Study Description
To compare the efficacy and safety of remibrutinib versus teriflunomide in patients with relapsing multiple sclerosis (RMS) The study CLOU064C12301 consists of an initial Core Part (CP) (maximum duration per participant of up to 30 months), followed by an Extension Part (EP, of up to 5 years duration) for eligible participants.
The Core Part is a randomized, double-blind, double-dummy, active comparator-controlled, fixed-dose, parallel-group, multi-center study in approximately 800 participants with relapsing multiple sclerosis (RMS).
The Extension Part is an open-label, single-arm, fixed-dose design in which eligible participants are treated with remibrutinib for up to 5 years.
A second study of identical design (CLOU064C12302) will be conducted simultaneously. Both studies will be conducted globally and data from the two studies will be pooled for some of the endpoints.
Interventions
Remibrutinib
Teriflunomide
Eligibility Criteria
Inclusion Criteria:
* 18 to 55 years of age
* Diagnosis of RMS according to the 2017 McDonald diagnostic criteria
* At least: 1 documented relapse within the previous year. OR 2 documented relapses within the previous 2 years, OR 1 active Gadolinium (Gd)-enhancing lesion in the 12 months.
* EDSS score of 0 to 5.5 (inclusive)
* Neurologically stable within 1 month
Exclusion Criteria:
* Diagnosis of primary progressive multiple sclerosis (PPMS)
* Disease duration of more than 10 years in participants with EDSS score of 2 or less at screening
* History of clinically significant CNS disease other than MS
* Ongoing substance abuse (drug or alcohol)
* History of malignancy of any organ system (other than complete resection of localized basal cell carcinoma of the skin or in situ cervical cancer),
* Participants with history of confirmed Progressive Multifocal Leukoencephalopathy (PML) or Neurological symptoms consistent with PML
* suicidal ideation or behavior
* Evidence of clinically significant cardiovascular, neurological, psychiatric, pulmonary , renal, hepatic, endocrine, metabolic, hematological disorders or gastrointestinal disease that can interfere with interpretation of the study results or protocol adherence
* Participants who have had a splenectomy
* Active clinically significant systemic bacterial, viral, parasitic or fungal infections
* Positive results for syphilis or tuberculosis testing
* Uncontrolled disease states, such as asthma, or inflammatory bowel disease, where flares are commonly treated with oral or parenteral corticosteroids
* Active, chronic disease of the immune system (including stable disease treated with immune therapy (e.g. Leflunomide, Methotrexate)) other than MS (e.g. rheumatoid arthritis, systemic lupus erythematosus, etc.) with the exception of well-controlled diabetes or thyroid disorder.
* Participants with a known immunodeficiency syndrome (AIDS, hereditary immune deficiency, drug induced immune deficiency), or tested positive for HIV antibody
* History or current treatment for hepatic disease including but not limited to acute or chronic hepatitis, cirrhosis (including all Child-Pugh classes) or hepatic failure or any chronic liver or biliary disease.
* History of severe renal disease or creatinine level
* Participants at risk of developing or having reactivation of hepatitis
* Hematology parameters at screening:
* Hemoglobin: \< 10 g/dl (\<100g/L)
* Platelets: \< 100000/mm3 (\<100 x 109/L)
* Absolute lymphocyte count \< 800/mm3 (\<0.8 x 109/L)
* White blood cells: \<3 000/mm3 (\<3.0 x 109/L)
* Neutrophils: \< 1 500/mm3 (\<1.5 x 109/L)
* B-cell count \< 50% lower limit of normal (LLN) or total IgG \& total IgM \< LLN (only required for participants who had a history of receiving B-cell therapies, such as rituximab, ocrelizumab or ofatumumab, prior to screening)
* History or current diagnosis of significant ECG abnormalities
* Resting QTcF ≥450 msec (male) or ≥460 msec (female) at pre-treatment as per central ECG reading at screening visit
* Use of other investigational drugs
* Requirement for anticoagulant medication or use of dual anti-platelet therapy Significant bleeding risk or coagulation disorders,
* History of gastrointestinal bleeding
* Major surgery within 8 weeks prior to screening
* History of hypersensitivity to any of the study drugs or excipients
* Pregnant or nursing (lactating) female participants, prior to randomization
* Women of childbearing potential not using highly effective contraception
* Sexually active males not agreeing to use condom
* Have received any live or live-attenuated vaccines within 6 weeks of randomization or requirement to receive these vaccinations during study
* Use of strong CYP3A4 inhibitors or use of moderate or strong CYP3A4 inducers within two weeks prior to randomization
Inclusion to Extension part:
• Participants who complete the Core Part of the study on double-blind study treatment and conduct the Accelerated Elimination Procedure (AEP)
Other inclusion and exclusion criteria may apply
Novartis Investigative Site
Recruiting
Klagenfurt,9020,Austria
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Graz,8036,Austria
