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This is a randomized, parallel group, placebo-controlled study designed to assess whether GSK239512 can enhance lesion remyelination in subjects with Relapsing Remitting Multiple Sclerosis (RRMS). Subjects with RRMS on stable background treatment with either Avonex (Interferon-beta1a) or Copaxone (Glatiramer Acetate) are eligible to participate. Subjects will be randomized in a 1:1 ratio between placebo and GSK239512, and will continue to be managed with their current standard of care therapy (Copaxone or Avonex). The total treatment period is 48 weeks, including a standard 4 week titration period and 44 week maintenance treatment period (which could be adapted to a 5-week titration and 43 week maintenance period, if needed). Titration doses start at 10 micrograms (mcg) and increase up to 80 mcg (10 mcg first week, 20 mcg second week, 40 mcg third week, 80 mcg fourth week). Subjects will be titrated to the maximum tolerated dose with the objective of titrating to the highest dose (80 mcg GSK239512), whenever possible, based on investigator judgement of tolerability. The post-treatment follow-up period will be a minimum of 2 weeks in duration following the end of treatment at Week 48 or early withdrawal, as appropriate.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GSK239512 Arm | Experimental | GSK239512 once daily orally, started at 10 mcg and titrated to the maximum tolerated dose, Up to the highest dose of 80 mcg (10 mcg first week, 20 mcg second week, 40 mcg third week, 80 mcg fourth week) followed by 44 week maintenance treatment period |
|
| Placebo Arm | Placebo Comparator | Placebo once daily orally |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GSK239512 | Drug | White to almost white, round tablets. Once daily orally, started at 10 mcg and titrated to the maximum tolerated dose, Up to the highest dose of 80 mcg (10 mcg first week, 20 mcg second week, 40 mcg third week, 80 mcg fourth week) followed by 44 week maintenance treatment period |
| Measure | Description | Time Frame |
|---|---|---|
| Mean change in gadolinium (Gd) enhanced (GdE) lesion magnetization transfer ratio (MTR) differences (calibrated to reference scan) from before enhancement to stable recovery (>=3 months post new GdE lesion) | A single Baseline magnetic resonance image (MRI) prior to randomization. Following randomization, a total of 8 MRIs at approximate 6 week intervals: Week 6, Week 12, Week 18, Week 24, Week 30, Week 36, Week 42, Week 48. Reference MRI: In order to accommodate variations in MTR images acquired using different scanners, the images must be normalized to eliminate intensity shifts and contrast variations. For each scanner, images from a normal subject will be obtained and processed to serve as a calibration for each scanner prior to initiating scanning for subjects participating in the study | Up to Week 48 |
| Mean change in Delta MTR lesion MTR differences (calibrated to reference scan) from before lesion appearance to stable recovery (>=3 months post lesion appearance) | A single Baseline MRI prior to randomization Following randomization, a total of 8 MRIs at approximate 6 week intervals: Week 6, Week 12, Week 18, Week 24, Week 30, Week 36, Week 42, Week 48. Reference MRI: In order to accommodate variations in MTR images acquired using different scanners, the images must be normalized to eliminate intensity shifts and contrast variations. For each scanner, images from a normal subject will be obtained and processed to serve as a calibration for each scanner prior to initiating scanning for subjects participating in the study | Up to Week 48 |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in T2 lesion MTR at Week 48 | Baseline and Week 48 | |
| Cumulative new and enlarging Gd enhancing, T2 and Combined Unique Active lesions comparing placebo to GSK239512 treated subjects | Up to Week 48 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| GSK Clinical Trials | GlaxoSmithKline | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| GSK Investigational Site | Sofia | 1113 | Bulgaria | |||
| GSK Investigational Site |
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| Label | URL |
|---|---|
| Researchers can use this site to request access to anonymised patient level data and/or supporting documents from clinical studies to conduct further research. | View source |
| ID | Type | URL | Comment |
|---|---|---|---|
| 116477 | Individual Participant Data Set | View IPD |
Patient-level data for this study will be made available through www.clinicalstudydatarequest.com following the timelines and process described on this site.
