Relapsing Remitting Multiple Sclerosis (RRMS)Phase 3TOFIINGONCT01499667
Disease Control and Safety in Patients With Relapsing Remitting Multiple Sclerosis (RRMS) Switching From Natalizumab to Fingolimod
A Phase 3 study testing Fingolimod in people with Relapsing Remitting Multiple Sclerosis (RRMS), run by Novartis Pharmaceuticals at 44 sites in 11 countries.
Trial summary
This study evaluated disease control during different lengths of treatment transition from natalizumab to fingolimod. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Relapsing Remitting Multiple Sclerosis (RRMS)
- What is being tested?
- Fingolimod
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 142 participants
- Where
- 44 sitesin 11 countries
- Study dates
- Sep 2011to Nov 2012
- 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 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients must:
- Have relapsing remitting multiple sclerosis
- Have been on treatment with natalizumab for at least 6 months prior to screening and discontinuation is an option.
Who cannot join
- Patients with:
- History of chronic immune disease
- Crohn's disease
- Certain cancers
- Uncontrolled diabetes
- Certain eye disorders
Show all 14Show fewer
- Negative for varicella-zoster virus IgG antibodies
- Certain hepatic conditions
- Low white blood cell count
- On certain immunosuppressive medications or heart medications
- Resting heart rate less than 45 bpm.
- Certain heart conditions or certain lung conditions
- Inability to undergo MRI scans
- Other protocol-defined inclusion/exclusion criteria may apply
Trial locations and contacts
44 sites in 11 countries.
44 sites in 11 countries
Germany20 sites
Novartis Investigative Site
Bad Mergentheim, 97980
Novartis Investigative Site
Berlin, 10713
Novartis Investigative Site
Berlin, 12163
Novartis Investigative Site
Bielefeld, 33647
Novartis Investigative Site
Bochum, 44791
Novartis Investigative Site
Celle, Germany, 29223
Novartis Investigative Site
Erbach im Odenwald, 64711
Novartis Investigative Site
Erfurt, 99089
Novartis Investigative Site
Hamburg, 22083
Novartis Investigative Site
Itzehoe, 25524
Novartis Investigative Site
Kandel, 76870
Novartis Investigative Site
Krefeld, 47805
Novartis Investigative Site
Leipzig, 04275
Novartis Investigative Site
Münster, 48149
Novartis Investigative Site
Neuburg am Inn, 86633
Novartis Investigative Site
Neuruppin, 16816
Novartis Investigative Site
Ostfildern, Baden-Wurttemberg, 73760
Novartis Investigative Site
Rüdersdorf, 15562
Novartis Investigative Site
Siegen, 57076
Novartis Investigative Site
Ulm, 89073
Greece5 sites
Novartis Investigative Site
Athens, GR, 115 25
Novartis Investigative Site
Athens, GR 151 25
Novartis Investigative Site
Athens, GR-106 76
Novartis Investigative Site
Ioannina, GR, 455 00
Novartis Investigative Site
Thessaloniki, GR, 570 10
Spain5 sites
Novartis Investigative Site
Barcelona, Barcelona, 08025
Novartis Investigative Site
Barcelona, Catalonia, 08035
Novartis Investigative Site
Madrid, Madrid, 28046
Novartis Investigative Site
Málaga, Andalusia, 29010
Novartis Investigative Site
Seville, Andalusia, 41009
Czechia3 sites
Novartis Investigative Site
Prague, 128 08
Novartis Investigative Site
Prague, 150 00
Novartis Investigative Site
Teplice, 415 29
Australia2 sites
Novartis Investigative Site
Box Hill, Victoria, 3128
Novartis Investigative Site
Heidelberg, Victoria, 3084
Hungary2 sites
Novartis Investigative Site
Budapest, 1074
Novartis Investigative Site
Budapest, 1085
Israel2 sites
Novartis Investigative Site
Ashkelon, 78278
Novartis Investigative Site
Jerusalem, 91120
Italy2 sites
Novartis Investigative Site
Cefalù, PA, 90015
Novartis Investigative Site
Milan, MI, 20132
About this study
Official title: A 32-week, Patient- and Rater-blinded, Randomized, Multi-center, Parallel-group Study to Evaluate Disease Control and Safety in Patients With Relapsing Remitting Multiple Sclerosis Transferred From Previous Treatment With Natalizumab to Fingolimod (FTY720)
This study evaluated disease control during different lengths of treatment transition from natalizumab to fingolimod.
