Multiple Sclerosis RelapsePhase 3TERACLESNCT01252355
Efficacy and Safety of Teriflunomide in Patients With Relapsing Multiple Sclerosis and Treated With Interferon-beta
A Phase 3 study testing Teriflunomide and Interferon-beta (IFN-beta) in people with Multiple Sclerosis Relapse, run by Sanofi at 185 sites in 28 countries.
Trial summary
The primary objective was to demonstrate the effect of teriflunomide, in comparison to placebo, on frequency of Multiple Sclerosis (MS) relapses in patients with relapsing forms of MS who are treated with Interferon-beta (IFN-beta). Read more about this study
- Who is it for?
- Ages 18 to 55 years
- Conditions the study is for
- Multiple Sclerosis Relapse
- What is being tested?
- Teriflunomide and Interferon-beta (IFN-beta)
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 534 participants
- Where
- 185 sitesin 28 countries
- Study dates
- Jan 2011to Apr 2013
- 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 to 55 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Patient with relapsing forms of MS treated with IFN-beta
- Stable dose of IFN-beta (approved brand) for at least 6 months prior to randomization
- Disease activity in the 12 months prior to randomization and after first 3 months of IFN-beta treatment (defined by at least 1 relapse supported by EDSS or equivalent neurological examination, or, at least 1 brain or spinal cord MRI with at least one T1 gadolinium enhancing lesion)
Who cannot join
- McDonald criteria for MS diagnosis not met at time of screening visit
- EDSS score greater than (>) 5.5 at randomization visit
- A relapse within 30 days prior randomization
- Persistent significant or severe infection
- Patients must not have used adrenocorticotrophic hormone or systemic corticosteroids for 2 weeks prior to randomization
- Prior or concomitant use of cytokine therapy (except baseline interferons), glatiramer acetate or intravenous immunoglobulins in the 3 months preceding randomization
Show all 15Show fewer
- Liver function impairment or persisting elevations (confirmed by retest) of alanine aminotransferase (ALT), aspartate aminotransferase (AST), or direct bilirubin greater than 2 times the upper limit of normal range (ULN)
- Active hepatitis or hepatobiliary disease or known history of severe hepatitis
- Pregnant or breast-feeding women or those who were planning to become pregnant during the study
- Significantly impaired bone marrow function or significant anemia, leukopenia, or thrombocytopenia
- Human Immunodeficiency Virus (HIV) positive
- Known history of active tuberculosis not adequately treated
- Prior use within 2 years preceding randomization or concomitant use of cladribine and mitoxantrone
- Prior use within 6 months preceding randomization or concomitant use of natalizumab, or any other immunosuppressive agents such as azathioprine, cyclophosphamide, cyclosporine, methotrexate, mycophenolate, or fingolimod
- The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Trial locations and contacts
185 sites in 28 countries.
185 sites in 28 countries
United States32 sites
Investigational Site Number 840023
Albuquerque, New Mexico, 87131
Investigational Site Number 840041
Baltimore, Maryland, 21201
Investigational Site Number 840028
Baltimore, Maryland, 21287
Investigational Site Number 840006
Bismarck, North Dakota, 58501
Investigational Site Number 840027
Charlotte, North Carolina, 28204
Investigational Site Number 840034
Chicago, Illinois, 60637
Investigational Site Number 840016
Clinton Township, Michigan, 48035
Investigational Site Number 840005
Cordova, Alaska, 38018
Investigational Site Number 840049
Cullman, Alabama, 35058
Investigational Site Number 840046
Dayton, Ohio, 45409
Investigational Site Number 840037
Elk Grove Village, Illinois, 60007
Investigational Site Number 840007
Fargo, North Dakota, 58103
Investigational Site Number 840036
Fort Collins, Colorado, 80528
