The Wearing-off Effect of Anti-CD20 Therapies in Patients With Multiple Sclerosis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 157
- 试验地点
- 1
- 主要终点
- Proportion of patients with worsening ≥1 category for PROMIS physical health NRS
研究概览
简要总结
The nature, intensity, and prevalence of this wearing-off effect remain poorly understood. To our knowledge, there is no consensus in the literature on what symptoms constitute a wearing-off effect, nor is there a single validated scale that measures wearing-off effect. The current study will explore the wearing-off effect associated with OCR and OMB, using a variety of validated scales assessing MS symptoms (i.e., fatigue, mobility, pain, depression, cognition), as well as some global questions on wearing-off. In addition, impact of worsening of MS symptoms on patients' health-related quality of life (HRQoL) and their work productivity will be assessed using relevant MS-specific validated scales
详细描述
This will be a non-interventional, primary data collection study in patients with MS treated with an established anti-CD20 treatment regimen (OCR or OMB) in the United States. Patients who satisfy the inclusion criteria and consent to participate in the study will be surveyed at four timepoints at the beginning and the end of OCR or OMB treatment cycles according to the following assessment schedule:
- Assessment 1. 0-10 days before 1st dose post-enrollment (index dose)
- Assessment 2: 5-14 days after index dose
- Assessment 3: 0-10 days before 2nd dose post-enrollment (follow-up dose)
- Assessment 4: 5-14 days after follow-up dose dose
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 21 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •OCR sample:
- •Self-reported diagnosis of RMS, SPMS or CIS
- •≥21 years old at the time of initial contact
- •Under treatment with OCR at the time of initial contact
- •Have been on OCR for ≥ 1 year at the time of initial contact (i.e., prevalent users)
- •Able to answer the questionnaires in English
- •Self-reported diagnosis of RMS, SPMS or CIS
- •≥21 years old at the time of initial contact
- •Under treatment with OMB at the time of initial contact
- •Have been on OMB for ≥6 months at the time of initial contact (i.e., prevalent users)
- •Able to answer the questionnaires in English
排除标准
- •OCR sample:
- •Currently participating in a clinical trial involving MS drugs
- •Last Ocrevus infusion was less than 3 months back
- •OMB sample:
- •Currently participating in a clinical trial involving MS drugs
研究组 & 干预措施
OMB
Patients under treatment with ofatumumab (OMB) for at least 6 months prior to study start
干预措施: ofatumumab (Drug)
OCR
Patients under treatment with Ocrelizumab (OCR) for at least 1 year prior to study start.
干预措施: ocrelizumab (Drug)
结局指标
主要结局
Proportion of patients with worsening ≥1 category for PROMIS physical health NRS
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
The PROMIS Global-10 is a publicly available global health assessment tool that allows measurements of symptoms, functioning, and healthcare-related quality of life (HRQoL) for a wide variety of chronic diseases and conditions. PROMIS physical health is measured using the item 3 from the PROMIS Global-10. Scale for PROMIS physical health a is from 1 (worst) - 5 (best).
Median score change for the physical health, mental health, fatigue and pain domains of PROMIS NRS
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
PROMIS is a publicly available system of highly reliable, precise measures of patient-reported health status relevant to a variety of chronic conditions including MS. Mean score change for PROMIS physical health, mental health fatigue and pain NRS to be provided.
Median score change for Neuro-QoL fatigue scale
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
Neuro-QoL is a publicly available set of self-report measures that assesses the HRQoL of adults and children with neurological disorders. Neuro-QoL is comprised of item banks and scales that evaluate symptoms, concerns, and issues that are relevant across disorders along with instruments that assess areas most relevant for specific patient populations. The Neuro-Qol fatigue scale is an eight-item short form with a scale ranging from 29.5 (best) - 74.1 (worst).
Proportion of patients with worsening ≥ SID for Neuro-QoL depression scale
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
Neuro-QoL is a publicly available set of self-report measures that assesses the HRQoL of adults and children with neurological disorders. Neuro-QoL is comprised of item banks and scales that evaluate symptoms, concerns, and issues that are relevant across disorders along with instruments that assess areas most relevant for specific patient populations. The Neuro-Qol depression scale is an eight-item short form with a scale ranging from 36.9 (best) - 75.0 (worst).
Proportion of patients who experience wearing-off effect
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
The wearing-off effect questionnaire for this study was modified from a pre-existing tool designed by (Toorop, et al., 2022) such that it is now suitable to assess wearing-off in patients on either infusible or self-injectable disease modifying therapies (DMTs) with different dosing intervals. There is no numeric rating scale (NRS) associated with this endpoint.
