Trial Outcomes & Findings for Atorvastatin (Lipitor) Therapy in Patients With Clinically Isolated Syndrome (CIS) at Risk for Multiple Sclerosis (NCT NCT00094172)

NCT ID: NCT00094172

Last Updated: 2017-04-28

Results Overview

The occurrence of ≥ T2 lesions\[1\] with or without gadolinium lesion (Gd+) enhancement\[2\] or clinical exacerbation\[3\] through 12 months. A higher score indicates more severe disease 1. A new T2 lesion is an abnormal, hyperintense white-matter area visible on T2 weighted images that were not present on the baseline scan 2. A Gd+ enhancement is defined as a contrast enhancement visible on a new T2 lesion 3. A clinical exacerbation is a new neurological symptom that lasts more than 48 hours in a participant who has been neurologically stable for 30 days following start of study medication

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

82 participants

Primary outcome timeframe

12 months post-randomization

Results posted on

2017-04-28

Participant Flow

Fourteen centers enrolled 83 participants and randomized 82 participants(one participant voluntarily withdrew prior to randomization) who had experienced clinically isolated syndrome and were at risk for developing Multiple Sclerosis (MS) (two or more lesions on Magnetic Resonance Image (MRI) scans) between February 14, 2005 and July 24, 2007.

At a screening visit, participants underwent procedures to establish that all inclusion criteria were met and none of the exclusion criteria were met. Participants then signed an informed consent form.

Participant milestones

Participant milestones
Measure
Atorvastatin
Drug: Atorvastatin
Placebo
Non-Active Comparator
Overall Study
STARTED
50
32
Overall Study
COMPLETED
36
25
Overall Study
NOT COMPLETED
14
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Atorvastatin
Drug: Atorvastatin
Placebo
Non-Active Comparator
Overall Study
Adverse Event
0
1
Overall Study
Lost to Follow-up
2
0
Overall Study
Protocol Violation
0
1
Overall Study
Withdrawal by Subject
10
5
Overall Study
Primary endpoint met.
1
0
Overall Study
Started other MS therapy due to disease
1
0

Baseline Characteristics

Atorvastatin (Lipitor) Therapy in Patients With Clinically Isolated Syndrome (CIS) at Risk for Multiple Sclerosis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Atorvastatin
n=50 Participants
Drug: Atorvastatin
Placebo
n=32 Participants
Non-Active Comparator
Total
n=82 Participants
Total of all reporting groups
Age, Continuous
33.6 years
STANDARD_DEVIATION 9.4 • n=5 Participants
33.9 years
STANDARD_DEVIATION 8.6 • n=7 Participants
33.7 years
STANDARD_DEVIATION 9.0 • n=5 Participants
Sex: Female, Male
Female
40 Participants
n=5 Participants
23 Participants
n=7 Participants
63 Participants
n=5 Participants
Sex: Female, Male
Male
10 Participants
n=5 Participants
9 Participants
n=7 Participants
19 Participants
n=5 Participants
Region of Enrollment
United States
46 participants
n=5 Participants
29 participants
n=7 Participants
75 participants
n=5 Participants
Region of Enrollment
Canada
4 participants
n=5 Participants
3 participants
n=7 Participants
7 participants
n=5 Participants
Number of T2 Lesions at Baseline
21.6 Lesion Count
STANDARD_DEVIATION 17.6 • n=5 Participants
19.5 Lesion Count
STANDARD_DEVIATION 16.5 • n=7 Participants
20.8 Lesion Count
STANDARD_DEVIATION 17.1 • n=5 Participants
Number of Gd+ Lesions at Baseline
0.7 Lesion Count
STANDARD_DEVIATION 2.7 • n=5 Participants
0.2 Lesion Count
STANDARD_DEVIATION 0.5 • n=7 Participants
0.5 Lesion Count
STANDARD_DEVIATION 2.1 • n=5 Participants

PRIMARY outcome

Timeframe: 12 months post-randomization

Population: Intent-to-Treat

The occurrence of ≥ T2 lesions\[1\] with or without gadolinium lesion (Gd+) enhancement\[2\] or clinical exacerbation\[3\] through 12 months. A higher score indicates more severe disease 1. A new T2 lesion is an abnormal, hyperintense white-matter area visible on T2 weighted images that were not present on the baseline scan 2. A Gd+ enhancement is defined as a contrast enhancement visible on a new T2 lesion 3. A clinical exacerbation is a new neurological symptom that lasts more than 48 hours in a participant who has been neurologically stable for 30 days following start of study medication

Outcome measures

Outcome measures
Measure
Atorvastatin
n=49 Participants
Drug: Atorvastatin
Placebo
n=32 Participants
Non-Active Comparator
The Occurrence of ≥ 3 New T2 Lesions With or Without Gd+ Enhancement or Clinical Exacerbation Through 12 Months.
26 Participants
18 Participants

