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Efficacy and Safety Study of Ozanimod in Relapsing Multiple Sclerosis (RADIANCE)

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ClinicalTrials.gov Identifier: NCT02047734
Recruitment Status : Completed
First Posted : January 28, 2014
Results First Posted : February 11, 2021
Last Update Posted : February 11, 2021
Sponsor:
Information provided by (Responsible Party):
Celgene

Brief Summary:

This study is a two-part trial consisting of Part A (see NCT01628393) and Part B, presented within this record.

The primary objective of Part B is to assess whether the clinical efficacy of ozanimod (RPC1063) is superior to interferon beta-1a (IFN β-1a; Avonex®) in reducing the rate of clinical relapses at the end of Month 24 in patients with relapsing multiple sclerosis (RMS).


Condition or disease Intervention/treatment Phase
Relapsing Multiple Sclerosis Drug: Ozanimod Drug: Ozanimod placebo Drug: Interferon beta-1a Drug: Interferon beta-1a placebo Phase 3

Detailed Description:

This clinical trial (RPC01-201; RADIANCE) consisted of 2 parts, each reported separately on ClinicalTrials.gov: Part A (NCT01628393) and Part B (this record).

Part A was a phase 2 study in which two doses of ozanimod were administered daily for 24 weeks with an efficacy and safety comparison to a placebo control and is reported separately as ClinicalTrials.gov record NCT01628393.

Part B, reported herein, was a phase 3 study in which two doses of ozanimod were administered daily for a 24 month period compared to an active control, interferon β-1a. Participants were allowed to enroll in the open-label extension study RPC01-3001 (NCT02576717) or complete the study with a safety follow-up visit 28 days after their last dose of study treatment.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1320 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 2/3, Multi-center, Randomized, Double-blind, Placebo-controlled (Part A) and Double-blind, Double-dummy, Active-controlled (Part B), Parallel Group Study to Evaluate the Efficacy and Safety of RPC1063 Administered Orally to Relapsing Multiple Sclerosis Patients
Actual Study Start Date : December 3, 2013
Actual Primary Completion Date : March 27, 2017
Actual Study Completion Date : April 13, 2017

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Ozanimod 0.5 mg
Ozanimod 0.5 mg oral capsules daily and a weekly intramuscular placebo injection (identical in appearance to Interferon) for 24 months.
Drug: Ozanimod
Oral capsule, daily for 24 months
Other Names:
  • RPC1063
  • Zeposia®

Drug: Interferon beta-1a placebo
Intramuscular injection, weekly for 24 months

Experimental: Ozanimod1 mg
Ozanimod 1 mg oral capsules daily and a weekly intramuscular placebo injection (identical in appearance to Interferon) for 24 months.
Drug: Ozanimod
Oral capsule, daily for 24 months
Other Names:
  • RPC1063
  • Zeposia®

Drug: Interferon beta-1a placebo
Intramuscular injection, weekly for 24 months

Active Comparator: Interferon β-1a
interferon beta-1a (IFN β-1a) 30 µg intramuscular (IM) injection weekly and matching placebo capsules (identical in physical appearance to ozanimod) orally daily for 24 months.
Drug: Ozanimod placebo
Oral capsule, daily for 24 months

Drug: Interferon beta-1a
Intramuscular injection, 30 µg, weekly for 24 months
Other Name: Avonex




Primary Outcome Measures :
  1. Adjusted Annualized Relapse Rate (ARR) at the End of Month 24 [ Time Frame: At the end of month 24 ]

    A relapse was defined as new or worsening neurological symptoms attributable to MS and preceded by a relatively stable or improving neurological state for at least 30 days. Symptoms must have persisted for > 24 hours and not be attributable to confounding clinical factors. Relapses were confirmed when accompanied by objective neurological worsening based on examination by the blinded evaluator, consistent with an increase of ≥ 0.5 on the overall EDSS score relative to the most recent EDSS assessment, or 2 points on one of the functional system scale scores, or 1 point on ≥ two functional system scale scores.

    Relapse rate was calculated as the total number of confirmed relapses divided by the total number of days in the study * 365.25.

    ARR was based on a Poisson regression model, adjusted for region (Eastern Europe vs Rest of the World), age, and the Baseline number of gadolinium-enhancing lesions, and included the natural log transformation of time on study as an offset term.



