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Trial registered on ANZCTR
Registration number
ACTRN12608000226303
Ethics application status
Approved
Date submitted
29/02/2008
Date registered
1/05/2008
Date last updated
7/04/2024
Date data sharing statement initially provided
7/04/2024
Date results provided
7/04/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
A double-blind, placebo controlled, randomised trial to prove the therapeutic concept and to determine the pharmacokinetic profile of ATL1102 (VLA-4 antisense oligonucleotide) by subcutaneous injections in patients with relapsing remitting multiple sclerosis.
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Scientific title
A double-blind, placebo controlled, randomised trial to prove the therapeutic concept and to determine the pharmacokinetic profile of ATL1102 (VLA-4 antisense oligonucleotide) by subcutaneous injections in patients with multiple sclerosis.
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Secondary ID [1]
311902
0
Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Multiple Sclerosis
2760
0
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Condition category
Condition code
Neurological
2890
2890
0
0
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Multiple sclerosis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients receive 200 mg ATL1102 (VLA-4 antisense oligonucleotide) by subcutaneous injection three times in the first week, then twice weekly for the next seven weeks. The patients are monitored for a further eight weeks following completion of dosing.
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Intervention code [1]
2500
0
Treatment: Drugs
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Comparator / control treatment
1.3 ml placebo comprising sodium chloride and colorant by subcutaneous injection three times in the first week, then twice weekly for the next seven weeks. The patients are monitored for a further eight weeks following completion of dosing.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Cumulative number of new active lesions on Magnetic Resonance Imaging (MRI), corrected for the number of enhancing lesions at baseline.
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Assessment method [1]
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Timepoint [1]
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At 4, 8 and 12 weeks after intervention commencement.
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Secondary outcome [1]
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Cumulative volume of gadolinium-enhancing lesions on MRI, corrected for the volume of enhancing lesions at baseline.
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Assessment method [1]
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Timepoint [1]
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At 4, 8 and 12 weeks after intervention commencement.
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Eligibility
Key inclusion criteria
Males and females aged 18 to 55 years
Diagnosis of Relapsing Remitting Multiple Sclerosis (RRMS)
At least 9 T2 lesions or at least 4 if one is gadolinium-enhancing
Last relapse in the previous 12 months
No relapse in the previous four weeks
Score of EDSS 0 to 6.0
Reliable contraception (e.g. surgical sterilisation, oral contraceptives)
Written informed consent to participate in the study by signature on the Patients Consent Form
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Minimum age
18
Years
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Maximum age
55
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Administration of any investigational drug within the previous 2 months before enrolment (4 months if the previous drug was a new chemical entity).
Progressive disease.
Concomitant clinically relevant other findings on MRI that may interfere with outcome assessment.
Previous treatment with VLA-4 antibodies, anti-CD4 antibodies, or other monoclonal antibodies.
Total lymphoid irradiation at any time.
Treatment with immune-modulating drugs in the previous two months or treatment with immune-suppressive drugs in the previous six months.
HIV positive patients.
Detectable levels of JC Virus in the blood measured by quantitative PCR.
Patients with renal impairment with serum creatinine greater than or equal to 2,0 mg/dl.
History of clinically relevant gastrointestinal, hepatic, renal, endocrine, haematological, metabolic, neurologic (other than multiple sclerosis (MS)) and psychiatric disease.
Patients with infections (lymphocytes greater than 3000/microL).
History of any bleeding.
History of coagulation abnormalities.
Concomitant medication acetyl salicylic acid (greater than 300 mg/day) and phenprocoumon.
Clinically relevant abnormalities in physical findings at screening examination if interfering with the study objective.
Pregnant or breast-feeding women.
History of drug or alcohol abuse.
Epileptics.
Suicidal subjects.
History of drug allergy and/or known drug hypersensitivity.
Inability to communicate or cooperate with the Investigator due to language problem, poor mental development or impaired cerebral function.
Any medical condition which, in the judgement of the Investigator, might interfere with the objectives of the study.
Repeated participation in this study.
Contraindication for application of study drug.
Corticoid-treatment in the previous six weeks and during the study period, exceptions are corticoid-treatment before the study period (not in the previous six weeks) and of relapses during the study period: Relapses are characterised by the occurrence of neurological dysfunction symptoms, appearing after a 30-day period of stability or improvement and lasting for more than 24 hours (no infection, no fever).
