Comprimidos de cladribina: estudio colaborativo para evaluar el impacto en los biomarcadores del sistema nervioso central en la esclerosis múltiple (CLOCK-MS)
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
Tipo de estudio
Tipo de estudio
Inscripción (Actual)
Inscripción
Fase
Fase
- Fase 4
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Gregory F Wu, MD, PhD
- Número de teléfono: 314-362-3293
- Correo electrónico: gfwu@wustl.edu
Copia de seguridad de contactos de estudio
- Nombre: Dana Perantie
- Correo electrónico: dperantie@wustl.edu
Ubicaciones de estudio
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Missouri
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St Louis, Missouri, Estados Unidos, 63110
- Washington University School of Medicine
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Oklahoma
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Oklahoma City, Oklahoma, Estados Unidos, 73104
- Oklahoma Medical Research Foundation
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Pennsylvania
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Philadelphia, Pennsylvania, Estados Unidos, 19104
- University of Pennsylvania
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Texas
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Dallas, Texas, Estados Unidos, 75390
- University of Texas Southwestern Medical Center
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Wisconsin
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Milwaukee, Wisconsin, Estados Unidos, 53226
- Medical College of Wisconsin
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Descripción
Criterios de inclusión:
- Tiene una forma recurrente de esclerosis múltiple (EMR; para incluir EMRR o EM progresiva secundaria activa)
- Están dispuestos y son capaces de recibir al menos 2 punciones lumbares
- Tener un EDSS de 0 a ≤ 5,5 durante el período de selección
- Tuvo al menos 1 recaída o 1 realce de gadolinio o 1 lesión T2 nueva o agrandada en los últimos 12 meses
- Tener un recuento absoluto de linfocitos (ALC) dentro del rango normal del laboratorio local o evaluado como normal por el investigador dentro del período de selección de 3 semanas y cumplir con todos los demás criterios de elegibilidad para el tratamiento con tabletas de cladribina
- Capaz de dar consentimiento informado firmado
Criterio de exclusión:
- Tiene alguna contraindicación para la punción lumbar.
- Tener malignidad actual
- Están infectados con el virus de la inmunodeficiencia humana (VIH)
- Tiene infecciones crónicas activas (p. hepatitis o tuberculosis)
- Tiene signos o síntomas sugestivos de leucoencefalopatía multifocal progresiva (LMP) en la resonancia magnética
- Tiene antecedentes de hipersensibilidad a la cladribina o a cualquiera de los excipientes enumerados en las tabletas de cladribina Información de prescripción de EE. UU.
- Alergia o hipersensibilidad al gadolinio y/o cualquier otra contraindicación para realizar una resonancia magnética
- Tiene otras condiciones comórbidas que impiden la participación.
- Han sido tratados previamente con cladribina
- Han sido tratados previamente con ocrelizumab, alemtuzumab, rituximab o daclizumab
- Haber recibido tratamiento con natalizumab durante los últimos 6 meses
- Actualmente recibe terapia inmunosupresora o mielosupresora, por ejemplo, metotrexato, ciclofosfamida, ciclosporina o azatioprina, o tratamiento crónico con corticosteroides sistémicos
- Haber recibido tratamiento con terapia inmunosupresora o mielosupresora durante los últimos 6 meses
- Haber recibido tratamiento crónico con corticoides sistémicos durante las últimas 4 semanas
- Tener insuficiencia hepática moderada o grave (puntuación de Child-Pugh > 6)
- Tiene insuficiencia renal moderada o grave (aclaramiento de creatinina
- Está embarazada o no quiere o no puede usar un método anticonceptivo eficaz durante la dosificación de las tabletas de cladribina y durante 6 meses después de la última dosis en cada ciclo de tratamiento.
- Tiene la intención de amamantar en un día de tratamiento con comprimidos de cladribina y/o durante los 10 días posteriores a la última dosis de comprimidos de cladribina.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Ciencia básica
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
|---|---|
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Otro: Grupo 1: LP al inicio y semana 5
Grupo 1: LP al inicio y al final de la semana 5. La semana 5 es el momento óptimo para evaluar las concentraciones de cladribina en LCR
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Todos los participantes recibirán comprimidos de cladribina de 10 mg en una dosis acumulada de 3,5 mg/kg divididos en 2 ciclos de tratamiento según la información de prescripción de los Estados Unidos (USPI) (1,75 mg/kg por ciclo de tratamiento; tratamiento del año 1 y del año 2).
