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Fatigue in Multiple SclerosisPhase 4PACENCT01490840

Effect of Physical ACtivity in Fingolimod Treated patiEnts (PACE) With Relapsing-remitting Multiple Sclerosis

A Phase 4 study testing Physical exercise in people with Fatigue in Multiple Sclerosis, run by Novartis Pharmaceuticals at 32 sites in Germany.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This study evaluated the effect of an individualized web-based physical training in fingolimod -treated patients. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Fatigue in Multiple Sclerosis
What is being tested?
Physical exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
178 participants
Where
32 sitesGermany
Study dates
Nov 2011to Jul 2014
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

  • Subjects with relapsing remitting MS defined by 2010 revised McDonald criteria
  • Patients with Expanded Disability Status Scale (EDSS) score of 0-3.5 (including)
  • Immunomodulatory treatment with prescribed fingolimod for at least one month prior to baseline
  • Fatigue score assessed by mFIS of equal or greater than 14 at screening
  • Neurologically stable with no evidence of relapse within 30 days prior to inclusion date

Who cannot join

  • Patients who have been treated with:
  • systemic corticosteroids or immunoglobulins within 1 month prior to randomization;
  • immunosuppressive medications such as azathioprine, cyclophosphamide, or methotrexate within 3 months prior to randomization;
  • monoclonal antibodies (including natalizumab) within 3 months prior to randomization;
  • mitoxantrone within 6 months prior to randomization
  • cladribine at any time.
Show all 22Show fewer
  • Patients with any medically unstable condition, as assessed by the primary treating physician at each site.
  • Patients with any of the following cardiovascular conditions :
  • history of cardiac arrest;
  • history of myocardial infarction or with current unstable ischemic heart disease;
  • history of angina pectoris due to coronary spasm or history of Raynaud syndrome
  • Heart failure (NYHA III-IV) or any severe cardiac disease as determined by the investigator;
  • history or presence of a second-degree AV block, Type II or a third-degree AV
  • block
  • patients receiving Class Ia (ajmaline, disopyramide, procainamide, quinidine) or
  • III antiarrhythmic drugs (e.g., amiodarone, bretylium, sotalol, ibulitide, azimilide,
  • dofelitide);
  • proven history of sick sinus syndrome or sino-atrial heart block;
  • uncontrolled hypertension
  • Clinically relevant internal disease (e.g. uncorrected anemia) or orthopedic diseases (e.g. scoliosis) that might interfere with physical training
  • Any severe disability or clinical impairment that can prevent the patient to meet all study requirements at the investigator's discretion
  • Other protocol-defined inclusion/exclusion criteria may apply.

Trial locations and contacts

32 sites in 1 country.

32 sites in 1 country

Germany32 sites
  • Novartis Investigative Site

    Aachen, 52062

  • Novartis Investigative Site

    Alzenau in Unterfranken, 63755

  • Novartis Investigative Site

    Aschaffenburg, 63739

  • Novartis Investigative Site

    Bad Mergentheim, 97980

  • Novartis Investigative Site

    Bamberg, 96052

  • Novartis Investigative Site

    Bayreuth, 95445

  • Novartis Investigative Site

    Berlin, 10437

  • Novartis Investigative Site

    Berlin, 10625

  • Novartis Investigative Site

    Berlin, 10691

  • Novartis Investigative Site

    Berlin, 12587

  • Novartis Investigative Site

    Berlin, 13347

  • Novartis Investigative Site

    Bielefeld, 33647

  • Novartis Investigative Site

    Böblingen, 71032

  • Novartis Investigative Site

    Bochum, 44787

  • Novartis Investigative Site

    Dortmund, Germany, 44135

  • Novartis Investigative Site

    Erbach im Odenwald, 64711

  • Novartis Investigative Site

    Erlangen, 91054

  • Novartis Investigative Site

    Frankfurt, 65929

  • Novartis Investigative Site

    Hamburg, 22179

  • Novartis Investigative Site

    Heidelberg, 69120

  • Novartis Investigative Site

    Jena, 07740

  • Novartis Investigative Site

    Kassel, 34121

  • Novartis Investigative Site

    Leipzig, Germany, 04299

  • Novartis Investigative Site

    Potsdam, 14471

  • Novartis Investigative Site

    Prien am Chiemsee, 83209

  • Novartis Investigative Site

    Regensburg, 93053

  • Novartis Investigative Site

    Siegen, 57076

  • Novartis Investigative Site

    Sinsheim, 74889

  • Novartis Investigative Site

    Stuttgart, 70174

  • Novartis Investigative Site

    Stuttgart, 70178

  • Novartis Investigative Site

    Teupitz, 15755

  • Novartis Investigative Site

    Unterhaching, 82008

Other trials in Germany

About this study

Official title: A 6-month, Multicenter, Randomized, Controlled Parallel Group Study to Evaluate the Effect of Physical Training on Fatigue in Patients With Relapsing-remitting Multiple Sclerosis Treated With Fingolimod, Followed by a 6 Month Optional Extension Phase

This study evaluated the effect of an individualized web-based physical training in fingolimod -treated patients.

