AIOLOS: A NIS Evaluating Injectable Treatments in Patients With Relapsing Multiple Sclerosis

Sponsor

Novartis Pharmaceuticals (Industry)

Overall Status

Recruiting

CT.gov ID

NCT05344469

Collaborator

(none)

800

Enrollment

Locations

41.3

Anticipated Duration (Months)

22.2

Patients Per Site

0.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This is an observational, non-interventional, multicenter, open-label study in patients being treated with any approved injectable Disease-modifying Therapy (DMT) for Relapsing Multiple Sclerosis in Germany. Prospective, primary data will be collected via questionnaires and an electronic case report form (eCRF) over a period of up to approx. two years of treatment. Additionally, medical history of participants will be collected including disease duration, EDSS, MRI parameters and relapses.

Condition or Disease	Intervention/Treatment	Phase
Relapsing Multiple Sclerosis	Other: ofatumumab Other: glatiramer acetate Other: interferon β1

Detailed Description

The prerequisite for participation in this observational study is the independent decision of the treating physician and patient to start an approved injectable DMT for RMS as routine medical treatment. This decision must have been made prior to enrollment in this study.

The prospective observational period per patient will be up to approx. two years from the time of consent (2 years +2 months visit window). The observational period will not be dictated by the protocol. The follow-up documentation will take place at a frequency defined as per investigator's discretion. The diagnostic or monitoring procedures are only those ordinarily applied to the therapeutic strategy and to routine clinical care, can be performed as telemedicine visits and will take place as per investigator's discretion.

Study Design

Study Type:

Observational

Anticipated Enrollment :

800 participants

Observational Model:

Cohort

Time Perspective:

Prospective

Official Title:

A Non-interventional Study Evaluating Injectable Treatments (Ofatumumab, Glatiramer Acetate and Interferon β1) in Patients With Relapsing Multiple Sclerosis [AIOLOS]

Actual Study Start Date :

May 10, 2022

Anticipated Primary Completion Date :

Oct 17, 2025

Anticipated Study Completion Date :

Oct 17, 2025

Arms and Interventions

Arm	Intervention/Treatment
Ofatumumab Patients treated with ofatumumab	Other: ofatumumab There is no treatment allocation. Patients administered ofatumumab by prescription that have started as routine medical treatment will be enrolled.
Standard of Care (SoC) Patients treated with either interferon β1 (IFN-β1) or glatiramer acetate (GA)	Other: glatiramer acetate There is no treatment allocation. Patients administered glatiramer acetate by prescription that have started as routine medical treatment will be enrolled. Other: interferon β1 There is no treatment allocation. Patients administered interferon β1 by prescription that have started as routine medical treatment will be enrolled.

Arm

Intervention/Treatment

Ofatumumab

Patients treated with ofatumumab

Other: ofatumumab

There is no treatment allocation. Patients administered ofatumumab by prescription that have started as routine medical treatment will be enrolled.

Standard of Care (SoC)

Patients treated with either interferon β1 (IFN-β1) or glatiramer acetate (GA)

Other: glatiramer acetate

There is no treatment allocation. Patients administered glatiramer acetate by prescription that have started as routine medical treatment will be enrolled.

Other: interferon β1

There is no treatment allocation. Patients administered interferon β1 by prescription that have started as routine medical treatment will be enrolled.

Outcome Measures

Primary Outcome Measures

Proportion of patients who continue to receive their first-line treatment [Month 24]
Proportion of patients who continue to receive their first-line treatment (ofatumumab or injectable SOC therapies (IFN-β1 or GA))