A 5-day methylprednisolone treatment 1000 mg intravenous (i.v) is allowed in this case followed by a reducing procedure.
Corticoid-treatment if applied locally (e.g. inhaled products) is allowed.
Additionally MRI exclusion criteria: Metal residing in the body (e.g. implants), Cardiac pacemaker, valves, cochlear implants, CNS vascular clips.
Contrast medium allergy Gadolinium Diethylenetriamine Penta-Acetic Acid (Gd-DTPA).
No MRI exclusion criteria but caution is advised in case of: Cardiovascular disease including coronary heart disease, Immune deficiency, Haematologic disorder.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
19/02/2005
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Actual
19/02/2005
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Date of last participant enrolment
Anticipated
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Actual
17/04/2008
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Date of last data collection
Anticipated
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Actual
17/04/2008
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Sample size
Target
80
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Accrual to date
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Final
77
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Recruitment outside Australia
Country [1]
754
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Slovakia
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State/province [1]
754
0
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Country [2]
755
0
Poland
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State/province [2]
755
0
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Country [3]
756
0
Czech Republic
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State/province [3]
756
0
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Country [4]
757
0
Romania
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State/province [4]
757
0
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Country [5]
758
0
Bulgaria
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State/province [5]
758
0
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Country [6]
759
0
Germany
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State/province [6]
759
0
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Funding & Sponsors
Funding source category [1]
3143
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Commercial sector/Industry
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Name [1]
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Antisense Therapeutics Limited
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Address [1]
3143
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10 Wallace Avenue, Level 1
Toorak
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Country [1]
3143
0
Australia
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Primary sponsor type
Commercial sector/Industry
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Name
Antisense Therapeutics Limited
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Address
10 Wallace Avenue, Level 1
Toorak
Vic 3142
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Country
Australia
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Secondary sponsor category [1]
2718
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None
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Name [1]
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0
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Address [1]
2718
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Country [1]
2718
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
5044
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Ethics Committee of the Faculty of Medicine, University of Duisburg-Essen, University Clinic Essen
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Ethics committee address [1]
5044
0
Robert-Koch-Str. 9-11 45147 Essen
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Ethics committee country [1]
5044
0
Germany
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Date submitted for ethics approval [1]
5044
0
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Approval date [1]
5044
0
05/08/2004
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Ethics approval number [1]
5044
0
Idnr: 04-2508
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Ethics committee name [2]
5045
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Ethics Committee of the State Chamber of Physicians of the Federal State of Hessen
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Ethics committee address [2]
5045
0
Im Vogelsang 3 60488 Frankfurt am Main
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Ethics committee country [2]
5045
0
Germany
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Date submitted for ethics approval [2]
5045
0
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Approval date [2]
5045
0
12/10/2004
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Ethics approval number [2]
5045
0
E 258/2004MC
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Ethics committee name [3]
5046
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Ethics Committee of the Chamber of Physicians of the Federal State of Lower Saxony, Corporation under Public Law
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Ethics committee address [3]
5046
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Berliner Allee 20 30175 Hannover
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Ethics committee country [3]
5046
0
Germany
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Date submitted for ethics approval [3]
5046
0
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Approval date [3]
5046
0
05/10/2004
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Ethics approval number [3]
5046
0
Grae 212/2004
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Ethics committee name [4]
5047
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Ethics Committee of the Chamber of Physicians of the Federal State of Mecklenburg-West Pomerania at the University of Rostock, Institute of Forensic Medicine
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Ethics committee address [4]
5047
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Postfach 100888 18055 Rostock
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Ethics committee country [4]
5047
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Germany
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Date submitted for ethics approval [4]
5047
0
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Approval date [4]
5047
0
20/10/2004
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Ethics approval number [4]
5047
0
II SV 68/2004
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Ethics committee name [5]
5048
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Ethics Committee of the State Chamber of Physicians of Thuringia, Corporation under Public Law
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Ethics committee address [5]
5048
0
Im Semmicht 33 07751 Jena
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Ethics committee country [5]
5048
0
Germany
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Date submitted for ethics approval [5]
5048
0
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Approval date [5]
5048
0
21/10/2004
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Ethics approval number [5]
5048
0
kl/1117/04112
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Ethics committee name [6]
5049
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Ethics Committee of the Chamber of Physicians of Berlin, Corporation under Public Law