Investigational Site Number 840033
Louisville, Kentucky, 40217
Investigational Site Number 840012
Maitland, Florida, 32761
Investigational Site Number 840009
Missoula, Montana, 59802
Investigational Site Number 840002
Nashville, Tennessee, 37232
Investigational Site Number 840015
New York, New York, 10029
Investigational Site Number 840011
Oceanside, California, 92056
Investigational Site Number 840013
Ormond Beach, Florida, 32174
Investigational Site Number 840003
Phoenix, Arizona, 85060
Investigational Site Number 840055
Pompano Beach, Florida, 33060
Investigational Site Number 840040
Round Rock, Texas, 78681
Investigational Site Number 840020
San Antonio, Texas, 78231
Investigational Site Number 840031
St Louis, Missouri, 63104
Investigational Site Number 840030
St Louis, Missouri, 63110
Investigational Site Number 840021
St. Petersburg, Florida, 33713
Investigational Site Number 840004
Tampa, Florida, 33609-4052
Investigational Site Number 840047
Tampa, Florida, 33612
Investigational Site Number 840017
Toledo, Ohio, 43699
Investigational Site Number 840043
Tulsa, Oklahoma, 74137
Investigational Site Number 840032
Vienna, Virginia, 22182
Germany23 sites
Investigational Site Number 276009
Bad Mergentheim, 97980
Investigational Site Number 276020
Bamberg, 96047
Investigational Site Number 276003
Bayreuth, 95445
Investigational Site Number 276015
Berlin, 10117
Investigational Site Number 276016
Berlin, 10713
Investigational Site Number 276021
Berlin, 12099
Investigational Site Number 276012
Bonn, 53105
Investigational Site Number 276005
Dresden, 01307
Investigational Site Number 276032
Düsseldorf, 40211
Investigational Site Number 276018
Erbach im Odenwald, 64711
Investigational Site Number 276004
Erlangen, 91054
Investigational Site Number 276028
Freiburg im Breisgau, 79098
Investigational Site Number 276006
Giessen, 35385
Investigational Site Number 276010
Hamburg, 20249
Investigational Site Number 276022
Hennigsdorf, 16761
Investigational Site Number 276024
Kassel, 34121
Investigational Site Number 276001
Leipzig, 04103
Investigational Site Number 276013
Mainz, 55131
Investigational Site Number 276023
Minden, 32429
Investigational Site Number 276002
Münster, 48149
Investigational Site Number 276031
Rostock, 18055
Investigational Site Number 276008
Wiesbaden, 65191
Investigational Site Number 276026
Wuppertal, 42283
Russia17 sites
Investigational Site Number 643012
Kaluga, 248007
Investigational Site Number 643007
Kazan', 420021
Investigational Site Number 643001
Kemerovo, 650066
Investigational Site Number 643013
Moscow, 129110
Investigational Site Number 643006
Nizhny Novgorod, 603076
Investigational Site Number 643004
Nizhny Novgorod, 603126
Investigational Site Number 643015
Novosibirsk, 630007
Investigational Site Number 643010
Rostov-on-Don, 344015
Investigational Site Number 643009
Rostov-on-Don, 344022
Investigational Site Number 643011
Saint Petersburg, 194044
Investigational Site Number 643018
Saint Petersburg, 194291
Investigational Site Number 643003
Saint Petersburg, 194354
Investigational Site Number 643017
Saint Petersburg, 197089
Investigational Site Number 643002
Saint Petersburg, 197376
Investigational Site Number 643016
Samara, 443095
Investigational Site Number 643005
Smolensk, 214019
Investigational Site Number 643014
Yaroslavl, 150030
Italy11 sites
Investigational Site Number 380009
Catania, 95123
Investigational Site Number 380002
Cefalù, 90015
Investigational Site Number 380003
Fidenza, 43036
Investigational Site Number 380004
Gallarate, 21013
Investigational Site Number 380012
Montichiari, 25012
Investigational Site Number 380010
Naples, 80131
Investigational Site Number 380011
Naples, 80131
Investigational Site Number 380006
Padova, 35128
Investigational Site Number 380005
Roma, 00133
Investigational Site Number 380008
Roma, 00161
Investigational Site Number 380014
Verona, 37134
Canada9 sites