Secondary Outcome Measures

Proportion of patients who continue to receive their first-line treatment [Month 12]
Proportion of patients who continue to receive their first-line treatment (ofatumumab or injectable SOC therapies (IFN-β1 or GA))
Impact of first-line treatment on health economy [Baseline, month 6, month 12, month 18 and month 24]
Mean annual health care resource utilization cost, annual direct medical costs, annual direct nonmedical costs and annual indirect costs as measured by MS Health Resource Utilization Survey [MS-HRS] MS-HRS is a 24-item questionnaire covers societal resource use, regardless of the issue of reimbursement, as well as impact of the disease on work, family and leisure. With the help of this questionnaire a monetary value can be assigned to e.g. the stage of MS, a relapse or a therapy.
Fatigue Symptoms and Impact Questionnaire-RMS [Baseline, month 3, month 6, month 12, month 18, month 24]
Fatigue Symptoms and Impact Questionnaire-RMS [FSIQ-RMS] The FSIQ-RMS comprises 20 items organized in a conceptual framework with 2 symptom domains (energy, muscle weakness) and 7 impact domains (daily activities, cognition, emotions, physical impact, self-care, sleep, social impact) in order to measure fatigue symptoms and impacts in relapsing multiple sclerosis. A scoring algorithm standardizes scores on both the symptoms domain (daily and weekly) and impacts subdomains (weekly) to a 0 to 100 scale, with higher scores indicating more severe symptoms and impacts. There is no single summary score across the FSIQ-RMS instrument, but rather 1 symptoms score and 3 impacts subdomain scores.
Patient Health Questionnaire 8 [PHQ-8] [Baseline, month 3, month 6, month 12, month 18, month 24]
The PHQ-8 is a valid diagnostic and severity measure for depressive disorders. It consists of eight items, each of which is scored 0 to 3, providing a 0 to 24 severity score. Scores of 5, 10, 15, and 20 represent cutpoints for mild, moderate, moderately severe and severe depression, respectively.
Generalized Anxiety Disorder Scale 7 [GAD-7] [Baseline, month 3, month 6, month 12, month 18, month 24]
The GAD-7 is a validated 7-item anxiety scale to diagnose generalized anxiety disorder. Each of the items is scored 0 to 3, providing a 0 to 21 severity score. Scores of 5, 10, and 15 represent cutpoints for mild, moderate, and severe anxiety, respectively
MS Treatment Concerns Questionnaire [MSTCQ] [Baseline, month 3, month 6, month 12, month 18, month 24]
MS Treatment Concerns Questionnaire [MSTCQ] is used to assess participants' satisfaction with their treatment injections. The MSTCQ includes 20 items pertaining satisfaction with the injection system (including issues related to use of the device and preparation of the medication for injection), and AEs related to the patient MS treatment. All questions have a 5-point response choice, with the responses scored between 1-5. The MSTCQ scores are formed as the sum of all scores. The maximum total score is 100. Lower scores indicate a better state.
Expanded disability status scale (EDSS) [Baseline, month 3, month 6, month 9, month 12, month 15, month 18, month 21, month 24]
EDSS is a widely used and accepted instrument to evaluate disability status at a given time and, longitudinally, to assess accumulation of disability in clinical studies in MS. The EDSS scale consists of scores in each of seven functional systems (FSs) and an ambulation score that are then combined to determine the EDSS steps (ranging from 0 (normal) to 10 (death due to MS)). The FSs are Visual, Brain Stem, Pyramidal, Cerebellar, Sensory, Bowel & Bladder, and Cerebral functions (Fatigue contributes)
Time to onset of confirmed disability progression (CDP) [Baseline, month 3, month 6, month 9, month 12, month 15, month 18, month 21, month 24]
Time to onset of confirmed disability progression (CDP) defined as an increase from baseline in EDSS sustained for at least 3 and 6 months, respectively
Proportion of patients with confirmed disability progression (CDP) [Baseline, month 3, month 6, month 9, month 12, month 15, month 18, month 21, month 24]
Proportion of patients with confirmed disability progression (CDP) defined as an increase from baseline in EDSS sustained for at least 3 and 6 months, respectively
Time to onset of confirmed disability improvement (CDI) [Baseline, month 3, month 6, month 9, month 12, month 15, month 18, month 21, month 24]
Time to onset of confirmed disability improvement (CDI) defined as a decrease from baseline in EDSS sustained for at least 3 and 6 months
Proportion of patients with CDI [Baseline, month 3, month 6, month 9, month 12, month 15, month 18, month 21, month 24]