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Ethics committee address [6]
5049
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Friedrichstrasse 16 10969 Berlin
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Ethics committee country [6]
5049
0
Germany
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Date submitted for ethics approval [6]
5049
0
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Approval date [6]
5049
0
19/01/2005
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Ethics approval number [6]
5049
0
Eth-012/05
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Ethics committee name [7]
5050
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Ethics Committee of the Medical University of Hannover
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Ethics committee address [7]
5050
0
Carl-Neuberg-Str. 1 30625 Hannover
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Ethics committee country [7]
5050
0
Germany
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Date submitted for ethics approval [7]
5050
0
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Approval date [7]
5050
0
21/03/2005
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Ethics approval number [7]
5050
0
Nr. 3884
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Ethics committee name [8]
5051
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Ethics Committee of the State Chamber of Physicians of Rhineland-Palatinate, Corporation under Public Law
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Ethics committee address [8]
5051
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Postfach 2926 55019 Mainz
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Ethics committee country [8]
5051
0
Germany
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Date submitted for ethics approval [8]
5051
0
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Approval date [8]
5051
0
19/09/2006
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Ethics approval number [8]
5051
0
837.253.06 (5351)
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Ethics committee name [9]
5052
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Ethics Committee of the Chamber of Physicians of Hamburg, Corporation under Public Law
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Ethics committee address [9]
5052
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Postfach 760109 22051 Hamburg
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Ethics committee country [9]
5052
0
Germany
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Date submitted for ethics approval [9]
5052
0
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Approval date [9]
5052
0
22/08/2006
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Ethics approval number [9]
5052
0
M-206/06
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Ethics committee name [10]
5053
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Ethics Committee of the Faculty of Medicine, University of Witten/Herdecke
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Ethics committee address [10]
5053
0
Alfred-Herrhausen-Str.50 D58448 Witten
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Ethics committee country [10]
5053
0
Germany
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Date submitted for ethics approval [10]
5053
0
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Approval date [10]
5053
0
24/04/2006
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Ethics approval number [10]
5053
0
Antragsnr. 33/2006
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Ethics committee name [11]
5055
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MHAT "Tzaritza Ioanna" Ltd Local Ethics Committee
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Ethics committee address [11]
5055
0
Byalo more Str. Sofia 1504, 8
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Ethics committee country [11]
5055
0
Bulgaria
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Date submitted for ethics approval [11]
5055
0
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Approval date [11]
5055
0
31/10/2006
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Ethics approval number [11]
5055
0
231/25.10.2006
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Ethics committee name [12]
5056
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Local Ethics Committee at SHATNP "Sv. Naum
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Ethics committee address [12]
5056
0
4 km Tsarigradsko shose Blvd.1113 Sofia
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Ethics committee country [12]
5056
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Bulgaria
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Date submitted for ethics approval [12]
5056
0
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Approval date [12]
5056
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18/10/2006
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Ethics approval number [12]
5056
0
10/18.10.2006
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Ethics committee name [13]
5057
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Local Ethics Committee at SHATCVD
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Ethics committee address [13]
5057
0
Sofia, 65 Konyovitsa Str
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Ethics committee country [13]
5057
0
Bulgaria
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Date submitted for ethics approval [13]
5057
0
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Approval date [13]
5057
0
18/10/2006
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Ethics approval number [13]
5057
0
10/18.10.2006
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Ethics committee name [14]
5058
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MHAT "St. Marina" Ltd. Varna Local Ethics Committee
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Ethics committee address [14]
5058
0
1 Hristo Smirnenski Str. 9010 Varna
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Ethics committee country [14]
5058
0
Bulgaria
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Date submitted for ethics approval [14]
5058
0
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Approval date [14]
5058
0
10/10/2006
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Ethics approval number [14]
5058
0
17/10.10.2006
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Ethics committee name [15]
5059
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Ethics Committee FN Olomouc
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Ethics committee address [15]
5059
0
I.P. Pavlova 6 77520 Olomouc
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Ethics committee country [15]
5059
0
Czech Republic
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Date submitted for ethics approval [15]
5059
0
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Approval date [15]
5059
0
11/12/2006
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Ethics approval number [15]
5059
0
174/06 MEK 44
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Ethics committee name [16]
5060
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Ethics Committee of Slezska Nemocnice Opava
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Ethics committee address [16]
5060
0
Olomoucka 86 Opava, 74601
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Ethics committee country [16]
5060
0
Czech Republic
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Date submitted for ethics approval [16]
5060
0
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Approval date [16]
5060
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03/05/2007
