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Efficacy and Safety of Fingolimod in Patients With Relapsing-remitting Multiple Sclerosis With Optional Extension Phase (TRANSFORMS)

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ClinicalTrials.gov Identifier: NCT00340834
Recruitment Status : Completed
First Posted : June 21, 2006
Results First Posted : May 16, 2011
Last Update Posted : September 21, 2017
Sponsor:
Information provided by (Responsible Party):
Novartis

Brief Summary:
This study assessed the safety, tolerability, and efficacy of 2 doses of oral fingolimod versus interferon β-1a to reduce the frequency of relapses in patients with relapsing-remitting multiple sclerosis.

Condition or disease Intervention/treatment Phase
Multiple Sclerosis Drug: Fingolimod 1.25 mg Drug: Fingolimod 0.5 mg Drug: Interferon β-1a 30 µg Phase 3

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1292 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A 12-month Double-blind, Randomized, Multicenter, Active-controlled, Parallel-group Study Comparing the Efficacy and Safety of 0.5 mg and 1.25 mg Fingolimod (FTY720) Administered Orally Once Daily Versus Interferon ß-1a (Avonex) Administered im Once Weekly in Patients With Relapsing-remitting Multiple Sclerosis With Optional Extension Phase
Study Start Date : May 2006
Actual Primary Completion Date : July 2011
Actual Study Completion Date : July 2011


Arm Intervention/treatment
Experimental: Fingolimod 1.25 mg Drug: Fingolimod 1.25 mg

Core: Patients self-administered fingolimod 1.25 mg capsules orally once daily. In addition, they self-administered an interferon β-1a placebo intramuscular (im) injection once weekly.

Extension: Patients self-administered fingolimod 1.25 mg capsules orally once daily until switched to 0.5 mg capsules upon study protocol amendment.

Other Name: FTY720

Experimental: Fingolimod 0.5 mg Drug: Fingolimod 0.5 mg

Core: Patients self-administered fingolimod 0.5 mg capsules orally once daily. In addition, they self-administered an interferon β-1a placebo intramuscular (im) injection once weekly.

Extension: Patients self-administered fingolimod 0.5 mg capsules orally once daily.

Other Name: FTY720

Active Comparator: Interferon β-1a 30 µg Drug: Interferon β-1a 30 µg

Core: Patients self-administered interferon β-1a 30 μg in an intramuscular (im) injection once weekly. In addition, they self-administered a fingolimod placebo capsule orally once daily.

Extension: Patients self-administered either fingolimod 1.25 mg or 0.5 mg capsules orally once daily until switched to 0.5 mg capsules upon study protocol amendment.





Primary Outcome Measures :
  1. Estimated Annualized Aggregate Relapse Rate (ARR) in the Core Phase of the Study [ Time Frame: Baseline to Month 12 ]
    The ARR is defined as the number of confirmed relapses in a year. 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. The annualized ARR for each treatment group was calculated using negative binomial regression adjusted by treatment, country, number of relapses in the previous 2 years, and the baseline Expanded Disability Status Scale score.


Secondary Outcome Measures :
  1. Number of New or Newly Enlarged T2 Lesions in Comparison With Baseline in the Core Phase of the Study [ Time Frame: Baseline to Month 12 ]
    The number of new or newly enlarged T2 lesions in comparison to baseline was assessed with T2-weighted magnetic resonance image (MRI) scans. A T2-weighted MRI scan utilizes particular values of the echo time (TE) and the repetition time (TR) parameters of image acquisition. Inflammation and tissue damage are seen as bright areas in T2 images and are often referred to as T2 lesions. T2-weighted MRI scans are a sensitive way to evaluate the brain for demyelinating diseases, such as multiple sclerosis.

  2. Percentage of Participants Free of 3-month Disability Progression Assessed With the Expanded Disability Status Scale (EDSS) at the End of the Core Phase of the Study [ Time Frame: Baseline to Month 12 ]
    The EDSS is a scale for assessing disability in 8 functional systems (visual, brain stem, pyramidal, cerebellar, sensory, bowel & bladder, cerebral, other functions). An overall score ranging from 0 (normal) to 10 (death due to MS) is calculated. Disability progression was determined by the EDSS score based on the following criteria: One point increase from baseline in patients with baseline EDSS score from 0 to 5.0; or half a point increase in patients with baseline EDSS score of 5.5 or above. Percent of patients free of disability progression was calculated using the Kaplan-Meier method.