Proportion of patients with CDI defined as a decrease from baseline in EDSS sustained for at least 3 and 6 months
Number of T1 Gd-enhancing lesions per brain [Baseline, month 3, month 6, month 9, month 12, month 15, month 18, month 21, month 24]
Number of T1 Gd-enhancing lesions per brain to be measured
Number of new or enlarging T2 lesions [Baseline, month 3, month 6, month 9, month 12, month 15, month 18, month 21, month 24]
Number of new or enlarging T2 lesions per brain and per year (annualized T2 lesion rate)
Proportion of patients with no evidence of disease activity (NEDA3) upon discretion of the investigator. [Baseline, month 3, month 6, month 9, month 12, month 15, month 18, month 21, month 24]
Proportion of patients with no evidence of disease activity (NEDA3) upon discretion of the investigator. NEDA3 is defined as no 3mCDP, no confirmed MS relapse and no new or enlarging T2 lesions on any MRI scan compared to baseline
Proportion of patients with no clinical disease activity and no discontinuation of current treatment due to AEs [Up to 24 months]
Proportion of patients with no clinical disease activity measured by relapse and disease progression and no discontinuation of current treatment due to AEs (excluding pregnancies) and lack of effectiveness
Annualized relapse rate [Up to 24 months]
Annualized relapse rate, defined as the number of confirmed Multiple Sclerosis relapses in a year. Relapse defined as an appearance of a new neurological abnormality or worsening of previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding clinical demyelinating event. The abnormality must have been present for at least 24 hours and occurred in the absence of fever (< 37.5°C) or a known infection.
Time to first relapse [Up to 24 months]
Relapse defined as an appearance of a new neurological abnormality or worsening of previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding clinical demyelinating event. The abnormality must have been present for at least 24 hours and occurred in the absence of fever (< 37.5°C) or a known infection.
Proportion of relapse free patients [Up to 24 months]
Relapse defined as an appearance of a new neurological abnormality or worsening of previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding clinical demyelinating event. The abnormality must have been present for at least 24 hours and occurred in the absence of fever (< 37.5°C) or a known infection.
Number of patients and reasons for discontinuation of treatment [Up to 24 months]
Number of patients and reasons for discontinuation of treatment classified by category: efficacy (e.g. occurrence of relapse, evidence of disease activity in MRI) safety and tolerability (e.g. injection-site reactions, influenza-like symptoms) or convenience (e.g. inconvenient administration, frequency of injections)
Proportion of patients who continue to receive their subsequent treatment [Up to 24 months]
Proportion of patients who, at a given time over the period of 2 years, continue to receive their subsequent treatment
Reasons for and number of treatment interruptions per patient [Up to 24 months]
Reasons for and number of treatment interruptions per patient to be collected
Duration of treatment interruptions per patient [Up to 24 months]
Duration of treatment interruptions per patient to be collected
Number of patients with treatment interruptions [Up to 24 months]
Number of patients with treatment interruptions to be collected
Proportion of drug-related adverse events (AEs) [Up to 24 months]
Proportion of drug-related adverse events (AEs) including those of special interest (main focus on injection site reactions such as scarring, skin reactions, influenza-like symptoms)
Persistence of drug-related adverse events (AEs) [Up to 24 months]
Persistence of drug-related adverse events (AEs) including those of special interest (main focus on injection site reactions such as scarring, skin reactions, influenza-like symptoms)
Specific safety assessment of injection related AEs [Up to 24 months]
Specific safety assessment of injection related AEs. (i.e. injection site reaction AEs vs. injection systemic reaction AEs) summarized by providing the number and percentage of patients with each of the symptoms and pre-specified grouping of symptoms as well as overall.
Proportion of participants discontinuing treatment due to insufficient effectiveness (lack of efficacy) or tolerability/safety reasons [Up to 24 months]
Proportion of participants discontinuing treatment due to insufficient effectiveness (lack of efficacy) or tolerability/safety reasons

