Multiple SclerosisPhase 3EXCHANGENCT03623243
Safety and Tolerability of Conversion From Oral, Injectable, or Infusion Disease Modifying Therapies to Dose-titrated Oral Siponimod (Mayzent) in Advancing RMS Patients
A Phase 3 study testing Siponimod in people with Multiple Sclerosis and Relapsing Multiple Sclerosis, run by Novartis Pharmaceuticals at 55 sites in 2 countries.
Trial summary
To assess safety and tolerability of patients converting from approved Relapsing Multiple Sclerosis (RMS) Disease Modifying Therapies (DMTs) to siponimod. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Multiple Sclerosis, Relapsing Multiple Sclerosis, Advancing Multiple Sclerosis
- What is being tested?
- Siponimod
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 185 participants
- Where
- 55 sitesin 2 countries
- Study dates
- 14 Feb 2019to 6 Jul 2022
- 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 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Signed informed consent.
- Male or female aged 18 to 65 years (inclusive).
- Patients with advancing RMS as defined by the principal investigator.
- Prior history of relapsing MS (RMS), with or without progressive features, according to the 2010 Revised McDonald or Lublin criteria (Lublin et al, 2013).
- EDSS score of >/= 2.0 to 6.5 (inclusive).
- Having been continuously treated with RMS Disease Modifying Therapies.
Who cannot join
- Pregnant or nursing (lactating) women.
- Patients with any medically unstable condition as determined by the investigator.
- Certain cardiac risk factors defined in the protocol
- History of hypersensitivity to the study drug or to drugs of similar chemical classes.
- Other protocol-defined inclusion/exclusion criteria may apply.
Trial locations and contacts
55 sites in 2 countries.
55 sites in 2 countries
United States54 sites
Abington Neurological Associates, Ltd
Abington, Pennsylvania, 19001
Novartis Investigative Site
Asheville, North Carolina, 28806
Novartis Investigative Site
Birmingham, Alabama, 35209
Novartis Investigative Site
Boca Raton, Florida, 33487
Novartis Investigative Site
Bradenton, Florida, 34205
Novartis Investigative Site
Cincinnati, Ohio, 45219
MS & Neuromuscular Center of Excellence
Clearwater, Florida, 33761
Novartis Investigative Site
Cleveland, Ohio, 44106-5028
Novartis Investigative Site
Clinton Township, Michigan, 48035
Novartis Investigative Site
Colorado Springs, Colorado, 80907
Novartis Investigative Site
Cordova, Tennessee, 38018
Novartis Investigative Site
Cullman, Alabama, 35058
Novartis Investigative Site
Denver, Colorado, 80209
Novartis Investigative Site
Falls Church, Virginia, 22043
Novartis Investigative Site
Flossmoor, Illinois, 60422
Novartis Investigative Site
Fort Collins, Colorado, 80528
Novartis Investigative Site
Fresno, California, 93710
Novartis Investigative Site
Fullerton, California, 92835
Novartis Investigative Site
Greensboro, North Carolina, 27405
Novartis Investigative Site
Greer, South Carolina, 29650
Novartis Investigative Site
Hackensack, New Jersey, 07601
Alabama Neurology Associates
Homewood, Alabama, 35209
Novartis Investigative Site
Indianapolis, Indiana, 46256
Novartis Investigative Site
Irvine, California, 92617
Novartis Investigative Site
Johnson City, Tennessee, 37604
Novartis Investigative Site
Kirkland, Washington, 98034
Novartis Investigative Site
Las Vegas, Nevada, 89128
Novartis Investigative Site
Lexington, Kentucky, 40503
Novartis Investigative Site
Lexington, Kentucky, 40509
Novartis Investigative Site
Lexington, Kentucky, 40513
Novartis Investigative Site
Maitland, Florida, 32751
Novartis Investigative Site
Miami, Florida, 33136
Novartis Investigative Site
Ocala, Florida, 34471
Novartis Investigative Site
Oklahoma City, Oklahoma, 73104
Novartis Investigative Site
Old Point Station, South Carolina, 29707
Novartis Investigative Site
Oldsmar, Florida, 34677
Novartis Investigative Site
Orlando, Florida, 32806
Novartis Investigative Site
Ormond Beach, Florida, 32174
Novartis Investigative Site
Philadelphia, Pennsylvania, 19141
Novartis Investigative Site
Raleigh, North Carolina, 27607
Novartis Investigative Site
Rockville, Maryland, 20854
Novartis Investigative Site
Round Rock, Texas, 78681
Novartis Investigative Site
San Antonio, Texas, 78258
Novartis Investigative Site
Sarasota, Florida, 34243
Novartis Investigative Site
Seattle, Washington, 98122
Novartis Investigative Site
Spokane, Washington, 99202
Novartis Investigative Site
St Louis, Missouri, 63110
Novartis Investigative Site
Sunrise, Florida, 33351
Novartis Investigative Site
Tacoma, Washington, 98405
Novartis Investigative Site
Tampa, Florida, 33612
Novartis Investigative Site
Tucson, Arizona, 85718
Novartis Investigative Site
Vero Beach, Florida, 32960
Novartis Investigative Site
Waukesha, Wisconsin, 53188
Novartis Investigative Site
Willow Grove, Pennsylvania, 19090
About this study
Official title: Exploring the Safety and Tolerability of Conversion From Oral, Injectable, or Infusion Disease Modifying Therapies to Dose-titrated Oral Siponimod (Mayzent) in Patients With Advancing Forms of Relapsing Multiple Sclerosis: A 6-month Open Label, Multi- Center Phase IIIb Study
To assess safety and tolerability of patients converting from approved Relapsing Multiple Sclerosis (RMS) Disease Modifying Therapies (DMTs) to siponimod.
