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Efficacy and Safety of BIIB019 (Daclizumab High Yield Process) Versus Interferon β 1a in Participants With Relapsing-Remitting Multiple Sclerosis

Multicenter, Double-blind, Randomized, Parallel-group, Monotherapy, Active-control Study to Determine the Efficacy and Safety of Daclizumab High Yield Process (DAC HYP) Versus Avonex® (Interferon β 1a) in Patients With Relapsing-Remitting Multiple Sclerosis

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01064401
Acronym
(DECIDE)
Enrollment
1841
Registered
2010-02-08
Start date
2010-05-31
Completion date
2014-07-31
Last updated
2016-07-11

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Relapsing-Remitting Multiple Sclerosis

Brief summary

The primary study objective is to test the superiority of Daclizumab High Yield Process (DAC HYP) compared to interferon β 1a (IFN β-1a) in preventing multiple sclerosis (MS) relapse in participants with relapsing remitting multiple sclerosis. The secondary study objectives are to test the superiority of DAC HYP compared to IFN β-1a in slowing functional decline and disability progression and maintaining quality of life in this participant population.

Interventions

Daclizumab High Yield Process for subcutaneous injection

Placebo to interferon beta-1a intramuscular injection

BIOLOGICALInterferon beta-1a

Interferon beta-1a for intramuscular injection

DRUGDaclizumab High Yield Process Placebo

Placebo to Daclizumab High Yield Process subcutaneous injection

Sponsors

AbbVie
CollaboratorINDUSTRY
Biogen
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No

Inclusion criteria

Key Inclusion Criteria: * Must have a confirmed diagnosis of Relapsing Remitting Multiple Sclerosis (RRMS), and a cranial magnetic resonance imaging (MRI) demonstrating lesion(s) consistent with MS * Must have a baseline Expanded Disability Status Scale (EDSS) between 0.0 and 5.0, inclusive * Male subjects and female subjects of childbearing potential must be willing to practice effective contraception during the study and be willing and able to continue contraception for 4 months after their last dose of study treatment Key

Exclusion criteria

* Known intolerance, contraindication to, or history of non-compliance with Avonex® 30 µg * History of treatment with Daclizumab High Yield Process (Dac HYP) * History of malignancy * History of severe allergic or anaphylactic reactions * Known hypersensitivity to study drugs or their excipients * History of abnormal laboratory results indicative of any significant disease * History of human immunodeficiency virus (HIV) or other immunodeficient conditions * History of drug or alcohol abuse (as defined by the Investigator) within the 2 years prior to randomization * History of seizure disorder or unexplained blackouts OR history of a seizure within 6 months prior to Baseline * History of suicidal ideation or an episode of clinically severe depression (as determined by the Investigator) within 3 months prior to Day 1 * An MS relapse that has occurred within the 50 days prior to randomization AND/OR the subject has not stabilized from a previous relapse prior to randomization * Known history of, or positive screening test result for hepatitis C virus or hepatitis B virus * Varicella or herpes zoster virus infection or any severe viral infection within 6 weeks before screening * Exposure to varicella zoster virus within 21 days before screening NOTE: Other protocol-defined Inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Adjusted Annualized Relapse Rate (ARR)Up to 144 weeksRelapses are defined as new or recurrent neurological symptoms not associated with fever or infection, lasting at least 24 hours, and accompanied by new objective neurological findings upon examination by the examining neurologist. Only relapses confirmed by Independent Neurology Evaluation Committee (INEC) are included in this analysis. Adjusted ARR was estimated from a negative binomial regression model adjusted for the baseline relapse rate, history of prior IFN beta use, baseline Expanded Disability Status Scale score (EDSS; ≤ 2.5 vs \> 2.5) and baseline age (≤ 35 vs \> 35 years). Data after participants switched to alternative MS medications are excluded.

