Conduction abnormalities in patients with relapsing-remitting multiple sclerosis MedDRA version: 18.1 Level: PT Classification code 10063399 Term: Relapsing-remitting multiple sclerosis System Organ Class: 10029205 - Nervous system disorders
Conditions
Sponsors
Novartis Pharma GmbH
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Written informed consent from patients capable of giving or withholding full informed consent must be obtained before any assessment is performed. 2. Subjects with relapsing remitting MS 3. a. Patients with highly active disease despite a full and adequate course of treatment with at least one disease modifying therapy. b. Patients who were previously on 2nd line therapies. It is understood that these patients satisfied the above mentioned criteria listed under a. in the past. This also includes patients, who were previously treated with Fingolimod (regardless of whether or not they had already been treated within START study) but discontinued treatment due to medical reasons. 4. or patients with rapidly evolving severe RRMS (e.g. = 2 relapses with disease progression in one year and = 1 Gd-enhancing lesion or with a significant increase in T2 lesions compared to a recent MRI). 5. Male or female aged 18 years or older at Screening. Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 7000 F.1.3 Elderly (>=65 years) no F.1.3.1 Number of subjects for this age range
Exclusion criteria
Exclusion criteria: 1. Known immunodeficiency syndrome. 2. Patients with increased risk for opportunistic infections, including immunocompromised patients (including those currently receiving immunosuppressive therapies or those immunocompromised by prior therapies). 3. Severe active infections, active chronic infections (hepatitis, tuberculosis). 4. Presence of malignancy (other than localized basal cell carcinoma of the skin). 5. Negative for varicella-zoster virus IgG antibodies at Screening 6. Patients with severe hepatic dysfunction (Child-Pugh-Class C) 7. Patients with the following cardiovascular conditions • Patients receiving antiarrythmics class Ia (e.g. quinidine, disopyramide) or class III (e.g. amiodarone, sotalol) or beta blockers • Patients receiving heart rate lowering calcium channel blockers (e.g. verapamil, diltiazem or ivabradine) or other substances which may decrease heart rate (e.g. digoxin, anticholinesteratic agents or pilocarpine). • 2nd degree Mobitz Type II or higher degree AV block, Sick-sinus syndrome, or Sino-atrial heart block • Significant QT prolongation (QTc>470 msec (female) or >450 msec (males)) • History of symptomatic bradycardia or recurrent syncope, known ischaemic heart disease (including angina pectoris), cerebrovascular disease, history of myocardial infarction, hypokalaemia, congestive heart failure, history of cardiac arrest, uncontrolled hypertension, or severe sleep apnea 8. Patients with calculated GFR> 30 ml/min 9. Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test (> 5mIU/ml). Women of child-bearing potential defined as all women physiologically capable of becoming pregnant, UNLESS they are using a reliable method of contraception according to the label during the study and for 2 months after stopping treatment. At the discretion of the investigator, total abstinence from sexual intercourse is acceptable in cases where the age, career, lifestyle, or sexual orientation of the patient ensures the prevention of pregnancy. Women are considered post-menopausal and not of child bearing potential if they have had 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile (e.g. age appropriate, history of vasomotor symptoms) or six months of spontaneous amenorrhea with serum FSH levels > 40 mIU/mL or have had surgical bilateral oophorectomy (with or without hysterectomy) or tubal ligation at least six weeks prior to baseline. In the case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment is she considered not of child bearing potential. 10. History of hypersensitivity to the active substance or to any other of the excipients of the study drugs. 11. Use of other investigational drugs at the time of enrollment, or within 30 days or 5 half-lives of enrollment, whichever is longer
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: To evaluate the incidence of patients with bradycardia (heart rate < 45 beats per min) and bradyarrhythmic ECG events during 6-hour monitoring period as measured by heart rate and second and third-degree AV blocks after treatment initiation of fingolimod 0.5 mg. ;Secondary Objective: • To evaluate the incidence of patients with other conduction abnormalities (such as QT prolongation, first degree AV block) after treatment initiation of fingolimod 0.5 mg. • Investigate the occurrence of subsequent cardiac AEs and serious cardiac AEs during the study. ;Primary end point(s): To evaluate the incidence of patients with bradycardia (heart rate < 45 beats per min) and bradyarrhythmic ECG events during 6-hour monitoring period as measured by heart rate and second and third-degree AV blocks after treatment initiation of fingolimod 0.5 mg.;Timepoint(s) of evaluation of this end point: after 6 h | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): • To evaluate the incidence of patients with other conduction abnormalities (such as QT prolongation, first degree AV block) after treatment initiation of fingolimod 0.5 mg. • Investigate the occurrence of subsequent cardiac AEs and serious cardiac AEs during the study ;Timepoint(s) of evaluation of this end point: after 7 days | — |
Countries
Germany
Contacts
Public ContactMedizinischer Infoservice (MCC)
Novartis Pharma GmbH
Outcome results
None listed