Clinical Disease Activity With Long Term Natalizumab Treatment

January 3, 2019 updated by: Biogen

MRI and Clinical Disease Activity in Patients Treated Long Term With Natalizumab

The primary objective of the study is to retrospectively investigate the proportion of participants free of new or enlarging fluid-attenuated inversion recovery (FLAIR) lesions over time in approximately 300 Relapsing-Remitting Multiple Sclerosis (RRMS) participants with regular MRI follow-up, who have received natalizumab ≥24 month from two different observational cohorts: 1) approximately 230 participants from the Czech Republic; and 2) approximately 70 participants from Belgium. The secondary objectives of this study are as follows: Brain volume change by various measures; Changes in the number and volume of magnetic resonance imaging (MRI) lesions; No evidence of disease activity (NEDA) with and without brain volume change.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Natalizumab will not be provided to participants by Biogen as a part of this study. Participants will remain on natalizumab therapy as prescribed by their physician.

Study Type

Observational

Enrollment (Actual)

277

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

  • Belgium
      • Brussels, Belgium
        • Research Site 1
      • Brussels, Belgium
        • Research Site 2
      • Overpelt, Belgium
        • Research Site
  • Czechia
      • Prague, Czechia
        • Research Site

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

Sampling Method

Probability Sample

Study Population

Participants who have been receiving treatment with natalizumab for ≥24 months.

Description

Key Inclusion Criteria:

  • Diagnosis of RRMS.
  • Continuous treatment with natalizumab of ≥24 months. In case of a treatment interruption from natalizumab ≥60 days after a total treatment period of ≥24 months, only the treatment prior to the interruption will be analyzed. Any data after this treatment interruption (even if the patient restarts natalizumab) will not be analyzed/collected.
  • ≥1 MRI scan of sufficient quality for reliable measurement.
  • Baseline MRI scan ≤6 month prior to natalizumab treatment acquired.
  • ≥1 MRI scan of sufficient quality for reliable measurement taken while on natalizumab treatment for ≥6 months.
  • EDSS ≤ 6.5.

Key Exclusion Criteria:

  • Anti-natalizumab antibody detection.
  • Prior treatment with alemtuzumab.
  • Prior treatment with mitoxantrone within 12 months of the first infusion of natalizumab.

NOTE: 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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Czech Republic
Approximately 230 participants with RRMS receiving commercial natalizumab in Czech Republic
Drug: natalizumab
Participants with RRMS receiving commercial natalizumab in Belgium and Czech Republic
Other Names:
  • Tysabri
  • BG00002
Belgium
Approximately 70 participants with RRMS receiving commercial natalizumab in Belgium
Drug: natalizumab
Participants with RRMS receiving commercial natalizumab in Belgium and Czech Republic
Other Names:
  • Tysabri
  • BG00002

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change over time in the number of participants free of new or enlarging FLAIR lesions
Time Frame: Treatment years 3 and 4
Lesions that are ≥5 mm per scan (slice thickness 3 mm) as assessed by semiautomatic lesion count (by the Icometrix algorithm).
Treatment years 3 and 4

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Annualized brain volume change rate as assessed by % change in brain parenchymal fraction [BPF]
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
Post long term treatment with natalizumab (>2 years) through Year 4
Annualized brain volume change rate as assessed by percent brain volume change [PBVC]
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
Post long term treatment with natalizumab (>2 years) through Year 4
Annualized brain volume change rate as assessed by white matter [WM] and gray matter [GM] atrophy)
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
Post long term treatment with natalizumab (>2 years) through Year 4
Cumulative number of new ≥6-month confirmed T1-hypointense lesions
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
Post long term treatment with natalizumab (>2 years) through Year 4
Annualized T1-hypointense and FLAIR lesion volume change
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
Post long term treatment with natalizumab (>2 years) through Year 4
Cumulative percent change in T1-hypointense and FLAIR lesion volume
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
Post long term treatment with natalizumab (>2 years) through Year 4
Cumulative number of ≥6-month-confirmed T1-hypointense lesions arising from new on- treatment Gadolinium (Gd+)-enhancing lesions
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
No relapse and no ≥6-month confirmed Expanded Disability Status Scale (EDSS) progression and no new or enlarging FLAIR lesions and no new Gd+-enhancing lesions
Post long term treatment with natalizumab (>2 years) through Year 4
Number of total participants and 4-year completers with NEDA as measured by clinical measures
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
No relapse and no ≥6-month confirmed EDSS progression and no new or enlarging FLAIR lesions and no new Gd+-enhancing lesions, brain volume change rate as assessed by PBVC
Post long term treatment with natalizumab (>2 years) through Year 4
Number of total participants and 4-year completers with NEDA as measured by radiological measures
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
No new or enlarging FLAIR lesions and no new Gd+-enhancing lesions
Post long term treatment with natalizumab (>2 years) through Year 4
Number of participants with brain volume loss ≤0.2% and ≤0.4%
Time Frame: Post long term treatment with natalizumab (>2 years) through Year 4
Post long term treatment with natalizumab (>2 years) through Year 4

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Biogen

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 (Actual)

December 31, 2015

Primary Completion (Actual)

August 18, 2016

Study Completion (Actual)

August 18, 2016

Study Registration Dates

First Submitted

December 3, 2015

First Submitted That Met QC Criteria

February 4, 2016

First Posted (Estimate)

February 9, 2016

Study Record Updates

Last Update Posted (Actual)

January 4, 2019

Last Update Submitted That Met QC Criteria

January 3, 2019

Last Verified

December 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • BEL-TYS-14-10727

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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