Secondary Outcome Measures :
  1. Adjusted Mean Number of New or Enlarging Hyperintense T2-Weighted Brain Magnetic Resonance Imaging (MRI) Lesions Per Scan Over 24 Months [ Time Frame: 24 month treatment period; MRI scans were performed at Months 12 and 24 ]

    The adjusted mean number of new or enlarging hyperintense T2-weighted brain MRI lesions per scan was based on the cumulative number of new or enlarging T2 lesions since Baseline over 24 months. MRI images were assessed and scored by an independent MRI analysis center with no knowledge of treatment assignment or outcomes.

    The adjusted mean per scan over 24 months was based based on a negative binomial regression model using observed data, adjusted for region (Eastern Europe vs. Rest of the World), age at Baseline, and Baseline number of GdE lesions. The natural log transformation of the number of available MRI scans over 24 months is used as an offset term.


  2. Adjusted Mean Number of Gadolinium Enhancing Brain Lesions at Month 24 [ Time Frame: Month 24 ]

    MRI images were assessed and scored by an independent MRI analysis center with no knowledge of treatment assignment or outcomes.

    The number of gadolinium-enhancing (GdE) lesions at 24 months was analyzed based on observed data using a negative binomial regression model adjusted for region (Eastern Europe vs Rest of World), Baseline age, and Baseline number of GdE lesions, with natural log transformation of number of available MRI scans over 24 months as an offset term (1 scan for per participant).


  3. Time to Onset of Disability Progression Confirmed After 3 Months [ Time Frame: From first dose to the end of the 24-month treatment period ]

    EDSS is used to quantify disability and disability progression over time in MS. Based on a neurological examination, 8 functional systems (visual, brain stem, pyramidal, cerebellar, sensory, bowel & bladder, cerebral, and other functions) are scored from 0 (no disability) to 5 or 6 (more severe disability). Ambulation is assessed based on distance the patient is able to walk, whether assistance is required or restrictions are present.

    The EDSS score ranges from 0 (normal) to 10 (death due to MS) in 0.5 unit increments.

    Disability progression is defined by a sustained worsening in EDSS score of 1.0 point or more confirmed after 3 months. Time to onset of disability progression was calculated from the date of first dose to the date of the first visit at which the 1.0 point increase in EDSS was met using Kaplan-Meier methods. Participants without a sustained disease progression event were censored on the date of their last assessment or last dose of study drug, whichever was later.


  4. Time to Onset of Disability Progression Confirmed After 6 Months [ Time Frame: From first dose to the end of the 24-month treatment period ]

    EDSS is used to quantify disability and disability progression over time in MS. Based on a neurological examination, 8 functional systems (visual, brain stem, pyramidal, cerebellar, sensory, bowel & bladder, cerebral, and other functions) are scored from 0 (no disability) to 5 or 6 (more severe disability). Ambulation is assessed based on distance the patient is able to walk, whether assistance is required or restrictions are present.

    The EDSS score ranges from 0 (normal) to 10 (death due to MS) in 0.5 unit increments.

    Disability progression is defined by a sustained worsening in EDSS score of 1.0 point or more confirmed after 3 months. Time to onset of disability progression was calculated from the date of first dose to the date of the first visit at which the 1.0 point increase in EDSS was met using Kaplan-Meier methods. Participants without a sustained disease progression event were censored on the date of their last assessment or last dose of study drug, whichever was later.


  5. Percentage of Participants Who Were Gadolinium Enhancing (GdE) Lesion-Free at Month 24 [ Time Frame: Month 24 ]

    Participants were considered lesion free at Month 24 if they did not show evidence of GdE lesions at the Month 24 MRI scan.

    MRI images were assessed and scored by an independent MRI analysis center with no knowledge of treatment assignment or outcomes.


  6. Percentage of Participants Who Were New or Enlarging T2 Lesion-Free at Month 24 [ Time Frame: Month 24 ]
    MRI images were assessed and scored by an independent MRI analysis center with no knowledge of treatment assignment or outcomes.

  7. Percent Change From Baseline in Normalized Brain Volume to Month 24 [ Time Frame: Baseline and Month 24 ]
    Brain volume (a measure of brain atrophy) was measured by brain MRI scans that were assessed and scored by an independent MRI analysis center with no knowledge of treatment assignment or outcomes.

