Relapsing Forms of Multiple SclerosisPhase 4EPOCNCT01216072
A 6-month, Randomized, Open-label, Patient OutComes, Safety and Tolerability Study of Fingolimod (FTY720) 0.5 mg/Day vs. Comparator in Patients With Relapsing Forms of Multiple Sclerosis
A Phase 4 study testing Fingolimod and Standard MS DMTs in people with Relapsing Forms of Multiple Sclerosis, run by Novartis Pharmaceuticals at 149 sites in 3 countries.
Trial summary
The purpose of this study is to evaluate the change in patient-reported outcomes, physician assessment of a change as well as safety and tolerability in patients with Relapsing Forms of Multiple Sclerosis on previous Disease Modifying Therapy (DMT) who are randomized to one of two treatment arms: fingolimod vs. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Relapsing Forms of Multiple Sclerosis
- What is being tested?
- Fingolimod and Standard MS DMTs
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,053 participants
- Where
- 149 sitesin 3 countries
- Study dates
- Aug 2010to Aug 2012
- Phase
- Phase 4
- 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 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Relapsing forms of MS
- Expanded Disability Status Scale (EDSS) 0-5.5
- Continuous treatment with MS DMT for a minimum of 6 months
- Fingolimod naive
Who cannot join
- Immune system diseases other than MS
- Active macular edema
- History of selected prior infections and criteria for immunizations
- History of selected immune system treatments and/or medications
- Selected cardiovascular, pulmonary, or hepatic conditions
- Selected abnormal laboratory values
- Pregnant or nursing women
- Other protocol-defined inclusion/exclusion criteria applied
Trial locations and contacts
149 sites in 3 countries.
149 sites in 3 countries
United States142 sites
Novartis Investigative Site
Akron, Ohio, 44320
Novartis Investigative Site
Amherst, New York, 14226
Novartis Investigative Site
Anaheim, California, 92801
Novartis Investigative Site
Anderson, Indiana, 46011
Novartis Investigative Site
Asheville, North Carolina, 28806
Novartis Investigative Site
Atlanta, Georgia, 30302
Novartis Investigative Site
Atlanta, Georgia, 30309
Novartis Investigative Site
Atlantis, Florida, 33462-6608
Novartis Investigative Site
Austin, Texas, 78756
Novartis Investigative Site
Baltimore, Maryland, 21201
Novartis Investigative Site
Baton Rouge, Louisiana, 70809
Novartis Investigative Site
Bellevue, Ohio, 44811
Novartis Investigative Site
Berkeley, California, 94705
Novartis Investigative Site
Bethesda, Maryland, 20814
Novartis Investigative Site
Beufort, South Carolina, 29902
Novartis Investigative Site
Billings, Montana, 59102
Novartis Investigative Site
Birmingham, Alabama, 35209
Novartis Investigative Site
Bolivar, Missouri, 65613
Novartis Investigative Site
Boston, Massachusetts, 02135
Novartis Investigative Site
Boulder, Colorado, 80304
Novartis Investigative Site
Bradenton, Florida, 32405
Novartis Investigative Site
Burlington, North Carolina, 27215
Novartis Investigative Site
Canton, Ohio, 44718
Novartis Investigative Site
Charlotte, North Carolina, 28204
Novartis Investigative Site
Charlotte, North Carolina, 28207
Novartis Investigative Site
Cincinnati, Ohio, 45219
Novartis Investigative Site
Colleyville, Texas, 76034
Novartis Investigative Site
Colorado Springs, Colorado, 80920
Novartis Investigative Site
Columbia, Tennessee, 38401
Novartis Investigative Site
Columbus, Georgia, 31901
Novartis Investigative Site
Columbus, Ohio, 43221
Novartis Investigative Site
Cordova, Tennessee, 38018
