Multiple SclerosisPhase 3FREEDOMS IINCT00355134
Efficacy and Safety of Fingolimod (FTY720) in Patients With Relapsing-remitting Multiple Sclerosis
A Phase 3 study testing Fingolimod in people with Multiple Sclerosis, run by Novartis at 112 sites in 8 countries.
Trial summary
This study assessed the safety, tolerability and efficacy of two doses of oral fingolimod compared to placebo on efficacy parameters in patients with relapsing-remitting multiple sclerosis (RRMS). Read more about this study
- Who is it for?
- Ages 18 to 55 years
- Conditions the study is for
- Multiple Sclerosis
- What is being tested?
- Fingolimod
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 1,083 participants
- Where
- 112 sitesin 8 countries
- Study dates
- Jun 2006to Aug 2011
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 55 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Male and female patients between ages 18-55 with a diagnosis of multiple sclerosis
- Patients with a relapsing-remitting disease course
- Patients with expanded disability status scale (EDSS) score of 0-5.5
Who cannot join
- Patients with other chronic disease of the immune system, malignancies, acute pulmonary disease, cardiac failure, etc.
- Pregnant or nursing women
- For inclusion in the extension phase patients should complete the 24 month core study with or without 24 months on study drug. If a patient discontinued study drug during the core study due to an adverse event, serious adverse event, laboratory abnormality etc. they would be excluded from the Extension Phase.
- Other protocol-defined inclusion/exclusion criteria may apply.
Trial locations and contacts
112 sites in 8 countries.
112 sites in 8 countries
United States100 sites
Neurology & Neuroscience Associates, Inc.
Akron, Ohio, 44302
University of New Mexico Health Science Center
Albuquerque, New Mexico, 87131
University of Michigan Mulitiple Sclerosis Clinic
Ann Arbor, Michigan, 48109
MS Center of Atlanta
Atlanta, Georgia, 30327
Medical College of Georgia
Augusta, Georgia, 30912
University of Maryland
Baltimore, Maryland, 21201
Johns Hopkins MS Center
Baltimore, Maryland, 21287
Northern Ohio Neuroscience, LLC.
Bellevue, Ohio, 44811
Research and Education Institute of Alta Bates Summit Medical Center
Berkeley, California, 94705
University of Alabama Birmingham
Birmingham, Alabama, 35249
Caritas St. Elizabeth's Medical Center
Brighton, Massachusetts, 02135
Mountain Empire Neurological Associates, PC
Bristol, Tennessee, 37620
Neurology Health Care Service - Fletcher Allen Hospital
Burlington, Vermont, 05401
NeuroCare Center, Inc
Canton, Ohio, 44718
UNC - Chapel Hill Neuroscience Hospital
Chapel Hill, North Carolina, 27599
University of Virginia - Fontaine Adult Neurology
Charlottesville, Virginia, 22903
Northwestern University Medical School - Dept of Neurology
Chicago, Illinois, 60611
Rush University Medical Center Department of Neurological Sciences
Chicago, Illinois, 60612
University of Chicago - Dept of Neurology
Chicago, Illinois, 60637
River Hills Health Care
Cincinnati, Ohio, 45219
Ohio State University
Columbus, Ohio, 48221
North Central Neurology Associates, PC
Cullman, Alabama, 35058
Associated Neurologists, PC
Danbury, Connecticut, 06810
University of Colorado
Denver, Colorado, 80262
Ruan Neurology Clinical Research Center
Des Moines, Iowa, 50314
Wayne State University MS Clinic
Detroit, Michigan, 48201
Henry Ford Hospital, Department of Neurology
Detroit, Michigan, 48202
Duke University Medical Center
Durham, North Carolina, 27705
Michigan State University MS Clinic
East Lansing, Michigan, 48824
Alexian Brothers Neurosciences Research
Elk Grove Village, Illinois, 60007
Associated Neurologists of Southern CT, P.C.
Fairfield, Connecticut, 06824
South Suburban Neurology
Flossmoor, Illinois, 60402
Fort Wayne Neurological Center
Fort Wayne, Indiana, 46805
Michigan Medical, P.C.
Grand Rapids, Michigan, 49525
Absher Neurology
Greenville, South Carolina, 29615
Sunrise Clinical Research, Inc.