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Dec 1, 2016 | |
| Reset | Jan 26, 2017 | |
| Release | Feb 23, 2017 |
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|
| Placebo | Drug | White to almost white, round tablets. Once daily orally. |
|
| Change from baseline at Week 48 in total brain volume, white matter volume and grey matter volume comparing placebo to GSK239512 treated subjects | Baseline and Week 48 |
| Cumulative number of persistent black holes and new unenhancing T1 lesion counts comparing placebo to GSK239512 treated subjects over treatment duration up to Week 48 | Up to Week 48 |
| Proportion of new GdE lesions evolving into chronic (unenhancing) T1 lesions (black holes) comparing placebo to GSK239512 treated subjects over treatment duration up to Week 48 | Up to Week 48 |
| Mean change from baseline in overall cognitive impairment and cognitive domains comparing placebo to GSK239512 treated subjects | A cognitive battery (computerized battery) is included in this study to assess the impact, if any, on several cognitive functional domains. The battery will be executed twice during the screen visit to familiarize the subject with the use of the tool | Baseline and Week 48 |
| Comparison of Relapse Rates between placebo and GSK239512 treated subjects | A relapse in this protocol is defined as: "patient-reported symptoms or objectively observed signs typical of an acute inflammatory demyelinating event in the central nervous system (CNS), current or historical". It must occur in the absence of fever or infection and should - follow improvement from a previous relapse, occur at least 30 days following the onset of a previous relapse, and be persistent for at least 24 hours | Up to 50 Weeks |
| Comparison of Time to First Relapse between placebo and GSK239512 | A relapse in this protocol is defined as: "patient-reported symptoms or objectively observed signs typical of an acute inflammatory demyelinating event in the central nervous system (CNS), current or historical". It must occur in the absence of fever or infection and should - follow improvement from a previous relapse, occur at least 30 days following the onset of a previous relapse, and be persistent for at least 24 hours | Up to 50 Weeks |
| Comparison of the proportion of subjects Relapse Free between placebo and GSK239512 treated subjects | A relapse in this protocol is defined as: "patient-reported symptoms or objectively observed signs typical of an acute inflammatory demyelinating event in the central nervous system (CNS), current or historical". It must occur in the absence of fever or infection and should - follow improvement from a previous relapse, occur at least 30 days following the onset of a previous relapse, and be persistent for at least 24 hours | Up to 50 Weeks |
| Proportion of subjects with sustained worsening of Expanded Disability Severity Scale (EDSS) over 3 months comparing placebo to GSK239512 treated subjects | The EDSS is an assessment of disability specifically associated with Multiple Sclerosis. The assessment will be captured in the medical records including the detailed assessment and scoring for each functional system and domain | Up to 48 Weeks |
| Mean change from baseline in the EDSS functional systems and a subset of component assessments comparing placebo to GSK239512 treated subjects | The EDSS is an assessment of disability specifically associated with Multiple Sclerosis. The assessment will be captured in the medical records including the detailed assessment and scoring for each functional system and domain | Up to 48 Weeks |
| Safety and tolerability as assessed by frequency and severity of Adverse Events (AEs) and Serious Adverse Events (SAEs) | Up to Week 50 |
| Safety and tolerability as assessed by percentage of subjects withdrawing due to AEs | Up to Week 50 |
| Safety and tolerability as assessed by summary of suicide behavior and ideation risk as assessed by the electronic Columbia Suicide Severity Rating Scale (eC-SSRS) | Up to Week 50 |
| Safety and tolerability as assessed by summary of suicide behavior and ideation risk as assessed by Possible Suicidality Related Adverse Event (PSRAE) | Up to Week 50 |
| Safety and tolerability as assessed by change from baseline in clinical chemistry, hematology, and urinalysis parameters | Up to Week 50 |
| Safety and tolerability as assessed by frequency of clinical chemistry, hematology, and urinalysis parameters of potential clinical concern | Up to Week 50 |
| Safety and tolerability as assessed by change from baseline in blood pressure | Up to Week 50 |
| Safety and tolerability as assessed by change from baseline in heart rate | Up to Week 50 |
