CARE-MS Extension Study
What it found
Results are posted in the registry, but without a statistical test of the main measure. See the numbers below.
What was tested
Treatment tested
- Alemtuzumab
CAMPATH-1 antigen inhibitor
Results by group
Annualized Relapse Rate (ARR)
Year 3, 4, 5, 6 from the Baseline (Month 0 of CAMMS323 and Month 0 of CAMMS324 for "Alemtuzumab Treatment CAMMS323 Extension" group and "Alemtuzumab Treatment CAMMS324 Extension" group, respectively)
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Alemtuzumab Treatment CAMMS323 Extension | 0.19 relapses per participant per year | 353 | |
| Alemtuzumab Treatment CAMMS324 Extension | 0.22 relapses per participant per year | 391 | |
| Alemtuzumab Treatment CAMMS323 Extension | 0.16 relapses per participant per year | 353 | |
| Alemtuzumab Treatment CAMMS324 Extension | 0.24 relapses per participant per year | 391 | |
| Alemtuzumab Treatment CAMMS323 Extension | 0.15 relapses per participant per year | 353 | |
| Alemtuzumab Treatment CAMMS324 Extension | 0.19 relapses per participant per year | 391 | |
| Alemtuzumab Treatment CAMMS323 Extension | 0.12 relapses per participant per year | 353 | |
| Alemtuzumab Treatment CAMMS324 Extension | 0.16 relapses per participant per year | 391 |
Annualized Relapse Rate (ARR) Before and After Receiving Alemtuzumab
Baseline (Year 0 of initial studies) up to Year 4
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| IFNB-1a/Alemtuzumab Switch CAMMS323/03409 (Pre Alemtuzumab) | 0.42 relapses per participant per year | 0.28–0.64 | 139 |
| IFNB-1a/Alemtuzumab Switch CAMMS323/03409 (Post Alemtuzumab) | 0.14 relapses per participant per year | 0.09–0.21 | 139 |
| IFNB-1a/Alemtuzumab Switch CAMMS324/03409 (Pre Alemtuzumab) | 0.60 relapses per participant per year | 0.45–0.78 | 143 |
| IFNB-1a/Alemtuzumab Switch CAMMS324/03409 (Post Alemtuzumab) | 0.15 relapses per participant per year | 0.1–0.22 | 143 |
IFNB-1a/Alemtuzumab Switch CAMMS323/03409 (Pre Alemtuzumab)
IFNB-1a/Alemtuzumab Switch CAMMS323/03409 (Post Alemtuzumab)
IFNB-1a/Alemtuzumab Switch CAMMS324/03409 (Pre Alemtuzumab)
IFNB-1a/Alemtuzumab Switch CAMMS324/03409 (Post Alemtuzumab)
Annualized Relapse Rate (ARR) Before and After Alemtuzumab Retreatment
Year 1 prior to retreatment, Year 1, 2, 3 after retreatment
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Alemtuzumab Retreatment | 0.79 relapses per participant per year | 0.73–0.87 | 321 |
| Alemtuzumab Retreatment | 0.18 relapses per participant per year | 0.14–0.24 | 321 |
| Alemtuzumab Retreatment | 0.29 relapses per participant per year | 0.23–0.38 | 321 |
| Alemtuzumab Retreatment | 0.30 relapses per participant per year | 0.21–0.41 | 321 |
Alemtuzumab Retreatment
Alemtuzumab Retreatment
Alemtuzumab Retreatment
Alemtuzumab Retreatment
Number of Participants With Sustained Accumulation of Disability (SAD)
Baseline (Year 0) up to Year 6
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Alemtuzumab Treatment CAMMS323 Extension | 79 Participants | 376 | |
| Alemtuzumab Treatment CAMMS324 Extension | 118 Participants | 426 |
Alemtuzumab Treatment CAMMS323 Extension
Alemtuzumab Treatment CAMMS324 Extension
Percentage with SAD 22.33 (95% CI 18.33–27.06)
Number of Participants With Sustained Accumulation of Disability (SAD) Before and After Alemtuzumab Treatment: 2 Year Comparison
Baseline (Year 0 of initial studies) up to Year 4
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| IFNB-1a/Alemtuzumab Switch CAMMS323/03409 (Pre Alemtuzumab) | 13 Participants | 139 | |
| IFNB-1a/Alemtuzumab Switch CAMMS323/03409 (Post Alemtuzumab) | 11 Participants | 139 | |
| IFNB-1a/Alemtuzumab Switch CAMMS324/03409 (Pre Alemtuzumab) | 29 Participants | 143 | |
| IFNB-1a/Alemtuzumab Switch CAMMS324/03409 (Post Alemtuzumab) | 17 Participants | 143 |
IFNB-1a/Alemtuzumab Switch CAMMS323/03409 (Pre Alemtuzumab)
IFNB-1a/Alemtuzumab Switch CAMMS323/03409 (Post Alemtuzumab)
IFNB-1a/Alemtuzumab Switch CAMMS324/03409 (Pre Alemtuzumab)
IFNB-1a/Alemtuzumab Switch CAMMS324/03409 (Post Alemtuzumab)
Percentage with SAD 9.35 (95% CI 5.54–15.56)
Values as posted on ClinicalTrials.gov. Outcomes measured differently across trials are not directly comparable.