SECONDARY outcome

Timeframe: 12 months post-randomization

Population: Intent-to-Treat

Number of participants diagnosed with Multiple Sclerosis (MS) according to the McDonald criteria\[1\] 1. The McDonald criteria uses dissemination in time and space\[2\] established by Magnetic Resonance Image (MRI) findings to provide a clinical diagnosis for MS 2. Dissemination in time is established by a new T2 or gadolinium-enhancing (Gd+) lesion found on a repeat MRI. The presence of any 3 of the following establishes dissemination in space: 1 Gd+ lesion or 9 T2 bright lesions if there is no enhancement; ≥1 infratentorial lesion; ≥1 juxtacortical lesion; ≥3 periventricular lesions

Outcome measures

Outcome measures
Measure
Atorvastatin
n=49 Participants
Drug: Atorvastatin
Placebo
n=32 Participants
Non-Active Comparator
Proportion of Participants Who Are Diagnosed With Multiple Sclerosis According to the McDonald Criteria
29 Participants
24 Participants

SECONDARY outcome

Timeframe: 18 months post-randomization

Population: Intent-to-Treat

Number of participants diagnosed with Multiple Sclerosis (MS) according to the McDonald criteria\[1\] 1. The McDonald criteria uses dissemination in time and space\[2\] established by Magnetic Resonance Image (MRI) findings to provide a clinical diagnosis for MS 2. Dissemination in time is established by a new T2 or gadolinium-enhancing (Gd+) lesion found on a repeat MRI. The presence of any 3 of the following establishes dissemination in space: 1 Gd+ lesion or 9 T2 bright lesions if there is no enhancement; ≥1 infratentorial lesion; ≥1 juxtacortical lesion; ≥3 periventricular lesions

Outcome measures

Outcome measures
Measure
Atorvastatin
n=49 Participants
Drug: Atorvastatin
Placebo
n=32 Participants
Non-Active Comparator
Proportion of Participants Diagnosed With Multiple Sclerosis According to the McDonald Criteria
37 Participants
24 Participants

Adverse Events

Atorvastatin

Serious events: 3 serious events
Other events: 48 other events
Deaths: 0 deaths

Placebo

Serious events: 1 serious events
Other events: 32 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Atorvastatin
n=51 participants at risk
Drug: Atorvastatin
Placebo
n=32 participants at risk
Non-Active Comparator
Investigations
Alanine aminotransferase increased
2.0%
1/51 • Number of events 1 • 18 months
0.00%
0/32 • 18 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Uterine leiomyoma
2.0%
1/51 • Number of events 1 • 18 months
0.00%
0/32 • 18 months
Nervous system disorders
Convulsion
0.00%
0/51 • 18 months
3.1%
1/32 • Number of events 1 • 18 months
Reproductive system and breast disorders
Menorrhagia
2.0%
1/51 • Number of events 1 • 18 months
0.00%
0/32 • 18 months