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Ethics approval number [16]
5060
0
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Ethics committee name [17]
5061
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Ethics Commitee of FNKV
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Ethics committee address [17]
5061
0
Scrobarova 50 100 34 Praha 10
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Ethics committee country [17]
5061
0
Czech Republic
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Date submitted for ethics approval [17]
5061
0
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Approval date [17]
5061
0
05/01/2007
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Ethics approval number [17]
5061
0
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Ethics committee name [18]
5062
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Ethics Committee of District Hospital Pardubice
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Ethics committee address [18]
5062
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Kyjevska 44 53203 Pardubice
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Ethics committee country [18]
5062
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Czech Republic
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Date submitted for ethics approval [18]
5062
0
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Approval date [18]
5062
0
17/01/2007
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Ethics approval number [18]
5062
0
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Ethics committee name [19]
5063
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Ethics Committee at FNsP Bratislava Ruzinov Facility
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Ethics committee address [19]
5063
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Ruzinovska 6 82606 Bratislava
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Ethics committee country [19]
5063
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Slovakia
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Date submitted for ethics approval [19]
5063
0
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Approval date [19]
5063
0
14/11/2006
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Ethics approval number [19]
5063
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2006-004736-79
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Ethics committee name [20]
5064
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Ethics Committee at FNsP BratislavaSt.cyril and Method Hospital pracovisko Petrzalka
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Ethics committee address [20]
5064
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Antolska 11 85107 Bratislava
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Ethics committee country [20]
5064
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Slovakia
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Date submitted for ethics approval [20]
5064
0
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Approval date [20]
5064
0
14/11/2006
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Ethics approval number [20]
5064
0
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Ethics committee name [21]
5065
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Ethics committee at University Hospital Nitra
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Ethics committee address [21]
5065
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Spitalska 6 PP41C 95001 Nitra
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Ethics committee country [21]
5065
0
Slovakia
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Date submitted for ethics approval [21]
5065
0
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Approval date [21]
5065
0
20/12/2006
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Ethics approval number [21]
5065
0
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Ethics committee name [22]
5066
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Bioethical Committee of Medical University of Lodz
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Ethics committee address [22]
5066
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Al. Kosciuszki 4 90-419 Lodz
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Ethics committee country [22]
5066
0
Poland
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Date submitted for ethics approval [22]
5066
0
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Approval date [22]
5066
0
16/01/2007
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Ethics approval number [22]
5066
0
RNN/4/07KE
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Ethics committee name [23]
5067
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Ministry of Health National Ethics Committee
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Ethics committee address [23]
5067
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Av. Sanatescu 48 sector 1 Bucharest
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Ethics committee country [23]
5067
0
Romania
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Date submitted for ethics approval [23]
5067
0
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Approval date [23]
5067
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14/11/2006
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Ethics approval number [23]
5067
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Nr. 4302
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Summary
Brief summary
Background: Antisense oligonucleotides (ASOs) are an innovative new class of drugs that inhibit the expression of proteins by sequence-specific binding to the protein’s mRNA. ATL1102 is a 2nd generation antisense inhibitor of CD49d, a subunit of Very Late Antigen 4 (VLA-4) which plays a key role in cell adhesion to vessel walls. VLA-4 blockade, as shown by monoclonal antibodies such as natalizumab, prevents activated lymphocytes from migrating into the CNS and significantly reduces disease activity in MS. Objective: To evaluate VLA-4 Antisense (ATL1102) in the treatment of RR-MS Methods: Randomized, double-blind, placebo-controlled multicenter Phase-IIa trial. 77 patients with RR-MS were treated for 8 weeks with either 200mg of ATL1102 or placebo subcutaneously twice weekly and evaluated for 16 weeks. MRI scans were performed at screening, and then monthly over 16 weeks. Primary efficacy variable: cumulative number of new active lesions (CNNAL; new gadolinium-enhancing T1 lesions (T1-Gd), new or enlarging T2 lesions) on MRIs taken at weeks 4, 8 and 12. Secondary efficacy variable: cumulative volume of T1-Gd lesions (CVT1L) on MRIs taken at weeks 4, 8 and 12. Results: ITT population: 74 patients with a valid baseline MRI and at least one post-baseline MRI scan after first injection of study medication (n=39 placebo, n=35 ATL1102). ATL1102 showed a significant reduction, 54.4%, in CNNAL (6.2 placebo, 3.0 ATL1102; p=0.01). A reduction of 66.7% (p=0.002) was observed in the cumulative number (weeks 4,8,12) of new T1-Gd lesions with ATL1102. A reduction in CVT1L was also observed under ATL1102 but did not reach significance (589.4 mm3 placebo, 358.0 mm3 ATL1102; p=0.1068). Adverse events that were more frequent under ATL1102 included mild to moderate injection site reactions and a tendency for decreased platelet counts which were reversible after treatment interruption. Conclusions: This proof-of-concept study of a drug designed to inhibit VLA-4 mRNA showed a significant reduction of the cumulative number of new active lesions in RR-MS patients following 8 weeks of treatment. These promising results warrant further investigation.