Read the detailed description

In this study, it was planned to randomize 226 participants. However, only 178 participants were randomized during a timeframe of 2 years and 8 months. Therefore, the study was terminated due to slow enrollment and low participant compliance to the physical training schedule.

Being tested
Physical exercise
Keywords
Fatigue, MS, Multiple Sclerosis, Exercise, Physical activity, Physical training, Fingolimod
Medical subject headings
Fatigue, Multiple Sclerosis, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Physical exerciseOther

    Strength training exercises are performed against own body weight or with training aids like elastic rubber bands or gym balls. All exercises are home-based. To increase balance and core stability, a subset of exercises is performed on shaky ground and/or one-legged. Exercise intensity, duration and frequency are individually assigned by a sports therapist. For each muscle group, a set of exercises of increasing difficulty allows for individual and progressive training adaption. Therapists can choose from an exercise database of approximately 150 different strength exercises with different graduation.

Study groups in NCT01490840
Study groupRoleWhat they receive
E-trainingExperimentalFingolimod as baseline immunomodulatory multiple sclerosis treatment was prescribed as per clinical practice. During phase 1, participants randomized to this arm had an introductory group session, hosted by a sports therapist. The individual training schedule was comprised of strength exercises twice a week for 30-45 minutes and endurance training once a week for 20-60 minutes for 6 months. The participants documented each training session thoroughly via the web-based application (duration, type of exercises, number of repetitions and sets, perceived exertion). A standard course of corticosteroids (methylprednisolone) on an inpatient or outpatient basis was allowed for treatment of relapses as clinically warranted. Steroid treatment consisted of 3-5 days and up to 1,000 mg methylprednisolone/day. After 6 months, Phase 2, the same Phase 1 regimen applied.
Receives: Other: Physical exercise
WaitingExperimentalFingolimod as baseline immunomodulatory multiple sclerosis treatment is prescribed as per clinical practice. During Phase 1, participants randomized to this arm did not receive e-training exercise. After a 6 months waiting period, phase 2, participants had an introductory group session, hosted by a sports therapist. The individual training schedule was comprised of strength exercises twice a week for 30-45 minutes and endurance training once a week for 20-60 minutes for 6 months. The participants documented each training session thoroughly via the web-based application (duration, type of exercises, number of repetitions and sets, perceived exertion). A standard course of corticosteroids (methylprednisolone) on an inpatient or outpatient basis was allowed for treatment of relapses as clinically warranted. Steroid treatment consisted of 3-5 days and up to 1,000 mg methylprednisolone/day.
Receives: Other: Physical exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline in Fatigue as Measured by the Modified Fatigue Impact Scale (mFIS ).

    The mFIS provides an assessment of the effects of fatigue in terms of physical, cognitive, and psychosocial functioning. It is a 21-item, structured, self-report questionnaire that generally can be completed with little or no intervention from an interviewer. The mFIS score ranged from 0 (not tired) to 84 (tired). A negative change from baseline indicates improvement.

    Measured: Baseline, 6 months

Secondary outcomes (8)
  1. Change From Baseline in Isometric and Dynamic Muscular Strength as Measured by Sit-to-stand Test

    The Sit to Stand Test is a functional outcome measure of the lower-extremity muscle power. The test was performed 3 times with one minute rest in between. The best attempt out of three was used for the analysis. A positive change from baseline indicates improvement.

    Measured: baseline, 6 months

  2. Change From Baseline in Isometric and Dynamic Muscular Strength as Measured by Change in Leg Strength and Trunk Strength

    Isometric and dynamic muscular strength was measured by an Isomed 2000 isometric measurement device (knee flexion/tension, trunk flexion/extension).

    Isomed 2000 device measures muscular flexion and tension under standardized training conditions. A positive change from baseline indicates improvement.

    Measured: baseline, 6 months

  3. Change From Baseline in Isometric and Dynamic Muscular Strength as Measured by Leg Strength Endurance

    Isometric and dynamic muscular strength was measured by an Isomed 2000 isometric measurement device (knee flexion/tension, trunk flexion/extension).