Investigational Site Number 124005
Calgary, T2N 2T9
Investigational Site Number 124004
Edmonton, T6G 2G3
Investigational Site Number 124003
Gatineau, J9J 0A5
Investigational Site Number 124006
Kingston, K7L 2V7
Investigational Site Number 124007
Montreal, H3A 2B4
Investigational Site Number 124008
Ottawa, K1H 8L6
Investigational Site Number 124002
Regina, S4T 1A5
Investigational Site Number 124001
Sherbrooke, J1H 5N4
Investigational Site Number 124009
Winnipeg, R3A 1R9
Hungary8 sites
Investigational Site Number 348002
Budapest, 1106
Investigational Site Number 348006
Budapest, 1145
Investigational Site Number 348010
Budapest, 1204
Investigational Site Number 348009
Eger, 3300
Investigational Site Number 348003
Esztergom, 2500
Investigational Site Number 348001
Szeged, 6720
Investigational Site Number 348005
Székesfehérvár, 8000
Investigational Site Number 348007
Zalaegerszeg, 8900
Spain8 sites
Investigational Site Number 724001
Barcelona, 08035
Investigational Site Number 724002
Barcelona, 08036
Investigational Site Number 724009
Córdoba, 14004
Investigational Site Number 724003
Girona, 17007
Investigational Site Number 724004
Madrid, 28005
Investigational Site Number 724005
Madrid, 28040
Investigational Site Number 724007
Murcia, 30120
Investigational Site Number 724008
Seville, 41008
Belgium7 sites
Investigational Site Number 056005
Charleroi, 6000
Investigational Site Number 056004
Ghent, 9000
Investigational Site Number 056003
Hasselt, B-3590
Investigational Site Number 056006
La Louvière, 7100
Investigational Site Number 056002
Leuven, 3000
Investigational Site Number 056001
Sijsele-Damme, 8340
Investigational Site Number 056007
Wilrijk, 2610
France6 sites
Investigational Site Number 250003
Besançon, 25030
Investigational Site Number 250010
Clermont-Ferrand, 63003
Investigational Site Number 250002
Lyon, 69394
Investigational Site Number 250004
Montpellier, 34000
Investigational Site Number 250001
Nancy, 54036
Investigational Site Number 250006
Nantes, 44093
United Kingdom6 sites
Investigational Site Number 826008
Birmingham, B15 2TH
Investigational Site Number 826005
Leeds, LS1 3EX
Investigational Site Number 826006
Liverpool, L9 7LJ
Investigational Site Number 826003
London, SW17 0QT
Investigational Site Number 826004
Plymouth, PL6 8BX
Investigational Site Number 826001
Salford, M6 8HD
Australia5 sites
Investigational Site Number 036008
Bedford Park, 5042
Investigational Site Number 036005
Chatswood, 2067
Investigational Site Number 036001
Heidelberg West, 3081
Investigational Site Number 036004
Kogarah, 2217
Investigational Site Number 036010
New Lambton, 2305
Brazil5 sites
Investigational Site Number 076009
Joinville, 89202-165
Investigational Site Number 076012
Passo Fundo, 99010-180
Investigational Site Number 076003
Porto Alegre, 90020-090
Investigational Site Number 076007
São Paulo, 04024-002
Investigational Site Number 076013
São Paulo, 08270-070
Finland5 sites
Investigational Site Number 246003
Helsinki, 00100
Investigational Site Number 246006
Hyvinkää, 05800
Investigational Site Number 246004
Oulu, 90220
Investigational Site Number 246002
Pori, 28100
Investigational Site Number 246001
Turku, 20100
Colombia4 sites
Investigational Site Number 170001
Barranquilla
Investigational Site Number 170005
Bogotá
Investigational Site Number 170007
Bogotá
Investigational Site Number 170009
Medellín
Greece4 sites
Investigational Site Number 300002
Athens, 11527
Investigational Site Number 300001
Athens, 11535
Investigational Site Number 300003
Heraklion, 71110
Investigational Site Number 300006
Thessaloniki, 57010
Netherlands4 sites
Investigational Site Number 528001
Breda, 4818 CK
Investigational Site Number 528005
Nieuwegein, 3435 CM
Investigational Site Number 528002
Sittard-Geleen, 6162 BG
Investigational Site Number 528006
Venray, 5801 CE
Portugal4 sites
Investigational Site Number 620001
Amadora, 2720-276
Investigational Site Number 620002
