Tato stránka byla automaticky přeložena a přesnost překladu není zaručena. Podívejte se prosím na anglická verze pro zdrojový text.

PRIMUS : Real World Usage for Real World Evidence of CDSS Use in Multiple Sclerosis (PRIMUS)

9. června 2026 aktualizováno: Nantes University Hospital

PRIMUS a Multi-centre, Controlled, Cluster-randomised, Open Study of Multiple Impacts of CDSS Use in Multiple Sclerosis : Real World Usage for Real World Evidence

This study evaluates a Clinical Decision Support System (CDSS), named PRIMUS, designed to support therapeutic decision-making in MS. The CDSS is based on a validated reference database integrating retrospective data from randomized controlled trials and the French national MS cohort (Observatoire Français de la Sclérose en Plaques, OFSEP). This reference database consists of synthetic data derived from these sources.

PRIMUS enables visualization of disease activity at 1 and 2 years under different therapeutic scenarios, based on clinical and MRI characteristics of patients similar to the patient of interest. The CDSS PRIMUS aims to support informed and individualized treatment decisions. Because MRI is a critical marker of disease activity previously acquired MRI scans will be reanalyzed using automated segmentation and validated by a radiologist to standardize lesion assessment across centers. The results will be displayed to the neurologist and, if appropriate shown to the patient using a dedicated viewer, and can be discussed during the consultation.

A cluster-randomized controlled trial, with hospitals as the unit, will be conducted to evaluate the impact of the CDSS on treatment decision-making in patients with relapsing-remitting MS. The primary objective is to assess whether the use of the CDSS influences therapeutic choices during clinical consultations.

The study hypothesis is that use of the CDSS will increase the proportion of high-efficacy treatments initiated or selected, compared with usual care without CDSS support.

In parallel, an optional sub-study using a mixed-methods approach will explore clinicians' and patients' perceptions of, and interactions with, the CDSS.

Přehled studie

Postavení

Zatím nenabíráme

Podmínky

Intervence / Léčba

Typ studie

Intervenční

Zápis (Odhadovaný)

448

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní záloha kontaktů

Studijní místa

  • Francie
      • Angers, Francie, 49933
        • Angers Hospital
        • Kontakt:
      • Antibes, Francie, 06606
      • Bordeaux, Francie, 33076
      • Brest, Francie, 29609
      • Caen, Francie, 14000
        • Caen hospital
        • Kontakt:
      • Clermont-Ferrand, Francie
      • Colmar, Francie
      • Créteil, Francie, 94000
        • Hôpital Henri Mondor
        • Kontakt:
      • Dijon, Francie, 21079
      • Grenoble, Francie, 38700
        • Grenoble Alpes Hospital
        • Kontakt:
      • La Roche-sur-Yon, Francie, 85925
      • Lille, Francie, 59037
      • Lyon, Francie, 69500
        • Hospices Civils de Lyon
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Sandra Mrs VUKUSIC, Professor
      • Marseille, Francie, 13385
        • Marseille Hospital / La Timone
        • Kontakt:
      • Metz, Francie, 57530
      • Montpellier, Francie, 34295
        • Montpellier Hospital
        • Kontakt:
          • Pierre LABAUGE, Pr
          • Telefonní číslo: 04 67 33 94 69
          • E-mail: labauge@yahoo.fr
      • Nancy, Francie, 54035
        • Nancy Hospital
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Guillaume M MATHEY, PHD
      • Nice, Francie, 06000
        • Nice Hospital
        • Kontakt:
          • Christine Mrs LEBRUN-FRENAY, Professor
          • Telefonní číslo: 04 92 03 85 27
          • E-mail: lebrun.c@chu-nice.fr
        • Vrchní vyšetřovatel:
          • Christine Mrs LEBRUN-FRENAY, Professor
      • Nîmes, Francie, 30029
      • Paris, Francie, 75019
        • Hopital Fondation ROTSCHILD
      • Poissy, Francie, 78303
      • Poitiers, Francie, 86021
        • Poitiers Hospital
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Amélie Mrs DOS SANTOS, PHD
      • Rennes, Francie, 35000
        • Rennes Hospital
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Laure Michel, Professor
      • Rouen, Francie, 76000
        • Rouen Hospital
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Bertrand BOURRE, Professor
      • Saint-Brieuc, Francie, 22027
        • Saint-Brieuc Hospital
        • Kontakt:
        • Vrchní vyšetřovatel:
          • François M LALLEMENT, PHD
      • St-Malo, Francie
        • Groupement Hospitalier Rance Emeraude Saint Malo
        • Kontakt:
      • Strasbourg, Francie, 67200
        • Strasbourg Hospital
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Jerome M DE SEZE, Professor
      • Toulouse, Francie, 31059
        • Toulouse Hospital
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Jonathan M CIRON, PHD
      • Tours, Francie, 37044
      • Vannes, Francie, 56017
        • Groupement Hospitalier Brocéliande Atlantique Vannes
        • Kontakt:
      • Épinal, Francie, 88000