  3. Estimated Annualized Aggregate Relapse Rate (ARR) in the Core and Extension Phases of the Study [ Time Frame: Month 0 to end of study (up to approximately 4.5 years) ]
    The ARR is defined as the number of confirmed relapses in a year. 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. The annualized ARR for each treatment group was calculated using negative binomial regression adjusted by treatment, country, number of relapses in the previous 2 years, and the baseline Expanded Disability Status Scale score.

  4. Number of New or Newly Enlarged T2 Lesions in the Extension Phase of the Study [ Time Frame: Month 12 to end of study (up to approximately 3.5 years) ]
    The number of new or newly enlarged T2 lesions in comparison to baseline was assessed with T2-weighted magnetic resonance image (MRI) scans. A T2-weighted MRI scan utilizes particular values of the echo time (TE) and the repetition time (TR) parameters of image acquisition. Inflammation and tissue damage are seen as bright areas in T2 images and are often referred to as T2 lesions. T2-weighted MRI scans are a sensitive way to evaluate the brain for demyelinating diseases, such as multiple sclerosis.

  5. Percentage of Participants Free of 3-month and 6-month Disability Progression Assessed With the Expanded Disability Status Scale (EDSS) at the End of the Extension Phase of the Study [ Time Frame: Baseline to end of study (up to approximately 4.5 years) ]
    The EDSS is a scale for assessing disability in 8 functional systems (visual, brain stem, pyramidal, cerebellar, sensory, bowel & bladder, cerebral, other functions). An overall score ranging from 0 (normal) to 10 (death due to MS) is calculated. Disability progression was determined by the EDSS score based on the following criteria: One point increase from baseline in patients with baseline EDSS score from 0 to 5.0; or half a point increase in patients with baseline EDSS score of 5.5 or above. Percent of patients free of disability progression was calculated using the Kaplan-Meier method.



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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:

  • Male and female patients between ages 18-55 with a diagnosis of multiple sclerosis (MS)
  • Patients with a relapsing-remitting disease course
  • Patients with Expanded Disability Status Scale (EDSS) score of 0-5.5

Exclusion Criteria:

  • Patients with other chronic disease of the immune system, malignancies, acute pulmonary disease, cardiac failure, etc
  • Pregnant or nursing women
  • Patients who cannot tolerate treatment with an interferon

Other protocol-defined inclusion/exclusion criteria applied to the study.


