Exploring Diroximel Fumarate Real-world Experience in Canada and Israel

Relapsing Forms of MS Clinical Trial

— EXPER-CA/IL  

Official title:

A Prospective, Observational Study Evaluating Persistence on Treatment, Safety, Tolerability, and Effectiveness of Diroximel Fumarate in the Real-World Setting (EXPERIENCE-CA+IL Study)

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT04948606
• Other study ID #: CA-VUM-11892
• Status: Terminated
• Start date: December 9, 2021
• Est. completion date: April 14, 2023

Study information

• Verified date: May 2023
• Source: Biogen
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The primary objective of the study is to characterize the persistence to therapy in participants with relapsing forms of multiple sclerosis (RMS) treated with diroximel fumarate (DRF) in routine clinical practice. The secondary objectives of the study are to assess short-term persistence to treatment; to assess long-term persistence on treatment; to assess the effect of DRF on relapses; to assess the impact of DRF on cognition; to assess the impact of DRF on participant reported outcomes (PROs); to assess the impact of DRF on disability; to assess treatment satisfaction with DRF; to explore the real-world safety profile of DRF (i.e., gastrointestinal [GI] tolerability, lymphocyte dynamics, adverse events [AEs] leading to discontinuation, and serious adverse events [SAEs].

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 64
• Est. completion date: April 14, 2023
• Est. primary completion date: April 14, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Key Inclusion Criteria:

• Have a diagnosis of MS and satisfy the approved therapeutic indication for DRF per the prescribing information.

• DRF prescribed and planned to be initiated within 60 days of enrollment or already initiated, with enrollment occurring no more than 7 days since the first dose.

Key Exclusion Criteria:

• History of gastric bypass or required use of feeding tubes.

• Current enrollment in any interventional study or in any study which may conflict with this study, per the discretion of the principal investigator (PI) and Biogen

• Have received prior treatment with DRF (more than 7 days before enrollment).

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

Related Conditions & MeSH terms

• Relapsing Forms of MS

Intervention

Drug:
• Diroximel Fumarate
Administered as specified in the treatment arm.

Locations

Country	Name	City	State
Israel	Lady Davis Carmel Medical Center	Haifa
Israel	Hadassah Medical Center	Jerusalem
Israel	Meir Medical Center	Kfar Saba
Israel	Rabin Medical Center	Petah Tikva
Israel	Tel Aviv Sourasky Medical	Tel-Aviv
Israel	Sheba Medical Center	Tel-Hashomer

Sponsors (1)

Lead Sponsor	Collaborator
Biogen

Country where clinical trial is conducted

Israel, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percentage of Participants on Treatment with DRF		Year 1
Secondary	Percentage of Participants on Treatment with DRF		Month 3
Secondary	Percentage of Participants on Treatment with DRF		Year 2
Secondary	Annualized Relapse Rate (ARR) with DRF	For ARR at 1 year, the total number of days on study will be defined as the number of days since date of first dose to 1 year (365 days) if participant stay on DRF treatment for longer than 1 year, or the date of first dose to the date of DRF discontinuation if participant die or withdraw from the study prior to 1 year. For ARR at 2 years, the total number of days on study is defined as the number of days since the date of first dose to the date of DRF discontinuation. The relapse rate will be calculated as the total number of relapses experienced divided by the total number of days on DRF treatment, and the ratio multiplied by 365.	Year 1 and 2
Secondary	Percentage of Participants Relapsed		Year 1 and 2
Secondary	Change in Cognitive Processing Speed Test (CPST) Score	Change in CPST will be assessed using the Konectom application. Cognitive function will be evaluated based on elements of attention, psychomotor speed, visual processing and working memory. Cognitive function is assessed by having the participant pair abstract symbols with specific numbers using a key as a guide. Higher number of correct responses indicates better cognition	Baseline, Year 1 and 2
Secondary	Change in Score for Each Domain of Quality of Life in Neurological Disorders (Neuro- QoL™) Questionnaire	Neuro-QoL uses a T score which has a mean of 50 and SD of 10, based on the norming sample used. All Neuro-QOL banks and scales are scored such that a high score reflects more of what is being measured.	Baseline, Year 1 and 2
Secondary	Change in Disability, as Measured by Expanded Disability Status Scale (EDSS)	The EDSS measures disability status on a scale ranging from 0 (normal) to 10 (death due to multiple sclerosis [MS]), with higher scores indicating more disability. Scoring is based on measures of impairment in eight functional systems on examination by a neurologist.	Baseline, Year 1 and 2
Secondary	Mean Change in Treatment Satisfaction Questionnaire for Medication (TSQM) Score	TSQM Version 1.4 is comprised of 14 questions that provide scores on four scales: effectiveness (3 items), side effects (5 items), convenience (3 items) and global satisfaction (3 items). The scale scores are transformed and range from 0 to 100. Higher scores indicate greater satisfaction.	Baseline, Year 1 and 2
Secondary	Number of Participants with Gastrointestinal (GI) Adverse Events (AEs)	An AE is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.	Up to Month 32
Secondary	Number of Participants with AEs Leading to Treatment Discontinuation	An AE is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.	Up to Month 32
Secondary	Number of Participants with Serious Adverse Events (SAEs)	An SAE is any untoward medical occurrence that at any dose results in death, in the view of the investigator, places the participant at immediate risk of death (a life-threatening event), requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, results in a congenital anomaly/birth defect or is a medically important event.	Up to Month 32
Secondary	Number of Participants with Relevant Concomitant Medication Use	The concomitant medication may include GI symptom medication, coronavirus disease of 2019 (COVID-19) vaccine, etc.	Up to Month 32
Secondary	Number of Participants Categorized by the Types of Actions Taken Due to GI AEs	The actions taken will include temporary dose reduction, temporary dose interruption, initiation of concomitant GI medication, taking DRF dose with food, permanent discontinuation, or other action.	Up to Month 32
Secondary	Median Absolute Lymphocyte Count (ALC) Over Time		Baseline, Month 6, Year 1 and 2
Secondary	Percent Change from Baseline in Median ALC		Baseline, Month 6, Year 1 and 2
Secondary	Number of Participants with Lymphopenia According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI/CTCAE) Severity Grading		Up to Month 32