Trial Outcomes & Findings for Cognition and HRQoL in Adults With Highly-active RMS in Year 3 and 4 After Initial Mavenclad® Dose (CLARIFY MS Extension) (NCT NCT04776213)

NCT ID: NCT04776213

Last Updated: 2024-05-28

Results Overview

The SDMT is a test of information processing speed. It consists of 9 abstract symbols. Each symbol is paired with a single digit. The participant is provided with a "key", showing each symbol digit pair. In addition, the participants are shown several rows of the 9 symbols, which are arranged pseudo-randomly, without the digit. Participants are asked to voice the digit associated with each symbol as rapidly as possible for 90 seconds. The SDMT score ranges from 0 to 110 where higher scores indicated improvement and lower scores indicated worsening.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

280 participants

Primary outcome timeframe

Baseline (Baseline of parent study [NCT03369665]) and Month 48 after initial dose of Mavenclad® in parent study (NCT03369665)

Results posted on

2024-05-28

Participant Flow

A total of 280 participants were enrolled in the study from different study sites.

Participant milestones

Participant milestones
Measure
Mavenclad®
This low interventional extension study involves the follow up of participants in the parent study (NCT03369665). The participants were followed up for an additional 2 year period (until 4 years after initial administration of Mavenclad® tablets), during which the participants are not treated with Mavenclad®, as per European Medicines Agency (EMA) label of Mavenclad®.
Overall Study
STARTED
280
Overall Study
COMPLETED
269
Overall Study
NOT COMPLETED
11

Reasons for withdrawal

Reasons for withdrawal
Measure
Mavenclad®
This low interventional extension study involves the follow up of participants in the parent study (NCT03369665). The participants were followed up for an additional 2 year period (until 4 years after initial administration of Mavenclad® tablets), during which the participants are not treated with Mavenclad®, as per European Medicines Agency (EMA) label of Mavenclad®.
Overall Study
Other
1
Overall Study
Withdrawal by Subject
7
Overall Study
Protocol Violation
1
Overall Study
Lost to Follow-up
2

Baseline Characteristics

Cognition and HRQoL in Adults With Highly-active RMS in Year 3 and 4 After Initial Mavenclad® Dose (CLARIFY MS Extension)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Mavenclad®
n=280 Participants
This low interventional extension study involves the follow up of participants in the parent study (NCT03369665). The participants were followed up for an additional 2 year period (until 4 years after initial administration of Mavenclad® tablets), during which the participants are not treated with Mavenclad®, as per European Medicines Agency (EMA) label of Mavenclad®.
Age, Continuous
41.4 years
STANDARD_DEVIATION 10.44 • n=5 Participants
Sex: Female, Male
Female
201 Participants
n=5 Participants
Sex: Female, Male
Male
79 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
18 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
202 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
60 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
248 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
31 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline (Baseline of parent study [NCT03369665]) and Month 48 after initial dose of Mavenclad® in parent study (NCT03369665)

Population: Full analysis set (FAS) included all eligible participants, for whom any Visit data had been collected after end date of CLARIFY MS (NCT03369665) Year 2 Visit (Month 24 Visit).

The SDMT is a test of information processing speed. It consists of 9 abstract symbols. Each symbol is paired with a single digit. The participant is provided with a "key", showing each symbol digit pair. In addition, the participants are shown several rows of the 9 symbols, which are arranged pseudo-randomly, without the digit. Participants are asked to voice the digit associated with each symbol as rapidly as possible for 90 seconds. The SDMT score ranges from 0 to 110 where higher scores indicated improvement and lower scores indicated worsening.

Outcome measures

Outcome measures
Measure
Mavenclad®
n=280 Participants
This low interventional extension study involves the follow up of participants in the parent study (NCT03369665). The participants were followed up for an additional 2 year period (until 4 years after initial administration of Mavenclad® tablets), during which the participants are not treated with Mavenclad®, as per European Medicines Agency (EMA) label of Mavenclad®.
Percentage of Participants With No or Minimal Decline in Cognitive Function, Defined As an Improved or Stable Symbol Digit Modalities Test (SDMT) Score or a Decline of 4 Points or Less in the SDMT Score, From Baseline of Parent Study to Month 48
68.6 percentage of participants
Interval 62.9 to 73.7

SECONDARY outcome

Timeframe: Baseline (baseline of parent study [NCT03369665]), 4 years after initial dose of Mavenclad® in parent study (NCT03369665)

Population: Full analysis set (FAS) included all eligible participants, for whom any Visit data had been collected after end date of CLARIFY MS (NCT03369665) Year 2 Visit (Month 24 Visit). Here, overall number of participants analyzed signifies those who were evaluable for this outcome measure.

The MSQOL-54 was a multidimensional health-related QOL measure that combines both generic and MS-specific items into a single instrument. This 54-item instrument generates 12 sub-scales along with two summary scores, and two additional single-item measures. Sub-scales are: physical function, role limitations-physical, role limitations-emotional, pain, emotional well-being, energy, health perceptions, social function, cognitive function, health distress, overall quality of life, and sexual function. The two summary scores physical health and mental health are derived from a weighted combination of scale scores. Each composite summary score has a range from 0-100 where higher scores indicate better QOL. A positive change from baseline indicates improvement.