Other adverse events

Other adverse events
Measure
Atorvastatin
n=51 participants at risk
Drug: Atorvastatin
Placebo
n=32 participants at risk
Non-Active Comparator
Investigations
C-reactive protein increased
5.9%
3/51 • Number of events 3 • 18 months
6.2%
2/32 • Number of events 2 • 18 months
Investigations
Low density lipoprotein decreased
25.5%
13/51 • Number of events 18 • 18 months
3.1%
1/32 • Number of events 1 • 18 months
Investigations
Low density lipoprotein increased
5.9%
3/51 • Number of events 3 • 18 months
9.4%
3/32 • Number of events 3 • 18 months
Musculoskeletal and connective tissue disorders
Arthralgia
19.6%
10/51 • Number of events 12 • 18 months
12.5%
4/32 • Number of events 5 • 18 months
Musculoskeletal and connective tissue disorders
Back pain
15.7%
8/51 • Number of events 10 • 18 months
15.6%
5/32 • Number of events 9 • 18 months
Musculoskeletal and connective tissue disorders
Musculoskeletal stiffness
7.8%
4/51 • Number of events 5 • 18 months
9.4%
3/32 • Number of events 3 • 18 months
Musculoskeletal and connective tissue disorders
Myalgia
9.8%
5/51 • Number of events 9 • 18 months
12.5%
4/32 • Number of events 4 • 18 months
Musculoskeletal and connective tissue disorders
Neck pain
11.8%
6/51 • Number of events 6 • 18 months
6.2%
2/32 • Number of events 2 • 18 months
Musculoskeletal and connective tissue disorders
Pain in extremity
15.7%
8/51 • Number of events 11 • 18 months
12.5%
4/32 • Number of events 6 • 18 months
Blood and lymphatic system disorders
Lymphadenopathy
7.8%
4/51 • Number of events 4 • 18 months
3.1%
1/32 • Number of events 2 • 18 months
Eye disorders
Eye pain
3.9%
2/51 • Number of events 6 • 18 months
12.5%
4/32 • Number of events 5 • 18 months
Eye disorders
Vision blurred
11.8%
6/51 • Number of events 9 • 18 months
15.6%
5/32 • Number of events 9 • 18 months
Gastrointestinal disorders
Nausea
27.5%
14/51 • Number of events 14 • 18 months
9.4%
3/32 • Number of events 4 • 18 months
Gastrointestinal disorders
Vomiting
5.9%
3/51 • Number of events 4 • 18 months
9.4%
3/32 • Number of events 3 • 18 months
General disorders
Asthenia
17.6%
9/51 • Number of events 10 • 18 months
15.6%
5/32 • Number of events 6 • 18 months
General disorders
Disease progression
45.1%
23/51 • Number of events 27 • 18 months
59.4%
19/32 • Number of events 22 • 18 months
General disorders
Fatigue
27.5%
14/51 • Number of events 16 • 18 months
25.0%
8/32 • Number of events 9 • 18 months
General disorders
Influenza like illness
13.7%
7/51 • Number of events 9 • 18 months
28.1%
9/32 • Number of events 14 • 18 months
Infections and infestations
Bronchitis
3.9%
2/51 • Number of events 2 • 18 months
9.4%
3/32 • Number of events 4 • 18 months
Infections and infestations
Nasopharyngitis
7.8%
4/51 • Number of events 5 • 18 months
12.5%
4/32 • Number of events 5 • 18 months
Infections and infestations
Sinusitis
7.8%
4/51 • Number of events 5 • 18 months
9.4%
3/32 • Number of events 3 • 18 months
Infections and infestations
Upper respiratory tract infection
15.7%
8/51 • Number of events 16 • 18 months
25.0%
8/32 • Number of events 11 • 18 months
Infections and infestations
Urinary tract infection
3.9%
2/51 • Number of events 3 • 18 months
12.5%
4/32 • Number of events 7 • 18 months
Investigations
Alanine aminotransferase increased
17.6%
9/51 • Number of events 18 • 18 months
3.1%
1/32 • Number of events 1 • 18 months
Investigations
Aspartate aminotransferase increased
15.7%
8/51 • Number of events 14 • 18 months
3.1%
1/32 • Number of events 1 • 18 months
Investigations
Blood creatine phosphokinase increased
7.8%
4/51 • Number of events 4 • 18 months
6.2%
2/32 • Number of events 3 • 18 months
Nervous system disorders
Dizziness
13.7%
7/51 • Number of events 8 • 18 months
15.6%
5/32 • Number of events 6 • 18 months
Nervous system disorders
Headache
23.5%
12/51 • Number of events 17 • 18 months
21.9%
7/32 • Number of events 10 • 18 months
Nervous system disorders
Hypoaesthesia
39.2%
20/51 • Number of events 41 • 18 months
50.0%
16/32 • Number of events 26 • 18 months
Nervous system disorders
Migraine
9.8%
5/51 • Number of events 5 • 18 months
3.1%
1/32 • Number of events 1 • 18 months
Nervous system disorders
Multiple sclerosis
5.9%
3/51 • Number of events 4 • 18 months
9.4%
3/32 • Number of events 3 • 18 months
Nervous system disorders
Paraesthesia
25.5%
13/51 • Number of events 15 • 18 months
25.0%
8/32 • Number of events 14 • 18 months
Psychiatric disorders
Anxiety
9.8%
5/51 • Number of events 6 • 18 months
3.1%
1/32 • Number of events 1 • 18 months
Psychiatric disorders
Depression
15.7%
8/51 • Number of events 8 • 18 months
31.2%
10/32 • Number of events 10 • 18 months
Psychiatric disorders
Insomnia
21.6%
11/51 • Number of events 11 • 18 months
18.8%
6/32 • Number of events 6 • 18 months
Respiratory, thoracic and mediastinal disorders
Cough
2.0%
1/51 • Number of events 1 • 18 months
15.6%
5/32 • Number of events 6 • 18 months
Respiratory, thoracic and mediastinal disorders
Pharyngolaryngeal pain
9.8%
5/51 • Number of events 5 • 18 months
6.2%
2/32 • Number of events 3 • 18 months
Skin and subcutaneous tissue disorders
Rash
7.8%
4/51 • Number of events 4 • 18 months
9.4%
3/32 • Number of events 4 • 18 months

Additional Information

Director, Clinical Research Program

DAIT/NIAID

Phone: 301-594-7669

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place