REFLEXION
What it found
The main measure showed a statistically significant benefit.
| Measure | Estimate | 95% CI | p |
|---|---|---|---|
| Time to Conversion to Clinically Definite Multiple Sclerosis (CDMS) Defined by Either a Second Attack or a Sustained Increase (Greater Than or Equal to 1.5 Points) in the Expanded Disability Status Scale (EDSS) Score up to 36 Months | Hazard Ratio (HR) 0.555 | 0.378–0.816 | 0.002 |
| Time to Conversion to Clinically Definite Multiple Sclerosis (CDMS) Defined by Either a Second Attack or a Sustained Increase (Greater Than or Equal to 1.5 Points) in the Expanded Disability Status Scale (EDSS) Score up to 36 Months | Hazard Ratio (HR) 0.573 | 0.391–0.839 | 0.006 |
| Time to Conversion to Clinically Definite Multiple Sclerosis (CDMS) Defined by Either a Second Attack or a Sustained Increase (Greater Than or Equal to 1.5 Points) in the Expanded Disability Status Scale (EDSS) Score up to 36 Months | Hazard Ratio (HR) 0.993 | 0.654–1.510 | 0.941 |
Statistical analysis as posted on ClinicalTrials.gov.
What was tested
Treatment tested
- Interferon beta-1a
Interferon alpha/beta receptor agonist
Placebo or sham
- Placebo
Results by group
Time to Conversion to Clinically Definite Multiple Sclerosis (CDMS) Defined by Either a Second Attack or a Sustained Increase (Greater Than or Equal to 1.5 Points) in the Expanded Disability Status Scale (EDSS) Score up to 36 Months
Baseline (Day 1 of Study 27025) up to 36 Months
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Placebo/RNF 44 Mcg Thrice Weekly (Integrated ITT Population) | 41.3 Cumulative % of participants with CDMS | 33.5–49.1 | 171 |
| RNF 44 Mcg Once Weekly (Integrated ITT Population) | 27.6 Cumulative % of participants with CDMS | 20.6–34.6 | 175 |
| RNF 44 Mcg Thrice Weekly (Integrated ITT Population) | 27.1 Cumulative % of participants with CDMS | 19.9–34.3 | 171 |
Placebo/RNF 44 Mcg Thrice Weekly (Integrated ITT Population)
RNF 44 Mcg Once Weekly (Integrated ITT Population)
RNF 44 Mcg Thrice Weekly (Integrated ITT Population)
p = 0.002; Hazard Ratio (HR) 0.555 (95% CI 0.378–0.816)
Values as posted on ClinicalTrials.gov. Outcomes measured differently across trials are not directly comparable.
Safety
| Group | Participants at risk | Serious adverse events | Deaths |
|---|---|---|---|
| Placebo/RNF 44 Mcg Thrice Weekly (DB Population) | 84 | 7 (8.3%) | |
| RNF 44 Mcg Once Weekly (DB Population) | 117 | 7 (6.0%) | |
| RNF 44 Mcg Thrice Weekly (DB Population) | 99 | 9 (9.1%) | |
| Placebo/RNF 44 Mcg Thrice Weekly/OL RNF 44 Mcg Thrice Weekly | 58 | 2 (3.4%) | |
| RNF 44 Mcg Once Weekly /OL RNF 44 Mcg Thrice Weekly | 51 | 3 (5.9%) | |
| RNF 44 Mcg Thrice Weekly/OL RNF 44 Mcg Thrice Weekly | 46 | 4 (8.7%) |
As posted on ClinicalTrials.gov. Serious adverse events include any serious health event during the trial, whether or not the treatment caused it.
What it measured
Main measures
Time to Conversion to Clinically Definite Multiple Sclerosis (CDMS) Defined by Either a Second Attack or a Sustained Increase (Greater Than or Equal to 1.5 Points) in the Expanded Disability Status Scale (EDSS) Score up to 36 Months
Baseline (Day 1 of Study 27025) up to 36 Months
Disability progressionRelapsesMRI lesionsThe primary endpoint is the time to conversion to CDMS, defined by either a second attack or a sustained increase (≥1.5 points) in the EDSS score (as defined in study 27025), from randomisation in study 27025 up to Month 36.
