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Multiple SclerosisPhase 3TENERENCT00883337

A Study Comparing the Effectiveness and Safety of Teriflunomide and Interferon Beta-1a in Patients With Relapsing Multiple Sclerosis

A Phase 3 study testing Interferon β-1a and Teriflunomide in people with Multiple Sclerosis, run by Sanofi at 54 sites in 13 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Primary objective was to assess the effectiveness evaluated by the time to failure of two doses of teriflunomide in comparison to interferon beta-1a in participants with relapsing Multiple Sclerosis [MS]. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Multiple Sclerosis
What is being tested?
Interferon β-1a and Teriflunomide
Could I receive a placebo?
No, everyone receives an active treatment
How many people
324 participants
Where
54 sitesin 13 countries
Study dates
Apr 2009to May 2015
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Relapsing form of MS meeting McDonald's criteria for MS diagnosis and Expanded Disability Status Scale [EDSS] score ≤5.5 at screening visit.

Who cannot join

  • Significantly impaired bone marrow function or, significant anemia, leukopenia or thrombocytopenia;
  • Persistent significant or severe infection.
  • Liver function impairment or known history of hepatitis.
  • Use of adrenocorticotrophic hormone [ACTH] or systemic corticosteroids for 2 weeks prior to randomization.
  • Human immunodeficiency virus [HIV] positive.
  • Prior use of Rebif®, or prior or concomitant use of other interferons in the 3 months prior to randomization.
Show all 15Show fewer
  • Prior or concomitant use of cladribine, mitoxantrone, or other immunosuppressant agents such as azathioprine, cyclophosphamide, cyclosporin, methotrexate, mycophenolate, or natalizumab.
  • Pregnant or breast-feeding woman.
  • Extension criteria:
  • The participants who met all the following criteria at the end of the core study period were eligible for enrolment into the open-label extension phase:
  • Participants who had not discontinued treatment in the core period and who had a minimum treatment of 48 weeks and completed the EOT visit (Visit 18).
  • Participants who had not met criteria for treatment withdrawal.
  • An informed consent must be obtained in writing from the participant for this open-label extension phase prior to entering and prior to completion of any extension phase procedure.
  • Participants who demonstrated a willingness and ability to roll over to the extension phase with the opportunity to continue treatment on 14 mg/day of teriflunomide under open-label.
  • The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Trial locations and contacts

54 sites in 13 countries.