Novartis Investigative Site
Corvallis, Oregon, 97330
Novartis Investigative Site
Cullman, Alabama, 35058
Novartis Investigative Site
Dallas, Texas, 75204
Novartis Investigative Site
Decatur, Georgia, 30083
Novartis Investigative Site
Des Moines, Iowa, 50314-2611
Novartis Investigative Site
Destrehan, Louisiana, 70047
Novartis Investigative Site
Detroit, Michigan, 48201
Novartis Investigative Site
Doral, Florida, 33166
Novartis Investigative Site
Dover, Delaware, 19901
Novartis Investigative Site
Elk Grove Village, Illinois, 60007
Novartis Investigative Site
Eugene, Oregon, 97401
Novartis Investigative Site
Evanston, Illinois, 60201
Novartis Investigative Site
Fairfield, Connecticut, 06824
Novartis Investigative Site
Flossmoor, Illinois, 60422
Novartis Investigative Site
Fort Collins, Colorado, 80528
Novartis Investigative Site
Fort Lauderdale, Florida, 33308
Novartis Investigative Site
Freehold, New Jersey, 07728
Novartis Investigative Site
Fresno, California, 93710
Novartis Investigative Site
Fullerton, California, 92835
Novartis Investigative Site
Grand Rapids, Michigan, 49503
Novartis Investigative Site
Greensboro, North Carolina, 27401
Novartis Investigative Site
Greenville, North Carolina, 27834
Novartis Investigative Site
Hammond, Louisiana, 70403
Novartis Investigative Site
Hollywood, Florida, 33021
Novartis Investigative Site
Houston, Texas, 77025
Novartis Investigative Site
Idaho Falls, Idaho, 83402
Novartis Investigative Site
Indianapolis, Indiana, 46202-5111
Novartis Investigative Site
Indianapolis, Indiana, 46256
Novartis Investigative Site
Jacksonville, Florida, 32209
Novartis Investigative Site
Jacksonville, Florida, 32216
Novartis Investigative Site
Kalamazoo, Michigan, 49007
Novartis Investigative Site
Kansas City, Missouri, 64111
Novartis Investigative Site
Kansas City, Missouri, 64132
Novartis Investigative Site
Kirkland, Washington, 98034
Novartis Investigative Site
Knoxville, Tennessee, 37934
Novartis Investigative Site
La Habra, California, 90631
Novartis Investigative Site
Latham, New York, 12110
Novartis Investigative Site
Lenexa, Kansas, 66214
Novartis Investigative Site
Lighthouse PT, Florida, 33064
Novartis Investigative Site
Loma Linda, California, 92354
Novartis Investigative Site
Lubbock, Texas, 79410
Novartis Investigative Site
Maitland, Florida, 32751
Novartis Investigative Site
Medford, Oregon, 97504
Novartis Investigative Site
Merrillville, Indiana, 46410
Novartis Investigative Site
Metairie, Louisiana, 70001
Novartis Investigative Site
Miami, Florida, 33015
Novartis Investigative Site
Miami, Florida, 33133
Novartis Investigative Site
Monroeville, Pennsylvania, 15146
Novartis Investigative Site
Morgantown, West Virginia, 26506-9260
Novartis Investigative Site
Nashville, Tennessee, 37205
Novartis Investigative Site
New London, Connecticut, 06320
Novartis Investigative Site
New York, New York, 10023
Novartis Investigative Site
Newark, Delaware, 19713
Novartis Investigative Site
Newport Beach, California, 92660
Novartis Investigative Site
Newport News, Virginia, 23606
Novartis Investigative Site
Nixa, Missouri, 65714-7807
Novartis Investigative Site
North Kansas City, Missouri, 64116
Novartis Investigative Site
Northbrook, Illinois, 60062
Novartis Investigative Site
Oceanside, California, 92056
Novartis Investigative Site
Oklahoma City, Oklahoma, 73112
Novartis Investigative Site
Patchogue, New York, 11772
Novartis Investigative Site
Phoenix, Arizona, 85004
Novartis Investigative Site
Phoenix, Arizona, 85006
Novartis Investigative Site
Phoenix, Arizona, 85013
Novartis Investigative Site