Hollywood, Florida, 33021
University of Texas - Houston Medical School
Houston, Texas, 77030
Indiana University Medical Center
Indianapolis, Indiana, 46202
University of California - Irvine, Deptarment of Neurology
Irvine, California, 92697
University of Florida Health Sciences Center/Shands Jacksonville
Jacksonville, Florida, 32209
University of Kansas Medical Center
Kansas City, Kansas, 66160
St. Luke's Hospital - Mid-America Brain and Stroke Institute
Kansas City, Missouri, 64111
Empire Neurology, PC
Latham, New York, 12110
Multiple Sclerosis Center
Lebanon, New Hampshire, 03756
Mid America Neuroscience Institute
Lenexa, Kansas, 66214
Cedars Sinai Medical Center
Los Angeles, California, 90048
Kentucky Research Associates
Louisville, Kentucky, 40202
Investigational Site - Private Practice
Lubbock, Texas, 79410
Dean Foundation
Madison, Wisconsin, 53715
University of Wisconsin Medical School
Madison, Wisconsin, 53792
Neurology Associates, PA
Maitland, Florida, 32751
University of Miami, Department of Neurology
Miami, Florida, 33136
St. Luke's Medical Center
Milwaukee, Wisconsin, 53215
University of South Alabama - Dept of Neurology
Mobile, Alabama, 36693
University Health Associates - West Virgina University
Morgantown, West Virginia, 26506
Advanced Neurosciences Institute
Nashville, Tennessee, 37205
Vanderbilt Stallworth Rehabilitation Hospital
Nashville, Tennessee, 37212
Yale University - Yale Multiple Sclerosis Center
New Haven, Connecticut, 06510
NYU Hospital for Joint Diseases
New York, New York, 10003
Cornell University - NY Presbyterian Hospital
New York, New York, 10021
Mount Sinai School of Medicine
New York, New York, 10029
Newton Wesley Hospital
Newton, Massachusetts, 02462
The Neurology Center
Oceanside, California, 92056
MS Center of Oklahoma, Mercy Neuroscience Institute
Oklahoma City, Oklahoma, 73120
Neurologic Associates, Ltd.
Palos Heights, Illinois, 60453
Neuro-Therapeutics, Inc.
Pasadena, California, 91105
University of Pennsylvania, Department of Neurology
Philadelphia, Pennsylvania, 19104
Thomas Jefferson University Hospital, Department of Neurology
Philadelphia, Pennsylvania, 19107
Barrow Neurology Clinic
Phoenix, Arizona, 85013
Allegheny Neurological Associates
Pittsburgh, Pennsylvania, 15212
University of Pittsburgh - Dept of Neurology
Pittsburgh, Pennsylvania, 15213
Island Neurological Associates, PC
Plainview, New York, 11803
Neurological Associates
Pompano Beach, Florida, 33060
Raleigh Neurology Associates
Raleigh, North Carolina, 27607
Institute for Neurosciences
Reno, Nevada, 85902
University of Rochester Medical Center
Rochester, New York, 14642
UC Davis Medical Center
Sacramento, California, 95817
Michigan Neurology Associates, PC
Saint Clair Shores, Michigan, 48080
Integra Clinical Research, LLC
San Antonio, Texas, 78231
Multiple Sclerosis Center at UCSF
San Francisco, California, 94117
Roskamp Institute, Clinical Trials Division
Sarasota, Florida, 34243
Virginia Mason Multiple Sclerosis Center
Seattle, Washington, 98111
Seattle Neuroscience Institute at Swedish Medical Center
Seattle, Washington, 98122
Springfield Neurology
Springfield, Massachusetts, 01104
The MS Center for Innovation in Care
St Louis, Missouri, 63110
Alpha Neurology
Staten Island, New York, 10306
SUNY Stony Brook
Stony Brook, New York, 11794
Neurology Clinical Research, Inc
Sunrise, Florida, 33351
SUNY Upstate Medical University
Syracuse, New York, 13210
AMO Corporation
Tallahassee, Florida, 32308
Axiom Clinical Research of Florida
Tampa, Florida, 33609
Gimbel Multiple Sclerosis Center at Holy Name Hospital
Teaneck, New Jersey, 07666
University of Toledo Health Science Campus
Toledo, Ohio, 43614
Oregon Neurology
Tualatin, Oregon, 97062
Neurologial Associates of Tulsa
Tulsa, Oklahoma, 74137
Oak Clinic
Uniontown, Ohio, 44685
The MS Center of Vero Beach
Vero Beach, Florida, 32960
Georgetown University Hospital - Dept of Neurology
Washington D.C., District of Columbia, 20007
Wake Forest University Baptist Medical Center
Winston-Salem, North Carolina, 27157
UMass Memorial Medical Center
Worchester, Massachusetts, 01605
Turkey (Türkiye)3 sites
Novartis Investigative Site
Istanbul
Novartis Investigative Site
Izmir
Novartis Investigative Site
Yenisehir/Izmir
Canada2 sites
Novartis Investigative Site
Greenfield Park, Quebec
Novartis Investigative Site
Ottawa, Ontario
Poland2 sites
Novartis Investigative Site
Bialystok
Novartis Investigative Site
Warsaw
Romania2 sites
Novartis Investigative Site
Bucharest
Novartis Investigative Site
Târgu Mureş
About this study
Official title: 24-month Double-blind, Randomized, Multicenter, Placebo-controlled, Parallel-group Study Comparing the Efficacy and Safety of 0.5 mg and 1.25 mg Fingolimod (FTY720) Administered Orally Once Daily Versus Placebo in Patients With Relapsing-remitting Multiple Sclerosis With Optional Extension Phase
This study assessed the safety, tolerability and efficacy of two doses of oral fingolimod compared to placebo on efficacy parameters in patients with relapsing-remitting multiple sclerosis (RRMS).
