Secondary Progressive Multiple Sclerosis Clinical Trial
Official title:
A Randomized, Controlled, Open-Label Study to Evaluate the Efficacy of Extracorporeal Photopheresis (ECP) Versus Corticosteroids in the Treatment of Patients With Secondary Progressive Multiple Sclerosis (SPMS)
In this research study, the investigators will determine whether a procedure called Extracorporeal Photopheresis (ECP) is helpful in preventing progression of disability in people with SPMS when compared to monthly corticosteroid infusions. This study will determine whether ECP has an effect on inflammatory cells in people with SPMS and whether it has a beneficial therapeutic effect.
This is a Phase II randomized, open-label study to evaluate the efficacy of extracorporeal
photopheresis (ECP) versus IVMP on disability progression in subjects with SPMS. At the
initial screening visit, an extensive medical history will be obtained and a detailed
neurological examination will be performed to determine eligibility. Subjects who meet
eligibility criteria will be enrolled in one of two study arms. Subjects will be randomized
at a 1:1 ratio to receive ECP (study arm) or active treatment with intravenous
methylprednisolone pulses (control arm) administered every 4 Weeks (1 gram per infusion) for
52 weeks.
ECP will be administered according to the following schedule:
Study Arm: Weeks 1-8: 3 times per week Weeks 9-16: Twice per week Weeks 17-36: Treatment on
two consecutive days every 2 weeks (or optionally, one treatment per week) Weeks 37-43: Once
every 2 weeks Weeks 44-52: Once every 4 Weeks
All subjects, including patients who receive corticosteroids, will be evaluated using the
MSFC tool at baseline and every 3 months through 2 years. They will also be scored using the
EDSS at baseline and every 3 months through 2 years. Subjects in the control arm will be
evaluated by MSFC and EDSS during the week prior to their next intravenous methylprednisolone
infusion and every three months from baseline through two year mark. Blood will be collected
for immune function (cytokines) testing at baseline, and months 3, 6, 9 and 12. MRI will be
done at baseline as well as months 6 and 12 following initiation of treatment; if the
disability measurements are stable or improved at any point in time, then ECP will be
continued per protocol..
Patients in the ECP arm should have all of their treatments with the CELLEX ® System.
Patients randomized to the ECP arm must receive their treatment within 5 days of baseline
visit.
In the ECP process, UVADEX ® (methoxsalen) Sterile Solution will be injected directly the
recirculation bag of the extracorporeal circuit after completion of the buffy coat
collection. The dose of UVADEX® (methoxsalen) Sterile Solution will be calculated based on
the standard treatment volume formula.
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