Disability progressionRelapses
Other measures (24)
Time to Confirmed Expanded Disability Status Scale (EDSS) Progression up to 36 Months
Baseline (Day 1 of Study 27025) up to 36 Months
Disability progressionNumber of Combined Unique Active (CUA) Lesions, New Time Constant 2 (T2) Lesions, New Gadolinium Enhanced (Gd+) Lesions and New Time Constant 1 (T1) Lesions Per Participant Per Scan at Month 36
Month 36
MRI lesionsChange From Baseline in Time Constant 1 (T1) Hypointense Lesion Volume and Time Constant 2 (T2) Lesion Volume at Month 36
Baseline (Day 1 of Study 27025), Month 36
MRI lesionsPercent Change From Baseline in Brain Volume at Month 36
Baseline (Day 1 of Study 27025), Month 36
MRI lesionsBrain volume lossPercentage of Participants With Conversion to McDonald Multiple Sclerosis (MS) up to 36 Months
Baseline (Day 1 of Study 27025) up to CDMS conversion and/or up to 36 Months
MRI lesionsChange From Baseline in Paced Auditory Serial Addition Test 3 (PASAT-3) Score at Month 36
Baseline (Day of Study 27025), Month 36
Thinking and memoryPercentage of Relapse-Free Participants at Month 36
Month 36
RelapsesChange From Baseline in Expanded Disability Status Scale (EDSS) Score at Month 36
Baseline (Day of Study 27025), Month 36
Disability progressionChange From Baseline in Multiple Sclerosis Functional Composite (MSFC) Score at Month 36
Baseline (Day 1 of Study 27025), Month 36
Disability progressionThinking and memoryWalking and mobilityArm and hand functionNumbers of Participants With Binding Antibodies (BAb) and Neutralizing Antibody (NAb) at Month 36
Month 36
Immune response
Who could take part
Early (CIS/RIS) · 18 and over
Inclusion Criteria: * Reach scheduled end of study in Study 27025 (REFLEX) (completion of 24 months participation) * Medical assessment by the Investigator/treating physician from study 27025 that there is no objection to the subject's participation in this extension trial considering the medical experience from Study 27025 (REFLEX). Special attention should be given to laboratory abnormalities and clinically significant liver, renal and bone-marrow dysfunction * If female, subject must: * be neither pregnant nor breast-feeding, nor attempting to conceive * use a highly effective method of contraception. A highly effective method of contraception is defined as those which result in a low failure rate (that is [i.e.] less than 1 percent [%] per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some intrauterine devices (IUDs), sexual abstinence or vasectomized partner * Subject is willing to follow study procedures * Subject has given written informed consent Exclusion Criteria: * Subject has any disease other than MS that could better explain the subject's signs and symptoms * Subject has a primary progressive course of MS * Subject has total bilirubin greater than 2.5 times upper limit of normal (ULN) at both Month 24 and at the previous visit (i.e. Month 21) (subjects with greater than 2.5 times ULN at Month 24 only are eligible for enrollment and should be managed as per label recommendations until normalization of the value) * Subject has total aspartate aminotransferase (AST) or alanine aminotransferase (ALT) or alkaline phosphatase (ALP) greater than 2.5 times the ULN values at both Month 24 and at the previous visit (i.e. Month 21) (subjects with greater than 2.5 times ULN at Month 24 only are eligible for enrollment and should be managed as per label recommendations until normalization of the value) * Subject suffers from another current autoimmune disease * Subject suffers from major medical or psychiatric illness (including history of, or current, severe depressive disorders and/or suicidal ideation) that in the opinion of the investigator creates undue risk to the subject or could affect compliance with the study protocol * Subject has a history of seizures not adequately controlled by treatment * Subject has cardiac disease, such as angina, congestive heart failure or arrhythmia * Subject has a known allergy to IFN-beta or the excipient(s) of the study medication * Subject has any condition that could interfere with the MRI evaluation * Subject has a known allergy to gadolinium-diethylene triamine pentaacetic acid (DTPA) * Subject has a history of alcohol or drug abuse * Subject has previously participated in this study * Subject has moderate to severe renal impairment * Subject is pregnant or lactating * Subject has any medical, psychiatric or other conditions that compromise his/her ability to understand the subject information, to give informed consent, to comply with the study protocol, or to complete the study
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
REFLEXION is a double blind extension of the study 27025 (NCT00404352) (REFLEX). The purpose of the study is to obtain long-term follow-up data in subjects with clinically definite multiple sclerosis (MS) and subjects with a first demyelinating event at high risk of converting to MS, treated with fetal bovine serum [FBS]-free/human serum albumin [HSA]-free formulation of interferon [IFN]-beta-1a (RNF).
Papers
Loading reviews and guidelines…
Linked trials
Extension of
REFLEXPhase 3 · Completed
Links found where a registry record names another trial's registry number.
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History
Started
Dec 2008
Main results due
Aug 2011
Finished
Sept 2013
Results posted
Oct 2013
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