Read the detailed description
This randomized, multicenter, parallel-group study consisted of 2 phases: a 24-month double-blind, randomized, multicenter, placebo-controlled, parallel-group study and an Extension phase which consisted of a dose-blinded period and an open-label period.
In the Core phase, patients were randomized to receive a fixed dose of fingolimod (0.5 mg/day), fingolimod (1.25 mg/day) or placebo for up to 24 months.
For the Extension phase, patients who were treated with fingolimod during the Core phase continued treatment at the assigned dose level, while those previously treated with placebo during the Core phase were re-randomized in a 1:1 ratio to receive one of the two doses of fingolimod (1.25 mg or 0.5 mg). All patients in the extension received blinded investigational drug: fingolimod 1.25 mg and 0.5 mg in capsules for oral administration once daily until the decision to discontinue the fingolimod 1.25 mg dose became effective and subsequently all patients were switched to open-label fingolimod 0.5 mg.
With the implementation of Amendment 11, the 1.25 mg dose was discontinued and all patients were switched to fingolimod 0.5 mg dose. With the implementation of Amendment 12, all patients treated with Placebo in the fingolimod Core phase were switched to treatment with 0.5 mg fingolimod per day. The Extension phase continued until all patients either discontinued or transferred to Study CFTY720D2399 (NCT01201356; initiated in September 2010).
- Conditions
- Multiple Sclerosis
- Being tested
- Fingolimod, Placebo
- Keywords
- fingolimod, FTY720, relapsing-remitting multiple sclerosis, MS, RRMS
- Medical subject headings
- Multiple Sclerosis, Multiple Sclerosis, Relapsing-Remitting
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
FingolimodDrug
Also called FTY720, Gilenya®
Fingolimod capsules for oral administration
PlaceboDrug
Matching placebo capsules for oral administration.
| Study group | Role | What they receive |
|---|---|---|
| Fingolimod 1.25 mg | Experimental | Participants received 1.25 mg fingolimod orally once a day for up to 24 months during the core phase. In the Extension phase participants continued to receive 1.25 mg fingolimod orally once a day.
Note: Upon implementation of a protocol amendment all patients taking 1.25 mg fingolimod were switched to 0.5 mg fingolimod orally once a day. Receives: Drug: Fingolimod |
| Fingolimod 0.5 mg | Experimental | Participants received 0.5 mg fingolimod orally once a day for up to 24 months during the core phase. In the Extension phase participants continued to receive 0.5 mg fingolimod orally once a day. Receives: Drug: Fingolimod |
| Placebo | Experimental | Participants received placebo capsules orally once a day for up to 24 months during the core phase. In the Extension phase participants received either 1.25 or 0.5 mg fingolimod orally once a day.
Note: Upon implementation of a protocol amendment all patients taking 1.25 mg fingolimod were switched to 0.5 mg fingolimod orally once a day. Upon implementation of a protocol amendment, all patients taking placebo were switched to 0.5 mg fingolimod orally once a day. Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Aggregate Annualized Relapse Rate (ARR) Estimate up to Month 24
ARR is the average number of relapses in a year calculated by negative binomial regression as the sum of confirmed relapses of all patients in the group divided by the sum of the number of days on study of all patients in the group and multiplied by 365.25.
