Longitudinal Analysis And Sample Collection To Evaluate PML Risk Host Markers for PML Risk Host Markers for PML Risk (SRA-001)
17 de febrero de 2021 actualizado por: John F. Foley, MD, Rocky Mountain MS Research Group, LLC
Longitudinal Meta-Analysis and Further Sample Collection To Evaluate Potential Host Markers for PML Risk
The purpose of the study is to develop an improved understanding of the long term pharmacokinetics and pharmacodynamics of natalizumab with both standard dosing and extended dosing, and collect additional samples to explore cell-based biomarkers of natalizumab treatment and PML risk.
Descripción general del estudio
Estado
Terminado
Condiciones
Descripción detallada
The underlying etiology for the association of natalizumab therapy to an increase risk of progressive multifocal leukoencephalopathy (PML) remains unknown.
It is possible that persistently high natalizumab levels lead to sustained immune-modulation or suppression resulting in an increased PML risk.
Since 2010 we have conducted three investigator initiated trials (IITs) at our center to measure serum natalizumab concentration, lymphocyte alpha 4 integrin saturation, and other biomarkers to understand the association of these markers to PML risk.
A number of the patients who participated in these clinical trials are still infusing.
These studies have demonstrated that plasma natalizumab concentrations continue to rise over time with a plateau effect not yet clearly delineated.
Improved drug clearance in patients with higher body weight is described in the prescribing information.
We have accumulated preliminary data suggesting that patients with lower body weight may be at higher risk for PML and that this may relate to higher drug concentrations and saturations seen in this group.
Dose extension may be a viable option to lower drug concentration (pharmacokinetic, PK) and saturation (pharmacodynamic, PD) in patients with lower body weight to potentially impact PML incidence.
In addition to the PK/PD of natalizumab, host related biomarkers may allow for more specific PML risk stratification.
Further validation of these biomarkers is critical for our understanding of their utility.
Tipo de estudio
De observación
Inscripción (Actual)
196
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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Utah
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Salt Lake City, Utah, Estados Unidos, 84103
- Rocky Mountain MS Research Group
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Método de muestreo
Muestra no probabilística
Población de estudio
Up to 200 patients with relapsing forms of multiple sclerosis.
All subjects will receive open label natalizumab according to their prescribing physician.
Descripción
Inclusion Criteria:
- Ability to understand the purpose and risks of the study and provide signed and dated consent and authorization to use protected health information (PHI) in accordance with national and local subject privacy regulations.
- Must be enrolled in the TOUCH Prescribing Program for Tysabri® (natalizumab) prior to informed consent.
- In the opinion of the Principal Investigator, must be able and willing to comply with all study directions
- ≥ 18 years of age at the time of informed consent
Exclusion Criteria:
- In the opinion of the Principal Investigator, subject is unwilling or unable to comply with study directions.
Subject who is pregnant, breastfeeding, or likely to becoming pregnant during the course of the study. Women of child-bearing potential must be practicing an acceptable form of birth control.
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Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Modelos observacionales: Grupo
- Perspectivas temporales: Otro
Cohortes e Intervenciones
Grupo / Cohorte |
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Group A: Natalizumab Naïve
This group will consist of up to 10 people who are naïve to natalizumab (haven't received the drug before) and are just beginning therapy.
These participants will meet with the study staff at Week 0 (Baseline) prior to their natalizumab infusion.
They will then have a follow up appointment every 3 months for the first 12 months of their natalizumab infusions, for a total of 5 visits.
Natalizumab concentration and other biomarkers will be measured at each visit.
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Group B: Intracycle Regular Dosing
This group will consist of at least 50 people who are on a regular infusing cycle of 28-31 days.
These participants will be consented at Week 0 (Baseline) and asked to come back each week during their regular cycle at Week 1, Week 2, and Week 3, for a total of 4 study visits.
Natalizumab concentration and other biomarkers will be measured during their participation in the study.
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Group C: Intracycle Extended Dosing
This group will consist of up to 60 people who are on an extended infusing cycle of greater than 30 days.
These participants will be consented at Week 0 (Baseline) and asked to come back each week for a blood draw to measure Natalizumab concentration and other biomarkers during their extended cycle at Week 2, and Week 4, for a total of 3 study visits.
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Group D: Transition Dosing
This group will consist of up to 10 people who are on a regular infusing cycle of 28-30 days who will be transitioning to an extended dosing cycle.
The decision to transition will be made by their treating neurologist.
These participants will be consented at Week 0 (Baseline) and will be followed for 8 cycles.
Natalizumab concentration will be measured at each cycle.
During certain cycles, other biomarkers will be measured.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Pharmacokinetic (PK) Changes over Time
Periodo de tiempo: 12 month
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Changes in natalizumab concentration (ug/ml) will be collected and compared to similar infusion cycle lengths collected previously in investigator-initiated trials at this site.
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12 month
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Pharmacodynamic (PD) Changes over Time
Periodo de tiempo: 12 month
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Changes in natalizumab saturation (%) will be collected and compared to similar infusion cycle lengths collected previously in investigator-initiated trials at this site.
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12 month
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Investigadores
- Investigador principal: John F Foley, MD, Rocky Mountain MS Research Group, LLC
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de octubre de 2014
Finalización primaria (Actual)
1 de marzo de 2017
Finalización del estudio (Actual)
1 de julio de 2020
Fechas de registro del estudio
Enviado por primera vez
16 de octubre de 2014
Primero enviado que cumplió con los criterios de control de calidad
6 de mayo de 2015
Publicado por primera vez (Estimar)
12 de mayo de 2015
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
21 de febrero de 2021
Última actualización enviada que cumplió con los criterios de control de calidad
17 de febrero de 2021
Última verificación
1 de febrero de 2021
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- SRA-001
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
No
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