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

Inclusion Criteria:

  • Men and women aged >18 and ≤50 years.
  • Patients with relapsing-remitting multiple sclerosis (RRMS) according to the McDonald 2024 criteria.

  • Patients for whom a change in therapeutic management is being considered due to:

    • intolerance to treatment or personal preference in the absence of inflammatory activity, whether patients are:

      • on a moderately effective disease-modifying therapy [Interferon beta; Glatiramer acetate; Teriflunomide; Dimethyl fumarate; Diroximel fumarate] for at least 12 months without interruption
      • on anti-S1P therapy [Fingolimod; Ponesimod] for at least 12 months without interruption or

    • recent inflammatory activity (relapse or at least one T1 Gd+ lesion or one new T2 lesion) reported or observed at inclusion, whether patients are:

      • treatment-naïve
      • on a moderately effective disease-modifying therapy for at least 6 months or on anti-S1P therapy for at least 6 months
      • untreated for at least one year
  • Patients with MRI follow-up including at least one 3D brain FLAIR sequence and a T1 Gd+ sequence in the case of a re-baseline brain MRI within the past 6 months.
  • Patients whose MRI scans are available for download on the day of consultation.
  • Patients affiliated with or beneficiaries of a social security system.
  • Patients able to provide written informed consent. For women of childbearing potential, use of an effective method of contraception throughout the study in accordance with the recommendations of the Clinical Trials Coordination Group

Exclusion Criteria:

  • Patients with a progressive form of multiple sclerosis (primary or secondary).
  • Patients with current or past history of other autoimmune diseases.
  • Patients with uncontrolled disease, other than active MS.
  • Patients exposed to Mitoxantrone, Alemtuzumab, or Cladribine within the 3 years prior to inclusion.
  • Patients exposed to Ocrelizumab or Rituximab within the 18 months prior to inclusion.
  • Patients exposed to Ofatumumab within the 12 months prior to inclusion.
  • Patients receiving high-efficacy disease-modifying therapy [Natalizumab; Ofatumumab; Alemtuzumab; Cladribine; Mitoxantrone; Ocrelizumab], or Rituximab, with the exception of S1P receptor modulators.
  • Patients receiving Mycophenolate mofetil, azathioprine, cyclophosphamide (Endoxan), or having undergone stem cell transplantation.
  • Patients participating in another clinical trial, whether therapeutic or not, that could interfere with the objectives of the study.
  • Patients who have participated in a therapeutic trial within the 24 months prior to inclusion.
  • Pregnant or breastfeeding women, or those planning pregnancy during the study.
  • Patients under legal protection (guardianship, curatorship, or other protective measures).

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Jiný
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Consultation with clinical decision support system CDSS
Participants will undergo a consultation supported by a CDSS when initiation or modification of MS treatment is being considered.
Přístroj: Clinical decision support system

The Clinical Decision Support System (CDSS) PRIMUS is a software (as medical device) designed to support therapeutic decisions in multiple sclerosis (MS) and assist clinicians during consultations in which initiation or modification of MS treatment is considered.