  8. Change From Baseline to Month 24 in Multiple Sclerosis Functional Composite (MSFC) Score Including the Low-Contrast Letter Acuity (LCLA) Test [ Time Frame: Baseline to Month 24 ]

    The MSFC-LCLA is a battery including the following 4 individual scales:

    • Timed 25-Foot Walk is an ambulation measure of walking 25 feet with time taken recorded in seconds
    • 9-Hole Peg Test (9HPT) is a quantitative measure of upper extremity (arm and hand) function
    • Symbol Digit Modalities Test (SDMT) is a measure of executive cognitive function that assesses processing speed, flexibility, and calculation ability
    • Low-Contrast Letter Acuity Test (LCLA) used a standardized set of charts to assess low contrast visual acuity, charts are scored according to the number of letters that are identified correctly

    Z-scores were calculated for for each component and averaged to create an overall composite score, using the study population as the reference population. A Z-score represents the number of standard deviations a patient's test result is higher (Z > 0) or lower (Z < 0) than the average test result (Z = 0) of the reference population. A positive change indicates improvement.


  9. Mean Change From Baseline in Multiple Sclerosis Quality of Life (MSQOL)-54 Physical Health Composite Summary and Mental Health Composite Summary Scores [ Time Frame: Baseline to Month 24 ]

    The MSQOL-54 is a multidimensional health-related QOL measure that combines both generic and MS-specific items into a single instrument. The instrument includes 12 subscales, two summary scores, and two single-item measures.

    The two summary scores - physical health and mental health - are derived from a weighted combination of scale scores.

    The physical health composite score includes Physical function, Health perceptions, Energy/fatigue, Role limitations - physical, Pain, Sexual function, Social function, and Health distress.

    The mental health composite score includes Health distress, Overall quality of life, Emotional well-being, Role limitations - emotional, and Cognitive function.

    Each composite summary score has a range from 0 to 100 where higher scores indicate better quality of life. A positive change from Baseline indicates improvement.


  10. Number of Participants With Treatment Emergent Adverse Events [ Time Frame: From the first dose of study drug up to the first dose of the open-label extension study RPC01-3001, or up to 28 days after last dose for participants who did not continue into the open-label extension study; median duration of treatment was 24 months. ]

    An adverse event (AE) is any untoward medical occurrence that does not necessarily have a causal relationship with the investigational product (IP), including an abnormal laboratory finding, symptom or disease temporally associated with the use of an IP whether or not considered related to the IP. Serious AEs were events that resulted in death, were life-threatening, required hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability or incapacity, were congenital abnormalities/birth defects, or important medical events which may have required medical intervention to prevent one of the above outcomes.

    The investigator assessed the severity of AEs as mild, moderate, or severe and the relationship of each AE to treatment as unrelated, unlikely, possible, probable, or related based on timing and other known factors such as clinical state, environment, or other therapies.




Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 55 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Multiple sclerosis as diagnosed by the revised 2010 McDonald criteria
  • Expanded Disability Status Scale (EDSS) score between 0 and 5.0 at baseline

Exclusion Criteria:

  • Primary progressive multiple sclerosis

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02047734


Locations
Show Show 299 study locations
Sponsors and Collaborators
Celgene
  Study Documents (Full-Text)

Documents provided by Celgene:
Study Protocol  [PDF] October 4, 2014
Statistical Analysis Plan  [PDF] June 5, 2015

Publications of Results:
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Responsible Party: Celgene
ClinicalTrials.gov Identifier: NCT02047734    
Other Study ID Numbers: RPC01-201-PartB
2012-002714-40 ( EudraCT Number )
First Posted: January 28, 2014    Key Record Dates
Results First Posted: February 11, 2021
Last Update Posted: February 11, 2021
Last Verified: January 2021
Additional relevant MeSH terms:
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Multiple Sclerosis
Sclerosis
Pathologic Processes
Demyelinating Autoimmune Diseases, CNS
Autoimmune Diseases of the Nervous System
Nervous System Diseases
Demyelinating Diseases
Autoimmune Diseases
Immune System Diseases
Interferons
Interferon-beta
Interferon beta-1a
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Immunologic Factors
Physiological Effects of Drugs
Adjuvants, Immunologic