Read the detailed description
This is a 6-month, open-label, multi-center, single arm design, including advancing RMS patients, evaluating the overall safety and tolerability profile of converting from oral, injectable or infusion RMS DMTs to oral siponimod.
- Being tested
- Siponimod
- Keywords
- Multiple sclerosis, Relapsing multiple sclerosis, Advancing multiple sclerosis, conversion, siponimod, adult, BAF312, disease modifying therapies, cognitive assessment, open-label
- Medical subject headings
- Multiple Sclerosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SiponimodDrug
Also called BAF312
Siponimod 2mg tablets taken once daily
| Study group | Role | What they receive |
|---|---|---|
| Siponimod | Experimental | Participants will receive titrated doses of siponimod tablets, orally, once daily of 0.25 mg on Day 2, 0.5 mg on Day 3, 0.75 mg on Day 4, 1.25 mg on Day 5, and maintenance dose of siponimod 2.0 mg tablets, orally, once daily from Day 6 up to 6 months.
As of protocol amendment 3, participants entering the trial converting from fingolimod will start directly with 2 mg dose of siponimod. Receives: Drug: Siponimod |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With at Least One Treatment-emergent Adverse Event (TEAE) Related to Study Drug During the Treatment Period
An Adverse Event (AE) is any untoward medical occurrence in a participant that does not necessarily have a causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product. TEAEs are defined as the AEs started after the first dose of siponimod to 30 days after the date of the last actual administration, or events present prior to start of treatment but which increased in severity. TEAEs suspected to be related to study drug are reported.
Measured: From first dose of study drug up to 30 days after last dose of study drug (up to 7 months)
Secondary outcomes (5)
Number of Participants With at Least One Adverse Event (AE)
AE is any untoward sign or symptom that occurs during the study treatment plus 30 days post treatment.
Measured: From first dose of study drug up to 30 days after last dose of study drug (up to 7 months)
Change From Baseline in Treatment Satisfaction Questionnaire for Medication (TSQM-9)
TSQM-9 measures participant satisfaction with the medication in 3 domains: Effectiveness, convenience, and global satisfaction. The scores were computed by adding items for each domain, i.e., 1 to 3 for effectiveness, 4 to 6 for convenience, and 7 to 9 for global satisfaction. The lowest possible score (1 for each item and 3 for all 3 subscales) was subtracted from the composite score and divided by the greatest possible score range. The greatest range was (7-1) x 3 items = 18 for effectiveness and convenience, and (5-1) x 3 items = 12 for global satisfaction. This provided a transformed score between 0 and 1 that was then multiplied by 100. TSQM-9 domain scores range from 0 to 100, with higher scores indicating greater satisfaction for that domain. A positive change from baseline indicates improvement.
Measured: Baseline up to Day 168
Change in Heart Rate From Baseline to 6 Hours After First Treatment
Heart rate was evaluated from the time of initial dose intake until 6 hours post dose intake via heart monitor.
Measured: From the first dose up to 6 hours
Number of Participants With at Least One Hospitalization During the Treatment
Measured: From first dose of study drug up to last dose of study drug (up to 6 months)
Patient Retention Reported as Number of Participants Who Completed the Study
Patient retention was assessed over the study period.
Measured: From first dose of study drug up to 30 days after last dose of study drug (up to 7 months)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Aug 2018
- Study start14 Feb 2019
- Primary completion6 Jul 2022
- Study completion6 Jul 2022
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 (1)Papers the sponsor has linked to this study.
- Other trials for 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 3
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- Open-label single arm study
- Masking
- None (open label)
- Enrolment
- 185 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
- NCT03623243
- Sponsor's protocol ID
- CBAF312AUS02
- Acronym
- EXCHANGE
- Status last verified
- Jun 2024
- First submitted
- 7 Aug 2018
- Last updated
- 20 Jun 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Publications
Fox RJ, Cohan S, Mao-Draayer Y, Weinstock-Guttman B, Cruz LA, Arnould S, Cox GM, Bar-Or A. Safety and tolerability of conversion to siponimod from other disease-modifying therapies in patients with advancing forms of relapsing MS: Results from the EXCHANGE study. Mult Scler. 2025 May;31(6):706-718. doi: 10.1177/13524585251330085. Epub 2025 Apr 18.