The system uses retrospective clinical and MRI data from a reference database to generate visualizations of disease evolution over a 2-year period under different therapeutic scenarios, based on patient-specific characteristics entered by the clinician.

PRIMUS does not make treatment recommendations and does not replace clinical judgment. All treatment decisions remain at the discretion of the clinician
Žádný zásah: Usual care (consultation without CDSS)
Participants will receive standard clinical care without the use of a Clinical Decision Support System (CDSS). Treatment decisions will be made according to routine clinical practice.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Treatment choice
Časové okno: once at Month 1
Treatment decision at the end of the consultation with or without CDSS use. Patients will be classified into groups: high-efficacy disease-modifying therapies (anti-CD20 therapies, natalizumab, cladribine, S1P receptor modulators), moderate-efficacy therapies (interferon beta, dimethyl fumarate, teriflunomide), or no treatment. Results will be expressed as the percentage of patients in each category/ The distribution of treatment strategies will be expressed as the percentage of patients in each category.
once at Month 1

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Treatment decision concordance with expert recommendation
Časové okno: Month 1
Assessment of concordance defined as agreement (Yes/no) between the treatment decision made by the neurologist at the end of the consultation (Month 1, with or without CDSS use) and the treatment decision recommended by an independent expert panel of experts.
Month 1
Patient Adherence: Concordance Between Prescribed and Actual Treatment
Časové okno: Month 10, last visit
Assessment of concordance (yes/no) between the treatment decision made by the neurologist at the end of the consultation (Month 1, with or without CDSS use) and the treatment actually taken by the patient at Month 10.
Month 10, last visit
Treatment Decision Concordance with Dynamic Score Recommendation
Časové okno: Month 1
Assessment of concordance defined as agreement (yes/no) between the treatment decision made by the neurologist at the end of the consultation (M1, with or without CDSS use) and recommendations derived from a dynamic scoring system designed to guide early switching from first-line to second-line disease-modifying therapy in patients with relapsing-remitting MS.For this outcome measure, results will be reported as the proportion of participants whose treatment decision is concordant with the recommendation generated by the dynamic score (Yes/No).The dynamic score is based on predefined clinical and radiological criteria and identifies patients who may benefit from early treatment escalation to reduce the risk of relapse.The recommendation generated by the score (maintain first-line therapy or escalate to second-line therapy) will be compared to the neurologist's treatment decision.Concordance will be considered achieved if the neurologist's treatment decision matches the recommendations
Month 1
Evolution of treatment decision
Časové okno: Month 1

Assessment of concordance defined as agreement (yes/no) between the treatment decision initially considered by the neurologist at inclusion (Month 0) and the treatment decision made at the end of the consultation (Month 1, with or without CDSS use).

This outcome evaluates whether the initial treatment strategy is maintained or modified between Month 0 and Month 1, including potential influence of CDSS use during the consultation
Month 1
Cost-utility analysis of CDSS use
Časové okno: Month 0 to Month 10

A cost-utility analysis will be conducted from a societal perspective over a 10-month period : at baseline (Month 0), Month 1, and Month 10 to evaluate the impact of CDSS use.

Health-related quality of life will be assessed using the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L). The EQ-5D-5L descriptive system includes five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), each with five response levels.

Utility index values range from values below 0 (health states worse than death) to 1 (perfect health), with higher scores indicating better health status.

Costs related to multiple sclerosis care will be collected over the study period (M0-M10) using patient diaries. Quality-adjusted life years (QALYs) will be estimated from EQ-5D-5L utility values and combined with cost data to perform the cost-utility analysis.
Month 0 to Month 10
Patient-Reported Outcomes: Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL) Score
Časové okno: Month 0 and Month 10

Health-related quality of life will be assessed using validated patient-reported outcome (PRO) instrument : the Multiple Sclerosis-specific quality of life questionnaire (MusiQoL) at baseline (Month 0) and Month 10.

