GALA
What it found
The main measure showed a statistically significant benefit.
| Measure | Estimate | 95% CI | p |
|---|---|---|---|
| Total Number of Confirmed Relapses During the Placebo Controlled (PC) Treatment Period Estimated by Negative Binomial Regression | Risk Ratio (RR) 0.656 | 0.539–0.799 | <0.0001 |
| Annualized Rate of Confirmed Relapses Comparing Early Starters to Delayed Starters Estimated by Negative Binomial Regression | Risk Ratio (RR) 0.8332 | 0.6995–0.9925 | 0.0409 |
Statistical analysis as posted on ClinicalTrials.gov.
What was tested
Treatment tested
- Glatiramer acetate
Unknown
Placebo or sham
- Placebo
Results by group
Total Number of Confirmed Relapses During the Placebo Controlled (PC) Treatment Period Estimated by Negative Binomial Regression
Day 1 to 12 months
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Early Start: GA 40 mg / GA 40 mg | 0.331 confirmed relapses | 0.028 (Standard Error) | 943 |
| Delayed Start: Placebo / GA 40 mg | 0.505 confirmed relapses | 0.049 (Standard Error) | 461 |
Early Start: GA 40 mg / GA 40 mg
Delayed Start: Placebo / GA 40 mg
p = <0.0001; Risk Ratio (RR) 0.656 (95% CI 0.539–0.799)
Annualized Rate of Confirmed Relapses Comparing Early Starters to Delayed Starters Estimated by Negative Binomial Regression
Day 1 up to 6.5 years
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Early Start: GA 40 mg / GA 40 mg | 0.2621 relapses per year | 0.0189 (Standard Error) | 943 |
| Delayed Start: Placebo / GA 40 mg | 0.3146 relapses per year | 0.0279 (Standard Error) | 461 |
Early Start: GA 40 mg / GA 40 mg
Delayed Start: Placebo / GA 40 mg
p = 0.0409; Risk Ratio (RR) 0.8332 (95% CI 0.6995–0.9925)
Values as posted on ClinicalTrials.gov. Outcomes measured differently across trials are not directly comparable.
Safety
| Group | Participants at risk | Serious adverse events | Deaths |
|---|---|---|---|
| Delayed Start: GA 40 mg | 419 | 36 (8.6%) | 1 |
| Delayed Start: Placebo | 461 | 21 (4.6%) | 1 |
| Early Start: GA 40 mg / GA 40 mg | 943 | 117 (12.4%) | 3 |
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
Total Number of Confirmed Relapses During the Placebo Controlled (PC) Treatment Period Estimated by Negative Binomial Regression
Day 1 to 12 months
Disability progressionRelapsesAnnualized Rate of Confirmed Relapses Comparing Early Starters to Delayed Starters Estimated by Negative Binomial Regression
Day 1 up to 6.5 years
RelapsesTotal number of confirmed relapses during the placebo-controlled treatment phase.
Relapses
Other measures (8)
The Cumulative Number of New/Enlarging T2 Lesions Taken at Month 6 and Month 12 During the Placebo Controlled (PC) Treatment Period Estimated by Negative Binomial Regression
Baseline (Day -7), Month 6, Month 12
MRI lesionsThe Cumulative Number of Gadolinium (Gd)-Enhanced Lesions on T1-Weighted Images At Month 6 and Month 12 of the Placebo-Controlled (PC) Treatment Period Estimated by Negative Binomial Regression
Baseline (Day -7), Month 6, Month 12
MRI lesionsBrain Atrophy As Defined by the Percent of Change in Normalized Brain Volume From Baseline to Month 12 During the Placebo Controlled (PC) Treatment Period
Baseline (Day -7), Month 12
MRI lesionsBrain volume lossThe Number of New/Enlarging T2 Lesions at Months 6, 12 and 36 Estimated by Negative Binomial Regression
Baseline (Day -7), Month 6, Month 12, Month 36
MRI lesionsThe Cumulative Number of Gadolinium (Gd)-Enhanced Lesions on T1-Weighted Images At Months 6, 12 and 36 Estimated by Negative Binomial Regression
Baseline (Day -7), Month 6, Month 12, Month 36
MRI lesionsBrain Atrophy As Defined by the Percent of Change in Brain Volume From Baseline to Months 6, 12 and 36 Estimated by a Mixed Model for Repeated Measures
Baseline (Day -7), Month 6, Month 12, Month 36
MRI lesionsBrain volume lossParticipants With Treatment-Emergent Adverse Events (TEAEs)
Early Start: Day 1 up to 6.5 years Delayed Start - Placebo: Day 1 up to Month 12 Delayed Start - GA: Month 13 up to 6.5 years
Safety1. The cumulative number of new/enlarging T2 lesions taken at month 6 and month 12 (end of PC phase).