Read the detailed description
Patient were screened, signed an informed consent at visit 1, at the 2nd visit, all patient received a baseline infusion of Natalizumub and subsequently randomized to one of 3 treatment arms. At the randomization visit, the Washout Phase started, and eligible patients were randomized 1:1:1 to one of three treatment groups:
- 8-week washout (8 weeks no treatment) followed by 24 weeks of treatment with fingolimod,
- 12-week washout (8 weeks no treatment and 4 weeks placebo) followed by 20 weeks of treatment with fingolimod, or
- 16-week washout (8 weeks no treatment and 8 weeks placebo) followed by 16 weeks of treatment with fingolimod.
- Being tested
- Fingolimod, Placebo
- Keywords
- Relapsing remitting multiple sclerosis, multiple sclerosis (MS), safety, tolerability, health outcomes, fingolimod, disease control, MRI
- Medical subject headings
- Multiple Sclerosis, Relapsing-Remitting, Multiple Sclerosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
FingolimodDrug
Fingolimod 0.5 mg capsules for oral administration once daily
PlaceboDrug
Matching placebo in capsules for oral administration once daily.
| Study group | Role | What they receive |
|---|---|---|
| 8-week washout + Fingolimod (FTY720) | Experimental | 8-week washout (8 weeks no treatment) followed by 24 weeks of treatment with fingolimod 0.5mg once a day Receives: Drug: Fingolimod |
| 12-week washout + Fingolimod (FTY720) | Experimental | 12-week washout (8 weeks no treatment and 4 weeks placebo) followed by 20 weeks of treatment with fingolimod 0.5mg once a day Receives: Drug: Fingolimod; Drug: Placebo |
| 16-week washout + Fingolimod (FTY720) | Experimental | 16-week washout (8 weeks no treatment and 8 weeks placebo) followed by 16 weeks of treatment with fingolimod 0.5mg once a day Receives: Drug: Fingolimod; Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Active (New or Newly Enlarging) T2 Lesions From the Last Natalizumab Infusion (Baseline) Through 8 Weeks of Fingolimod Treatment
Active lesions were measured on brain MRI scans, performed at week 8, compared to the prior scan. The primary variable was analyzed by fitting a negative binomial regression model adjusted for washout group.
Measured: Number of active T2 lesions from last natalizumab dose through 8 weeks of fingolimod treatment
Secondary outcomes (7)
Number of Active (New or Newly Enlarging) T2 Lesions From the Last Natalizumab Infusion (Baseline) up to the Initiation of Fingolimod Treatment
Lesions were measured by MRIs and the number of active (new or newly enlarging) T2 lesions was calculated from baseline to beginning of treatment.
Measured: 8, 12 and 16 weeks (number of active T2 lesions during the washout period only)
Number of Active (New or Newly Enlarging) T2 Lesions During the First 8 Weeks of Fingolimod Treatment
Lesions were measured by MRIs and the number of active (new or newly enlarging) T2 lesions was calculated for first 8 weeks of fingolimod treatment.
Measured: Number of active T2 lesions during 8 wks of fingolimod treatment
Number of Active (New or Newly Enlarging) T2 Lesions During the 24 Weeks After the Last Natalizumab Infusion (Baseline)
Lesions will be measured by MRIs and the number of active (new or newly enlarging) T2 lesions will be calculated for 24 weeks from baseline.