A relapse was defined as the 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 be present for at least 24 hours and occur in the absence of fever (<37.5C) or known infection. A relapse must be confirmed by the Independent Evaluating Physician (examining neurologist).
ARR estimates were calculated from a negative binomial regression model adjusted for treatment, pooled center, number of relapses in the previous 2 years prior to enrollment, and Baseline expanded disability status scale (EDSS).
Measured: 24 months
Secondary outcomes (10)
Aggregate Annualized Relapse Rate (ARR) Estimate up to End of Study
ARR is the average number of relapses in a year calculated by negative binomial regression as the sum of confirmed relapses of all patients in the group divided by the sum of the number of days on study of all patients in the group and multiplied by 365.25.
A relapse was defined as the 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 be present for at least 24 hours and occur in the absence of fever (<37.5C) or known infection. A relapse must be confirmed by the Independent Evaluating Physician (examining neurologist).
ARR estimates were calculated from a negative binomial regression model adjusted for treatment, pooled center, number of relapses in the previous 2 years prior to enrollment, and Baseline expanded disability status scale (EDSS).
Measured: From Baseline until end of study (up to approximately 54 months).
Percent Change From Baseline in Brain Volume
Brain volume was measured using magnetic resonance imaging (MRI). Change from Baseline in brain volume is expressed as a percentage of the Baseline brain volume.
Measured: Baseline, Month 24 and end of study (up to approximately 54 months)
Number of New or Newly Enlarged T2 Lesions
Inflammatory disease activity was assessed by magnetic resonance imaging (MRI) measurement of the number of new or newly enlarged T2 lesions, by year.
Measured: From Baseline until Month 48
Number of Gadolinium-enhanced T1 Lesions
Inflammatory disease activity was assessed by magnetic resonance imaging (MRI) measurement of the number of gadolinium-enhanced T1 lesions.
Measured: Month 24 and end of study (up to approximately 54 months)
Change From Baseline in Lesion Volume at Month 24 (Core Phase)
Change from Baseline in lesion volume was measured by MRI for T2 lesions and for T1 hypointense lesions.
Measured: Baseline and Month 24
Percentage of Participants Free of 3-month Confirmed Disability Progression at Month 24 and End of Study
Disability progression was defined using the following criteria: One point increase from baseline in patients with Baseline Expanded Disability Status Scale (EDSS) score from 0 to 5.0; or half a point increase from Baseline in patients with Baseline EDSS score of 5.5 or above. A 3-month confirmed disability progression was defined as a 3-month sustained increase from Baseline in EDSS score. The EDSS quantifies disability in multiple sclerosis in 8 functional systems; the score ranges from 0 (normal) to 10 (death due to MS). Progression curves were generated by the Kaplan-Meier method.
Measured: 24 months and end of study (up to approximately 54 months)
Percentage of Participants Free of 6-month Confirmed Disability Progression at Month 24 and End of Study
Disability progression was defined using the following criteria: One point increase from baseline in patients with Baseline Expanded Disability Status Scale (EDSS) score from 0 to 5.0; or half a point increase from Baseline in patients with Baseline EDSS score of 5.5 or above. A 6-month confirmed disability progression was defined as a 6-month sustained increase from Baseline in EDSS score. The EDSS quantifies disability in multiple sclerosis in 8 functional systems; the score ranges from 0 (normal) to 10 (death due to MS). Progression curves were generated by the Kaplan-Meier method.
Measured: 24 months and end of study (up to approximately 54 months)
Percentage of Participants Relapse-free up to Month 24
Estimates of the percentage of participants relapse-free at 24 months were generated from Kaplan-Meier curves of the time to first relapse. A relapse was defined as the 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 be present for at least 24 hours and occur in the absence of fever (<37.5C) or infection. A relapse was confirmed by an Independent Evaluating Physician.
Measured: 24 months
Percentage of Participants Relapse-free up to End of Study
Estimates of the percentage of participants relapse-free at end of study were generated from Kaplan-Meier curves of the time to first relapse. A relapse was defined as the 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 be present for at least 24 hours and occur in the absence of fever (<37.5C) or infection. A relapse was confirmed by an Independent Evaluating Physician.