Phoenix, Arizona, 85032
Novartis Investigative Site
Plainview, New York, 11803
Novartis Investigative Site
Plano, Texas, 75075
Novartis Investigative Site
Pompano Beach, Florida, 33060
Novartis Investigative Site
Ponte Vedra Beach, Florida, 32082-4627
Novartis Investigative Site
Port Orange, Florida, 32127
Novartis Investigative Site
Portland, Oregon, 97223
Novartis Investigative Site
Raleigh, North Carolina, 27607
Novartis Investigative Site
Richmond, Virginia, 23226
Novartis Investigative Site
Roanoke, Virginia, 24014
Novartis Investigative Site
Round Rock, Texas, 78681
Novartis Investigative Site
Rumford, Rhode Island, 02916
Novartis Investigative Site
Sacramento, California, 95817
Novartis Investigative Site
Salisbury, North Carolina, 28144
Novartis Investigative Site
Salt Lake City, Utah, 84103
Novartis Investigative Site
San Antonio, Texas, 78229
Novartis Investigative Site
San Antonio, Texas, 78258
Novartis Investigative Site
Sarasota, Florida, 34243
Novartis Investigative Site
Seattle, Washington, 98122
Novartis Investigative Site
Seattle, Washington, 98144
Novartis Investigative Site
Sherman, Texas, 75092
Novartis Investigative Site
Shreveport, Louisiana, 71101
Novartis Investigative Site
Shreveport, Louisiana, 71130
Novartis Investigative Site
Somerset, New Jersey, 08873
Novartis Investigative Site
Southfield, Michigan, 48034
Novartis Investigative Site
Springfield, Massachusetts, 01104
Novartis Investigative Site
St Louis, Missouri, 63104
Novartis Investigative Site
St. Petersburg, Florida, 33713
Novartis Investigative Site
Stratford, Connecticut, 06615
Novartis Investigative Site
Sunrise, Florida, 33351
Novartis Investigative Site
Tallahassee, Florida, 32308
Novartis Investigative Site
Tampa, Florida, 33609
Novartis Investigative Site
Tampa, Florida, 33612
Novartis Investigative Site
Teaneck, New Jersey, 07666
Novartis Investigative Site
Toms River, New Jersey, 08755
Novartis Investigative Site
Tucson, Arizona, 85741
Novartis Investigative Site
Uniontown, Ohio, 44685
Novartis Investigative Site
Valparaiso, Indiana, 46383
Novartis Investigative Site
Vero Beach, Florida, 32960
Novartis Investigative Site
Vienna, Virginia, 22182
Novartis Investigative Site
Walnut Creek, California, 94598
Novartis Investigative Site
West Palm Beach, Florida, 33407
Novartis Investigative Site
Wilmington, North Carolina, 28401
Novartis Investigative Site
Winston-Salem, North Carolina, 27103
Novartis Investigative Site
Worcester, Massachusetts, 01608
Novartis Investigative Site
Worcester, Massachusetts, 01665
Canada6 sites
Novartis Investigative Site
Calgary, Alberta, T2N 2T9
Novartis Investigative Site
Greenfield Park, Quebec, J4V 2J2
Novartis Investigative Site
Montreal, Quebec, H1T 2M4
Novartis Investigative Site
Montreal, Quebec, H3A 2B4
Novartis Investigative Site
Nepean, Ontario, K2G 6E2
Novartis Investigative Site
Ottawa, Ontario, K1H 8L6
About this study
Official title: A 6-month, Randomized, Active Comparator, Open-label, Multi-Center Study to Evaluate Patient OutComes, Safety and Tolerability of Fingolimod (FTY720) 0.5 mg/Day in Patients With Relapsing Forms of Multiple Sclerosis Who Are Candidates for MS Therapy Change From Previous Disease Modifying Therapy (EPOC)
The purpose of this study is to evaluate the change in patient-reported outcomes, physician assessment of a change as well as safety and tolerability in patients with Relapsing Forms of Multiple Sclerosis on previous Disease Modifying Therapy (DMT) who are randomized to one of two treatment arms: fingolimod vs. standard of care DMT.