MRI lesions
Who could take part
Relapsing MS · 18 to 55
Inclusion Criteria: 1. Subjects must have a confirmed and documented MS diagnosis as defined by the Revised McDonald criteria with a relapsing-remitting disease course. 2. Subjects must be ambulatory with an EDSS score of 0-5.5 in both screening and baseline visits. 3. Subjects must be in a relapse-free, stable neurological condition and free of corticosteroid treatment [intravenous (IV), intramuscular (IM) and/or per os (PO)] or ACTH 30 days prior to screening (month -1) and between screening and baseline (month 0) visits. 4. Subjects must have experienced one of the following: At least one documented relapse in the 12 months prior to screening, or At least two documented relapses in the 24 months prior to screening, or One documented relapse between 12 and 24 months prior to screening with at least one documented T1-Gd enhancing lesion in an MRI performed within 12 months prior to screening. 5. Subjects must be between 18 and 55 years of age, inclusive. 6. Women of child-bearing potential must practice an acceptable method of birth control. 7. Subjects must be able to sign and date a written informed consent prior to entering the study. 8. Subjects must be willing and able to comply with the protocol requirements for the duration of the study Exclusion Criteria: 1. Subjects with progressive forms of MS. 2. Use of experimental or investigational drugs, and/or participation in drug clinical studies within the 6 months prior to screening. 3. Use of immunosuppressive (including Mitoxantrone and Fingolimod) or cytotoxic agents within 6 months prior to the screening visit. 4. Use of natalizumab (Tysabri®) or any other monoclonal antibodies within 2 years prior to screening. 5. Use of cladribine within 2 years prior to screening. 6. Previous treatment with immunomodulators (including IFNβ 1a and 1b, and IV Immunoglobulin (IVIg) within 2 months prior to screening. 7. Previous use of GA or any other glatiramoid. 8. Chronic (more than 30 consecutive days) systemic (IV, PO or IM) corticosteroid treatment within 6 months prior to screening visit. 9. Previous total body irradiation or total lymphoid irradiation. 10. Previous stem-cell treatment, autologous bone marrow transplantation or allogenic bone marrow transplantation. 11. Pregnancy or breastfeeding. 12. Subjects with a clinically significant or unstable medical or surgical condition that would preclude safe and complete study participation, as determined by medical history, physical exams, ECG, abnormal laboratory tests and chest X-ray. Such conditions may include hepatic, renal or metabolic diseases, systemic disease, acute infection, current malignancy or recent history (5 years) of malignancy, major psychiatric disorder, history of drug and/or alcohol abuse and allergies that could be detrimental according to the investigator's judgment. 13. A known history of sensitivity to Gadolinium. 14. Inability to successfully undergo MRI scanning. 15. A known drug hypersensitivity to Mannitol.
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
The study is designed to assess the efficacy of Glatiramer Acetate (GA) injection 40 mg administered three times a week compared to placebo in subjects with RRMS, as measured by the number of confirmed relapses during the 12 month placebo controlled period. The study has two periods: * Placebo Controlled Period: 12 months of 40 mg administered three times a week by subcutaneous injection or matching placebo. * Open Label Extension Period: All subjects will continue treatment with GA 40 mg administered three times a week, until this dose strength is commercially available for the treatment of relapsing remitting multiple sclerosis (RRMS) patients or until the development of this GA dose regimen is stopped by the Sponsor
Papers
Results
The Effect of Three Times a Week Glatiramer Acetate on Cerebral T1 Hypointense Lesions in Relapsing-Remitting Multiple Sclerosis.J Neuroimaging · 2015
Results
Khan O, Rieckmann P, Boyko A, Selmaj K, Ashtamker N, Davis MD, Kolodny S, Zivadinov R. Efficacy and safety of a three-times-weekly dosing regimen of glatiramer acetate in relapsing-remitting multiple sclerosis patients: 3-year results of the Glatiramer Acetate Low-Frequency Administration open-label extension study. Mult Scler. 2017 May;23(6):818-829. doi: 10.1177/1352458516664033. Epub 2016 Aug 8
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History
Started
Jun 2010
Main results due
May 2012
Finished
May 2017
Results posted
Oct 2018
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