Measured: Baseline up to 24 weeks
Change From Baseline in Expanded Disability Status Scale (EDSS) by Washout Group
Kurtzke's Expanded Disability Status Scale (EDSS) measures the changes in neurologic impairment, either chronic (progression over time), or acute (MS relapses). The EDSS steps range from 0 (normal) to 10 (death due to MS). Relapse severity is assessed based on severity of neurologic impairment as evaluated using the EDSS.
Measured: Baseline to week 16 and week 32
Cumulative Number of Gadolinium-enhancing T1 Lesions From the Last Natalizumab Infusion
Gadolinium-enhancing lesions will be measured on post-contrast T1-weighted brain MRI scans
Measured: 8 weeks and 24 weeks
Number of Participants With Adverse Events (AE), Serious Adverse Events (SAE) and Death During Washout Period
Adverse events were summarized by the number of patients having any adverse event overall.
Measured: Baseline to maximum of 16 weeks
Number of Participants With Adverse Events (AE), Serious Adverse Events (SAE) and Death During Fingolimod Treatment
Adverse events were summarized by the number of patients having any adverse event overall.
Measured: Baseline to maximum of 16 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Dec 2011 (estimated)
- Study startSep 2011
- Primary completionNov 2012
- Study completionNov 2012
Why it stopped: Based on recent publications, determination of natalizumub washout period was no longer relevant.
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.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Relapsing Remitting Multiple Sclerosis (RRMS)Studies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe 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
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 142 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01499667
- Sponsor's protocol ID
- CFTY720D2324
- Other IDs
- 2011-001442-15
- Acronym
- TOFIINGO
- Status last verified
- Aug 2014
- First submitted
- 18 Aug 2011
- Last updated
- 8 Aug 2014
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Derfuss T, Kovarik JM, Kappos L, Savelieva M, Chhabra R, Thakur A, Zhang Y, Wiendl H, Tomic D. alpha4-integrin receptor desaturation and disease activity return after natalizumab cessation. Neurol Neuroimmunol Neuroinflamm. 2017 Aug 25;4(5):e388. doi: 10.1212/NXI.0000000000000388. eCollection 2017 Sep.
PubMed 28856176
Study at a glance
From the registry record, last updated by the sponsor on 8 Aug 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A 32-week, Patient- and Rater-blinded, Randomized, Multi-center, Parallel-group Study to Evaluate Disease Control and Safety in Patients With Relapsing Remitting Multiple Sclerosis Transferred From Previous Treatment With Natalizumab to Fingolimod (FTY720)
- ClinicalTrials.gov ID
- NCT01499667
- Acronym / sponsor ID
- TOFIINGO / CFTY720D2324
- Keywords
- Relapsing remitting multiple sclerosis, multiple sclerosis (MS), safety, tolerability, health outcomes, fingolimod, disease control, MRI
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Based on recent publications, determination of natalizumub washout period was no longer relevant.
- Enrolment
- 142 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- Sep 2011
- Primary completion
- Nov 2012 (actual)
- Study completion
- Nov 2012 (actual)
- First posted
- 26 Dec 2011 (estimated)
- Results
- Posted 4 Apr 2014
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study evaluated disease control during different lengths of treatment transition from natalizumab to fingolimod.
Detailed description
Patient were screened, signed an informed consent at visit 1, at the 2nd visit, all patient received a baseline infusion of Natalizumub and subsequently randomized to one of 3 treatment arms. At the randomization visit, the Washout Phase started, and eligible patients were randomized 1:1:1 to one of three treatment groups:
- 8-week washout (8 weeks no treatment) followed by 24 weeks of treatment with fingolimod,
- 12-week washout (8 weeks no treatment and 4 weeks placebo) followed by 20 weeks of treatment with fingolimod, or
- 16-week washout (8 weeks no treatment and 8 weeks placebo) followed by 16 weeks of treatment with fingolimod.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| 8-week washout + Fingolimod (FTY720) | Experimental | Drug: Fingolimod8-week washout (8 weeks no treatment) followed by 24 weeks of treatment with fingolimod 0.5mg once a day |
| 12-week washout + Fingolimod (FTY720) | Experimental | Drug: Fingolimod, Drug: Placebo12-week washout (8 weeks no treatment and 4 weeks placebo) followed by 20 weeks of treatment with fingolimod 0.5mg once a day |
| 16-week washout + Fingolimod (FTY720) | Experimental | Drug: Fingolimod, Drug: Placebo16-week washout (8 weeks no treatment and 8 weeks placebo) followed by 16 weeks of treatment with fingolimod 0.5mg once a day |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Have relapsing remitting multiple sclerosis
- Have been on treatment with natalizumab for at least 6 months prior to screening and discontinuation is an option.