Measured: From Baseline until the end of study (up to approximately 54 months)
Change From Baseline in Multiple Sclerosis Functional Composite (MSFC) Z-score
The Multiple Sclerosis Functional Composite (MSFC) is a multidimensional clinical outcome measure that includes quantitative tests of leg function/ambulation (Timed 25-Foot Walk), arm function (9-Hole Peg Test), and cognitive function (Paced Auditory Serial Addition Test). The overall MSFC z-score as an average of the three standardized scores derived using baseline data pooled over each treatment arm as reference population. Higher scores reflect better neurological function and a positive change from Baseline indicates improvement.
Measured: Baseline, Month 24 and end of study (up to approximately 54 months)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Jul 2006 (estimated)
- Study startJun 2006
- Primary completionJun 2011
- Study completionAug 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Multiple SclerosisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 1,083 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study chair, Novartis Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00355134
- Sponsor's protocol ID
- CFTY720D2309
- Acronym
- FREEDOMS II
- Status last verified
- Aug 2012
- First submitted
- 19 Jul 2006
- Last updated
- 7 Aug 2012
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Wang L, Tan H, Yu J, ZhangBao J, Huang W, Chang X, Zhou L, Lu C, Xiao Y, Lu J, Zhao C, Wang M, Wu X, Wu M, Dong Q, Ngew KY, Quan C. Baseline retinal nerve fiber layer thickness as a predictor of multiple sclerosis progression: New insights from the FREEDOMS II study. Eur J Neurol. 2023 Feb;30(2):443-452. doi: 10.1111/ene.15612. Epub 2022 Nov 15.
PubMed 36286605Fox RJ, Chan A, Zhang A, Xiao J, Levison D, Lewin JB, Edwards MR, Marantz JL. Comparative effectiveness using a matching-adjusted indirect comparison between delayed-release dimethyl fumarate and fingolimod for the treatment of multiple sclerosis. Curr Med Res Opin. 2017 Feb;33(2):175-183. doi: 10.1080/03007995.2016.1248380. Epub 2016 Nov 10.
PubMed 27733070Derfuss T, Bergvall NK, Sfikas N, Tomic DL. Efficacy of fingolimod in patients with highly active relapsing-remitting multiple sclerosis. Curr Med Res Opin. 2015;31(9):1687-91. doi: 10.1185/03007995.2015.1067191. Epub 2015 Aug 20.
PubMed 26121423Chinea Martinez AR, Correale J, Coyle PK, Meng X, Tenenbaum N. Efficacy and safety of fingolimod in Hispanic patients with multiple sclerosis: pooled clinical trial analyses. Adv Ther. 2014 Oct;31(10):1072-81. doi: 10.1007/s12325-014-0154-4. Epub 2014 Sep 23.
PubMed 25245812Calabresi PA, Radue EW, Goodin D, Jeffery D, Rammohan KW, Reder AT, Vollmer T, Agius MA, Kappos L, Stites T, Li B, Cappiello L, von Rosenstiel P, Lublin FD. Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2014 Jun;13(6):545-56. doi: 10.1016/S1474-4422(14)70049-3. Epub 2014 Mar 28.
PubMed 24685276Winges KM, Werner JS, Harvey DJ, Cello KE, Durbin MK, Balcer LJ, Calabresi PA, Keltner JL. Baseline retinal nerve fiber layer thickness and macular volume quantified by OCT in the North American phase 3 fingolimod trial for relapsing-remitting multiple sclerosis. J Neuroophthalmol. 2013 Dec;33(4):322-9. doi: 10.1097/WNO.0b013e31829c51f7.
PubMed 24051419
Study at a glance
From the registry record, last updated by the sponsor on 7 Aug 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- 24-month Double-blind, Randomized, Multicenter, Placebo-controlled, Parallel-group Study Comparing the Efficacy and Safety of 0.5 mg and 1.25 mg Fingolimod (FTY720) Administered Orally Once Daily Versus Placebo in Patients With Relapsing-remitting Multiple Sclerosis With Optional Extension Phase
- ClinicalTrials.gov ID
- NCT00355134
- Acronym / sponsor ID
- FREEDOMS II / CFTY720D2309
- Conditions
- Multiple Sclerosis
- Keywords
- fingolimod, FTY720, relapsing-remitting multiple sclerosis, MS, RRMS
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,083 participants (actual)
- Lead sponsor
- NovartisIndustry (pharma, biotech, devices)
- Study start
- Jun 2006
- Primary completion
- Jun 2011 (actual)
- Study completion
- Aug 2011 (actual)
- First posted
- 21 Jul 2006 (estimated)
- Results
- Posted 26 Jun 2012
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study assessed the safety, tolerability and efficacy of two doses of oral fingolimod compared to placebo on efficacy parameters in patients with relapsing-remitting multiple sclerosis (RRMS).
