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Physical and Cognitive Performance During the Two First Years of Lemtrada Treatment

Physical and Cognitive Performance During the Two First Years of Lemtrada Treatment - a Prospective Observational Study

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT03806387
Enrollment
17
Registered
2019-01-16
Start date
2017-03-01
Completion date
2021-06-30
Last updated
2023-09-06

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

Conditions

Multiple Sclerosis

Brief summary

Multiple Sclerosis (MS) is a chronic autoimmune neurodegenerative disease of the central nervous system (CNS). The symptoms of MS are wide-ranging, but patients perceive loss of physical function (gait) and cognitive function as the most critical consequences of the disease. Moreover, recent studies have shown that already at early disease stages functional impairments are present. One of the more recent approved medical treatments for MS patients is Alemtuzumab (product name Lemtrada), a humanized monoclonal antibody targeting CD52 cells, that depletes and repopulates B lymphocytes and T lymphocytes, causing sustained changes in the adaptive immunity. In 2013 and 2014 Alemtuzumab was approved in EU and USA, respectively. With the exception of the MS Functional Composite z-score, the previous clinical studies investigating the effect of Alemtuzumab have exclusively focused on clinical parameters such as MRI indications of disease activity (accumulation of lesion, total and regional brain atrophy etc.), relapse-rates, changes in 'expanded disability status scale' (EDSS) and side-effects/adverse events. However, no previous studies have performed in depth monitoring on how physical or cognitive performance are affected following initiation of treatment with Alemtuzumab despite the paramount importance to patients. The primary purpose of this project is to monitor the changes in physical performance during the first two years of treatment with Alemtuzumab in a well characterised Danish cohort of people with relapsing-remitting MS. A secondary purpose is to monitor the impact of Alemtuzumab treatment on cognition during the first two years of treatment.

Interventions

DRUGAlemtuzumab

Alemtuzumab will be given two times, separated by 1 year.

Sponsors

Genzyme, a Sanofi Company
CollaboratorINDUSTRY
University of Aarhus
Lead SponsorOTHER

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

* Clinical definite Multiple Sclerosis diagnosis according to the McDonald criteria * About to commence alemtuzumab (Lemtrada) treatment * Expanded Disability Status Scale (EDSS) ≤ 5.5 * Signed informed consent

Exclusion criteria

* Co-morbidities that prevent participation in the project (dementia, serious cognitive disorders etc.)

Design outcomes

Primary

MeasureTime frameDescription
Six minute walking test (6MWT)From baseline to 24 monthsChange in maximal walking distance covered in 6 minutes

Secondary

MeasureTime frameDescription
Six minute walking test (6MWT)From baseline to 3 months, 6 months, and 12 monthsChange in maximal walking distance covered in 6 minutes
5 times sit to stand test (5STS)From baseline to 3 months, 6 months, 12 months, and 24 monthsChange in time to perform 5 times sit to stand test (5STS)
Timed Up and Go (TUG)From baseline to 3 months, 6 months, 12 months, and 24 monthsChange in time to perform Timed Up and Go (TUG)
Stair Climbing testFrom baseline to 3 months, 6 months, 12 months, and 24 monthsChange in time to perform 9-step stair climbing
Six Spot Step Test (SSST)From baseline to 3 months, 6 months, 12 months, and 24 monthsChange in maximal walking speed while challenging coordination/balance
Maximal oxygen uptake (VO2 max)From baseline to 3 months, 6 months, 12 months, and 24 monthsChange in aerobic power
Maximal muscle strengthFrom baseline to 3 months, 6 months, 12 months, and 24 monthsChange in isometric and dynamic knee extensor muscle strength, isometric hand grip strength
Neuromuscular activationFrom baseline to 3 months, 6 months, 12 months, and 24 monthsChange in neural drive during maximal isometric knee extension
Body composition - limb lean massFrom baseline to 3 months, 6 months, 12 months, and 24 monthsChange in total lower limb lean mass (kg) (assessed by Dual-energy X-ray Absorptiometry - DXA scan).
Body composition - limb fat massFrom baseline to 3 months, 6 months, 12 months, and 24 monthsChange in total lower limb fat mass (kg) (assessed by Dual-energy X-ray Absorptiometry - DXA scan).
Timed 25 foot walk (T25FWT)From baseline to 3 months, 6 months, 12 months, and 24 monthsChange in maximal walking speed
Body composition - whole body fat massFrom baseline to 3 months, 6 months, 12 months, and 24 monthsChange in total body fat mass (kg) (assessed by Dual-energy X-ray Absorptiometry - DXA scan).
Selective Reminding Test (SRT)From baseline to 3 months, 6 months, 12 months, and 24 monthsChange in cognitive test assessing memory
Symbol Digit Modalities Test (SDMT)From baseline to 3 months, 6 months, 12 months, and 24 monthsChange in cognitive test assessing processing speed
Physical activityFrom baseline to 3 months, 6 months, 12 months, and 24 monthsChange in accelerometer-based assessment of 24-hour physical activity
Clinical Severity of DiseaseFrom baseline to 3 months, 6 months, 12 months, and 24 monthsEstimation of disease severity by the Expanded Disability Severity Scale (EDSS scores: best 0 = normal neurological exam, worst 10 = death due to multiple sclerosis)
Relapse frequencyFrom baseline to 3 months, 6 months, 12 months, and 24 monthsNumber of relapses
12-item Multiple Sclerosis Walking Scale (MSWS-12)From baseline to 3 months, 6 months, 12 months, and 24 monthsSelf-reported questionnaire assessing impact of MS on walking ability (MSWS-12 scores: best 0, worst 100)
Modified Fatigue Impact Scale (MFIS)From baseline to 3 months, 6 months, 12 months, and 24 monthsSelf-reported questionnaire assessing impact of MS-induced fatigue on a persons life (MFIS total scores: best 0, worst 84; physical subscale scores: best 0, worst 36; cognitive subscale scores: best 0, worst 40; psychosocial subscale scores: best 0, worst 8)
Multiple Sclerosis Impact Scale (MSIS-29)From baseline to 3 months, 6 months, 12 months, and 24 monthsSelf-reported questionnaire assessing impact of MS on day-to-day life, from a physical perspective (MSIS-29 physical scale: best 0, worst 100 (greater impact of disease on daily function = worse health) and from a psychological perspective (MSIS-29 psychological scale: best 0, worst 100 (greater impact of disease on daily function = worse health)
Hospital Anxiety and Depression Scale (HADS)From baseline to 3 months, 6 months, 12 months, and 24 monthsSelf-reported questionnaire assessing impact of MS on anxiety (scores: best 0, worst 21) and depression (scores: best 0, worst 21)
Body composition - whole body lean massFrom baseline to 3 months, 6 months, 12 months, and 24 monthsChange in total body lean mass (kg) (assessed by Dual-energy X-ray Absorptiometry - DXA scan).

Countries

Denmark

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 18, 2026