Coimbra, 3000-075
Investigational Site Number 620004
Coimbra, 3041-801
Investigational Site Number 620003
Setúbal, 2910-446
Tunisia4 sites
Investigational Site Number 788002
Manouba, 2010
Investigational Site Number 788005
Monastir, 5000
Investigational Site Number 788004
Sfax, 3029
Investigational Site Number 788006
Tunis, 1008
Argentina3 sites
Investigational Site Number 032002
Argentina, 1426
Investigational Site Number 032003
Buenos Aires
Investigational Site Number 032004
Caba
Chile3 sites
Investigational Site Number 152003
Santiago, 7500710
Investigational Site Number 152004
Santiago, 838-0456
Investigational Site Number 152005
Viña del Mar, 2570017
Lithuania3 sites
Investigational Site Number 440002
Kaunas, LT-50009
Investigational Site Number 440004
Klaipėda, LT-92288
Investigational Site Number 440003
Šiauliai, LT-76231
South Korea3 sites
Investigational Site Number 410002
Goyang-si, 410-760
Investigational Site Number 410004
Seoul, 110-744
Investigational Site Number 410001
Seoul, 136-705
Sweden3 sites
Investigational Site Number 752004
Gothenburg, 413 45
Investigational Site Number 752003
Stockholm, 14186
Investigational Site Number 752001
Stockholm, 171 76
Austria2 sites
Investigational Site Number 040001
Graz, 8036
Investigational Site Number 040004
Linz, 4020
Estonia2 sites
Investigational Site Number 233002
Tallinn, 10617
Investigational Site Number 233001
Tartu, 50406
Slovakia2 sites
Investigational Site Number 703002
Martin, 03659
Investigational Site Number 703001
Trnava, 91775
About this study
Official title: A Multi-center Double-blind Parallel-group Placebo-controlled Study of the Efficacy and Safety of Teriflunomide in Patients With Relapsing Multiple Sclerosis Who Are Treated With Interferon-beta
The primary objective was to demonstrate the effect of teriflunomide, in comparison to placebo, on frequency of Multiple Sclerosis (MS) relapses in patients with relapsing forms of MS who are treated with Interferon-beta (IFN-beta).
The secondary objectives were:
- Assess the effect of teriflunomide, in comparison to placebo, when added to IFN-beta on:
- Disease activity as measured by brain Magnetic Resonance Imaging (MRI)
- Disability progression
- Burden of disease and disease progression as measured by brain MRI
- Evaluate the safety and tolerability of teriflunomide when added to IFN-beta therapy
- Assess the pharmacokinetics of teriflunomide in use in addition to baseline IFN-beta therapy
- Assess associations between variations in genes and clinical outcomes (safety and efficacy)
- Assess other measures of efficacy of teriflunomide such as fatigue and health-related quality of life
- Assess measures of health economics (hospitalization due to relapse, including the length of stay and any admission to intensive care unit)
Read the detailed description
The study period per patient was expected to be between 56 and 160 weeks depending on when the patient was randomized and this included the following:
- a screening period up to 4 weeks,
- a treatment period expected to be between 48 and 152 weeks,
- 4-week post rapid elimination follow-up period.
Patients were to continue on treatment until a fixed common end date which was approximately 48 weeks after randomization of the last patient.
For those patients who completed the treatment period, a long term extension study of approximately 1 year (including teriflunomide alone) was initially planned to be proposed.
- Conditions
- Multiple Sclerosis Relapse
- Being tested
- Teriflunomide, Placebo (for teriflunomide), Interferon-beta (IFN-beta)
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TeriflunomideDrug
Also called HMR1726
Film-coated tablet
Oral administration
Placebo (for teriflunomide)Drug
Film-coated tablet
Oral administration
Interferon-beta (IFN-beta)Drug
Any of the IFN-beta which are approved for marketed use in the country where the patient is enrolled.