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Brasschaat,2930,Belgium
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Sofia,1680,Bulgaria
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Sofia,1431,Bulgaria
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Pleven,5800,Bulgaria
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Sofia,1113,Bulgaria
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Shatin,Hong Kong
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Dehradun,Uttarakhand,248001,India
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Lucknow,Uttar Pradesh,226014,India
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Ludhiana,Punjab,141008,India
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Chandigarh,Punjab,160012,India
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New Delhi,National Capital Territory of Delhi,110 017,India
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Tel Aviv,6423906,Israel
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Haifa,3436212,Israel
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Sefad,13100,Israel
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Beirut,166378,Lebanon
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Kuching,Sarawak,93586,Malaysia
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Kuala Lumpur,Kuala Lumpur,50586,Malaysia
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Poznan,60-693,Poland
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Kielce,25 726,Poland
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Lodz,90 324,Poland
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Lodz,93-113,Poland
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Rzeszów,35-323,Poland
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Wroclaw,Lower Silesian Voivodeship,52-416,Poland
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Bydgoszcz,Woj Kujawsko Pomorskie,85-796,Poland
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Piotrkow Trybunalski,97-300,Poland
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Szczecin,70-111,Poland
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Jeddah,21423,Saudi Arabia
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Jeddah,21499,Saudi Arabia
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Alcorcón,Madrid,28922,Spain
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Valencia,46010,Spain
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Mersin,Yenisehir,33110,Turkey (Türkiye)
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Ankara,Bilkent-Cankaya,06800,Turkey (Türkiye)
Reliant Medical Research
Recruiting
Miami,Florida,33165,United States
Carlos Ramirez-Calderon
Norton Neurology MS Services
Recruiting
Louisville,Kentucky,40207,United States
Geeta Ganesh
Washington Hospital Center
Recruiting
Washington D.C.,District of Columbia,20010,United States
Brian Barry
The MS Center for Innovation in Care
Recruiting
St Louis,Missouri,63131,United States
Barry A Singer
Jersey Shore University Medical Ctr
Recruiting
Neptune City,New Jersey,07753,United States
Lana Zhovtis Ryerson
Montefiore Medical Center
Recruiting
The Bronx,New York,10467,United States
Daniel Sun
Lauren Gluck
Neurostudies Inc
Recruiting
Port Charlotte,Florida,33952,United States
Liliana Montoya
Christiana Care Health Services
Recruiting
Newark,Delaware,19713,United States
Jason M Silversteen
Beth Israel Deaconess Med Center
Recruiting
Boston,Massachusetts,02215,United States
Jacob Sloane
Neuro Center
Recruiting
Pomona,California,91767,United States
Sadiq Altamimi
Hoag Health System
Recruiting
Newport Beach,California,92663,United States
Yasir Jassam
The Research and Education Inst. of Alta Bates Summit Med. Grp
Recruiting
Berkeley,California,94705,United States
Deepak Soneji
Wayne State University Multiple Sclerosis Clinic
Recruiting
Detroit,Michigan,48201,United States
Jacob Rube
MS Center of Greater Washington, P.C.
Recruiting
Vienna,Virginia,22182,United States
Heidi Crayton
Providence St Vincent Med Center
Recruiting
Portland,Oregon,97225,United States
Stanley Cohan
The Neurological Institute PA
Recruiting
Charlotte,North Carolina,28204,United States
T Hemanth Hemanth Rao
Neurological Associates of Long Island PC
Recruiting
Lake Success,New York,11042,United States
Teresa DeAngelis
Honor Health Research Institute
Recruiting
Scottsdale,Arizona,85258,United States
Arrow Clinical Trials
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Daytona Beach,Florida,32117,United States
David Billmeier
Susan Black
Conquest Research
Recruiting
Winter Park,Florida,32789,United States
Gilbert Mbeo
Kendra Tandeski
NYU Langone Med Center CV Research
Recruiting
New York,New York,10016,United States
Nada Abou-Fayssal
Thomas Jefferson University Hospital
Recruiting
Philadelphia,Pennsylvania,19107-5098,United States
Thomas Leist
Palmetto Clinical Research
Recruiting
Summerville,South Carolina,29485,United States
Robert Carlile
DHR Health Institute
Recruiting
McAllen,Texas,78503,United States
Roberto Alejandro Cruz
Worldwide Contacts
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