine
🇺🇸
Philadelphia, Pennsylvania, United States
Allied Physicians Inc. of Fort Wayne
🇺🇸
Fort Wayne, Indiana, United States
Johns Hopkins University Medical Center
🇺🇸
Baltimore, Maryland, United States
Ohio Health Reserach Institute
🇺🇸
Columbus, Ohio, United States
University of Pittsburgh
🇺🇸
Pittsburgh, Pennsylvania, United States
Multiple Sclerosis Treatment Center of Dallas
🇺🇸
Dallas, Texas, United States
St. Vincent's Hospital
🇦🇺
Fitzroy, Victoria, Australia
Brain and Mind Research Institute
🇦🇺
Camperdown, New South Wales, Australia
Hospital de Cruces
🇪🇸
Barakaldo, Bizkaia, Spain
Fundacion Rosarina de Neuro Rehabilitacion
🇦🇷
Rosario, Santa Fe, Argentina
Fundacion Cardiovascular de Colombia
🇨🇴
Floridablanca, Santander, Colombia
Hospital Umum Sarawak
🇲🇾
Kuching, Sarawak, Malaysia
Thammasat University Hospital
🇹🇭
Pathum Thani, Thailand
National Cancer Center
🇰🇷
Goyang-si, Gyeonggi-do, Korea, Republic of
Krajska zdravotni, a.s. - Nemocnice
🇨🇿
Teplice, Czechia
Clinical Hospital Centre Zagreb
🇭🇷
Zagreb, Croatia
The University of Texas Health Science
🇺🇸
San Antonio, Texas, United States
University of Kansas Medical Center
🇺🇸
Kansas City, Kansas, United States
Prince of Wales Hospital
🇭🇰
Shatin, Hong Kong