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The purpose of this study is to evaluate the efficacy and safety of Ocrelizumab produced by CinnaGen compared with Ocrevus® (Roche, Switzerland) in subjects with relapsing remitting multiple sclerosis (RRMS).
All the participants will receive one of the following regimens:
Ocrelizumab (CinnaGen) or Ocrevus® (Roche, Switzerland) ,600 mg (given as dual infusions of ocrelizumab 300 mg on Days 1 and 15 of the first 24-week treatment cycle and as single infusions of 600 mg on Day 1 for each 24-week treatment cycle, thereafter) every 24 weeks.
The primary objective of this study is to verify the equivalency of Ocrelizumab (CinnaGen) versus Ocrevus® (Roche, Switzerland) in reducing the annualized relapse rate (ARR) in participants with relapsing remitting multiple sclerosis (RRMS) at 2 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ocrelizumab (CinnaGen, Iran) | Experimental | Ocrelizumab (CinnaGen, Iran) 600 mg (given as dual infusions of ocrelizumab 300 mg on Days 1 and 15 of the first 24-week treatment cycle and as single infusions of 600 mg on Day 1 for each 24-week treatment cycle, thereafter) every 24 weeks. |
|
| Ocrelizumab (Roche, Switzerland) | Active Comparator | Ocrelizumab (Roche, Switzerland) 600 mg (given as dual infusions of ocrelizumab 300 mg on Days 1 and 15 of the first 24-week treatment cycle and as single infusions of 600 mg on Day 1 for each 24-week treatment cycle, thereafter) every 24 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ocrelizumab (CinnaGen, Iran) | Biological | Ocrelizumab (CinnaGen, Iran) will be administered via intravenous (IV) infusion. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Annualized Relapse Rate at 48 weeks | Total number of confirmed relapses divided by the total number of days on study A relapse is defined as the appearance of a new or worsening of a previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding relapse. The abnormality must be present for at least 24 hours and occur in the absence of fever or infection | 48 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Time to onset of sustained disability progression for at least 12 weeks | Disability progression is defined as an increase in the Expanded Disability Status Scale (EDSS) score of: A) At least a 1.5-point increase in patients with a baseline score of 0 B) At least a 1.0-point increase on the EDSS in patients with a baseline score of 0<EDSS≤5.5 C) At least a 0.5-point increase on the EDSS in patients with a baseline score of >5.5 The EDSS scale ranges from 0 (normal neurological exam) to 10 (death due to multiple sclerosis) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mohammad Ali Sahraian, professor | Neurologist/MS Research Center, Neuroscience Institute ,Tehran University of Medical Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Qaem International Hospital | Rasht | Gilan Province | Iran | |||
| Golestan Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39438591 | Derived | Sahraian MA, Abolfazli R, Shaygannejad V, Ashtari F, Majdinasab N, Navardi S, Baghbanian SM, Sedighi B, Naser Moghadasi A, Nahayati MA, Ghalyanchi Langroodi H, Mohammadianinejad SE, Beladi Moghadam N, Ayromlou H, Nikseresht A, Ghiasian M, Razazian N, Asadollahzadeh E, Sabzvari A, Kafi H, Albooyeh S. Evaluating efficacy and safety of ocrelizumab biosimilar (Xacrel) compared to the originator (Ocrevus) in relapsing multiple sclerosis: a phase III, randomized, equivalency, clinical trial. Sci Rep. 2024 Oct 22;14(1):24921. doi: 10.1038/s41598-024-75745-y. |
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| Ocrelizumab (Roche, Switzerland) | Biological | Ocrelizumab (Roche, Switzerland) will be administered via intravenous (IV) infusion. |
|
|
| Baseline up to Week 96 |
| Time to onset of sustained disability progression for at least 24 weeks | Disability progression is defined as an increase in the Expanded Disability Status Scale (EDSS) score of: A) At least a 1.5-point increase in patients with a baseline score of 0 B) At least a 1.0-point increase on the EDSS in patients with a baseline score of 0<EDSS≤5.5 C) At least a 0.5-point increase on the EDSS in patients with a baseline score of >5.5 The EDSS scale ranges from 0 (normal neurological exam) to 10 (death due to multiple sclerosis) | Baseline up to Week 96 |
| Proportion of relapse-free patients by 96 weeks | A relapse is defined as the appearance of a new or worsening of a previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding relapse. The abnormality must be present for at least 24 hours and occur in the absence of fever or infection | Week 96 |
| Total number of new Gadolinium (Gd)-enhancing lesions as detected by brain MRI | Sum of the individual number of (Gd)-enhancing lesions at Weeks 24, 48, and 96 | Baseline up to Week 96 |
| Total number of new, and/or enlarging T2 hyperintense lesions as detected by brain MRI | Sum of the individual number of new, and/or enlarging T2 hyperintense lesions at Weeks 24, 48, and 96 | Baseline up to Week 96 |
| Change in total T2 lesion volume as detected by brain MRI from baseline to week 96 | Baseline up to Week 96 |
| Number of Participants With Adverse Events (AEs) | Intensity, seriousness and causality assessment of observed AEs, and abnormal laboratory findings every 12 weeks. | Baseline up to Week 96 |
| Number of Participants With Infusion Related Reactions (IRRs) | Assessment of IRRs every 24 weeks | Baseline up to Week 96 |
| Immunogenicity Assessment | Number of participants positive for anti-drug antibodies at weeks 24, 48 and 96 | Baseline up to Week 96 |
| Ahvāz |
| Khozestan |
| Iran |
| Bouali Hospital, MS Clinic | Sari | Mazandaran | Iran |
| Qaem Hospital | Mashhad | Razavi Khorasan Province | Iran |
| Sina Hospital | Hamadan | Iran |
| Ayatollah Kashani Hospital, MS Clinic | Isfahan | Iran |
| Shafa Hospital | Kerman | Iran |
| Imam Reza Hospital | Kermanshah | Iran |
| Dr. Nikseresht's office | Shiraz | Iran |
| Namazi Hospital | Shiraz | Iran |
| Imam Reza Hospital Department of Neurology | Tabriz | Iran |
| Amir Alam Hospital | Tehran | Iran |
| Imam Hossein Hospital, MS Clinic | Tehran | Iran |
| Imam Khomeini Hospital | Tehran | Iran |
| Sina Hospital, MS Research Center | Tehran | Iran |
| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| ID | Term |
|---|---|
| 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 |
|---|---|
| C533411 | ocrelizumab |
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