Key exclusion criteria (14 listed)
- History of chronic immune disease
- Crohn's disease
- Certain cancers
- Uncontrolled diabetes
- Certain eye disorders
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 |
|---|---|---|
| FingolimodFingolimod 0.5 mg capsules for oral administration once daily | Drug | 12-week washout + Fingolimod (FTY720), 16-week washout + Fingolimod (FTY720), 8-week washout + Fingolimod (FTY720) |
| PlaceboMatching placebo in capsules for oral administration once daily. | Drug | 12-week washout + Fingolimod (FTY720), 16-week washout + Fingolimod (FTY720) |
Primary outcome
Number of Active (New or Newly Enlarging) T2 Lesions From the Last Natalizumab Infusion (Baseline) Through 8 Weeks of Fingolimod Treatment
Time frame: Number of active T2 lesions from last natalizumab dose through 8 weeks of fingolimod treatment
Active lesions were measured on brain MRI scans, performed at week 8, compared to the prior scan. The primary variable was analyzed by fitting a negative binomial regression model adjusted for washout group.
7 secondary outcomes
Number of Active (New or Newly Enlarging) T2 Lesions From the Last Natalizumab Infusion (Baseline) up to the Initiation of Fingolimod Treatment
Time frame: 8, 12 and 16 weeks (number of active T2 lesions during the washout period only)
Number of Active (New or Newly Enlarging) T2 Lesions During the First 8 Weeks of Fingolimod Treatment
Time frame: Number of active T2 lesions during 8 wks of fingolimod treatment
Number of Active (New or Newly Enlarging) T2 Lesions During the 24 Weeks After the Last Natalizumab Infusion (Baseline)
Time frame: Baseline up to 24 weeks
Change From Baseline in Expanded Disability Status Scale (EDSS) by Washout Group
Time frame: Baseline to week 16 and week 32
Cumulative Number of Gadolinium-enhancing T1 Lesions From the Last Natalizumab Infusion
Time frame: 8 weeks and 24 weeks
Number of Participants With Adverse Events (AE), Serious Adverse Events (SAE) and Death During Washout Period
Time frame: Baseline to maximum of 16 weeks
Number of Participants With Adverse Events (AE), Serious Adverse Events (SAE) and Death During Fingolimod Treatment
Time frame: Baseline to maximum of 16 weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Aug 2014.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 28856176Derfuss T, Kovarik JM, Kappos L, Savelieva M, Chhabra R, Thakur A, Zhang Y, Wiendl H, Tomic D. alpha4-integrin receptor desaturation and disease activity return after natalizumab cessation. Neurol Neuroimmunol Neuroinflamm. 2017 Aug 25;4(5):e388. doi: 10.1212/NXI.0000000000000388. eCollection 2017 Sep.
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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.
Novartis Pharmaceuticals study director
Novartis Pharmaceuticals
44 sites in 11 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Fingolimod in people with Relapsing Remitting Multiple Sclerosis (RRMS), run by Novartis Pharmaceuticals at 44 sites in 11 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 14 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 8 Aug 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 44 sites in Germany, Greece, Spain, Czechia, Australia and 6 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 4 Apr 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?
Number of Active (New or Newly Enlarging) T2 Lesions From the Last Natalizumab Infusion (Baseline) Through 8 Weeks of Fingolimod Treatment (time frame: Number of active T2 lesions from last natalizumab dose through 8 weeks of fingolimod treatment). 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 NCT01499667, which also lists 1 linked publication.
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 8 Aug 2014.