The MusiQoL provides a disease-specific assessment of quality of life in multiple sclerosis. The MusiQoL global index score ranges from 0 to 100.

Higher scores indicate better health-related quality of life.
Month 0 and Month 10
Patient-Reported Outcomes: Health-Related Quality of life : 12-Item Short Form Health Survey (SF-12) Score
Časové okno: Month 0 and Month 10

General health-related quality of life will be assessed using the 12-Item Short Form Health Survey (SF-12) at baseline (Month 0) and Month 10. It evaluates general health-related quality of life.

The SF-12 generates Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Scores generally range from 0 to 100.

Higher scores indicate better health-related quality of life.
Month 0 and Month 10
Clinician-Reported Usability of the Clinical Decision Support System (CDSS)
Časové okno: Month 1

In the CDSS arm only, patient experience will be assessed using a dedicated 10-item questionnaire administered after a consultation supported by the Clinical Decision Support System (CDSS) at Month 1.

Each item is rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 10 to 50, with higher scores indicating a better patient experience with the CDSS-supported consultation.
Month 1
Patient experience with CDSS use Patient Experience with Clinical Decision Support System (CDSS) Use
Časové okno: Month 1

In the CDSS arm only, patient experience will be assessed using a dedicated 10-item questionnaire administered after a consultation supported by the Clinical Decision Support System (CDSS) at Month 1.

Each item is rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 10 to 50, with higher scores indicating a better patient experience with the CDSS-supported consultation.
Month 1
Neurologist Experience with MRI Viewer Use During Consultation
Časové okno: Month 1

Neurologists' experience with MRI viewer use during consultation will be assessed in both study arms (with or without CDSS use).

Experience will be assessed using a dedicated 10-item questionnaire rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 10 to 50, with higher scores indicating greater satisfaction and perceived usability of MRI visualization. All participating neurologists will complete the questionnaire.
Month 1
Patient Experience with MRI Viewer Use During Consultation
Časové okno: Month 1

Patient experience regarding MRI visualization using the viewer during neurological consultation will be assessed in both study arms.

Experience will be assessed using a dedicated 10-item questionnaire rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 10 to 50, with higher scores indicating greater satisfaction and improved understanding of MRI information. All included patients will complete the questionnaire.
Month 1
Consultation duration
Časové okno: Month 1
Impact of the (CDSS) on the duration of the neurological consultation. Consultation duration will be defined as the time (in minutes) elapsed between the start and end of the consultation (in minutes) at Month 1, conducted either with or without CDSS support
Month 1
Device reliability
Časové okno: Month 1

Reliability of the Clinical Decision Support System (CDSS) will be assessed by recording the number of device-related issues occurring during the study period. These issues include system failures, software bugs, interface malfunctions, security issues, interpretation errors, performance degradation, and connectivity problems.

All CDSS-related malfunctions or operational issues will be recorded
Month 1

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Nantes University Hospital

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

30. června 2026

Primární dokončení (Odhadovaný)

31. října 2027

Dokončení studie (Odhadovaný)

31. července 2028

Termíny zápisu do studia

První předloženo

2. června 2026

První předloženo, které splnilo kritéria kontroly kvality

9. června 2026

První zveřejněno (Aktuální)

15. června 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

15. června 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

9. června 2026

Naposledy ověřeno

1. června 2026

Více informací

Termíny související s touto studií

Klíčová slova

Další relevantní podmínky MeSH

Další identifikační čísla studie

  • RC22_0577
  • 2026-A00510-51 (Jiný identifikátor: Nantes Hospital)

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NEROZHODNÝ

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

Klinické studie na Clinical decision support system

Prohledejte podobné pokusy

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

CROs by country

CROs in Türkiye

Podmínky

Vzácné nemoci

Drogové intervence

Doplňky stravy

Sponzor / Spolupracovníci

Místa

Předplatit