| Safety and tolerability as assessed by change from baseline in Electrocardiogram (ECG) parameters | Up to Week 50 |
| Safety and tolerability as assessed by frequency of vital signs and ECG parameters of potential clinical concern | Up to Week 50 |
| Trough concentration of GSK239512 at Week 4, Week 24, Week 36 and Week 48 | Up to 48 weeks |
| Sparse Pharmacokinetics (PK) sampling for concentration of GSK239512 at Week 8 | 1 pre-dose and 3 post-dose samples. No samples should be collected within 30 minutes of the previous sample | Pre-dose, and 30 minutes (15 min to 1 hour), 2 hours (1 to 4 hours) and 6 hours (4 to 8 hours) post dose |
| Sofia |
| 1309 |
| Bulgaria |
| GSK Investigational Site | Sofia | 1431 | Bulgaria |
| GSK Investigational Site | Calgary | Alberta | T2N 2T9 | Canada |
| GSK Investigational Site | Edmonton | Alberta | T6G 1Z1 | Canada |
| GSK Investigational Site | Ottawa | Ontario | K1H 8L6 | Canada |
| GSK Investigational Site | Gatineau | Quebec | J9J 0A5 | Canada |
| GSK Investigational Site | Montreal | Quebec | H3A 2B4 | Canada |
| GSK Investigational Site | Jihlava | 586 33 | Czechia |
| GSK Investigational Site | Olomouc | 775 20 | Czechia |
| GSK Investigational Site | Teplice | 415 29 | Czechia |
| GSK Investigational Site | Ulm | Baden-Wurttemberg | 89073 | Germany |
| GSK Investigational Site | Alzenau in Unterfranken | Bavaria | 63755 | Germany |
| GSK Investigational Site | Unterhaching | Bavaria | 82008 | Germany |
| GSK Investigational Site | Hamburg | Free and Hanseatic City of Hamburg | 20249 | Germany |
| GSK Investigational Site | Hamburg | Free and Hanseatic City of Hamburg | 22083 | Germany |
| GSK Investigational Site | Cologne | North Rhine-Westphalia | 50935 | Germany |
| GSK Investigational Site | Münster | North Rhine-Westphalia | 48149 | Germany |
| GSK Investigational Site | Dresden | Saxony | 01069 | Germany |
| GSK Investigational Site | Leipzig | Saxony | 04103 | Germany |
| GSK Investigational Site | Berlin | State of Berlin | 10961 | Germany |
| GSK Investigational Site | Berlin | State of Berlin | 12163 | Germany |
| GSK Investigational Site | Barcelona | 08035 | Spain |
| GSK Investigational Site | Barcelona | 08036 | Spain |
| GSK Investigational Site | Madrid | 28034 | Spain |
| GSK Investigational Site | Madrid | 28040 | Spain |
| GSK Investigational Site | Madrid | 28046 | Spain |
| GSK Investigational Site | Majadahonda (Madrid) | 28222 | Spain |
| GSK Investigational Site | Málaga | 29010 | Spain |
| GSK Investigational Site | Seville | 41009 | Spain |
| GSK Investigational Site | Stockholm | SE-141 86 | Sweden |
| GSK Investigational Site | Donetsk | 83099 | Ukraine |
| GSK Investigational Site | Ivano-Frankivsk | 76008 | Ukraine |
| GSK Investigational Site | Kharkiv | 61068 | Ukraine |
| GSK Investigational Site | Kyiv | 04107 | Ukraine |
| GSK Investigational Site | Lutsk | 43005 | Ukraine |
| GSK Investigational Site | Lviv | 79010 | Ukraine |
| GSK Investigational Site | Poltava | 36024 | Ukraine |
| GSK Investigational Site | Vinnitsa | 21005 | Ukraine |
| GSK Investigational Site | London | NW1 2BU | United Kingdom |
| GSK Investigational Site | London | SE5 9RS | United Kingdom |
| GSK Investigational Site | Romford | RM7 0AG | United Kingdom |
| GSK Investigational Site | Sheffield | S10 2JF | United Kingdom |
For additional information about this study please refer to the GSK Clinical Study Register |
| 116477 | Study Protocol | View IPD | For additional information about this study please refer to the GSK Clinical Study Register |
| 116477 | Clinical Study Report | View IPD | For additional information about this study please refer to the GSK Clinical Study Register |
| 116477 | Annotated Case Report Form | View IPD | For additional information about this study please refer to the GSK Clinical Study Register |
| 116477 | Informed Consent Form | View IPD | For additional information about this study please refer to the GSK Clinical Study Register |
| 116477 | Dataset Specification | View IPD | For additional information about this study please refer to the GSK Clinical Study Register |
| 116477 | Statistical Analysis Plan | View IPD | For additional information about this study please refer to the GSK Clinical Study Register |
| Unrelease | Yes |
| Release | Mar 21, 2017 |
| Reset | May 1, 2017 |
| Release | Nov 30, 2017 |
| Unrelease | Aug 15, 2018 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Dec 1, 2016 | Jan 26, 2017 | |||
| Feb 23, 2017 | Yes | |||
| Mar 21, 2017 | May 1, 2017 | |||
| Nov 30, 2017 | Aug 15, 2018 |
| ID | Term |
|---|---|
| D020529 | Multiple Sclerosis, Relapsing-Remitting |
| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| C584220 | GSK239512 |
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