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): NCT00340834


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Locations
United States, Alabama
North Central Neurology Associates, PC, 1809 Kress Street
Cullman, Alabama, United States, 35058
United States, Arizona
Barrow Neurological Institute
Phoenix, Arizona, United States, 85013
United States, California
The Neurology Center, 3907 Waring Road, Suite 3
Oceanside, California, United States, 92056
United States, Connecticut
Associated Neurologists, PC, 69 Sand Pit Road, Suite 300
Danbury, Connecticut, United States, 06810
Associated Neurologists of Southern CT, PC, 75 Kings Highway Cutoff
Fairfield, Connecticut, United States, 06824
Yale University Multiple Sclerosis Center
New Haven, Connecticut, United States, 06510
United States, Florida
University of Florida Health Science Center
Jacksonville, Florida, United States, 32209
Neurology Associates, PA, 301 N. Maitland Avenue, Suite A1
Maitland, Florida, United States, 32751
University of Miami, Department of Neurology
Miami, Florida, United States, 33136
Neurological Associates
Pompano Beach, Florida, United States, 33060
Roskamp Institute, 2040 Whitfield Ave.
Sarasota, Florida, United States, 34243
AMO Corporation
Tallahassee, Florida, United States, 32308
Axiom Clinical Research of Florida, 2919 Swann Avenue, Suite 401
Tampa, Florida, United States, 33609
University of South Florida, Department of Neurology
Tampa, Florida, United States, 33612
The MS Center of Vero Beach
Vero Beach, Florida, United States, 32960
United States, Kansas
University of Kansas Medical Center
Kansas City, Kansas, United States, 66160
Mid America Neuroscience Institute, 8550 Marshall Drive, Suite 100
Lenexa, Kansas, United States, 66214
United States, Missouri
University Physician Group, #1 Barnes-Jewish Hospital Plaza, Suite 16304
Saint Louis, Missouri, United States, 63110
United States, North Carolina
Neuroscience and Spine Center
Charlotte, North Carolina, United States, 28207
Raleigh Neurology Associates, 1540 Sunday Drive
Raleigh, North Carolina, United States, 27607
United States, Ohio
Neurology & Neuroscience Associates, Inc
Akron, Ohio, United States, 44302
Northern Ohio Neuroscience, LLC
Bellevue, Ohio, United States, 44811
Cleveland Clinic
Cleveland, Ohio, United States, 44195
United States, Oregon
Oregon Neurology
Tualatin, Oregon, United States, 97062
United States, Pennsylvania
University of Pittsburgh, Department of Neurology
Pittsburgh, Pennsylvania, United States, 15213
United States, South Carolina
Absher Neurology, 274-A Commonwealth Drive
Greenville, South Carolina, United States, 29615
United States, Tennessee
Mountain Empire Neurological Associates, PC, 3183 West State Street, Suite 1201
Bristol, Tennessee, United States, 37620
Advanced Neurosciences Institute
Franklin, Tennessee, United States, 37064
United States, Texas
Baylor College of Medicine
Houston, Texas, United States, 77030
Private Practice, 3815 23rd Street
Lubbock, Texas, United States, 79410
Integra Clinical Research, 4242 Medical Drive, Suite 6100
San Antonio, Texas, United States, 78229
United States, Washington
Swedish Neuroscience Institute
Seattle, Washington, United States, 98122
Rockwood Clinic, P.S.
Spokane, Washington, United States, 99202
United States, West Virginia
West Virginia University Health Associates
Morgantown, West Virginia, United States, 26506
United States, Wisconsin
Center for Neurological Disorders - Aurora St. Luke's Med Center
Milwaukee, Wisconsin, United States, 53215
Argentina
Ineba