Detailed description
This randomized, multicenter, parallel-group study consisted of 2 phases: a 24-month double-blind, randomized, multicenter, placebo-controlled, parallel-group study and an Extension phase which consisted of a dose-blinded period and an open-label period.
In the Core phase, patients were randomized to receive a fixed dose of fingolimod (0.5 mg/day), fingolimod (1.25 mg/day) or placebo for up to 24 months.
For the Extension phase, patients who were treated with fingolimod during the Core phase continued treatment at the assigned dose level, while those previously treated with placebo during the Core phase were re-randomized in a 1:1 ratio to receive one of the two doses of fingolimod (1.25 mg or 0.5 mg). All patients in the extension received blinded investigational drug: fingolimod 1.25 mg and 0.5 mg in capsules for oral administration once daily until the decision to discontinue the fingolimod 1.25 mg dose became effective and subsequently all patients were switched to open-label fingolimod 0.5 mg.
With the implementation of Amendment 11, the 1.25 mg dose was discontinued and all patients were switched to fingolimod 0.5 mg dose. With the implementation of Amendment 12, all patients treated with Placebo in the fingolimod Core phase were switched to treatment with 0.5 mg fingolimod per day. The Extension phase continued until all patients either discontinued or transferred to Study CFTY720D2399 (NCT01201356; initiated in September 2010).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Fingolimod 1.25 mg | Experimental | Drug: FingolimodParticipants received 1.25 mg fingolimod orally once a day for up to 24 months during the core phase. In the Extension phase participants continued to receive 1.25 mg fingolimod orally once a day. Note: Upon implementation of a protocol amendment all patients taking 1.25 mg fingolimod were switched to 0.5 mg fingolimod orally once a day. |
| Fingolimod 0.5 mg | Experimental | Drug: FingolimodParticipants received 0.5 mg fingolimod orally once a day for up to 24 months during the core phase. In the Extension phase participants continued to receive 0.5 mg fingolimod orally once a day. |
| Placebo | Experimental | Drug: PlaceboParticipants received placebo capsules orally once a day for up to 24 months during the core phase. In the Extension phase participants received either 1.25 or 0.5 mg fingolimod orally once a day. Note: Upon implementation of a protocol amendment all patients taking 1.25 mg fingolimod were switched to 0.5 mg fingolimod orally once a day. Upon implementation of a protocol amendment, all patients taking placebo were switched to 0.5 mg fingolimod orally once a day. |
Who may qualify
- Ages
- 18 to 55 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Male and female patients between ages 18-55 with a diagnosis of multiple sclerosis
- Patients with a relapsing-remitting disease course
- Patients with expanded disability status scale (EDSS) score of 0-5.5
Key exclusion criteria (4 listed)
- Patients with other chronic disease of the immune system, malignancies, acute pulmonary disease, cardiac failure, etc.
- Pregnant or nursing women
- For inclusion in the extension phase patients should complete the 24 month core study with or without 24 months on study drug. If a patient discontinued study drug during the core study due to an adverse event, serious adverse event, laboratory abnormality etc. they would be excluded from the Extension Phase.
- Other protocol-defined inclusion/exclusion criteria may apply.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| FingolimodAlso: FTY720, Gilenya®Fingolimod capsules for oral administration | Drug | Fingolimod 0.5 mg, Fingolimod 1.25 mg |
| PlaceboMatching placebo capsules for oral administration. | Drug | Placebo |
Primary outcome
Aggregate Annualized Relapse Rate (ARR) Estimate up to Month 24
Time frame: 24 months
ARR is the average number of relapses in a year calculated by negative binomial regression as the sum of confirmed relapses of all patients in the group divided by the sum of the number of days on study of all patients in the group and multiplied by 365.25. A relapse was defined as the 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 be present for at least 24 hours and occur in the absence of fever (<37.5C) or known infection. A relapse must be confirmed by the Independent Evaluating Physician (examining neurologist). ARR estimates were calculated from a negative binomial regression model adjusted for treatment, pooled center, number of relapses in the previous 2 years prior to enrollment, and Baseline expanded disability status scale (EDSS).