PubMed 40248858
Study at a glance
From the registry record, last updated by the sponsor on 20 Jun 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Exploring the Safety and Tolerability of Conversion From Oral, Injectable, or Infusion Disease Modifying Therapies to Dose-titrated Oral Siponimod (Mayzent) in Patients With Advancing Forms of Relapsing Multiple Sclerosis: A 6-month Open Label, Multi- Center Phase IIIb Study
- ClinicalTrials.gov ID
- NCT03623243
- Acronym / sponsor ID
- EXCHANGE / CBAF312AUS02
- Keywords
- Multiple sclerosis, Relapsing multiple sclerosis, Advancing multiple sclerosis, conversion, siponimod, adult, BAF312, disease modifying therapies
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 185 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- 14 Feb 2019 (actual)
- Primary completion
- 6 Jul 2022 (actual)
- Study completion
- 6 Jul 2022 (actual)
- First posted
- 9 Aug 2018 (actual)
- Results
- Posted 20 Jul 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To assess safety and tolerability of patients converting from approved Relapsing Multiple Sclerosis (RMS) Disease Modifying Therapies (DMTs) to siponimod.
Detailed description
This is a 6-month, open-label, multi-center, single arm design, including advancing RMS patients, evaluating the overall safety and tolerability profile of converting from oral, injectable or infusion RMS DMTs to oral siponimod.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- Open-label single arm study
| Arm | Type | Receives |
|---|---|---|
| Siponimod | Experimental | Drug: SiponimodParticipants will receive titrated doses of siponimod tablets, orally, once daily of 0.25 mg on Day 2, 0.5 mg on Day 3, 0.75 mg on Day 4, 1.25 mg on Day 5, and maintenance dose of siponimod 2.0 mg tablets, orally, once daily from Day 6 up to 6 months. As of protocol amendment 3, participants entering the trial converting from fingolimod will start directly with 2 mg dose of siponimod. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Signed informed consent.
- Male or female aged 18 to 65 years (inclusive).
- Patients with advancing RMS as defined by the principal investigator.
- Prior history of relapsing MS (RMS), with or without progressive features, according to the 2010 Revised McDonald or Lublin criteria (Lublin et al, 2013).
- EDSS score of >/= 2.0 to 6.5 (inclusive).
Key exclusion criteria (5 listed)
- Pregnant or nursing (lactating) women.
- Patients with any medically unstable condition as determined by the investigator.
- Certain cardiac risk factors defined in the protocol
- History of hypersensitivity to the study drug or to drugs of similar chemical classes.
- 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 |
|---|---|---|
| SiponimodAlso: BAF312Siponimod 2mg tablets taken once daily | Drug | Siponimod |
Primary outcome
Number of Participants With at Least One Treatment-emergent Adverse Event (TEAE) Related to Study Drug During the Treatment Period
Time frame: From first dose of study drug up to 30 days after last dose of study drug (up to 7 months)
An Adverse Event (AE) is any untoward medical occurrence in a participant that does not necessarily have a causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product. TEAEs are defined as the AEs started after the first dose of siponimod to 30 days after the date of the last actual administration, or events present prior to start of treatment but which increased in severity. TEAEs suspected to be related to study drug are reported.
5 secondary outcomes
Number of Participants With at Least One Adverse Event (AE)
Time frame: From first dose of study drug up to 30 days after last dose of study drug (up to 7 months)
Change From Baseline in Treatment Satisfaction Questionnaire for Medication (TSQM-9)
Time frame: Baseline up to Day 168
Change in Heart Rate From Baseline to 6 Hours After First Treatment
Time frame: From the first dose up to 6 hours
Number of Participants With at Least One Hospitalization During the Treatment
Time frame: From first dose of study drug up to last dose of study drug (up to 6 months)
Patient Retention Reported as Number of Participants Who Completed the Study
Time frame: From first dose of study drug up to 30 days after last dose of study drug (up to 7 months)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Jun 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 40248858Fox RJ, Cohan S, Mao-Draayer Y, Weinstock-Guttman B, Cruz LA, Arnould S, Cox GM, Bar-Or A. Safety and tolerability of conversion to siponimod from other disease-modifying therapies in patients with advancing forms of relapsing MS: Results from the EXCHANGE study. Mult Scler. 2025 May;31(6):706-718. doi: 10.1177/13524585251330085. Epub 2025 Apr 18.
- Patient Lay Trial SummaryLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
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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
55 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Siponimod in people with Multiple Sclerosis and Relapsing Multiple Sclerosis, run by Novartis Pharmaceuticals at 55 sites in 2 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 6 inclusion and 5 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 20 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 55 sites in United States, 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 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 20 Jul 2023). 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?
Number of Participants With at Least One Treatment-emergent Adverse Event (TEAE) Related to Study Drug During the Treatment Period (time frame: From first dose of study drug up to 30 days after last dose of study drug (up to 7 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 NCT03623243, 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 20 Jun 2024.