    Isomed 2000 device measures muscular flexion and tension under standardized training conditions. A positive change from baseline indicates improvement.

    Measured: baseline, 6 months

  4. Change From Baseline in Quality of Life as Measured by the Hamburg Quality of Life Questionnaire in Multiple Sclerosis (HAQUAMS)

    The Hamburg Quality of Life Questionnaire in Multiple Sclerosis (HAQUAMS) consists of 44 items, 28 of which are the basis for computation of five subscale scores reflecting major dimensions of health-related quality of life (HRQoL) in MS: Fatigue/Thinking (4 items), Mobility lower limb (5 items), Mobility upper limb (5 items), Social function (6 items) and Mood (eight items). Subscales and total score range from 1 to 5, with high scores indicating a lower quality of life. In this study, the total score and following 3 subscales: fatigue/thinking, mobility lower limb and mobility upper limb only were analyzed. A negative change from baseline indicates improvement.

    Measured: Baseline, 6 months, 12 months

  5. Change From Baseline in Fatigue as Measured by the WEIMuS (Würzburg Fatigue Inventory for MS)

    The WEIMuS (Würzburg Fatigue Inventory for MS) scale is a validated self-assessment instrument to quantify the degree of fatigue. The scale consists of 17 items with 5 categories that are scored from '0' to '4'. The subscores for cognitive and physical fatigue range from 0 to 36 and from 0 to 32, respectively, with the total sum score ranging from 0 to 68; higher scores indicate higher degrees of fatigue. A negative change from baseline indicates improvement.

    Measured: Baseline, 6 months

  6. Change From Baseline in Depression as Measured by the Beck Depression Inventory Second Edition (BDI-II)

    The Beck Depression Inventory Second Edition (BDI-II) is a 21-item self-report instrument intended to assess the existence and severity of symptoms of depression as listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fourth Edition. Each of the 21 items corresponding to a symptom of depression is summed to give a single score for the BDI-II. There is a four-point scale for each item ranging from 0 to 3. The total score ranges from 0 - 63. Total score of 0-13 is considered minimal range, 14-19 is mild, 20-28 is moderate, and 29-63 is severe. A negative change from baseline indicates improvement.

    Measured: Baseline, 6 months

  7. Change From Baseline in Aerobic Capacity (VO2max) as Measured by a Physical Endurance Spiroergometry on a Treadmill

    Physical endurance spiroergometry was accomplished. Ergometry was assessed according to national guidelines of the German society for sports medicine. Ergometry is a combined examination of circulation and lung function and was performed as a submaximal or maximal test depending on the participant's individual performance. A negative change from baseline indicates improvement.

    Measured: Baseline, 6 months

  8. Change From Baseline in Peak Expiratory Flow as Measured by a Physical Endurance Spiroergometry on a Treadmill

    Physical endurance spiroergometry was accomplished. Ergometry was assessed according to national guidelines of the German society for sports medicine. Ergometry is a combined examination of circulation and lung function and was performed as a submaximal or maximal test depending on the participant's individual performance. A positive change from baseline indicates improvement.

    Measured: Baseline, 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Dec 2011 (estimated)
  2. Study startNov 2011
  3. Primary completionJul 2014
  4. Study completionJul 2014

Why it stopped: The study stopped due to slow enrollment and low participant compliance.

Resources

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
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
178 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01490840
Sponsor's protocol ID
CFTY720DDE07
Other IDs
2011-002969-38
Acronym
PACE
Status last verified
Apr 2016
First submitted
9 Dec 2011
Last updated
12 May 2016

Publications

  • Maurer M, Schuh K, Seibert S, Baier M, Hentschke C, Streber R, Tallner A, Pfeifer K. A randomized study to evaluate the effect of exercise on fatigue in people with relapsing-remitting multiple sclerosis treated with fingolimod. Mult Scler J Exp Transl Clin. 2018 Feb 14;4(1):2055217318756688. doi: 10.1177/2055217318756688. eCollection 2018 Jan-Mar.

    PubMed 29479457

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Physical exercise in people with Fatigue in Multiple Sclerosis, run by Novartis Pharmaceuticals at 32 sites in Germany.

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 5 inclusion and 22 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: stopped early, as of the sponsor's last update on 12 May 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 32 sites in Germany. 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 12 May 2016). 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 Fatigue as Measured by the Modified Fatigue Impact Scale (mFIS ). (time frame: Baseline, 6 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 NCT01490840, which also lists 1 linked publication.

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 12 May 2016.

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