- Conditions
- Relapsing Forms of Multiple Sclerosis
- Being tested
- Fingolimod, Standard MS DMTs
- Keywords
- Relapsing Forms of Multiple Sclerosis, Disease Modifying Therapy, fingolimod, Patient Reported Outcomes
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
FingolimodDrug
Also called GILENYA™
0.5 mg/day oral capsule
Standard MS DMTsDrug
Also called Avonex®,, Copaxone®,, Rebif®,, Betaseron®,
| Study group | Role | What they receive |
|---|---|---|
| Fingolimod | Experimental | Patients randomized in this arm received Fingolimod 0.5 mg/day oral capsule for 6 months core period . Receives: Drug: Fingolimod |
| Multiple Sclerosis Disease Modifying Treatments (MS DMTs) | Active comparator | Patients randomized in this arm received selected Standard MS DMT such as Interferon beta-1b or Interferon beta-1a or Glatiramer acetate for 6 months. An open-label extension of up to 3 months of treatment with fingolimod was to be available for patients in the DMT arm who successfully completed all study visits. Receives: Drug: Standard MS DMTs |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline in the Global Satisfaction Subscale of the Treatment Satisfaction Questionnaire for Medication (TSQM) at Month 6
The TSQM was developed and validated as a general measure for treatment satisfaction. It contains 14 items assessing the following 4 domains: effectiveness (sum of scores for questions 1 - 3), side effects (sum of scores for questions 4 - 8), convenience (sum of scores for questions 9 - 11) and Global Satisfaction (sum of scores for questions 12 - 14). The primary analysis was on Global Satisfaction. Question 12 scored as 1(not at all confident) to 5 (extremely confident); question 13 scored as 1(not at all certain) to 5(extremely certain); and question 14 scored as 1(extremely dissatisfied) to 7(extremely satisfied). The scores of the domain were added together and an algorithm was used to create a score of 0 to 100. Higher scores indicated greater satisfaction. A positive change from baseline indicates improvement.
Measured: Baseline, Month 6
Secondary outcomes (9)
Number of Patients Who Experienced Adverse Events, Serious Adverse Events and Death
In this analysis, patients with all (serious and non-serious) adverse events, serious adverse events and death were reported.
Measured: 9 months (6 month core + 3 month Extension)
Change From Baseline in Patient-reported Activities of Daily Living (ADL) Using the Multiple Sclerosis Activities Scale (PRIMUS-Activities) at Month 6
The PRIMUS activity measure is a 15-item assessment of patient-reported ADL. The PRIMUS-Activities total score was calculated by summing the 15 item scores after recoding the responses from 1 - 3 to 0 - 2. Totals scores range from 0 to 30 with higher scores indicating greater activity limitation. If no more than 20% of the items were missing, the total score was the product of the mean response of the non-missing items and the total number of items. If more than 20% of all items were missing, the total score was set to missing. A negative change from baseline indicates improvement.
Measured: Baseline, Month 6
Change From Baseline in Patient-reported Fatigue Using the Fatigue Severity Scale (FSS)
The Fatigue Severity Scale (FSS) is a 9-item assessment scale measuring fatigue and its effects, using a scale from 1 to 7, with higher scores indicating greater fatigue, or greater negative effects of fatigue on daily living. The FSS 9 item total score was calculated by summing the first 9 item scores and dividing by the number of non-missing items. If no more than 20% of the items were missing, the total score was the product of the mean response of the non missing items and the total number of items. If more than 20% of all items were missing, the total score was set to missing. A negative change from baseline indicates improvement.
Measured: Baseline, Month 3, Month 6
Change From Baseline in the Patient-reported Effectiveness Subscale Using the TSQM v1.4
The effectiveness scale was scored as follows: 1(extremely dissatisfied) to 7(extremely satisfied). The scores of the domain were added together and an algorithm was used to create a score of 0 to 100. Higher scores indicated greater satisfaction. A positive change from baseline indicates improvement.
Measured: Baseline, Month 6
Change From Baseline in the Patient-reported Side Effects Subscale Using the TSQM v1.4
The Side Effects subscale was scored as follows: question 4 scored as 0(no) or 1(yes); question 5 scored as 1(extremely bothersome) to 5(not at all bothersome); and questions 6 - 8 scored as 1(a great deal) to 5(not at all). The scores of the domain were added together and an algorithm was used to create a score of 0 to 100. Higher scores indicated greater satisfaction. A positive change from baseline indicates improvement.
Measured: Baseline, Month 6
Change From Baseline in the Patient-reported Convenience Subscale Using the TSQM v1.4
The convenience subscale was scored as follows: questions 9 and 10 scored as 1(extremely difficult) to 7 (extremely easy), and question 11 scored as 1(extremely inconvenient) to 7 (extremely convenient). The scores of the domain were added together and an algorithm was used to create a score of 0 to 100. Higher scores indicated greater satisfaction. A positive change from baseline indicates improvement.
