The Wearing-off Phenomenon of Ocrelizumab in Patients With Multiple Sclerosis (WOC)

September 22, 2021 updated by: Zoé van Kempen, Amsterdam UMC, location VUmc
The primary goal of this research is to study the prevalence of the wearing-off effect and possible risk factors for wearing-off symptoms in patients with multiple sclerosis using ocrelizumab with the use of questionnaires. Furthermore, the goal is to study whether patients receiving extended dosing of ocrelizumab experience more wearing-off symptoms or adverse events in general. Finally, we would like to extend knowledge on wearing-off symptoms in general.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Ocrelizumab is a monoclonal antibody very effective for the treatment of relapsing-remitting multiple sclerosis and primary progressive multiple sclerosis. Ocrelizumab is usually administered intravenous every six months. Natalizumab is another type of treatment used for relapsing-remitting multiple sclerosis and is administered every four weeks. Often patients report MS-related symptoms just prior to their next infusion such as fatigue, coordination problems or motor problems, the so-called wearing-off phenomenon. The exact etiology of this phenomenon remains unknown. Although not studied before, patients do report similar symptoms when using ocrelizumab. Furthermore, because of the COVID-19 pandemic, some patients receive extended dosing of ocrelizumab based on b-cell count. Whether this can increase wearing-off symptoms is unknown.

The goal of this research is to study the prevalence of wearing-off symptoms and possible risk factors for wearing-off symptoms in patients with multiple sclerosis using ocrelizumab. All patients using ocrelizumab during one year or more that provided written informed consent to participate in the study will be asked to complete three questionnaires before or during their next treatment with ocrelizumab. The questionnaires that will be used are the MSIS-29, the treatment satisfaction questionnaire and a questionnaire about wearing-off symptoms. Exact weight of the participants will be measured. Information about age, gender, date of diagnosis, start date of ocrelizumab, clinical and radiological disease activity, EDSS score, b-cell count and the biomarker neurofilament light will be extracted from the patient files. After two weeks, participants receive two additional digital questionnaires, the MSIS-29 and a follow-up questionnaire about wearing-off symptoms.

Study Type

Observational

Enrollment (Actual)

117

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

  • Netherlands
    • North-Holland
      • Amsterdam, North-Holland, Netherlands, 1007 MB
        • Amsterdam Umc, Location Vumc

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 and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Patients with multiple sclerosis using ocrelizumab.

Description

Inclusion Criteria:

  • 18 years or older
  • Diagnosis multiple sclerosis
  • Use of ocrelizumab as a treatment for multiple sclerosis for a minimum of one year

Exclusion Criteria:

  • Unable to answer questionnaires in Dutch
  • Different infusion protocol during the previous ocrelizumab infusion (e.g. 300 mg of ocrelizumab instead of 600 mg).

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

  • Observational Models: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Patients with multiple sclerosis using ocrelizumab.
Patients with multiple sclerosis using ocrelizumab for a minimum of one year.
Other: Questionnaires
All participants will fill in two questionnaires before or during their next treatment with ocrelizumab: the MSIS-29 questionnaire and a wearing-off questionnaire. After two weeks, participants fill in two digital questionnaires (MSIS-29, additional wearing-off questionnaire).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Wearing-off symptoms
Time Frame: Baseline
Prevalence of wearing-off symptoms prior to ocrelizumab infusion (yes/no assessed on questionnaires)
Baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
% of wearing-off symptoms (yes/no assessed on questionnaires) in correlation to the % of patients with extended dosing versus standard dosing with ocrelizumab.
Time Frame: At baseline (prior to next infusion with ocrelizumab)
% of wearing-off symptoms (yes/no assessed on questionnaires) in correlation to the % of patients with extended dosing versus standard dosing with ocrelizumab.
At baseline (prior to next infusion with ocrelizumab)
Neurofilament light levels in patients with wearing-off symptoms.
Time Frame: At baseline (prior to next infusion with ocrelizumab)
Neurofilament light levels in patients with wearing-off symptoms compared to patients without wearing-off symptoms.
At baseline (prior to next infusion with ocrelizumab)
Absolute B-cells count in blood in correlation to the presence of wearing-off symptoms (yes/no assessed on questionnaires)
Time Frame: At baseline (prior to next infusion with ocrelizumab)
Absolute B-cells count in blood in correlation to the presence of wearing-off symptoms (yes/no assessed on questionnaires) levels in patients with wearing-off symptoms.
At baseline (prior to next infusion with ocrelizumab)
Type of multiple sclerosis (either RRMS or PPMS) in correlation to % of patients with wearing-off symptoms (yes/no assessed on questionnaires).
Time Frame: At baseline (prior to next infusion with ocrelizumab)
Type of multiple sclerosis (either RRMS or PPMS) in correlation to % of patients with wearing-off symptoms (yes/no assessed on questionnaires).
At baseline (prior to next infusion with ocrelizumab)
Treatment satisfaction score measured by the treatment satisfaction questionnaire in correlation to the % of patients with wearing-off symptoms (yes/no assessed on questionnaires)
Time Frame: At baseline (prior to next infusion with ocrelizumab)
Treatment satisfaction score measured by the treatment satisfaction questionnaire in correlation to the % of patients with wearing-off symptoms (yes/no assessed on questionnaires)
At baseline (prior to next infusion with ocrelizumab)
Self-reported disability (MSIS-29 questionnaire) compared before and after ocrelizumab infusion in patients with wearing-off symptoms
Time Frame: At baseline (prior to next infusion with ocrelizumab) and after two weeks
Self-reported disability before ocrelizumab infusion compared before and after ocrelizumab (delta scores) in patients with wearing-off symptoms
At baseline (prior to next infusion with ocrelizumab) and after two weeks
Self-reported disability (MSIS-29 questionnaire) after ocrelizumab infusion in patients without wearing-off symptoms
Time Frame: At baseline (prior to next infusion with ocrelizumab) and after two weeks
Self-reported disability after ocrelizumab infusioSelf-reported disability before ocrelizumab infusion compared before and after ocrelizumab (delta scores) in patients with wearing-off symptomsn in patients without wearing-off symptoms
At baseline (prior to next infusion with ocrelizumab) and after two weeks
Change of wearing-off symptoms after ocrelizumab infusion in patients with wearing-off symptoms
Time Frame: Two weeks after ocrelizumab infusion
Change of wearing-off symptoms after ocrelizumab infusion in patients with wearing-off symptoms as measured with the wearing-off questionnaire (questionnaire designed for this study evaluating wearing-off symptoms).
Two weeks after ocrelizumab infusion
Post-dose symptoms after ocrelizumab infusion
Time Frame: Two weeks after ocrelizumab infusion
Post-dose symptoms after ocrelizumab infusion as measured with the wearing-off questionnaire (questionnaire designed for this study evaluating wearing-off symptoms).
Two weeks after ocrelizumab infusion

Collaborators and Investigators

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

Sponsor

Amsterdam UMC, location VUmc

Investigators

  • Principal Investigator: Joep Killestein, MD, PhD., Amsterdam Umc, Location Vumc

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)

May 12, 2020

Primary Completion (Actual)

April 1, 2021

Study Completion (Actual)

May 1, 2021

Study Registration Dates

First Submitted

June 24, 2020

First Submitted That Met QC Criteria

July 15, 2020

First Posted (Actual)

July 20, 2020

Study Record Updates

Last Update Posted (Actual)

September 28, 2021

Last Update Submitted That Met QC Criteria

September 22, 2021

Last Verified

September 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2020.191

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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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