Los pacientes serán aleatorizados 1:2:2:1 para recibir un total de 2 punciones lumbares en momentos específicos durante el ciclo de tratamiento.
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Otro: Grupo 3: LP al inicio y al final del año 1
Grupo 3: LP al inicio y al final del año 1.
Evaluar si los efectos de la cladribina en los marcadores del LCR se mantienen al final del primer ciclo de tratamiento
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Todos los participantes recibirán comprimidos de cladribina de 10 mg en una dosis acumulada de 3,5 mg/kg divididos en 2 ciclos de tratamiento según la información de prescripción de los Estados Unidos (USPI) (1,75 mg/kg por ciclo de tratamiento; tratamiento del año 1 y del año 2).
Los pacientes serán aleatorizados 1:2:2:1 para recibir un total de 2 punciones lumbares en momentos específicos durante el ciclo de tratamiento.
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Otro: Grupo 4: LP al inicio y al final del año 2
Grupo 4: LP al inicio y al final del año 2. Para evaluar si los efectos de la cladribina en los marcadores del LCR se mantienen al final del último ciclo de tratamiento
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Todos los participantes recibirán comprimidos de cladribina de 10 mg en una dosis acumulada de 3,5 mg/kg divididos en 2 ciclos de tratamiento según la información de prescripción de los Estados Unidos (USPI) (1,75 mg/kg por ciclo de tratamiento; tratamiento del año 1 y del año 2).
Los pacientes serán aleatorizados 1:2:2:1 para recibir un total de 2 punciones lumbares en momentos específicos durante el ciclo de tratamiento.
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Otro: Group 2: LP at Baseline and Week 10
Group 2: LP at Baseline and end of Week 10.
Week 10 is the hypothesized "nadir" time for lymphocyte and monocyte levels in CSF
|
Todos los participantes recibirán comprimidos de cladribina de 10 mg en una dosis acumulada de 3,5 mg/kg divididos en 2 ciclos de tratamiento según la información de prescripción de los Estados Unidos (USPI) (1,75 mg/kg por ciclo de tratamiento; tratamiento del año 1 y del año 2).
Los pacientes serán aleatorizados 1:2:2:1 para recibir un total de 2 punciones lumbares en momentos específicos durante el ciclo de tratamiento.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Change in CD3+ T Cells % From Baseline to Week 5
Periodo de tiempo: Baseline to Week 5 (5 weeks after first cladribine dose)
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Change in CSF level of CD3+ T lymphocytes from Baseline to second LP at Week 5, using quality-controlled flow cytometry and assays.
Within-group differences from baseline to Week 5 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD3+ T cell percentage and a negative number indicates decrease in CD3+ T cell percentage.
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Baseline to Week 5 (5 weeks after first cladribine dose)
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Change in CD3+ T Cells % From Baseline to Week 10
Periodo de tiempo: Baseline to Week 10 (10 weeks after first cladribine dose)
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Change in CSF level of CD3+ T lymphocytes from Baseline to second LP at Week 10, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Week 10 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD3+ T cell percentage and a negative number indicates decrease in CD3+ T cell percentage.
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Baseline to Week 10 (10 weeks after first cladribine dose)
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Change in CD3+ T Cells % From Baseline to Year 1
Periodo de tiempo: Baseline to Year 1 (45 weeks after first cladribine dose)
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Change in CSF level of CD3+ T lymphocytes from Baseline to second LP at Year 1, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Year 1 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD3+ T cell percentage and a negative number indicates decrease in CD3+ T cell percentage.
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Baseline to Year 1 (45 weeks after first cladribine dose)
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Change in CD3+ T Cells % From Baseline to Year 2
Periodo de tiempo: Baseline to Year 2 (45 weeks after last cladribine dose)
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Change in CSF level of CD3+ T lymphocytes from Baseline to second LP at Year 2, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Year 2 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD3+ T cell percentage and a negative number indicates decrease in CD3+ T cell percentage.
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Baseline to Year 2 (45 weeks after last cladribine dose)
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Change in CD3+ T Cells Absolute Numbers (Cells/mL) From Baseline to Week 5
Periodo de tiempo: Baseline to Week 5
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Change in CSF level of CD3+ T cells absolute numbers from Baseline to second LP at Week 5, using quality-controlled flow cytometry and assays.
Within-group differences from baseline to Week 5 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD3+ T cells absolute numbers and a negative number indicates decrease in CD3+ T cells absolute numbers.