10 secondary outcomes
Aggregate Annualized Relapse Rate (ARR) Estimate up to End of Study
Time frame: From Baseline until end of study (up to approximately 54 months).
Percent Change From Baseline in Brain Volume
Time frame: Baseline, Month 24 and end of study (up to approximately 54 months)
Number of New or Newly Enlarged T2 Lesions
Time frame: From Baseline until Month 48
Number of Gadolinium-enhanced T1 Lesions
Time frame: Month 24 and end of study (up to approximately 54 months)
Change From Baseline in Lesion Volume at Month 24 (Core Phase)
Time frame: Baseline and Month 24
Percentage of Participants Free of 3-month Confirmed Disability Progression at Month 24 and End of Study
Time frame: 24 months and end of study (up to approximately 54 months)
Percentage of Participants Free of 6-month Confirmed Disability Progression at Month 24 and End of Study
Time frame: 24 months and end of study (up to approximately 54 months)
Percentage of Participants Relapse-free up to Month 24
Time frame: 24 months
Percentage of Participants Relapse-free up to End of Study
Time frame: From Baseline until the end of study (up to approximately 54 months)
Change From Baseline in Multiple Sclerosis Functional Composite (MSFC) Z-score
Time frame: Baseline, Month 24 and end of study (up to approximately 54 months)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Aug 2012.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 36286605Wang L, Tan H, Yu J, ZhangBao J, Huang W, Chang X, Zhou L, Lu C, Xiao Y, Lu J, Zhao C, Wang M, Wu X, Wu M, Dong Q, Ngew KY, Quan C. Baseline retinal nerve fiber layer thickness as a predictor of multiple sclerosis progression: New insights from the FREEDOMS II study. Eur J Neurol. 2023 Feb;30(2):443-452. doi: 10.1111/ene.15612. Epub 2022 Nov 15.
- Derived from this study: PubMed 27733070Fox RJ, Chan A, Zhang A, Xiao J, Levison D, Lewin JB, Edwards MR, Marantz JL. Comparative effectiveness using a matching-adjusted indirect comparison between delayed-release dimethyl fumarate and fingolimod for the treatment of multiple sclerosis. Curr Med Res Opin. 2017 Feb;33(2):175-183. doi: 10.1080/03007995.2016.1248380. Epub 2016 Nov 10.
- Derived from this study: PubMed 26121423Derfuss T, Bergvall NK, Sfikas N, Tomic DL. Efficacy of fingolimod in patients with highly active relapsing-remitting multiple sclerosis. Curr Med Res Opin. 2015;31(9):1687-91. doi: 10.1185/03007995.2015.1067191. Epub 2015 Aug 20.
- Derived from this study: PubMed 25245812Chinea Martinez AR, Correale J, Coyle PK, Meng X, Tenenbaum N. Efficacy and safety of fingolimod in Hispanic patients with multiple sclerosis: pooled clinical trial analyses. Adv Ther. 2014 Oct;31(10):1072-81. doi: 10.1007/s12325-014-0154-4. Epub 2014 Sep 23.
- Derived from this study: PubMed 24685276Calabresi PA, Radue EW, Goodin D, Jeffery D, Rammohan KW, Reder AT, Vollmer T, Agius MA, Kappos L, Stites T, Li B, Cappiello L, von Rosenstiel P, Lublin FD. Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2014 Jun;13(6):545-56. doi: 10.1016/S1474-4422(14)70049-3. Epub 2014 Mar 28.
- Derived from this study: PubMed 24051419Winges KM, Werner JS, Harvey DJ, Cello KE, Durbin MK, Balcer LJ, Calabresi PA, Keltner JL. Baseline retinal nerve fiber layer thickness and macular volume quantified by OCT in the North American phase 3 fingolimod trial for relapsing-remitting multiple sclerosis. J Neuroophthalmol. 2013 Dec;33(4):322-9. doi: 10.1097/WNO.0b013e31829c51f7.
- Fingolimod clinical trials information websiteLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Novartis Pharmaceuticals study chair
Novartis Pharmaceuticals
112 sites in 8 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Fingolimod in people with Multiple Sclerosis, run by Novartis at 112 sites in 8 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Aug 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 112 sites in United States, Turkey (Türkiye), Canada, Poland, Romania and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 26 Jun 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Aggregate Annualized Relapse Rate (ARR) Estimate up to Month 24 (time frame: 24 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00355134, which also lists 6 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Aug 2012.