Secondary

MeasureTime frameDescription
Adjusted Mean Number of New or Newly Enlarging T2 Hyperintense Lesions up to Week 96up to 96 weeksThe quantity of lesions is assessed by brain magnetic resonance imaging (MRI). The adjusted mean number is estimated from a negative binomial regression model, adjusted for baseline volume of T2 from a negative binomial regression model, adjusted for baseline volume of T2 hyperintense lesions, history of prior IFN beta use and baseline age (≤ 35 vs \> 35 years). To account for the timing of the MRI measurement, the logarithmic transformation of the scan number of the MRI assessment is included in the model as the 'offset' parameter. Observed data after participants switched to alternative MS medications are excluded. Missing data are not imputed. Only observed new or newly enlarging T2 lesions at the last visit of the participant up to Week 96 visit are used in this analysis.
Proportion of Participants With Sustained Disability Progression at 144 WeeksBaseline through 144 weeksSustained disability progression is defined as: at least a 1.0-point increase on the EDSS from Baseline EDSS ≥ 1.0 that is sustained for 12 weeks, or at least a 1.5-point increase on the EDSS from baseline EDSS = 0 that is sustained for 12 weeks. The EDSS measures the disability status of people with MS on a scale that ranges from 0 to 10, with higher scores indicating more disability. Estimated proportion of participants with progression is based on the Kaplan-Meier product limit method. Participants were censored at the time of withdrawal/switch if they withdrew from study or switched to alternative MS medication without a progression. Participants with a tentative progression at the End of Treatment Period Visit (or the last EDSS assessment prior to alternative MS start date) and no confirmation assessment were censored at their last EDSS assessment.
Proportion of Participants Relapse-free at Week 144144 weeksRelapses are defined as new or recurrent neurological symptoms not associated with fever or infection, lasting at least 24 hours, and accompanied by new objective neurological findings upon examination by the examining neurologist. Only relapses confirmed by INEC are included in this analysis. Data after participants switched to alternative MS medications are excluded. The estimated proportion of subjects relapse-free at Week 144 is based on the Kaplan-Meier product limit method.
Percentage of Participants With a ≥ 7.5 Point Worsening From Baseline in the Multiple Sclerosis Impact Scale (MSIS-29) Physical Impact Score at 96 WeeksBaseline and 96 weeksThe MSIS-29 is a 29-item disease-specific patient-reported outcome measure that has been developed and validated to examine the physical and psychological impact of MS from a patient's perspective; it measures physical and psychological items. Worsening in the MSIS-29 physical score is defined as an increase of ≥ 7.5 points in the MSIS-29 physical score at 96 weeks compared to baseline. If a participant was missing data for less than 10 of the 20 items that make up the physical score, then the mean of the non-missing items were used for the missing items. If a participant was missing 10 or more of the 20 items that make up the physical score, or missing the questionnaire entirely, or if the questionnaire was completed after the participant switched to alternative MS medication, a random effects model was used to estimate the MSIS-29 physical score.

Countries

Argentina, Australia, Brazil, Canada, Czechia, Denmark, Finland, France, Georgia, Germany, Greece, Hungary, India, Ireland, Israel, Italy, Mexico, Moldova, Poland, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Ukraine, United Kingdom, United States

Participant flow

Participants by arm

ArmCount
Interferon Beta-1a
IFN β-1a 30 µg IM injection once weekly plus placebo to DAC HYP SC once every 4 weeks for 96 to 144 weeks
922
Daclizumab High Yield Process
DAC HYP 150 mg SC injection once every 4 weeks plus placebo to IFN β-1a IM injection once weekly for 96 to 144 weeks
919
Total1,841

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event4756
Overall StudyConsent Withdrawn9880
Overall StudyDeath40
Overall StudyInvestigator Decision46
Overall StudyLack of Efficacy4623
Overall StudyLost to Follow-up129
Overall StudyNoncompliance78
Overall StudyOther21
Overall StudyPregnancy47
Overall StudySite Closure45

Baseline characteristics

CharacteristicInterferon Beta-1aDaclizumab High Yield ProcessTotal
Age, Continuous36.2 years
STANDARD_DEVIATION 9.32
36.4 years
STANDARD_DEVIATION 9.36
36.3 years
STANDARD_DEVIATION 9.34
Age, Customized
18 to 19 years
25 participants14 participants39 participants
Age, Customized
20 to 29 years
227 participants236 participants463 participants
Age, Customized
30 to 39 years
327 participants322 participants649 participants
Age, Customized
40 to 49 years
256 participants250 participants506 participants
Age, Customized
50 to 55 years
86 participants96 participants182 participants
Age, Customized
> 55 years
1 participants1 participants2 participants
Sex: Female, Male
Female
627 Participants625 Participants1252 Participants
Sex: Female, Male
Male
295 Participants294 Participants589 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
783 / 922731 / 919
serious
Total, serious adverse events
194 / 922221 / 919

Outcome results

Primary

Adjusted Annualized Relapse Rate (ARR)

Relapses are defined as new or recurrent neurological symptoms not associated with fever or infection, lasting at least 24 hours, and accompanied by new objective neurological findings upon examination by the examining neurologist. Only relapses confirmed by Independent Neurology Evaluation Committee (INEC) are included in this analysis. Adjusted ARR was estimated from a negative binomial regression model adjusted for the baseline relapse rate, history of prior IFN beta use, baseline Expanded Disability Status Scale score (EDSS; ≤ 2.5 vs \> 2.5) and baseline age (≤ 35 vs \> 35 years). Data after participants switched to alternative MS medications are excluded.