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Baseline to Week 5
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Change in CD3+ T Cells Absolute Numbers (Cells/mL) From Baseline to Week 10
Periodo de tiempo: Baseline to Week 10 (10 weeks after first cladribine dose)
|
Change in CSF level of CD3+ T cells absolute numbers from Baseline to second LP at Week 10, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Week 10 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD3+ T cells absolute numbers and a negative number indicates decrease in CD3+ T cells absolute numbers.
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Baseline to Week 10 (10 weeks after first cladribine dose)
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Change in CD3+ T Cells Absolute Numbers (Cells/mL) From Baseline to Year 1
Periodo de tiempo: Baseline to Year 1 (45 weeks after first cladribine dose)
|
Change in CSF level of CD3+ T cells absolute numbers from Baseline to second LP at Year 1, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Year 1 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD3+ T cells absolute numbers and a negative number indicates decrease in CD3+ T cells absolute numbers.
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Baseline to Year 1 (45 weeks after first cladribine dose)
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Change in CD3+ T Cells Absolute Numbers (Cells/mL) From Baseline to Year 2
Periodo de tiempo: Baseline to Year 2 (45 weeks after last cladribine dose)
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Change in CSF level of CD3+ T cells absolute numbers from Baseline to second LP at Year 2, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Year 2 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD3+ T cells absolute numbers and a negative number indicates decrease in CD3+ T cells absolute numbers.
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Baseline to Year 2 (45 weeks after last cladribine dose)
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Change in CD19+ B Cells % From Baseline to Week 5
Periodo de tiempo: Baseline to Week 5 (5 weeks after first cladribine dose)
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Change in CSF level of CD19+ B lymphocytes from Baseline to second LP at Week 5, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Week 5 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD19+ B cell percentage and a negative number indicates decrease in CD19+ B cell percentage.
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Baseline to Week 5 (5 weeks after first cladribine dose)
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Change in CD19+ B Cells % From Baseline to Week 10
Periodo de tiempo: Baseline to Week 10 (10 weeks after first cladribine dose)
|
Change in CSF level of CD19+ B lymphocytes from Baseline to second LP at Week 10, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Week 10 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD19+ B cell percentage and a negative number indicates decrease in CD19+ B cell percentage.
|
Baseline to Week 10 (10 weeks after first cladribine dose)
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Change in CD19+ B Cells % From Baseline to Year 1
Periodo de tiempo: Baseline to Year 1 (45 weeks after first cladribine dose)
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Change in CSF level of CD19+ B lymphocytes from Baseline to second LP at Year 1, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Year 1 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD19+ B cell percentage and a negative number indicates decrease in CD19+ B cell percentage.
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Baseline to Year 1 (45 weeks after first cladribine dose)
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Change in CD19+ B Cells % From Baseline to Year 2
Periodo de tiempo: Baseline to Year 2 (45 weeks after last cladribine dose)
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Change in CSF level of CD19+ B lymphocytes from Baseline to second LP at Year 2, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Year 2 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD19+ B cell percentage and a negative number indicates decrease in CD19+ B cell percentage.
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Baseline to Year 2 (45 weeks after last cladribine dose)
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Change in CD19+ B Cells Absolute Numbers (Cells/mL) From Baseline to Week 5
Periodo de tiempo: Baseline to Week 5 (5 weeks after first cladribine dose)
|
Change in CSF level of CD19+ B cells absolute numbers from Baseline to second LP at Week 5, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Week 5 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD19+ B cells absolute numbers and a negative number indicates decrease in CD19+ B cells absolute numbers.
|
Baseline to Week 5 (5 weeks after first cladribine dose)
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Change in CD19+ B Cells Absolute Numbers (Cells/mL) From Baseline to Week 10
Periodo de tiempo: Baseline to Week 10 (10 weeks after first cladribine dose)
|
Change in CSF level of CD19+ B cells absolute numbers from Baseline to second LP at Week 10, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Week 10 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD19+ B cells absolute numbers and a negative number indicates decrease in CD19+ B cells absolute numbers.
|
Baseline to Week 10 (10 weeks after first cladribine dose)
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Change in CD19+ B Cells Absolute Numbers (Cells/mL) From Baseline to Year 1
Periodo de tiempo: Baseline to Year 1 (45 weeks after first cladribine dose)
|
Change in CSF level of CD19+ B cells absolute numbers from Baseline to second LP at Year 1, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Year 1 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD19+ B cells absolute numbers and a negative number indicates decrease in CD19+ B cells absolute numbers.
|
Baseline to Year 1 (45 weeks after first cladribine dose)
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Change in CD19+ B Cells Absolute Numbers (Cells/mL) From Baseline to Year 2
Periodo de tiempo: Baseline to Year 2 (45 weeks after last cladribine dose)
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Change in CSF level of CD19+ B cells absolute numbers from Baseline to second LP at Year 2, using quality-controlled flow cytometry and assays.