Guarda Vieja 4435, Capital Federal, Buenos Aires, Argentina, 1428
Fundacion Rosarina de Neurorehabilitacion
Rosario, Santa Fe, Argentina, 2000
Instituto de Neurociencias de Rosario
Rosario, Santa Fe, Argentina, 2000
Hospital Italiano de Buenos Aires
Buenos Aires, Argentina, C118ACK
Fundacion Lenox Cordoba
Cordoba, Argentina, 5000
Hospital J. M. Ramos Mejia
General Urquiza 609, Buenos Aires, Argentina, C1221ADC
FLENI
Montaneses 2325, Buenos Aires, Argentina, C1428AQK
Australia, New South Wales
Strategic Health Evaluators
Chatswood, New South Wales, Australia, 2067
Royal Prince Alfred Hospital
Department of Medicine, Level, Missenden R, Camperdown, New South Wales, Australia, 2050
Liverpool Hospital, Neurology Department, Health Services Building, 4th Floor, Goulburn and Campbell Street
Liverpool, New South Wales, Australia, 2170
Gosford Private Hospital
North Gosford, New South Wales, Australia, 2250
St George Private Hospital
Suite 7E, Level 5, South Street, Kogarah, New South Wales, Australia, 2217
Australia, Victoria
Box Hill Hopsital, Level 3, 16 Arnold Street
Box Hill, Victoria, Australia, 3128
Royal Melbourne Hospital
Suite 30, Grattan St., Parkbville, Victoria, Australia, 3050
Austria
Landesklinikum St. Poelten, Probst-Ruehrer-Str. 4
St. Poelten, Sankt Poelten, Austria, 3100
Landes-Narvenklinik Wagner-Jauregg
Abteilung fuer Neurologie, Linz, Austria, A-4020
Universitätsklinik f. Neurologie Innsbruck
Anichstrasse 35, Innsbruck, Austria, 6020
Landes-Nervenklinik Christian Doppler Klinik
Ignaz Harrerstr. 79 , Salzburg, Austria, A-5020
Evangel.Krankenh./Wien-Waehring Außenstelle
Vienna, Austria, 1010
Univ.-Klinik fuer Neurologie AKH
Vienna, Austria, 1090
Belgium
Cliniques Universitaires Saint Luc
Avenue Hippocrate 10, Bruxelles, Belgium, 1200
UZ Brussel
Laarbeeklaan 101, Brussels, Belgium, 1090
Nationaal Multiple Sclerose Centrum v.z.w
Melsbroek, Belgium, 1820
Regionaal Ziekenhuis Sint-Trudo - Campus Sint-Jozef
Sint-Truiden, Belgium, 3800
Brazil
Hospital Sao Rafael
Salvador, BA, Brazil, 41256 900
Hospital das Clincas - UNICAMP
Campinas, SP, Brazil, 13083-970
Hospital das Clinicas da FMRPUSP
Ribeirao Preto, SP, Brazil, 48000-900
Irmandade da Santa Casa de Misericordia de Porto Alegre
Porto Alegre, Brazil, RS 90020-090
Hospital dos Servidores do Estado
Rio de Janeiro, Brazil, RJ 20221-903
Hospital Universitario Gaffree e Guinle
Rio de Janeiro, Brazil, RJ 20270-004
Canada, British Columbia
Fraser Health MS Clinic, Burnaby Hospital, 3935 Kincaid Street
Vancouver, British Columbia, Canada, V56 2X6
UBC MS Research, 2211 Westbrook Mall
Vancouver, British Columbia, Canada, V6T 2B5
Canada, Ontario
Nepean Medical Centre, 1 Centrepointe Drive, Suite 407
Ottawa, Ontario, Canada, K2G 6E2
St. Michael's Hospital, Chief, Division of Neurology, 30 Bond Street,Suite 3007 - Shuter Wing
Toronto, Ontario, Canada, M5B 1W8
Canada, Quebec
Centre Hospitalier Universitaire de Sherbrooke, 3001 12th Avenue North
Fleurimont, Quebec, Canada, J1H 5N4
Charles Lemoyne Hospital
Greenfield Park, Quebec, Canada, J4V 2H1
CHUM - Hopital Notre-Dame
Montreal, Quebec, Canada, H2L 4M1
Montreal Neurological Institute, 3801 University Street
Montreal, Quebec, Canada, H3A 2B4
Canada
The Ottawa General Hospital, 501 Smyth Rd.
Ottawa, Canada, K1H 8L6
Egypt
Private Clinic, 48 Sidi Gaber St.
Alexandria, Egypt
35, Dokki St., Apt. 4
Cairo, Egypt
Al Azhar University, 11 Talaat Harb St, Fourth Floor, Apt 18
Cairo, Egypt
Private Clinic, 35 Dokki St., Apt. 4
Cairo, Egypt
Private Clinic, 7 Batal Ahmed Abdelaziz St Abdeen
Cairo, Egypt
France