Measured: Baseline, Month 6
Change From Baseline in Patient-reported Health-related Quality-of-life Using the Short Form Health Survey v2 Standard (SF-36 v2)
The SF-36v2 is a validated health-related quality of life instrument used in numerous disease states, including MS. It is a self-administered survey that measures 8 domains of health including: physical functioning, role limitations due to physical health, bodily pain, general health perceptions, vitality, social functioning, role limitations due to emotional problems and general mental health. Additionally, two summary scale scores can be calculated: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). If half or more questions within a domain were answered, then a score was calculated for that domain. Otherwise, the patient score for that domain was set to missing. If the patient was missing any 1 of the 8 scale scores, then the physical and mental component scores were set to missing. An algorithm was used to create a score from 0 to 100 for each domain score and component score. A positive change from baseline indicates improvement.
Measured: Baseline, Month 6
Change From Baseline in Patient-reported Depression Using the Beck Depression Inventory (BDI-II)
The Beck Depression Inventory (BDI-II) is a 21-question multiple-choice self-report inventory. Each item is scored from 0 to 3. The questions in the BDI-II refer to how the patient has been feeling over the past two weeks specifically. The BDI-II total score was calculated by summing the 21 item scores. Final scores ranged from 0 to 63 where higher scores indicated more severe depression. If no more than 20% of the items were missing, the total score was the product of the mean response of the non-missing items and the total number of items. If more than 20% of all items were missing, the total score was set to missing. A negative change indicates improvement.
Measured: Baseline, Month 3, Month 6
Physician-reported Clinical Global Impression of Improvement (CGI-I)
The CGI-I is a rating scale allowing a physician-reported global evaluation of the subject's improvement over time. The Investigator assessed the subject's clinical change relative to the symptoms at baseline on the CGI-I, a seven-point scale, with rating as follows: 1=Very much improved, 2=Much improved, 3=Minimally improved, 4=No change, 5=Minimally worse, 6=Much worse, 7=Very much worse. The assessments were completed at Month 3 and Month 6. A lower score indicates improvement.
Measured: Month 3, Month 6
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Oct 2010 (estimated)
- Study startAug 2010
- Primary completionAug 2012
- Study completionAug 2012
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 (4)Papers the sponsor has linked to this study.
- Other trials for Relapsing Forms of Multiple SclerosisStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- 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 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 1,053 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01216072
- Sponsor's protocol ID
- CFTY720DUS01
- Acronym
- EPOC
- Status last verified
- Jan 2014
- First submitted
- 7 Sep 2010
- Last updated
- 10 Feb 2014
- Results posted
- Yes, on ClinicalTrials.gov
Publications
Hughes B, Cascione M, Freedman MS, Agius M, Kantor D, Gudesblatt M, Goldstick LP, Agashivala N, Schofield L, McCague K, Hashmonay R, Barbato L; EPOC study investigators. First-dose effects of fingolimod after switching from injectable therapies in the randomized, open-label, multicenter, Evaluate Patient OutComes (EPOC) study in relapsing multiple sclerosis. Mult Scler Relat Disord. 2014 Sep;3(5):620-8. doi: 10.1016/j.msard.2014.06.006. Epub 2014 Jul 3.
PubMed 26265274Fox E, Edwards K, Burch G, Wynn DR, LaGanke C, Crayton H, Hunter SF, Huffman C, Kim E, Pestreich L, McCague K, Barbato L; EPOC study investigators. Outcomes of switching directly to oral fingolimod from injectable therapies: Results of the randomized, open-label, multicenter, Evaluate Patient OutComes (EPOC) study in relapsing multiple sclerosis. Mult Scler Relat Disord. 2014 Sep;3(5):607-19. doi: 10.1016/j.msard.2014.06.005. Epub 2014 Jul 4.