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 100 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Signed informed consent must be obtained prior to participation in the study
Male or female patients aged ≥18 years at enrollment
Diagnosis of MS according to the 2017 revised McDonald criteria (Thompson et al 2018b)
RMS with active disease as defined by Lublin et al. (2014)
Max. 1 relapse during the previous year or max. 2 relapses during the previous two years prior to enrollment
Disability status at enrollment with an EDSS score of 0 to 2.5 (inclusive)
Planned initiation or initiation within the past 14 days with an approved injectable DMT for MS as routine medical treatment

Exclusion Criteria:

Patients being treated outside of the approved label
3 years since first symptom(s) leading to MS diagnosis at enrollment
Previous therapy with any DMT for the treatment of MS prior to enrollment (except within the past 14 days with an approved injectable DMT for MS as routine medical treatment; see Inclusion criteria #7)
Relapse which has led to a severe deficit relevant to everyday life upon discretion of the investigator after exhaustion of the relapse therapy
Poor recovery from the first two relapses prior to enrollment upon discretion of the investigator
Pyramidal track signs prior to enrollment
Simultaneous participation in any investigational trial or simultaneous participation in another Novartis-sponsored non-interventional study with Ofatumumab

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Novartis Investigative Site	Untermeiting	Bayern	Germany	86836
2	Novartis Investigative Site	Schwetzingen	BW	Germany	68723
3	Novartis Investigative Site	Hannover	Lower Saxony	Germany	30449
4	Novartis Investigative Site	Muenster	Northwest	Germany	48165
5	Novartis Investigative Site	Alzey		Germany	55232
6	Novartis Investigative Site	Bad Homburg		Germany	61348
7	Novartis Investigative Site	Bergneustadt		Germany	51702
8	Novartis Investigative Site	Berlin		Germany	10437
9	Novartis Investigative Site	Boblingen		Germany	71032
10	Novartis Investigative Site	Bochum		Germany	44787
11	Novartis Investigative Site	Bonn		Germany	53111
12	Novartis Investigative Site	Bremen		Germany
13	Novartis Investigative Site	Chemnitz		Germany	09117
14	Novartis Investigative Site	Dortmund		Germany	44135
15	Novartis Investigative Site	Düsseldorf		Germany	40211
16	Novartis Investigative Site	Erbach		Germany	64711
17	Novartis Investigative Site	Essen		Germany	45257
18	Novartis Investigative Site	Frankfurt		Germany	60313
19	Novartis Investigative Site	Fulda		Germany	36037
20	Novartis Investigative Site	Gelsenkirchen		Germany	45894
21	Novartis Investigative Site	Gladenbach		Germany	35075
22	Novartis Investigative Site	Hagen		Germany	58095
23	Novartis Investigative Site	Ingelheim		Germany	55218
24	Novartis Investigative Site	Itzehoe		Germany	25524
25	Novartis Investigative Site	Kaiserslautern		Germany	67655
26	Novartis Investigative Site	Koln		Germany	50935
27	Novartis Investigative Site	Mannheim		Germany	66163
28	Novartis Investigative Site	Neuburg an der Donau		Germany	86633
29	Novartis Investigative Site	Osnabrück		Germany	49074
30	Novartis Investigative Site	Pforzheim		Germany	75172
31	Novartis Investigative Site	Regensburg		Germany	93059
32	Novartis Investigative Site	Remscheid		Germany	42853
33	Novartis Investigative Site	Siegen		Germany	57076
34	Novartis Investigative Site	Stuttgart		Germany	70174
35	Novartis Investigative Site	Stuttgart		Germany	70182
36	Novartis Investigative Site	Wolfratshausen		Germany	82515