Hopital La Timone Cpcet, Rue Jean Moulin
Marseille, France, 13385
Hopital Central, 29 Avenue du Marechal de Lattre de Tassigny
Nancy, France, 54035
Hôpital Pellegrin
Place Amélie Raba Léon, Bordeaux Cedex, France, 33076
Hopital De Purpan
Place du Dr. Baylac, Toulouse Cedex, France, 31059
Centre Hospitalier de Poissy, 10 rue du Champ Gaillard
Poissy, France, 78303
Hoppital Pasteur, Archet II, 30 avenue de la Voie
Romaine, France, 06602
Germany
Investigational Site
Bamberg, Germany, 96049
Investigational Site
Berlin, Germany, 10713
Investigational Site
Berlin, Germany, 13439
Investigational Site
Bremen, Germany, 28177
Investigational Site
Buchholz, Germany, 21244
Investigational Site
Dresden, Germany, 01307
Investigational Site
Dusseldorf, Germany, 40225
Investigational Site
Erbach/Odenwald, Germany, 64711
Investigational Site
Essen, Germany, 45122
Investigational Site
Freiburg, Germany, 79106
Investigational Site
Greifswald, Germany, 17475
Investigational Site
Hamburg, Germany, 66421
Investigational Site
Hannover, Germany, 30623
Investigational Site
Heidelberg, Germany, 69120
Investigational Site
Hennigsdorf, Germany, 16761
Investigational Site
Koeln, Germany, 51109
Investigational Site
Lengerich, Germany, 49525
Investigational Site
Mainz, Germany, 55131
Investigational Site
Muenchen, Germany, 80331
Investigational Site
Munchen, Germany, 81675
Investigational Site
Potsdam, Germany, 14471
Investigational Site
Teupitz, Germany, 15755
Investigational Site
Trier, Germany, 54292
Investigational Site
Tubingen, Germany, 72076
Investigational Site
Ulm, Germany, 89073
Investigational Site
Ulm, Germany, 89075
Investigational Site
Wermsdorf, Germany, 04779
Investigational Site
Wurzburg, Germany, 97070
Greece
Univ. Hospital of Heraklion
Voutes, Heraklion, Crete, Greece, GR 71001
Errikos Dinan General Hospital, 107 Mesogion Ave.
Athens, Greece, 11526
General Hospital of Athens G. Gennimatas, 154 Mesogeion Ave.
Athens, Greece, G-156 69
Metropolitan Hospital, Ethnarchou Makariou 6 & Eleftheriou Venizelou 1
Athens, Greece, GR 18547
General University Hospital of Patra-RIO
Patra - RIO, Greece, GR- 26500
Ahepa University General Hospital of Thessaloniki, 1 Stilp. Kyriakidi Str.
Thessaloniki, Greece, GR 54636
Hungary
Debreceni Egyetem Orvos es Egszstd. Centr.
Debrecen, Hungary, 4012
Petz Aladár Megyei Oktató Kórház
Györ, Hungary, 9024
Veszprem Megyei Csolnoky Ferenc Korhaz
Korhaz u. 1, Veszprem, Hungary, H-8200
Pecsi Tudomanyegyetem Neurologiai Klinika
Pecs, Hungary, 7623
Peterfy Sandor u. Hospital, Neurology
u. 8-20m, Budapest, Hungary, 1076
Uzsoki korhaz
Uzsoki u. 29., Budapest, Hungary, 1145
Italy
Azienda Sanitaria Osp. S. Luigi
Gonzaga, Orbassano, Italy, TO 10043
Ospedale S. Antonio Abate
via Pastori, 4, Gallarate, VA, Italy, 21013
Presidio Ospedaliero Roberto Binaghi
Cagliari, Italy, CA 09126
Azienda Ospedaliera Universitaria Arcispedale Sant'Anna
Ferrara, Italy, FE 44100
Presidio Ospedaliero di Vaio Fidenza
Fidenza, Italy, PR 43036
Osp. Magg. Pol. Mangiagalli e Regina Elena - Fond. IRCCS
Milano, Italy, MI 20122
Az. Osp. Niguarda Ca' Granda
Milano, Italy, MI 20162
Presidio Ospedaliero di Montichiari
Montichiari, Italy, BS 25018
IRCCS Neurologico C. Mondino
Pavia, Italy, PV 27100
Az. Osp. Ospedale Consorziale e Policlinico
piazza Giulio Cesare, 11 Bari, Italy, 70124
Az. Osp. Ospedale S. Martino - Università degli Studi
via Antonio De Toni, 5, Genova, Italy, 16132
Ist. Neurol. Mediterraneo Neuromed
Via Atinense, 18, Pozzilli, Italy, 86077
Ospedali Riuniti Umberto I - GM Lancisi - G.Salesi