PubMed 26265273Calkwood J, Cree B, Crayton H, Kantor D, Steingo B, Barbato L, Hashmonay R, Agashivala N, McCague K, Tenenbaum N, Edwards K. Impact of a switch to fingolimod versus staying on glatiramer acetate or beta interferons on patient- and physician-reported outcomes in relapsing multiple sclerosis: post hoc analyses of the EPOC trial. BMC Neurol. 2014 Nov 26;14:220. doi: 10.1186/s12883-014-0220-1.
PubMed 25424122Cascione M, Wynn D, Barbato LM, Pestreich L, Schofield L, McCague K. Randomized, open-label study to evaluate patient-reported outcomes with fingolimod after changing from prior disease-modifying therapy for relapsing multiple sclerosis: EPOC study rationale and design. J Med Econ. 2013 Jul;16(7):859-65. doi: 10.3111/13696998.2013.802239. Epub 2013 May 20.
PubMed 23647445
Study at a glance
From the registry record, last updated by the sponsor on 10 Feb 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A 6-month, Randomized, Active Comparator, Open-label, Multi-Center Study to Evaluate Patient OutComes, Safety and Tolerability of Fingolimod (FTY720) 0.5 mg/Day in Patients With Relapsing Forms of Multiple Sclerosis Who Are Candidates for MS Therapy Change From Previous Disease Modifying Therapy (EPOC)
- ClinicalTrials.gov ID
- NCT01216072
- Acronym / sponsor ID
- EPOC / CFTY720DUS01
- Conditions
- Relapsing Forms of Multiple Sclerosis
- Keywords
- Relapsing Forms of Multiple Sclerosis, Disease Modifying Therapy, fingolimod, Patient Reported Outcomes
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,053 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- Aug 2010
- Primary completion
- Aug 2012 (actual)
- Study completion
- Aug 2012 (actual)
- First posted
- 7 Oct 2010 (estimated)
- Results
- Posted 5 Dec 2013
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate the change in patient-reported outcomes, physician assessment of a change as well as safety and tolerability in patients with Relapsing Forms of Multiple Sclerosis on previous Disease Modifying Therapy (DMT) who are randomized to one of two treatment arms: fingolimod vs. standard of care DMT.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Fingolimod | Experimental | Drug: FingolimodPatients randomized in this arm received Fingolimod 0.5 mg/day oral capsule for 6 months core period . |
| Multiple Sclerosis Disease Modifying Treatments (MS DMTs) | Active comparator | Drug: Standard MS DMTsPatients randomized in this arm received selected Standard MS DMT such as Interferon beta-1b or Interferon beta-1a or Glatiramer acetate for 6 months. An open-label extension of up to 3 months of treatment with fingolimod was to be available for patients in the DMT arm who successfully completed all study visits. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Relapsing forms of MS
- Expanded Disability Status Scale (EDSS) 0-5.5
- Continuous treatment with MS DMT for a minimum of 6 months
- Fingolimod naive
Key exclusion criteria (8 listed)
- Immune system diseases other than MS
- Active macular edema
- History of selected prior infections and criteria for immunizations
- History of selected immune system treatments and/or medications
- Selected cardiovascular, pulmonary, or hepatic conditions
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: GILENYA™0.5 mg/day oral capsule | Drug | Fingolimod |
| Standard MS DMTsAlso: Avonex®,, Copaxone®,, Rebif®,, Betaseron®, | Drug | Multiple Sclerosis Disease Modifying Treatments (MS DMTs) |
Primary outcome
Change From Baseline in the Global Satisfaction Subscale of the Treatment Satisfaction Questionnaire for Medication (TSQM) at Month 6
Time frame: Baseline, Month 6
The TSQM was developed and validated as a general measure for treatment satisfaction. It contains 14 items assessing the following 4 domains: effectiveness (sum of scores for questions 1 - 3), side effects (sum of scores for questions 4 - 8), convenience (sum of scores for questions 9 - 11) and Global Satisfaction (sum of scores for questions 12 - 14). The primary analysis was on Global Satisfaction. Question 12 scored as 1(not at all confident) to 5 (extremely confident); question 13 scored as 1(not at all certain) to 5(extremely certain); and question 14 scored as 1(extremely dissatisfied) to 7(extremely satisfied). The scores of the domain were added together and an algorithm was used to create a score of 0 to 100. Higher scores indicated greater satisfaction. A positive change from baseline indicates improvement.