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Trial website
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Trial related presentations / publications
VLA-4 Antisense – An Oligonucleotide targeting VLA-4 mRNA (ATL1102) significantly reduces new active lesions in patients with RR-MS. Volker Limmroth, Frederik Barkhof, Nuket Desem, for the ATL1102 Study Group Presented at the World Congress on Treatment and Research in Multiple Sclerosis in Montreal Canada on 20 September 2008 and at the American Academy of Neurology (AAN) 61st Annual Meeting in Seattle, Washington USA on 29 April 2009 by the Principal Investigator of the trial, Volker Limmroth MD PhD. ATL/TV1102, an oligonucleotide targeting VLA-4 mRNA, significantly reduces new active lesions in patients with relapsing remitting multiple sclerosis. Volker Limmroth, Frederik Barkhof, Nuket Desem Presented at the New York Academy of Sciences Annual Meeting of the Oligonucleotide Therapeutics Society, Boston Massachusetts, USA on 18 October 2008 by Dr Christopher Wraight, Research Director, Antisense Therapeutics Ltd. ATL1102, an Antisense Drug Targeting VLA-4, Significantly Reduces the Development of Active Lesions in Relapsing-Remitting Multiple Sclerosis. Volker Limmroth, Frederik Barkhof, Nuket Desem Presented at the Keystone Symposia scientific conference entitled ‘Therapeutic Modulation of RNA Using Oligonucleotides’, in Alberta Canada on 13 February 2009 by Nuket Desem, Development Director, Antisense Therapeutics Ltd.
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Public notes
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Contacts
Principal investigator
Name
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Prof Volker Limmroth
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Address
28325
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Cologne-Merheim Hospital
Clinic for Neurology
Ostmerheimer Str. 200
51109 Cologne
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Country
28325
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Germany
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Phone
28325
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+49 221 89070
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Fax
28325
0
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Email
28325
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[email protected]
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Contact person for public queries
Name
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Susan Turner
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Address
11482
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Level 30, 35 Collins Street
MELBOURNE VIC 3000
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Country
11482
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Australia
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Phone
11482
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+61 3 9827 8999
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Fax
11482
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+61 3 9827 1166
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Email
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[email protected]
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Contact person for scientific queries
Name
2410
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Andrew McKenzie
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Address
2410
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Level 30, 35 Collins Street
Melbourne Vic 3000
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Country
2410
0
Australia
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Phone
2410
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+61 3 9827 8999
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Fax
2410
0
+61 3 9827 1166
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Email
2410
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
CD49d antisense drug ATL1102 reduces disease activity in patients with relapsing-remitting MS.
2014
https://dx.doi.org/10.1212/WNL.0000000000000926
Embase
Antisense oligonucleotides: The next frontier for treatment of neurological disorders.
2018
https://dx.doi.org/10.1038/nrneurol.2017.148
Embase
Clinical advances of RNA therapeutics for treatment of neurological and neuromuscular diseases.
2022
https://dx.doi.org/10.1080/15476286.2022.2066334
Embase
Targeting integrins in drug-resistant acute myeloid leukaemia.
2024
https://dx.doi.org/10.1111/bph.16149
N.B. These documents automatically identified may not have been verified by the study sponsor.
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