- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01317004
Patients With Relapse Remitting Multiple Sclerosis (RRMS): Candidates for MS Therapy Change (EPOC)
June 18, 2015 updated by: Novartis Pharmaceuticals
A 6-month, Randomized, Active Comparator, Open-label, Multi-Center Study to Evaluate Patient Outcomes, Safety and Tolerability of Fingolimod (FTY720) 0.5 mg/Day in Patients With Relapsing Remitting Multiple Sclerosis Who Are Candidates for MS Therapy Change From Previous Disease Modifying Therapy (EPOC)
The purpose of this study is to evaluate the change in patient-reported treatment satisfaction after 6 months of treatment with fingolimod 0.5mg/day vs. DMT standard of care, using the global satisfaction subscale of the Treatment Satisfaction Questionnaire for Medication (TSQM-9).
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
61
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Novara, Italy, 28100
- Novartis Investigative Site
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AN
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Ancona, AN, Italy, 60126
- Novartis Investigative Site
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BI
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Ponderano, BI, Italy, 13900
- Novartis Investigative Site
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CL
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Caltanissetta, CL, Italy, 93100
- Novartis Investigative Site
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CN
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Cuneo, CN, Italy, 12100
- Novartis Investigative Site
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CO
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Como, CO, Italy, 22100
- Novartis Investigative Site
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CT
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Catania, CT, Italy, 95122
- Novartis Investigative Site
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FG
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Foggia, FG, Italy, 71100
- Novartis Investigative Site
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FI
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Castelfiorentino, FI, Italy, 50051
- Novartis Investigative Site
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MI
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Milano, MI, Italy, 20133
- Novartis Investigative Site
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Milano, MI, Italy, 20122
- Novartis Investigative Site
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San Donato Milanese, MI, Italy, 20097
- Novartis Investigative Site
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MO
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Modena, MO, Italy, 41100
- Novartis Investigative Site
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PA
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Palermo, PA, Italy, 90146
- Novartis Investigative Site
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Palermo, PA, Italy, 90129
- Novartis Investigative Site
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PI
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Pisa, PI, Italy, 56126
- Novartis Investigative Site
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VR
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Legnago, VR, Italy, 37045
- Novartis Investigative Site
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients must be diagnosed with relapsing remitting MS (RRMS) as defined by 2005 revised McDonald criteria.
- Patients who explicitly agree to be assigned to a treatment group that may receive fingolimod or DMT after having been informed about their respective benefits and possible adverse events by the investigator.
- An Expanded Disability Status Scale (EDSS) score of 0-5.5 inclusive.
- Must have received continuous treatment with a single approved and indicated MS DMT for a minimum of 6 months prior to the screening visit. Patients must continue with this MS DMT until the randomization visit.
- Naïve to treatment with fingolimod.
Exclusion Criteria:
- A manifestation of MS other than those defined in the inclusion criteria.
- A history of chronic disease of the immune system other than MS or a known immunodeficiency syndrome.
- History of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years, regardless of whether there is evidence of local recurrence or metastases.
- Patients with uncontrolled diabetes mellitus (HbA1c > 7%).
- Diagnosis of macular edema during Screening Phase.
Other protocol-defined inclusion/exclusion criteria may apply
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Fingolimod
Patients randomized in this arm received Fingolimod 0.5 mg/day oral capsule for 6 months core period.
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0.5 mg/day oral capsule
Other Names:
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Active Comparator: Multiple Sclerosis Disease Modifying Treatment (MS DMT)
Patients randomized in this arm received selected Standard MS DMT such as Interferon beta-1b or Interferon beta-1a or Glatiramer acetate for 6 months.
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Interferon beta 1a or interferon beta 1b or Glatiramer Acetate
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change From Baseline in Patient-reported Treatment Satisfaction
Time Frame: baseline, 6 months
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The Treatment Satisfaction Questionnaire for Medication (TSQM-9) is a psychometric measure of a patient's satisfaction with medication.
It consists of 3 subscales: effectiveness, convenience and global satisfaction.
The scores were computed by adding items for each domain, i.e. 1 to 3 for effectiveness, 4 - 6 for convenience and 7 to 9 for global satisfaction.
The lowest possible score (1 for each item and 3 for all 3 subscales) was subtracted from the composite score and divided by the greatest possible score range.
The greatest range was (7-1) X 3 items = 18 for the effectiveness and convenience, and (5-1) x 3 items = 12 for global satisfaction.
This provided a transformed score between 0 and 1 that was then multiplied by 100.
A positive change from baseline indicates improvement.
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baseline, 6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change From Baseline in Patient-reported Activities of Daily Living (ADL)
Time Frame: baseline, 6 months
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The PRIMUS activity measure is a 15-item assessment used to evaluate patient-reported activities of daily living.