Within-group differences from Baseline to Year 2 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in CD19+ B cells absolute numbers and a negative number indicates decrease in CD19+ B cells absolute numbers.
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Baseline to Year 2 (45 weeks after last cladribine dose)
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Change in the Neurofilament Light Chain (NfL) Level From Baseline to Week 5
Periodo de tiempo: Baseline to Week 5 (5 weeks after first cladribine dose)
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Change in CSF level NfL (measured in pg/mL) from baseline to week 5 using the highly sensitive Neurology 4-Plex D Advantage Plus (N4PD+) single molecule array (SIMOA) technology.
A single batch of samples with duplicates were run at the conclusion of the study.
Within-group differences from baseline to Week 5 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in NfL value and a negative number indicates decrease in NfL value.
|
Baseline to Week 5 (5 weeks after first cladribine dose)
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Change in the Neurofilament Light Chain (NfL) Level From Baseline to Week 10
Periodo de tiempo: Baseline to Week 10 (10 weeks after first cladribine dose)
|
Change in CSF level NfL (measured in pg/mL) from baseline to Week 10 using the highly sensitive Neurology 4-Plex D Advantage Plus (N4PD+) single molecule array (SIMOA) technology.
A single batch of samples with duplicates were run at the conclusion of the study.
Within-group differences from baseline to Week 10 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in NfL value and a negative number indicates decrease in NfL value.
|
Baseline to Week 10 (10 weeks after first cladribine dose)
|
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Change in the Neurofilament Light Chain (NfL) Level From Baseline to Year 1
Periodo de tiempo: Baseline to Year 1 (45 weeks after first cladribine dose)
|
Change in CSF level NfL (measured in pg/mL) from baseline to Year 1 using the highly sensitive Neurology 4-Plex D Advantage Plus (N4PD+) single molecule array (SIMOA) technology.
A single batch of samples with duplicates were run at the conclusion of the study.
Within-group differences from baseline to Year 1 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in NfL value and a negative number indicates decrease in NfL value.
|
Baseline to Year 1 (45 weeks after first cladribine dose)
|
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Change in the Neurofilament Light Chain (NfL) Level From Baseline to Year 2
Periodo de tiempo: Baseline to Year 2 (45 weeks after last cladribine dose)
|
Change in CSF level NfL (measured in pg/mL) from baseline to year 2 using the highly sensitive Neurology 4-Plex D Advantage Plus (N4PD+) single molecule array (SIMOA) technology.
A single batch of samples with duplicates were run at the conclusion of the study.
Within-group differences from baseline to year 2 were analyzed using the Wilcoxon signed-rank test because outcome differences were non-normally distributed.
Positive number indicates increase in NfL value and a negative number indicates decrease in NfL value.
|
Baseline to Year 2 (45 weeks after last cladribine dose)
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Colaboradores
Colaboradores
Investigadores
Investigadores
- Investigador principal: Gregory Wu, MD, PhD, Washington University School of Medicine
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Inicio del estudio
Finalización primaria (Actual)
Finalización primaria
Finalización del estudio (Actual)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
- Enfermedades del Sistema Nervioso
- Enfermedades autoinmunes
- Enfermedades del sistema inmunológico
- Enfermedades Autoinmunes Desmielinizantes, SNC
- Enfermedades Autoinmunes del Sistema Nervioso
- Enfermedades desmielinizantes
- Esclerosis múltiple
- Esclerosis Múltiple Recurrente-Remitente
- Compuestos heterocíclicos
- Compuestos heterocíclicos, 2 anillos
- Compuestos heterocíclicos, anillo fusionado
- Ácidos nucleicos, nucleótidos y nucleósidos
- Purinas
- Nucleósidos
- Ribonucleósidos
- Desoxirribonucleósidos
- 2-cloroadenosina
- Adenosina
- Nucleósidos de purina
- Desoxiadenosinas
- Cladribina
Otros números de identificación del estudio
Otros números de identificación del estudio
- MS700568_0049-201906092
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
producto fabricado y exportado desde los EE. UU.
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