Administration according to the package insert.
| Study group | Role | What they receive |
|---|---|---|
| Teriflunomide 7 mg + IFN-beta | Experimental | Teriflunomide 7 milligram (mg) once a day concomitantly with IFN-beta therapy. Receives: Drug: Teriflunomide; Drug: Interferon-beta (IFN-beta) |
| Teriflunomide 14 mg + IFN-beta | Experimental | Teriflunomide 14 mg once a day concomitantly with IFN-beta therapy. Receives: Drug: Teriflunomide; Drug: Interferon-beta (IFN-beta) |
| Placebo + IFN-beta | Placebo comparator | Placebo (for teriflunomide) once a day concomitantly with IFN-beta therapy. Receives: Drug: Placebo (for teriflunomide); Drug: Interferon-beta (IFN-beta) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Annualized Relapse Rate (ARR) (Poisson Regression Estimates)
ARR is the total number of confirmed relapses that occurred during the treatment period divided by the total number of patient-years treated. 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. 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 IFN-beta dose stratum, and number of relapses in the year prior to randomization as covariates).
Measured: Up to a maximum of 108 weeks depending on time of enrollment
Secondary outcomes (9)
Brain Magnetic Resonance Imaging (MRI) Assessment: Number of Gadolinium Enhancing (Gd-enhancing) T1-lesions Per Scan (Poisson Regression Estimates)
Number of Gd-enhancing T1-lesions per scan is the total number of Gd-enhancing T1-lesions that occurred during the treatment period divided by the total number of scans performed during the treatment period. To account for the different number of scans among participants, a Poisson regression model with robust error variance was used (total number of Gd-enhancing T1-lesions as response variable; log-transformed number of scans as offset variable; treatment group, region of enrollment, IFN-beta dose stratum and baseline number of Gd-enhancing T1-lesions as covariates).
Measured: Up to a maximum of 108 weeks depending on time of enrollment
Time to 12-Week Sustained Disability Progression
The 12-week sustained disability progression was defined as an increase from baseline of at least 1-point in EDSS score (at least 0.5-point for participants with baseline EDSS score >5.5) that persisted for at least 12 weeks. Probability of disability progression was to be estimated using Kaplan-Meier method.
Measured: Up to a maximum of 108 weeks depending on time of enrollment
Brain MRI Assessment: Volume of Gd-enhancing T1-lesions Per MRI Scan
Total volume of Gd-enhancing T1-lesions per scan is the sum of the volumes of Gd-enhancing T1-lesions observed during the treatment period divided by the total number of scans performed during the treatment period.
Measured: Up to a maximum of 108 weeks depending on time of enrollment
Brain MRI Assessment: Change From Baseline in Total Lesion Volume (Burden of Disease) at Week 24
The total lesion volume (burden of disease) is the total volumes of hyperintense on T2 plus hypointense on T1 as measured by MRI scan. Least-square means were estimated using a Mixed-effect model with repeated measures (MMRM) on cubic root transformed volume data with factors for treatment, region, IFN-beta dose stratum, visit, treatment-by-visit interaction, cubic root transformed baseline burden of disease, and baseline-by-visit interaction.
Measured: Baseline, Week 24
Time to Relapse: Kaplan-Meier Estimates of the Probability of no Relapse at Week 24, 48, and 72
Probability of no relapse at 24, 48 and 72 weeks was estimated using Kaplan-Meier method on the time to relapse defined as the time from randomization to first EDSS confirmed relapse. Participants free of confirmed relapse (no EDSS confirmed relapse observed on treatment) were censored at the date of the last study drug intake. 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.
Measured: Up to a maximum of 108 weeks depending on time of enrollment
Change From Baseline in Fatigue Impact Scale (FIS) Total Score at Week 24
FIS is a participant-reported scale that qualifies the impact of fatigue on daily life in participants with MS.
Measured: Baseline, Week 24
Change From Baseline in Short Form Generic Health Survey - 36 Items, Version 2 (SF-36v2) Summary Scores at Week 24
SF-36 scale is a generic, self-administered, health-related quality-of-life (QOL) instrument.