The PRIMUS activities score was calculated summing the 15 items, after recoding the responses from 1 - 3 to 0 - 2. Therefore, the total score ranged from 0 - 3-, where high scores were indicative of greater function limitation.
A negative change from baseline indicates improvement.
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baseline, 6 months
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Change From Baseline in Patient-reported Fatigue
Time Frame: 6 months
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The fatigue Severity Scale (FSS) is a 9-item scale used to assess fatigue.
The FSS score was calculated summing the 9 items of the questionnaire and dividing by the number of non-missing items (each item is based on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree)).
A negative change from baseline indicates improvement.
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6 months
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Change From Baseline in Patient-Reported Effectiveness and Convenience
Time Frame: 6 months
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The Treatment Satisfaction Questionnaire for Medication (TSQM-9) is a psychometric measure of a patient's satisfaction with medication.
It consists of 3 subscales: effectiveness, convenience and global satisfaction.
The scores were computed by adding items for each domain, i.e. 1 to 3 for effectiveness, 4 - 6 for convenience and 7 to 9 for global satisfaction.
The lowest possible score (1 for each item and 3 for all 3 subscales) was subtracted from the composite score and divided by the greatest possible score range.
The greatest range was (7-1) X 3 items = 18 for the effectiveness and convenience, and (5-1) x 3 items = 12 for global satisfaction.
This provided a transformed score between 0 and 1 that was then multiplied by 100.
A positive change from baseline indicates improvement.
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6 months
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Change From Baseline in Patient-reported Depression
Time Frame: 6 months
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The Beck Depression Inventory Fast Screen (BDI-FS) is a brief, multiple choice, self reported inventory designed to evaluate depression in patients with medical illness.
The BDI-FS score was calculated summing the 7 items of the questionnaire.
Each item ranged from 0 (not present) to 3 (severe).
The total score ranges from 0-3 (minimal depression), 4-8 (mild depression), 9-12 (moderate depression) and 13-21 (severe depression).
A negative change from baseline indicates improvement.
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6 months
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Change From Baseline in Patient-reported Health Related Quality of Life (QOL)
Time Frame: 6 months
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The SF-36v2 is a validated health-related quality of life instrument used in numerous disease states, including MS.
It is a self-administered survey that measures 8 domains of health including: physical functioning, role limitations due to physical health, pain, general health, energy/fatigue, social functioning, role limitations due to emotional problems and emotional well-being.
Additionally, two summary scale scores can be calculated: the Physical Component Summary (PCS) and the Mental Component Summary (MCS).
If half or more questions within a domain were answered, then a score was calculated for that domain.
Otherwise, the patient score for that domain was set to missing.
If the patient was missing any 1 of the 8 scale scores, then the physical and mental component scores were set to missing.
An algorithm was used to create a score from 0 to 100 for each domain score and component score.
A positive change from baseline indicates improvement.
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6 months
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Physician-reported Clinical Global Impression of Improvement (CGI-I)
Time Frame: 6 months
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The CGI-I is a rating scale allowing a physician-reported global evaluation of the subject's improvement over time.
The Investigator assessed the subject's clinical change relative to the symptoms at baseline on the CGI-I, a seven-point scale, with rating as follows: 1=Very much improved, 2=Much improved, 3=Minimally improved, 4=No change, 5=Minimally worse, 6=Much worse, 7=Very much worse.
A lower score and a negative change from baseline indicate improvement.
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6 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Director: Renato Turrini, MD, Novartis Farma S.p.A.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
May 1, 2011
Primary Completion (Actual)
June 1, 2014
Study Completion (Actual)
June 1, 2014
Study Registration Dates
First Submitted
March 15, 2011
First Submitted That Met QC Criteria
March 15, 2011
First Posted (Estimate)
March 16, 2011
Study Record Updates
Last Update Posted (Estimate)
June 22, 2015
Last Update Submitted That Met QC Criteria
June 18, 2015
Last Verified
June 1, 2015
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Nervous System Diseases
- Immune System Diseases
- Demyelinating Autoimmune Diseases, CNS
- Autoimmune Diseases of the Nervous System
- Demyelinating Diseases
- Autoimmune Diseases
- Multiple Sclerosis
- Sclerosis
- Multiple Sclerosis, Relapsing-Remitting
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Immunosuppressive Agents
- Immunologic Factors
- Adjuvants, Immunologic
- Sphingosine 1 Phosphate Receptor Modulators
- Fingolimod Hydrochloride
- Interferon beta-1b
Other Study ID Numbers
- CFTY720DIT02
- 2010-024017-31 (EudraCT Number)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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