ASSESS
What it found
The trial ended early for another reason (see below).
annualized relapse rate (ARR)
relative reduction in ARR vs glatiramer acetate (fingolimod 40.7%
Total participants: 1064
Read by software from the paper's abstract
Reason given: slow recruitment
What was tested
Treatment tested
Compared with
- Glatiramer acetate
Unknown
Results by group
Confirmed Annualized Relapse Rate
up to 12 months
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| FTY720 0.5 mg | 0.153 relapses/year | 0.111–0.212 | 345 |
| FTY720 0.25 mg | 0.221 relapses/year | 0.168–0.29 | 366 |
| GA 20 mg | 0.258 relapses/year | 0.196–0.341 | 324 |
FTY720 0.5 mg
FTY720 0.25 mg
GA 20 mg
p = 0.0138
Values as posted on ClinicalTrials.gov. Outcomes measured differently across trials are not directly comparable.
Safety
| Group | Participants at risk | Serious adverse events | Deaths |
|---|---|---|---|
| Fingolimod 0.5 mg | 345 | 25 (7.2%) | 0 |
| FTY 0.25 mg | 366 | 32 (8.7%) | 0 |
| GA 20 mg | 324 | 20 (6.2%) | 0 |
| All@Patients | 1035 | 77 (7.4%) | 0 |
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
Confirmed Annualized Relapse Rate
up to 12 months
Relapses
Other measures (8)
New or Newly Enlarging T2 Lesions
At 12 months/end of study
MRI lesionsNumber of Participants Free of New/Newly Enlarged T2 Lesions
At 12 months/end of study
MRI lesionsChange From Baseline in T2 Lesion Volume
Baseline, 12 months/end of study
MRI lesionsGd Enhancing T1 Lesion Count
At 12 months/end of study
MRI lesionsGd Enhancing T1 Lesion Volume
Baseline, 12 months/end of study
MRI lesionsPercentage of Patients Free of New T1 Hypointense Lesions
12 months
MRI lesionsChange From Baseline in TSQM Scales
6 months, 12 months/end of study
Quality of life (reported by participants)Percent Brain Volume Change From Baseline
Baseline, 12 months, end of study
MRI lesionsBrain volume loss
Who could take part
Relapsing MS · 18 to 65
Inclusion criteria: * Written informed consent must be obtained before any assessment is performed * Male and female patients 18 to 65 years of age, inclusive. * Patients with RRMS, as defined by 2010 revised McDonald criteria. * Patients must be neurologically stable with no onset of relapse within 30 days of randomization * Patients with at least 1 documented relapse during the previous year or 2 documented relapses during the previous 2 years before randomization. * Patients with an EDSS score of 0 to 6, inclusive, at Screening. A score of 6.0 indicates unilateral assistance (cane or crutch) required to walk at least 100 meters with or without resting. Exclusion criteria: * Patients with a history of malignancy of any organ system (other than cutaneous basal cell carcinoma) in the last 5 years that do not have confirmation of absence of a malignancy prior to randomization * Patients with an active chronic disease (or stable but treated with immune therapy) of the immune system other than MS (e.g., rheumatoid arthritis, scleroderma, Sjogren's syndrome, Crohn's disease, ulcerative colitis) or with a known immunodeficiency syndrome (HIV-antibody positive, AIDS, hereditary immune deficiency, drug-induced immune deficiency). * Patients who have been treated with: * High-dose intravenous (IV) immunoglobulin (Ig) within 4 weeks before randomization * Immunosuppressive/chemotherapeutic medications (e.g., azathioprine, cyclophosphamide, methotrexate) within 6 months before randomization * Natalizumab within 2 months before randomization * Previous treatment with lymphocyte-depleting therapies (e.g., rituximab, alemtuzumab, ofatumumab, ocrelizumab, or cladribine) within 1 year before randomization Previous treatment with mitoxantrone within 6 months before randomization * Use of teriflunomide within 3.5 months prior to randomization, except if active washout (with either cholestyramine or activated charcoal) was done. In that case, plasma levels are required to be measured and be below 0.02 mg/L before randomization. No washout period is necessary for patients treated with dimethyl fumarate, interferon (IFN) beta, or glatiramer acetate. Patients being treated with dimethyl fumarate, glatiramer acetate, or IFN beta at the Screening visit can continue drug intake up to the day before Day 1 of this study (i.e., there is no need for a washout period). * Patients who have been treated with systemic corticosteroids or adrenocorticotropic hormones in the past 30 days prior to the screening magnetic resonance imaging (MRI) procedure. * Patients with uncontrolled diabetes mellitus (glycosylated hemoglobin >9%) or with diabetic neuropathy. * Patients with a diagnosis of macular edema during Screening (patients with a history of macular edema will be allowed to enter the study provided that they do not have macular edema at Screening). * Patients with severe active bacterial, viral, or fungal infections. * Patients without acceptable evidence of immunity to varicella zoster virus (VZV) at randomization. * Patients who have received any live or live-attenuated vaccines (including VZV, herpes simplex, or measles) within 1 month before randomization. * Patients who have received total lymphoid irradiation or bone marrow transplantation. * Patients with any unstable medical/psychiatric condition, as assessed by the primary treating physician at each site. * Patients who in the last 6 months experienced any of the following cardiovascular conditions or findings in the screening electrocardiogram (ECG): myocardial infarction, unstable angina, stroke, transient ischemic attack or decompensated heart failure requiring hospitalization or Class III/IV heart failure.
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
The purpose of this study was to demonstrate that at least one dose (0.5 mg followed by 0.25 mg) of fingolimod is superior to glatiramer acetate 20 mg SC in reducing the ARR up to 12 months in patients with relapsing-remitting MS
Papers
Results
Cree BAC, Goldman MD, Corboy JR, Singer BA, Fox EJ, Arnold DL, Ford C, Weinstock-Guttman B, Bar-Or A, Mientus S, Sienkiewicz D, Zhang Y, Karan R, Tenenbaum N; ASSESS Trial Investigators. Efficacy and Safety of 2 Fingolimod Doses vs Glatiramer Acetate for the Treatment of Patients With Relapsing-Remitting Multiple Sclerosis: A Randomized Clinical Trial. JAMA Neurol. 2020 Aug 24;78(1):1-13. doi: 10.Treatment with fingolimod, 0.5 mg, was superior to treatment with glatiramer acetate, 20 mg, in reducing ARR (40.7% relative reduction); the relative reduction with fingolimod, 0.25 mg, was 14.6%, which was not statistically significant (for fingolimod, 0.5 mg, ARR, 0.15; 95% CI, 0.11-0.21; for fingolimod, 0.25 mg, ARR, 0.22; 95% CI, 0.17-0.29; for glatiramer acetate, 20 mg, ARR, 0.26; 95% CI, 0.20-0.34).
Read by software from the paper's abstract
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History
Started
Aug 2012
Main results due
Apr 2018
Finished
Apr 2018
Results posted
May 2019
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