Time frame: Up to 144 weeks

Population: participants with a relapse

ArmMeasureValue (NUMBER)
Interferon Beta-1aAdjusted Annualized Relapse Rate (ARR)0.393 relapses per person-years
Daclizumab High Yield ProcessAdjusted Annualized Relapse Rate (ARR)0.216 relapses per person-years
p-value: <0.000195% CI: [0.469, 0.645]Negative Binomial Regression
95% CI: [35.5, 53.1]
Secondary

Adjusted Mean Number of New or Newly Enlarging T2 Hyperintense Lesions up to Week 96

The quantity of lesions is assessed by brain magnetic resonance imaging (MRI). The adjusted mean number is estimated from a negative binomial regression model, adjusted for baseline volume of T2 from a negative binomial regression model, adjusted for baseline volume of T2 hyperintense lesions, history of prior IFN beta use and baseline age (≤ 35 vs \> 35 years). To account for the timing of the MRI measurement, the logarithmic transformation of the scan number of the MRI assessment is included in the model as the 'offset' parameter. Observed data after participants switched to alternative MS medications are excluded. Missing data are not imputed. Only observed new or newly enlarging T2 lesions at the last visit of the participant up to Week 96 visit are used in this analysis.

Time frame: up to 96 weeks

Population: participants with baseline and at least one post-baseline MRI measurement

ArmMeasureValue (MEAN)
Interferon Beta-1aAdjusted Mean Number of New or Newly Enlarging T2 Hyperintense Lesions up to Week 969.44 lesions
Daclizumab High Yield ProcessAdjusted Mean Number of New or Newly Enlarging T2 Hyperintense Lesions up to Week 964.31 lesions
p-value: <0.000195% CI: [46.9, 60.8]Negative Binomial Regression
Secondary

Percentage of Participants With a ≥ 7.5 Point Worsening From Baseline in the Multiple Sclerosis Impact Scale (MSIS-29) Physical Impact Score at 96 Weeks

The MSIS-29 is a 29-item disease-specific patient-reported outcome measure that has been developed and validated to examine the physical and psychological impact of MS from a patient's perspective; it measures physical and psychological items. Worsening in the MSIS-29 physical score is defined as an increase of ≥ 7.5 points in the MSIS-29 physical score at 96 weeks compared to baseline. If a participant was missing data for less than 10 of the 20 items that make up the physical score, then the mean of the non-missing items were used for the missing items. If a participant was missing 10 or more of the 20 items that make up the physical score, or missing the questionnaire entirely, or if the questionnaire was completed after the participant switched to alternative MS medication, a random effects model was used to estimate the MSIS-29 physical score.

Time frame: Baseline and 96 weeks

Population: participants with a baseline and Week 96 assessment

ArmMeasureValue (NUMBER)
Interferon Beta-1aPercentage of Participants With a ≥ 7.5 Point Worsening From Baseline in the Multiple Sclerosis Impact Scale (MSIS-29) Physical Impact Score at 96 Weeks23 percentage of participants
Daclizumab High Yield ProcessPercentage of Participants With a ≥ 7.5 Point Worsening From Baseline in the Multiple Sclerosis Impact Scale (MSIS-29) Physical Impact Score at 96 Weeks19 percentage of participants
p-value: 0.017695% CI: [0.6, 0.95]Regression, Logistic
95% CI: [4.7, 39.6]
Secondary

Proportion of Participants Relapse-free at Week 144

Relapses are defined as new or recurrent neurological symptoms not associated with fever or infection, lasting at least 24 hours, and accompanied by new objective neurological findings upon examination by the examining neurologist. Only relapses confirmed by INEC are included in this analysis. Data after participants switched to alternative MS medications are excluded. The estimated proportion of subjects relapse-free at Week 144 is based on the Kaplan-Meier product limit method.

Time frame: 144 weeks

ArmMeasureValue (NUMBER)
Interferon Beta-1aProportion of Participants Relapse-free at Week 1440.508 proportion of participants
Daclizumab High Yield ProcessProportion of Participants Relapse-free at Week 1440.673 proportion of participants
p-value: <0.000195% CI: [0.5, 0.69]Cox Proportional Hazard
95% CI: [30.8, 49.5]
Secondary

Proportion of Participants With Sustained Disability Progression at 144 Weeks

Sustained disability progression is defined as: at least a 1.0-point increase on the EDSS from Baseline EDSS ≥ 1.0 that is sustained for 12 weeks, or at least a 1.5-point increase on the EDSS from baseline EDSS = 0 that is sustained for 12 weeks. The EDSS measures the disability status of people with MS on a scale that ranges from 0 to 10, with higher scores indicating more disability. Estimated proportion of participants with progression is based on the Kaplan-Meier product limit method. Participants were censored at the time of withdrawal/switch if they withdrew from study or switched to alternative MS medication without a progression. Participants with a tentative progression at the End of Treatment Period Visit (or the last EDSS assessment prior to alternative MS start date) and no confirmation assessment were censored at their last EDSS assessment.

Time frame: Baseline through 144 weeks

ArmMeasureValue (NUMBER)
Interferon Beta-1aProportion of Participants With Sustained Disability Progression at 144 Weeks0.203 proportion of participants
Daclizumab High Yield ProcessProportion of Participants With Sustained Disability Progression at 144 Weeks0.162 proportion of participants
p-value: 0.157595% CI: [0.66, 1.07]Cox Proportional Hazard
95% CI: [-7, 34.2]

Source: ClinicalTrials.gov · Data processed: Mar 13, 2026