Safety
| Group | Participants at risk | Serious adverse events | Deaths |
|---|---|---|---|
| Alemtuzumab | 1314 | 376 (28.6%) |
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
Annualized Relapse Rate (ARR)
Year 3, 4, 5, 6 from the Baseline (Month 0 of CAMMS323 and Month 0 of CAMMS324 for "Alemtuzumab Treatment CAMMS323 Extension" group and "Alemtuzumab Treatment CAMMS324 Extension" group, respectively)
RelapsesAnnualized Relapse Rate (ARR) Before and After Receiving Alemtuzumab
Baseline (Year 0 of initial studies) up to Year 4
RelapsesAnnualized Relapse Rate (ARR) Before and After Alemtuzumab Retreatment
Year 1 prior to retreatment, Year 1, 2, 3 after retreatment
RelapsesNumber of Participants With Sustained Accumulation of Disability (SAD)
Baseline (Year 0) up to Year 6
Disability progressionBladder, bowel and sexual functionNumber of Participants With Sustained Accumulation of Disability (SAD) Before and After Alemtuzumab Treatment: 2 Year Comparison
Baseline (Year 0 of initial studies) up to Year 4
Disability progressionBladder, bowel and sexual functionPrimary outcome measures:
Other measures (21)
Number of Participants With Sustained Reduction in Disability (SRD) Assessed by EDSS at Year 6
Baseline (Year 0) up to Year 6
Disability progressionBladder, bowel and sexual functionNumber of Participants With Sustained Reduction in Disability (SRD) Assessed by EDSS (After Alemtuzumab Treatment) at Year 2 of the Extension Study
Extension study (CAMMS03409) baseline up to Extension Year 2
Disability progressionBladder, bowel and sexual functionChange From Initial Study Baseline in EDSS Score at Year 3, 4, 5 and 6
Baseline (Month 0 of CAMMS323 and Month 0 of CAMMS324 for "Alemtuzumab Treatment CAMMS323 Extension" group and "Alemtuzumab Treatment CAMMS324 Extension" group, respectively), Year 3, 4, 5, 6
Disability progressionBladder, bowel and sexual functionChange From Initial Study Baseline in EDSS Score Before and After Alemtuzumab Treatment: 2 Year Comparison
Baseline (Year 0 of initial studies) up to Year 4
Disability progressionBladder, bowel and sexual functionChange From Retreatment Baseline in EDSS Score After Alemtuzumab Retreatment
Retreatment baseline, Year 1, 2 and 3 after retreatment baseline
Disability progressionBladder, bowel and sexual functionPercentage of Participants Without New or Enlarging Magnetic Resonance Imaging (MRI)-T2-Hypertense Lesion Activity
Year 3, 4, 5 and 6
MRI lesionsPercentage of Participants Without New or Enlarging MRI-T2-Hypertense Lesion Activity Before and After Alemtuzumab Treatment
Baseline (Year 0 of initial studies) up to Year 4
MRI lesionsPercentage of Participants Without New or Enlarging MRI-T2-Hypertense Lesion Activity Before and After Alemtuzumab Retreatment
Retreatment Baseline, Year 1, 2 and 3 after retreatment
MRI lesionsPercentage Change From Baseline in MRI-T2-Hypertense Lesion Volumes at Year 3, 4, 5, 6
Baseline (Month 0 of CAMMS323 and Month 0 of CAMMS324 for "Alemtuzumab Treatment CAMMS323 Extension" group and "Alemtuzumab Treatment CAMMS324 Extension" group, respectively), Year 3, 4, 5, 6
MRI lesionsPercentage of Participants Without New Gadolinium-enhancing MRI Lesion Activity
Year 3, 4, 5 and 6
MRI lesions
Who could take part
Relapsing MS
Inclusion Criteria: * 1.Received alemtuzumab in CAMMS323 or CAMMS324, completed the 2-year study period, and had not subsequently received disease modifying treatments (other than glatiramer acetate or interferon beta); or * 2.Received Rebif® in CAMMS323 or CAMMS324, completed the 2-year study period, and had not subsequently received alternative disease modifying treatments (other than glatiramer acetate or another interferon beta); or * 3.Participated in CAMMS223. * NOTE: Criteria 1 and 2 above meant that participants who enrolled in CAMMS323 or CAMMS324 but did not complete the 2-year study period or went on to receive non-study drug DMTs after randomization were not eligible for inclusion in the Extension Study. Participants who enrolled in CAMMS324 after participation in CAMMS223 must meet criteria 1 or 2 to be eligible for inclusion in the Extension Study. Exclusion Criteria: * Any alemtuzumab participant from CAMMS223, CAMMS323, or CAMMS324 who had received alemtuzumab off-label (ie, outside of one of the prior Genzyme-sponsored studies), or was participating in any other investigational study, unless approved by Genzyme. In addition, these participants must be screened for disqualifying safety concerns before receiving alemtuzumab retreatment. * Any Rebif® participants from CAMMS223, CAMMS323, or CAMMS324 who met any of the following criteria. In addition, these participants must be screened for disqualifying safety concerns before receiving alemtuzumab treatment. a) Did not wish to receive alemtuzumab; b) Ongoing participation in any other investigational study, unless approved by Genzyme; c) Had received alemtuzumab off-label (ie, outside of one of the prior Genzyme-sponsored studies); d) Known bleeding disorder or therapeutic anticoagulation; e) Diagnosis of idiopathic thrombocytopenia purpura or other autoimmune hematologic abnormality; f) History of malignancy, except basal cell skin carcinoma; g) Intolerance of pulsed corticosteroids, especially a history of steroid psychosis h) Significant Autoimmune disorder (other than MS); i) Major psychiatric disorder or epileptic seizures not adequately controlled by treatment; j) Active infection or high risk for infection k) Unwilling to use a reliable and acceptable contraceptive method during and for at least 6 months following each alemtuzumab treatment cycle (fertile participants only).