Outcome measures

Outcome measures
Measure
Mavenclad®
n=265 Participants
This low interventional extension study involves the follow up of participants in the parent study (NCT03369665). The participants were followed up for an additional 2 year period (until 4 years after initial administration of Mavenclad® tablets), during which the participants are not treated with Mavenclad®, as per European Medicines Agency (EMA) label of Mavenclad®.
Change From Baseline in Health Related Quality of Life (HRQoL) as Measured by Multiple Sclerosis Quality of Life 54 Questionnaire (MSQoL-54) Physical and Mental Health Composite Summary Scores at 4 Years
Physical health composite score
3.69 score on a scale
Interval 1.71 to 5.67
Change From Baseline in Health Related Quality of Life (HRQoL) as Measured by Multiple Sclerosis Quality of Life 54 Questionnaire (MSQoL-54) Physical and Mental Health Composite Summary Scores at 4 Years
Mental health composite score
5.13 score on a scale
Interval 2.73 to 7.53

SECONDARY outcome

Timeframe: Month 24 after initial dose of Mavenclad® in parent study (NCT03369665), 4 years after initial dose of Mavenclad® in parent study (NCT03369665)

Population: Full analysis set (FAS) included all eligible participants, for whom any Visit data had been collected after end date of CLARIFY MS (NCT03369665) Year 2 Visit (Month 24 Visit). Here, overall number of participants analyzed signifies those who were evaluable for this outcome measure.

The MSQOL-54 was a multidimensional health-related QOL measure that combines both generic and MS-specific items into a single instrument. This 54-item instrument generates 12 sub-scales along with two summary scores, and two additional single-item measures. Sub-scales are: physical function, role limitations-physical, role limitations-emotional, pain, emotional well-being, energy, health perceptions, social function, cognitive function, health distress, overall quality of life, and sexual function. The two summary scores physical health and mental health are derived from a weighted combination of scale scores. Each composite summary score has a range from 0-100 where higher scores indicate better QOL. A positive change from baseline indicates improvement.

Outcome measures

Outcome measures
Measure
Mavenclad®
n=232 Participants
This low interventional extension study involves the follow up of participants in the parent study (NCT03369665). The participants were followed up for an additional 2 year period (until 4 years after initial administration of Mavenclad® tablets), during which the participants are not treated with Mavenclad®, as per European Medicines Agency (EMA) label of Mavenclad®.
Change From Month 24 in Health Related Quality of Life (HRQoL) as Measured by Multiple Sclerosis Quality of Life 54 Questionnaire (MSQoL-54) Physical and Mental Health Composite Summary Scores at 4 Years
Physical health composite score
-2.02 score on a scale
Interval -3.81 to -0.22
Change From Month 24 in Health Related Quality of Life (HRQoL) as Measured by Multiple Sclerosis Quality of Life 54 Questionnaire (MSQoL-54) Physical and Mental Health Composite Summary Scores at 4 Years
Mental health composite score
-0.36 score on a scale
Interval -2.65 to 1.92

Adverse Events

Mavenclad®

Serious events: 15 serious events
Other events: 110 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Mavenclad®
n=280 participants at risk
This low interventional extension study involves the follow up of participants in the parent study (NCT03369665). The participants were followed up for an additional 2 year period (until 4 years after initial administration of Mavenclad® tablets), during which the participants are not treated with Mavenclad®, as per European Medicines Agency (EMA) label of Mavenclad®.
Gastrointestinal disorders
Diverticulum intestinal
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Infections and infestations
Appendicitis
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Infections and infestations
Bartholin's abscess
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Infections and infestations
COVID-19
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Injury, poisoning and procedural complications
Epicondylitis
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Injury, poisoning and procedural complications
Rib fracture
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Injury, poisoning and procedural complications
Thoracic vertebral fracture
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Musculoskeletal and connective tissue disorders
Intervertebral disc protrusion
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Musculoskeletal and connective tissue disorders
Neck pain
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Musculoskeletal and connective tissue disorders
Pain in extremity
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Basal cell carcinoma
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Chronic myeloid leukaemia
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Papillary thyroid cancer
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Parathyroid tumour benign
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Nervous system disorders
Loss of consciousness
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Nervous system disorders
Paraesthesia
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Psychiatric disorders
Depression
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Renal and urinary disorders
Stress urinary incontinence
0.36%
1/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).

Other adverse events

Other adverse events
Measure
Mavenclad®
n=280 participants at risk
This low interventional extension study involves the follow up of participants in the parent study (NCT03369665). The participants were followed up for an additional 2 year period (until 4 years after initial administration of Mavenclad® tablets), during which the participants are not treated with Mavenclad®, as per European Medicines Agency (EMA) label of Mavenclad®.
Infections and infestations
COVID-19
30.0%
84/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Nervous system disorders
Headache
7.5%
21/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Infections and infestations
Nasopharyngitis
5.7%
16/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).
Infections and infestations
Urinary tract infection
5.7%
16/280 • Up to 4 years after initial dose of Mavenclad® in parent study (NCT03369665).

Additional Information

Communication Center

Merck Healthcare KGaA, Darmstadt Germany, an affiliate of Merck KGaA, Darmstadt, Germany

Phone: +49-6151-72-5200

Results disclosure agreements

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