Measured: Baseline, Week 24
Resource Utilization When Relapse
Resource utilization each time a participant experiences an MS relapse, specifically the number of hospitalizations, the number of over night spent in the hospital and number of intensive care admissions if hospitalized were to be reported.
Measured: Up to a maximum of 108 weeks depending on time of enrollment
Overview of Adverse Events (AEs)
AEs are any unfavorable and unintended sign, symptom, syndrome, or illness observed by the investigator or reported by the participant during the study.
Measured: First study drug intake up to 28 days after last study drug intake, for up to 112 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Dec 2010 (estimated)
- Study startJan 2011
- Primary completionApr 2013
- Study completionApr 2013
Why it stopped: Sponsor decision to prematurely stop the study, not linked to any safety concern.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Multiple Sclerosis RelapseStudies of the same condition, open and under way.
- More trials run by SanofiThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 534 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sanofi
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Sciences & Operations, Study director, Sanofi
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01252355
- Sponsor's protocol ID
- EFC6058
- Other IDs
- 2010-023172-12, U1111-1115-2414
- Acronym
- TERACLES
- Status last verified
- May 2014
- First submitted
- 30 Nov 2010
- Last updated
- 9 Jun 2014
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 9 Jun 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multi-center Double-blind Parallel-group Placebo-controlled Study of the Efficacy and Safety of Teriflunomide in Patients With Relapsing Multiple Sclerosis Who Are Treated With Interferon-beta
- ClinicalTrials.gov ID
- NCT01252355
- Acronym / sponsor ID
- TERACLES / EFC6058
- Conditions
- Multiple Sclerosis Relapse
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Sponsor decision to prematurely stop the study, not linked to any safety concern.
- Enrolment
- 534 participants (actual)
- Lead sponsor
- SanofiIndustry (pharma, biotech, devices)
- Study start
- Jan 2011
- Primary completion
- Apr 2013 (actual)
- Study completion
- Apr 2013 (actual)
- First posted
- 3 Dec 2010 (estimated)
- Results
- Posted 22 May 2014
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary objective was to demonstrate the effect of teriflunomide, in comparison to placebo, on frequency of Multiple Sclerosis (MS) relapses in patients with relapsing forms of MS who are treated with Interferon-beta (IFN-beta).
The secondary objectives were:
- Assess the effect of teriflunomide, in comparison to placebo, when added to IFN-beta on:
- Disease activity as measured by brain Magnetic Resonance Imaging (MRI)
- Disability progression
- Burden of disease and disease progression as measured by brain MRI
- Evaluate the safety and tolerability of teriflunomide when added to IFN-beta therapy
- Assess the pharmacokinetics of teriflunomide in use in addition to baseline IFN-beta therapy
- Assess associations between variations in genes and clinical outcomes (safety and efficacy)
- Assess other measures of efficacy of teriflunomide such as fatigue and health-related quality of life
- Assess measures of health economics (hospitalization due to relapse, including the length of stay and any admission to intensive care unit)
Detailed description
The study period per patient was expected to be between 56 and 160 weeks depending on when the patient was randomized and this included the following:
- a screening period up to 4 weeks,
- a treatment period expected to be between 48 and 152 weeks,
- 4-week post rapid elimination follow-up period.
Patients were to continue on treatment until a fixed common end date which was approximately 48 weeks after randomization of the last patient.
