Study to Evaluate Safety, Efficacy and Pharmacokinetics (PK) of a Modified Regimen of Ublituximab

Official title

Evaluating Safety, Efficacy and Pharmacokinetics of a Modified Regimen of Ublituximab (ENHANCE )

Overview

The primary purpose of this phase 3b study is to assess the efficacy of a modified regimen of ublituximab in participants with relapsing multiple sclerosis (RMS) as measured by T1 Gadolinium (Gd)-enhancing lesions in Part A; PK in Part B along with efficacy of ublituximab as measured by T1 Gd-enhancing lesions in participants who had a suboptimal experience on prior anti-CD20 therapy in Part C. The study consists of 3 parts: Part A is single-armed and open-label, Part B is randomized, double-blind, placebo-controlled, and Part C is single-armed and open-label.

Interventions

• Biological Ublituximab
  Administered as an intravenous (IV) infusion.
• Drug Placebo
  IV infusion

Primary outcome measures

• Part A and Part C: Percentage of Participants With no Change or Reduction in Number of T1 Gd-Enhancing Lesions From Baseline to Week 48 [Time frame: Baseline up to Week 48]
• Part B: Area Under the Curve Over the First 16 Weeks (AUC0-W16) of Ublituximab [Time frame: Predose and at multiple timepoints up to Week 16]

Secondary outcome measures (3)

• Parts A: Percentage of Participants Free of T1 Gd-Enhancing Lesions [Time frame: Week 48]
• Parts A and B: Percentage of Participants Experiencing Infusion Related Reactions (IRRs) [Time frame: Up to Week 48]
• Parts A: Change From Baseline in Treatment Satisfaction Questionnaire for Medication (TSQM-9) Scores [Time frame: Part A: Baseline, Week 24 and Week 48]

Eligibility criteria

Inclusion criteria

• Diagnosis of RMS (2017 Revised McDonald criteria).
• Participants must meet one of the following prior treatment definitions:

• Participants naïve to treatment.
• Participants previously treated with a disease modifying therapy (DMT) who have discontinued treatment prior to consent and meet the washout requirements.
• Expanded Disability Status Scale (EDSS) score ≤ 5.5 at screening.
• Neurologically stable for > 30 days prior to first dose of ublituximab.
• Female participants of childbearing potential must consent to use a medically acceptable method of contraception from consent, throughout the study period, and for 6 months after the last dose of ublituximab.
• Part C: participants currently treated with an anti-CD20 agent for at least 6 months and meet the washout requirements prior to W1D1.
• Part C: Discontinuation of current anti-CD20 must be due to suboptimal experience

Exclusion criteria

• History of any serious 3 Infusion Related Reaction (IRR) on prior anti-CD20 therapy.
• Primary-progressive multiple sclerosis (PPMS) or inactive Secondary Progressive MS (SPMS).
• Active chronic (or stable but treated with immune therapy) disease of the immune system other than MS (e.g., rheumatoid arthritis, scleroderma, Sjögren's syndrome, Crohn's disease, ulcerative colitis, etc.) or immunodeficiency syndrome (hereditary immune deficiency, drug-induced immune deficiency, etc.).
• Current evidence or known history of clinically significant infection, including: chronic, recurrent, or ongoing active viral, bacterial, or fungal infectious disease requiring long term systemic treatment such as, but not limited to chronic urinary tract infection, chronic pulmonary infection with bronchiectasis, tuberculosis, or active hepatitis C virus (HCV).
• Previous serious opportunistic or atypical infection.
• Evidence of chronic active or history of hepatitis B virus (HBV) infection as evidenced by a detectable hepatitis B surface antigen (HBsAg), or positive hepatitis B core antibody (HBcAb), or chronic hepatitis C infection. Participants with positive hepatitis C virus antibody (HCV Ab) are eligible only if polymerase chain reaction (PCR) is negative for HCV ribonucleic acid (RNA).
• History or evidence (clinical, radiological, or biomarker) of suspected or confirmed progressive multifocal leukoencephalopathy (PML).
• Receipt of any live or live-attenuated vaccines (including vaccines for varicella-zoster virus or measles) within 4 weeks prior to first study drug administration.
• Participants requiring treatment with intravenous immune globulin (IVIG) for decreased immunoglobulins within the 12 months prior to W1D1.
• Any active malignancies other than adequately treated basal, squamous cell or in situ carcinoma.
• Participants who have ever received ublituximab, alemtuzumab, cyclophosphamide, mitoxantrone, cladribine, or daclizumab (including for non-MS indications).

Note: Other Inclusion/Exclusion criteria may apply.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Treatment

Study locations

United States · 36 centers

• TG Therapeutics Investigational Trial Site — Birmingham
• TG Therapeutics Investigational Trial Site — Cullman
• TG Therapeutics Investigational Trial Site — Orange
• TG Investigational Site — Fort Collins
• TG Therapeutics Investigational Trial Site — Washington D.C.
• TG Therapeutics Investigational Trial Site — Tampa
• TG Therapeutics Investigational Trial Site — Savannah
• TG Therapeutics Investigational Trial Site — Chicago
• … and 28 more centers

Poland · 11 centers

• TG Therapeutics Investigational Trial Site — Bydgoszcz
• TG Therapeutics Investigational Trial Site — Katowice
• TG Therapeutics Investigational Trial Site — Katowice
• TG Therapeutics Investigational Trial Site — Kielce
• TG Therapeutics Investigational Trial Site — Krakow
• TG Therapeutics Investigational Trial Site — Lodz
• TG Therapeutics Investigational Trial Site — Olsztyn
• TG Therapeutics Investigational Trial Site — Poznan
• … and 3 more centers

Identifiers

NCT: NCT05877963 · TG1101-RMS401 · 2024-519284-18-00

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