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
This open-label, rater-blinded extension study enrolled participants who had relapsing-remitting multiple sclerosis (RRMS) and who participated in one of three prior Genzyme-sponsored studies of alemtuzumab (CAMMS223 [NCT00050778], CAMMS323 [NCT00530348] also known as CARE-MS I, or CAMMS324 [NCT00548405] also known as CARE-MS II). The purposes of this study were: 1. To examine the long term safety and efficacy of alemtuzumab treatment in participants who received alemtuzumab as their study treatment in one of the prior studies. 2. To examine the safety and efficacy of initial alemtuzumab treatment in this study for participants who received Rebif® (interferon beta-1a) as their study treatment in one of the prior studies. 3. To determine the safety and efficacy of additional "as needed" alemtuzumab treatment courses. This applied both to participants who received alemtuzumab for the first time in one of the prior studies or for the first time in this extension study.
Papers
Results
Impact of alemtuzumab on health-related quality of life over 6 years in CARE-MS II trial extension patients with relapsing-remitting multiple sclerosis.Mult Scler · 2020
Results
Lymphocyte pharmacodynamics are not associated with autoimmunity or efficacy after alemtuzumab.Neurol Neuroimmunol Neuroinflamm · 2020
Results
Pregnancy outcomes and postpartum relapse rates in women with RRMS treated with alemtuzumab in the phase 2 and 3 clinical development program over 16 years.Mult Scler Relat Disord · 2020
Results
Efficacy and Safety of Alemtuzumab Through 9 Years of Follow-up in Patients with Highly Active Disease: Post Hoc Analysis of CARE-MS I and II Patients in the TOPAZ Extension Study.CNS Drugs · 2020
Results
Immune thrombocytopenia in alemtuzumab-treated MS patients: Incidence, detection, and management.Mult Scler · 2020
Results
Repopulation of T, B, and NK cells following alemtuzumab treatment in relapsing-remitting multiple sclerosis.J Neuroinflammation · 2020
Results
Infection risk with alemtuzumab decreases over time: pooled analysis of 6-year data from the CAMMS223, CARE-MS I, and CARE-MS II studies and the CAMMS03409 extension study.Mult Scler · 2019
Results
Alemtuzumab CARE-MS I 5-year follow-up: Durable efficacy in the absence of continuous MS therapy.Neurology · 2017
Results
Ziemssen T, Bass AD, Van Wijmeersch B, Eichau S, Richter S, Hoffmann F, Armstrong NM, Chirieac M, Cunha-Santos J, Singer BA. Long-term efficacy and safety of alemtuzumab in participants with highly active MS: TOPAZ clinical trial and interim analysis of TREAT-MS real-world study. Ther Adv Neurol Disord. 2025 Feb 10;18:17562864241306575. doi: 10.1177/17562864241306575. eCollection 2025.Results
Coles AJ, Achiron A, Traboulsee A, Singer BA, Pozzilli C, Oreja-Guevara C, Giovannoni G, Comi G, Freedman MS, Ziemssen T, Shiota D, Rawlings AM, Wong AT, Chirieac M, Montalban X. Safety and efficacy with alemtuzumab over 13 years in relapsing-remitting multiple sclerosis: final results from the open-label TOPAZ study. Ther Adv Neurol Disord. 2023 Sep 21;16:17562864231194823. doi: 10.1177/175628642
Loading reviews and guidelines…
Linked trials
Extension of
CARE-MS IPhase 3 · Completed
Extension of
CARE-MS IIPhase 3 · Completed
Extension of
A Phase II Study Comparing Low- and High-Dose Alemtuzumab…Phase 2 · Completed
Links found where a registry record names another trial's registry number.
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History
Started
Aug 2009
Main results due
Feb 2016
Finished
Feb 2016
Results posted
May 2017
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