For those patients who completed the treatment period, a long term extension study of approximately 1 year (including teriflunomide alone) was initially planned to be proposed.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Teriflunomide 7 mg + IFN-beta | Experimental | Drug: Teriflunomide, Drug: Interferon-beta (IFN-beta)Teriflunomide 7 milligram (mg) once a day concomitantly with IFN-beta therapy. |
| Teriflunomide 14 mg + IFN-beta | Experimental | Drug: Teriflunomide, Drug: Interferon-beta (IFN-beta)Teriflunomide 14 mg once a day concomitantly with IFN-beta therapy. |
| Placebo + IFN-beta | Placebo comparator | Drug: Placebo (for teriflunomide), Drug: Interferon-beta (IFN-beta)Placebo (for teriflunomide) once a day concomitantly with IFN-beta therapy. |
Who may qualify
- Ages
- 18 to 55 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Patient with relapsing forms of MS treated with IFN-beta
- Stable dose of IFN-beta (approved brand) for at least 6 months prior to randomization
- Disease activity in the 12 months prior to randomization and after first 3 months of IFN-beta treatment (defined by at least 1 relapse supported by EDSS or equivalent neurological examination, or, at least 1 brain or spinal cord MRI with at least one T1 gadolinium enhancing lesion)
Key exclusion criteria (15 listed)
- McDonald criteria for MS diagnosis not met at time of screening visit
- EDSS score greater than (>) 5.5 at randomization visit
- A relapse within 30 days prior randomization
- Persistent significant or severe infection
- Patients must not have used adrenocorticotrophic hormone or systemic corticosteroids for 2 weeks prior to randomization
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TeriflunomideAlso: HMR1726Film-coated tablet Oral administration | Drug | Teriflunomide 14 mg + IFN-beta, Teriflunomide 7 mg + IFN-beta |
| Placebo (for teriflunomide)Film-coated tablet Oral administration | Drug | Placebo + IFN-beta |
| Interferon-beta (IFN-beta)Any of the IFN-beta which are approved for marketed use in the country where the patient is enrolled. Administration according to the package insert. | Drug | Placebo + IFN-beta, Teriflunomide 14 mg + IFN-beta, Teriflunomide 7 mg + IFN-beta |
Primary outcome
Annualized Relapse Rate (ARR) (Poisson Regression Estimates)
Time frame: Up to a maximum of 108 weeks depending on time of enrollment
ARR is the total number of confirmed relapses that occurred during the treatment period divided by the total number of patient-years treated. 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. 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 IFN-beta dose stratum, and number of relapses in the year prior to randomization as covariates).
9 secondary outcomes
Brain Magnetic Resonance Imaging (MRI) Assessment: Number of Gadolinium Enhancing (Gd-enhancing) T1-lesions Per Scan (Poisson Regression Estimates)
Time frame: Up to a maximum of 108 weeks depending on time of enrollment
Time to 12-Week Sustained Disability Progression
Time frame: Up to a maximum of 108 weeks depending on time of enrollment
Brain MRI Assessment: Volume of Gd-enhancing T1-lesions Per MRI Scan
Time frame: Up to a maximum of 108 weeks depending on time of enrollment
Brain MRI Assessment: Change From Baseline in Total Lesion Volume (Burden of Disease) at Week 24
Time frame: Baseline, Week 24
Time to Relapse: Kaplan-Meier Estimates of the Probability of no Relapse at Week 24, 48, and 72
Time frame: Up to a maximum of 108 weeks depending on time of enrollment
Change From Baseline in Fatigue Impact Scale (FIS) Total Score at Week 24
Time frame: Baseline, Week 24
Change From Baseline in Short Form Generic Health Survey - 36 Items, Version 2 (SF-36v2) Summary Scores at Week 24
Time frame: Baseline, Week 24
Resource Utilization When Relapse
Time frame: Up to a maximum of 108 weeks depending on time of enrollment
Overview of Adverse Events (AEs)
Time frame: First study drug intake up to 28 days after last study drug intake, for up to 112 weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Jun 2014.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Sciences & Operations study director
Sanofi
185 sites in 28 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Teriflunomide and Interferon-beta (IFN-beta) in people with Multiple Sclerosis Relapse, run by Sanofi at 185 sites in 28 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 3 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: stopped early, as of the sponsor's last update on 9 Jun 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 185 sites in United States, Germany, Russia, Italy, Canada and 23 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. Some participants in this study may receive a placebo. 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 22 May 2014). 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?
Annualized Relapse Rate (ARR) (Poisson Regression Estimates) (time frame: Up to a maximum of 108 weeks depending on time of enrollment). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 9 Jun 2014.