54 sites in 13 countries

Germany11 sites
  • Investigational Site Number 276003

    Bad Mergentheim, 97980

  • Investigational Site Number 276011

    Berlin, 10117

  • Investigational Site Number 276012

    Berlin, 12099

  • Investigational Site Number 276001

    Bochum, 44791

  • Investigational Site Number 276005

    Dresden, 01307

  • Investigational Site Number 276007

    Erbach im Odenwald, 64711

  • Investigational Site Number 276006

    Essen, 45138

  • Investigational Site Number 276004

    Halle, 06120

  • Investigational Site Number 276010

    Hanover, 30559

  • Investigational Site Number 276009

    Mainz, 55131

  • Investigational Site Number 276002

    Münster, 48149

Other trials in Germany

Italy9 sites
  • Investigational Site Number 380010

    Ancona, 60020

  • Investigational Site Number 380005

    Bari, 70124

  • Investigational Site Number 380008

    Cagliari, 09126

  • Investigational Site Number 380003

    Cefalù, 90015

  • Investigational Site Number 380007

    Genova, 16132

  • Investigational Site Number 380001

    Milan, 20132

  • Investigational Site Number 380004

    Pavia, 27100

  • Investigational Site Number 380002

    Roma, 00185

  • Investigational Site Number 380006

    Torino, 10126

Other trials in Italy

Hungary6 sites
  • Investigational Site Number 348001

    Budapest, 1083

  • Investigational Site Number 348005

    Budapest, 1096

  • Investigational Site Number 348003

    Budapest, 1106

  • Investigational Site Number 348002

    Esztergom, 2500

  • Investigational Site Number 348007

    Kecskemét, 6000

  • Investigational Site Number 348004

    Veszprém, 8200

Other trials in Hungary

France5 sites
  • Investigational Site Number 250003

    Bordeaux, 33076

  • Investigational Site Number 250005

    Clermont-Ferrand, 63003

  • Investigational Site Number 250004

    Lille, 59037

  • Investigational Site Number 250001

    Montpellier, 34000

  • Investigational Site Number 250002

    Strasbourg, 67091

Other trials in France

Poland4 sites
  • Investigational Site Number 616002

    Bialystok, 15-276

  • Investigational Site Number 616004

    Gdansk, 80-803

  • Investigational Site Number 616003

    Lublin, 20-718

  • Investigational Site Number 616001

    Warsaw, 02-957

Other trials in Poland

Spain4 sites
  • Investigational Site Number 724007

    Barcelona, 08036

  • Investigational Site Number 724001

    Bilbao, 48013

  • Investigational Site Number 724002

    Majadahonda, 28222

  • Investigational Site Number 724003

    Murcia, 30120

Other trials in Spain

Belgium3 sites
  • Investigational Site Number 056003

    Brussels, 1070

  • Investigational Site Number 056001

    Ghent, 9000

  • Investigational Site Number 056002

    Hasselt, B-3590

Other trials in Belgium

Canada3 sites
  • Investigational Site Number 124003

    Lévis, G6V 3Z1

  • Investigational Site Number 124002

    London, N6A 5A5

  • Investigational Site Number 124004

    St. John's, A1B 3V6

Other trials in Canada

Czechia3 sites
  • Investigational Site Number 203004

    Jihlava, 58633

  • Investigational Site Number 203003

    Prague, 10034

  • Investigational Site Number 203002

    Prague, 12808

Other trials in Czechia

Greece2 sites
  • Investigational Site Number 300001

    Athens, 11527

  • Investigational Site Number 300002

    Thessaloniki

Other trials in Greece

United Kingdom2 sites
  • Investigational Site Number 826002

    London, SW17 0QT

  • Investigational Site Number 826003

    Plymouth, PL6 5BX

Other trials in United Kingdom

Switzerland1 site
  • Investigational Site Number 756002

    Sankt Gallen, 9007

Other trials in Switzerland

Tunisia1 site
  • Investigational Site Number 788002

    Monastir, 5000

Other trials in Tunisia

About this study

Official title: A Multi-center, Randomized, Parallel-group, Rater-blinded Study Comparing the Effectiveness and Safety of Teriflunomide and Interferon Beta-1a in Patients With Relapsing Multiple Sclerosis Plus a Long Term Extension Period

Primary objective was to assess the effectiveness evaluated by the time to failure of two doses of teriflunomide in comparison to interferon beta-1a in participants with relapsing Multiple Sclerosis [MS].

Secondary objectives were:

Read more
  • To assess the effect of the two doses in comparison to interferon beta-1a on:
  • Frequency of relapses,
  • Fatigue,
  • Participant's satisfaction with treatment.
  • To evaluate the safety and tolerability of the two doses in comparison to interferon beta-1a.

The study consisted of a core treatment period with a common end date defined as 48 weeks after randomization of the last participant, followed by an optional long-term extension treatment period until teriflunomide is commercially available in accordance with local regulations.

Read the detailed description

The core treatment period per participant was variable depending on the enrollment in the study (maximum of approximatively 118 weeks). The two doses of teriflunomide were administered in double-blind fashion, whereas interferon beta-1a (Rebif®) was open-label.

The opportunity to continue with the highest dose of teriflunomide in open-label fashion was offered to the participants who successfully completed treatment in the core study.

The overall treatment period was followed by a 4-week elimination follow-up period.

Being tested
Interferon β-1a, Teriflunomide
Keywords
Relapsing-remitting multiple sclerosis
Medical subject headings
Multiple Sclerosis, Multiple Sclerosis, Relapsing-Remitting

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Interferon β-1aDrug

    Also called Rebif®

    Sterile preservative-free solution packaged in graduated pre-filled syringes

    Subcutaneous injection

    Ascending doses from 8.8 to 44 mcg according to local standard for Rebif®

  • TeriflunomideDrug

    Also called HMR1726

    Film-coated tablet

    Oral administration

Study groups in NCT00883337
Study groupRoleWhat they receive
Teriflunomide 7 mg / 14 mgExperimentalTeriflunomide 7 mg once daily (core treatment period) and teriflunomide 14 mg once daily (extended treatment period).
Receives: Drug: Teriflunomide
Teriflunomide 14 mg / 14 mgExperimentalTeriflunomide 14 mg once daily (core treatment period) and teriflunomide 14 mg once daily (extension treatment period).
Receives: Drug: Teriflunomide
IFN-β-1a / 14 mgActive comparatorInterferon β-1a 3 times a week (core treatment period) and teriflunomide 14 mg once daily (extended treatment period).
Receives: Drug: Interferon β-1a; Drug: Teriflunomide

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Core Treatment Period: Overview of Failures

    Failure was defined as the first occurence of confirmed relapse or permanent treatment discontinuation (for any cause) which ever came first. If no events occurred, the participant was considered free of failure.

    Each episode of relapse - appearance, or worsening of a clinical symptom that was stable for at least 30 days, that persisted for a minimum of 24 hours in the absence of fever - was to be confirmed by an increase in Expanded Disability Status Scale [EDSS] score or Functional System scores.

    Measured: Core treatment period between 48 and 118 weeks depending on when the participant was enrolled

  2. Core Treatment Period: Time to Failure: Kaplan-Meier Estimates of the Rate of Failure at Timepoints

    Probability of disability progression at 24, 48 and 96 weeks was estimated using Kaplan-Meier method on the time to failure defined as the time from randomization to failure. Participants free of failure were censored at the date of last treatment.