9 secondary outcomes
Number of Patients Who Experienced Adverse Events, Serious Adverse Events and Death
Time frame: 9 months (6 month core + 3 month Extension)
Change From Baseline in Patient-reported Activities of Daily Living (ADL) Using the Multiple Sclerosis Activities Scale (PRIMUS-Activities) at Month 6
Time frame: Baseline, Month 6
Change From Baseline in Patient-reported Fatigue Using the Fatigue Severity Scale (FSS)
Time frame: Baseline, Month 3, Month 6
Change From Baseline in the Patient-reported Effectiveness Subscale Using the TSQM v1.4
Time frame: Baseline, Month 6
Change From Baseline in the Patient-reported Side Effects Subscale Using the TSQM v1.4
Time frame: Baseline, Month 6
Change From Baseline in the Patient-reported Convenience Subscale Using the TSQM v1.4
Time frame: Baseline, Month 6
Change From Baseline in Patient-reported Health-related Quality-of-life Using the Short Form Health Survey v2 Standard (SF-36 v2)
Time frame: Baseline, Month 6
Change From Baseline in Patient-reported Depression Using the Beck Depression Inventory (BDI-II)
Time frame: Baseline, Month 3, Month 6
Physician-reported Clinical Global Impression of Improvement (CGI-I)
Time frame: Month 3, Month 6
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Feb 2014.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 26265274Hughes B, Cascione M, Freedman MS, Agius M, Kantor D, Gudesblatt M, Goldstick LP, Agashivala N, Schofield L, McCague K, Hashmonay R, Barbato L; EPOC study investigators. First-dose effects of fingolimod after switching from injectable therapies in the randomized, open-label, multicenter, Evaluate Patient OutComes (EPOC) study in relapsing multiple sclerosis. Mult Scler Relat Disord. 2014 Sep;3(5):620-8. doi: 10.1016/j.msard.2014.06.006. Epub 2014 Jul 3.
- Derived from this study: PubMed 26265273Fox E, Edwards K, Burch G, Wynn DR, LaGanke C, Crayton H, Hunter SF, Huffman C, Kim E, Pestreich L, McCague K, Barbato L; EPOC study investigators. Outcomes of switching directly to oral fingolimod from injectable therapies: Results of the randomized, open-label, multicenter, Evaluate Patient OutComes (EPOC) study in relapsing multiple sclerosis. Mult Scler Relat Disord. 2014 Sep;3(5):607-19. doi: 10.1016/j.msard.2014.06.005. Epub 2014 Jul 4.
- Derived from this study: PubMed 25424122Calkwood J, Cree B, Crayton H, Kantor D, Steingo B, Barbato L, Hashmonay R, Agashivala N, McCague K, Tenenbaum N, Edwards K. Impact of a switch to fingolimod versus staying on glatiramer acetate or beta interferons on patient- and physician-reported outcomes in relapsing multiple sclerosis: post hoc analyses of the EPOC trial. BMC Neurol. 2014 Nov 26;14:220. doi: 10.1186/s12883-014-0220-1.
- Derived from this study: PubMed 23647445Cascione M, Wynn D, Barbato LM, Pestreich L, Schofield L, McCague K. Randomized, open-label study to evaluate patient-reported outcomes with fingolimod after changing from prior disease-modifying therapy for relapsing multiple sclerosis: EPOC study rationale and design. J Med Econ. 2013 Jul;16(7):859-65. doi: 10.3111/13696998.2013.802239. Epub 2013 May 20.
- Click here for more information about this study:Link 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 director
Novartis Pharmaceuticals
149 sites in 3 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Fingolimod and Standard MS DMTs in people with Relapsing Forms of Multiple Sclerosis, run by Novartis Pharmaceuticals at 149 sites in 3 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 4 inclusion and 8 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 10 Feb 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 149 sites in United States, Canada, Puerto Rico. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
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 5 Dec 2013). 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?
Change From Baseline in the Global Satisfaction Subscale of the Treatment Satisfaction Questionnaire for Medication (TSQM) at Month 6 (time frame: Baseline, Month 6). 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 NCT01216072, which also lists 4 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 10 Feb 2014.