via Conca, 71, Torrette di Ancona, Italy, 60020
Osp. Clinicizzato Colle dell'Ara - Università G. D'Annunzio
via dei Vestini, 5 Chieti, Italy, 66100
Azienda Ospedaliera Sant'Andrea - Università La Sapienza
Via di Grottarossa, 1035/1039, Roma, Italy, 00189
Azienda Ospedaliera di Padova - Università degli Studi
Via Giustiniani, 2, Padova, Italy, 35128
Az. Osp. Universitaria Policlinico Tor Vergata
via Montpellier, 1, Roma, Italy, 00133
Ospedale San Raffaele - IRCCS
via Olgettina, 48/60, Milano, Italy, 20132
Policlinico - Università degli Studi Federico II
via Pansini, 5, Napoli, Italy, 80131
Istituto di Scienze Neurologiche Università di Catania
via Santa Sofia, 78, Catania, Italy, 95123
Ospedale Bellaria Maggiore
via Toscana Nazionale, 17/19, Bologna, Italy, 40139
Azienda Ospedaliera Careggi - Università degli Studi
Viale Giovan Battista Morgagni, 85, Firenze, Italy, 50134
Korea, Republic of
National Cancer Center, 809 Madu 1-dong, Ilsan-gu
Kyunggi, Goyang, Korea, Republic of, 411-764
Samsung Medical Center
Seoul, Korea, Korea, Republic of, 135-710
Yonsei Univ. Med. Center,Severance Hospital, 134 Shinchon-dong, Suedaemoon-ku
Seoul, Korea, Republic of, 135-230
Kyung Pook National University Hospital
Taegu, Korea, Republic of, 700-721
Portugal
Hospital Fernando Fonseca
Amadora, Portugal, 2720-276
Hospitais da Universidade de Coimbra
Av. Dr. Bissaya Barreto, Coimbra, Portugal, 3000-075
Hospital Sto. António dos
Capuchos, Portugal
Hospital de São João
Porto, Portugal, 4200-319
Hospital de S. Bernardo
Rua Camilo Castelo Branco, Setubal, Portugal, 2910-446
Spain
Complejo Hospitalario Carlos Haya
Avda. Carlos Haya, s/n, Málaga, Spain, 29010
Hospital Universitario Virgen Macarena
Avenida Dr. Fedriani, 3, Sevilla, Spain, 41009
Ciutat Sanitaria I, Universitaria De Bellvitge, c/o Feixa Llarga, Hospitalet de Llobregat
Barcelona, Spain, 08907
Hospital de Basurto
Bilbao, Spain, 48013
Hospital Clinico San Carlos
C/ Dr. Martin Lagos, s/n, Madrid, Spain, 28040
Unitat de Neuroimmunologia Clinica, Hospital Vall d'Hebron
EUI-planta 2, Pg. Vall d'Hebron 119-29, Barcelona, Spain, 08035
Puerta de Huerro Univeristy Hospital
San Martin de Porres, 4, Madrid, Spain, 28035
Hospital Universitario La Fe.
Valencia, Spain, 46009
Switzerland
Universitätsspital Zuerich
Neurologische Klinik, Frauenklinikstrasse 26, Zuerich, Switzerland, 8091
Universitätsspital Basel, Neurochirugishen Poliklinik
Petersgraben 4, Basel, Switzerland, 4031
United Kingdom
Novartis
Investigational Site, United Kingdom
Charing Cross Hospital
London, United Kingdom, W8 6RF
The Walton Centre for Neurology and Neurosurgery
Lower Lane, Fazakerly, Liverpool, United Kingdom, L9 7LJ
Norfolk & Norwich University Hospital
Norwick, United Kingdom, NR4 7UY
Sponsors and Collaborators
Novartis
Investigators
Study Director: Novartis Pharmaceuticals Novartis Pharmacuticals

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Responsible Party: Novartis
ClinicalTrials.gov Identifier: NCT00340834     History of Changes
Other Study ID Numbers: CFTY720D2302
CFTY720D2302E1 ( Other Identifier: Novartis )
First Posted: June 21, 2006    Key Record Dates
Results First Posted: May 16, 2011
Last Update Posted: September 21, 2017
Last Verified: August 2017

Keywords provided by Novartis:
FTY720
Interferon
RRMS
Multiple Sclerosis
Efficacy

Additional relevant MeSH terms:
Sclerosis
Multiple Sclerosis
Multiple Sclerosis, Relapsing-Remitting
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
Fingolimod Hydrochloride
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Adjuvants, Immunologic