    Kaplan-Meier method consists in computing probabilities of non occurrence of event at any observed time of event and multiplying successive probabilities for time ≤t by any earlier computed probabilities to estimate the probability of being event-free for the amount of time t. Probability of event at time t is 1 minus the probability of being event-free for the amount of time t.

    Measured: Core treatment period between 48 and 118 weeks depending on when the participant was enrolled

Secondary outcomes (6)
  1. Core Treatment Period: Annualized Relapse Rate [ARR] - Poisson Regression Estimates

    ARR is obtained from the total number of confirmed relapses that occured during the treatment period divided by the sum of the treatment durations.

    To account for the different treatment durations among participants, a Poisson regression model with robust error variance was used (total number of confirmed relapses as response variable; log-transformed treatment duration as "offset" variable; treatment group, region of enrollment and baseline EDSS stratum as covariates).

    Measured: Core treatment period between 48 and 118 weeks depending on when the participant was enrolled

  2. Core Treatment Period: Change From Baseline in Fatigue Impact Scale (FIS) Total Score

    FIS is a subject-reported scale that qualifies the impact of fatigue on daily life in patients with MS. It consists of 40 statements that measure fatigue in three areas; physical, cognitive, and social.

    FIS total score ranges from 0 (no problem) to 160 (extreme problem).

    Least-square means were estimated using a Mixed-effect model with repeated measures [MMRM] on FIS total score data (treatment group, region of enrollment, baseline EDSS stratum, visit, treatment-by-visit interaction, baseline value, and baseline-by-visit interaction as factors).

    Measured: Baseline (before randomization) and 48 weeks

  3. Core Treatment Period: Treatment Satisfaction Questionnaire for Medication [TSQM] Scores

    TSQM version 1.4 is an instrument to assess patients' satisfaction with medication. It consists of 13 questions that cover three dimensions (effectiveness, side effects and convenience) plus a global satisfaction question. Four scores ranging from 0 to 100 (extremely satisfied) are obtained. Least-square means were estimated using a Mixed-effect model with repeated measures [MMRM] on TSQM score data (treatment group, region of enrollment, baseline EDSS stratum, visit, treatment-by-visit interaction as factors).

    Measured: 48 weeks

  4. Core Treatment Period: Overview of Adverse Events [AE]

    AE are any unfavorable and unintended sign, symptom, syndrome, or illness observed by the investigator or reported by the participant during the study.

    Measured: from first study drug intake up to 112 days after last intake in the core treatment period or up to first intake in the extension treatment period, whichever occurred first

  5. Extension Treatment Period: Overview of AEs

    AEs were any unfavourable and unintended sign, symptom, syndrome, or illness observed by the investigator or reported by the participant during the study.

    Measured: From first intake of study drug in extension treatment period up to 28 days after the last intake in the extension treatment period

  6. Extension Treatment Period: ARR Poisson Regression Estimates

    ARR was obtained from the total number of confirmed relapses that occurred during the treatment period divided by the sum of the standardized treatment durations.To account for the different treatment durations among participants, a Poisson Regression Model with robust error variance was used (total number of confirmed relapses as response variable; log-transformed treatment duration as "offset" variable; treatment group, region of enrolment and baseline EDSS stratum as covariates).

    Measured: Extension treatment period (Maximum: 197 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Apr 2009 (estimated)
  2. Study startApr 2009
  3. Primary completionSep 2011
  4. Study completionMay 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
324 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00883337
Sponsor's protocol ID
EFC10891
Other IDs
2008-006226-34, 2008
Acronym
TENERE
Status last verified
May 2016
First submitted
16 Apr 2009
Last updated
13 Jun 2016
Data monitoring committee
Yes

Publications

  • Vermersch P, Czlonkowska A, Grimaldi LM, Confavreux C, Comi G, Kappos L, Olsson TP, Benamor M, Bauer D, Truffinet P, Church M, Miller AE, Wolinsky JS, Freedman MS, O'Connor P; TENERE Trial Group. Teriflunomide versus subcutaneous interferon beta-1a in patients with relapsing multiple sclerosis: a randomised, controlled phase 3 trial. Mult Scler. 2014 May;20(6):705-16. doi: 10.1177/1352458513507821. Epub 2013 Oct 14.

    PubMed 24126064
  • Comi G, Freedman MS, Meca-Lallana JE, Vermersch P, Kim BJ, Parajeles A, Edwards KR, Gold R, Korideck H, Chavin J, Poole EM, Coyle PK. Prior treatment status: impact on the efficacy and safety of teriflunomide in multiple sclerosis. BMC Neurol. 2020 Oct 6;20(1):364. doi: 10.1186/s12883-020-01937-4.

    PubMed 33023488

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Interferon β-1a and Teriflunomide in people with Multiple Sclerosis, run by Sanofi at 54 sites in 13 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Jun 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 54 sites in Germany, Italy, Hungary, France, Poland and 8 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 6 Nov 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Core Treatment Period: Overview of Failures (time frame: Core treatment period between 48 and 118 weeks depending on when the participant was enrolled). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00883337, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jun 2016.

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