Proportion of patients with worsening ≥ 1 category for PROMIS fatigue NRS
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
The PROMIS Global-10 is a publicly available global health assessment tool that allows measurements of symptoms, functioning, and healthcare-related quality of life (HRQoL) for a wide variety of chronic diseases and conditions. PROMIS fatigue is measured using the item 8r from the PROMIS Global-10. Scale for PROMIS fatigue is from 1 (worst) - 5 (best).
Mean score change for Neuro-QoL mobility, depression and cognition domains
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
Neuro-QoL is a publicly available set of self-report measures that assesses the HRQoL of adults and children with neurological disorders. Neuro-QoL is comprised of item banks and scales that evaluate symptoms, concerns, and issues that are relevant across disorders along with instruments that assess areas most relevant for specific patient populations.
Proportion of patients with worsening ≥ 1 category for Neuro-QoL fatigue scale
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
Neuro-QoL is a publicly available set of self-report measures that assesses the HRQoL of adults and children with neurological disorders. Neuro-QoL is comprised of item banks and scales that evaluate symptoms, concerns, and issues that are relevant across disorders along with instruments that assess areas most relevant for specific patient populations. The Neuro-Qol fatigue scale is an eight-item short form with a scale ranging from 29.5 (best) - 74.1 (worst).
Proportion of patients with worsening ≥ SID for Neuro-QoL cognition scale
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
Neuro-QoL is a publicly available set of self-report measures that assesses the HRQoL of adults and children with neurological disorders. Neuro-QoL is comprised of item banks and scales that evaluate symptoms, concerns, and issues that are relevant across disorders along with instruments that assess areas most relevant for specific patient populations. The Neuro-Qol cognition scale is an eight-item short form with a scale ranging from 17.3 (worst) - 64.2 (best).
Proportion of patients with worsening ≥ 1 category for PROMIS mental health NRS
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
The PROMIS Global-10 is a publicly available global health assessment tool that allows measurements of symptoms, functioning, and healthcare-related quality of life (HRQoL) for a wide variety of chronic diseases and conditions. PROMIS mental health is measured using the item 4 from the PROMIS Global-10. Scale for PROMIS mental health is from 1 (worst) - 5 (best).
Proportion of patients with worsening ≥1 category for PROMIS pain NRS
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose
The PROMIS Global-10 is a publicly available global health assessment tool that allows measurements of symptoms, functioning, and healthcare-related quality of life (HRQoL) for a wide variety of chronic diseases and conditions. PROMIS pain is measured using the item 7rc from the PROMIS Global-10. Scale for PROMIS fatigue is from 0 (worst) - 10 (best).
Proportion of patients with worsening ≥ Minimal Clinically Important Difference (MCID) for Fatigue Severity Scale (FSS)
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
The FSS is a publicly available, self-report, nine-item instrument designed to assess fatigue as a symptom of a variety of different chronic conditions and disorders. Answers are scored on a seven-point scale where 1 corresponds to strongly disagreeing and 7 corresponds to strongly agreeing. Scale for FSS is from 9 (best) - 63 (worst), or 1 (best) - 7 (worst) if the mean of all the scores is reported. The MCID for the mean FSS score is in the 0.5-1.1 range based on (Robinson, et al., 2009)
Mean score change for Fatigue Severity Scale (FSS)
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
The FSS is a publicly available, self-report, nine-item instrument designed to assess fatigue as a symptom of a variety of different chronic conditions and disorders. Answers are scored on a seven-point scale where 1 corresponds to strongly disagreeing and 7 corresponds to strongly agreeing. Scale for FSS is from 9 (best) - 63 (worst), or 1 (best) - 7 (worst) if the mean of all the scores is reported. The MCID for the mean FSS score is in the 0.5-1.1 range based on (Robinson, et al., 2009)
Proportion of patients with worsening ≥ significant individual difference (SID) for Neuro-QoL mobility scale
时间窗: Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.
Neuro-QoL is a publicly available set of self-report measures that assesses the HRQoL of adults and children with neurological disorders. Neuro-QoL is comprised of item banks and scales that evaluate symptoms, concerns, and issues that are relevant across disorders along with instruments that assess areas most relevant for specific patient populations. The Neuro-Qol mobility scale is an eight-item short form with a scale ranging from 16.5 (worst) - 58.6 (best).
次要结局
- Proportion of patients with worsening ≥ MCID for the MSIS-29(Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.)
- Mean score change for both domains (physical impact and psychological impact) of Multiple Sclerosis Impact Scale (MSIS-29)(Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.)
- Mean score change for each of the 4 domains of the Work Productivity and Activity Impairment Questionnaire for MS (WPAI:MS)(Up to 10 days before index dose (first dose) post enrollment, from 5 to 14 days after index dose, up to 10 days before second dose post enrollment, from 5 to 14 days after second dose.)