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A two year, double-blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod administered orally once daily versus interferon beta-1a i.m. once weekly in pediatric patients with MS
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A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Dec 27, 2019

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Page 1: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

A two year, double-blind, randomized, multicenter,

active-controlled study to evaluate the safety en efficacy of fingolimod administered orally once

daily versus interferon beta-1a i.m. once weekly in pediatric patients with MS

Page 2: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Komende 20 minuten

Achtergrond

Wat houdt de studie in

Wie kunnen meedoen

Samenvatting

Vragen

Page 3: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Wat is MS ?

Page 4: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod
Page 5: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod
Page 6: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

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acht

en

Page 7: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

isch

e kl

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relapsing remitting

Page 8: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

isch

e kl

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relapsing remitting

Page 9: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

isch

e kl

acht

en

relapsing remitting

Page 10: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

isch

e kl

acht

en

relapsing remitting

Page 11: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

isch

e kl

acht

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relapsing remitting secundair progressief

Page 12: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

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relapsing remitting secundair progressief

ontstekingsfase

Page 13: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

isch

e kl

acht

en

relapsing remitting secundair progressief

ontstekingsfase axon verlies

Page 14: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

isch

e kl

acht

en

relapsing remitting secundair progressief

ontstekingsfase axon verlies

ontstekingsremmers

Page 15: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

isch

e kl

acht

en

relapsing remitting secundair progressief

ontstekingsfase axon verlies

ontstekingsremmers

Page 16: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

tijd (jaren)

Klin

isch

e kl

acht

en

relapsing remitting secundair progressief

ontstekingsfase axon verlies

ontstekingsremmers

Page 17: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod
Page 18: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod
Page 19: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Om te slikken: fingolimod

Werking

40-50% minder aanvallen

Minder MRI activiteit

Geen lange termijn data beschikbaar

Bijwerkingen

Eerste dosis: hartritme stoornis (2%)

Hoge bloeddruk (13%)

Lymphopenie (10%)

Leverenzymen verhoging (10%)

Meer infecties: lagere luchtweg infecties (12%),

Ernstige herpes en varicella zoster infecties (10%)

Huidkanker (basaascel-carcinoom 2%) andere maligniteiten

Macula oedeem (1%)

Page 20: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod
Page 21: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod
Page 22: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

A two year, double-blind, randomized, multicenter,

active-controlled study to evaluate the safety en efficacy of fingolimod administered orally once

daily versus interferon beta-1a i.m. once weekly in pediatric patients with MS

Page 23: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

A two year, double-blind, randomized, multicenter,

active-controlled study to evaluate the safety en efficacy of fingolimod administered orally once

daily versus interferon beta-1a i.m. once weekly in pediatric patients with MS

IPMSSG

Page 24: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

A two year, double-blind, randomized, multicenter,

active-controlled study to evaluate the safety en efficacy of fingolimod administered orally once

daily versus interferon beta-1a i.m. once weekly in pediatric patients with MS

IPMSSG

Page 25: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Hoe ziet studie eruit

Page 26: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Hoe ziet studie eruit

Voorbereidingsfase

Page 27: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Hoe ziet studie eruit

Loting voor Avonex of Fingolimod

Page 28: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Hoe ziet studie eruit

Studie duur 2 jaar

Page 29: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Hoe ziet studie eruit

Eind van de studie

Page 30: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Hoe ziet studie eruit

Vervolg:iedereen mag Fingolimod

Page 31: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Vragen die studie hoopt te beantwoorden

1. hoe effectief is fingolimod in vergelijk met avonex

Hoeveel aanvallen per jaar gedurende de studie

Hoeveel kinderen blijven aanvalsvrij

Hoe lang duurt het tot de eerste aanval onder medicatie

Effect op MRI: hoeveelheid aankleurende afwijkingen

2. hoe veilig is fingolimod bij kinderen

Aantal en soort bijwerkingen

Relatie tussen dosis fingolimod en spiegel meetbaar in bloed.

Page 32: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Wie kunnen mee doen

Kinderen van 10 tot en met 17 jaar

Zekere diagnose MS

Minimaal 1 aanval in afgelopen jaar of 2 aanvallen in afgelopen 2 jaar

EDSS onder de 6.0 (zelfstandig lopen)

Page 33: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Wie kunnen niet meedoen aan de studie

Kinderen met progressieve MS

Actieve chronische ziekte anders dan MS (Bv SLE) of immuun stoornis (BV HIV)

Kinderen met ADEM of ziekte van Devic (NMO) (spectrum)

Antistoffen tegen interferon beta

Eerdere behandeling met ACTH, immuunglobulinen, natalizumab, cladribine, cyclophosphamide, mitoxantrone, azathioprine, methotrexaat, rituximab, ofatumumab, ocrelizumab, alemtuzumab, teriflunomide en dimethylfumraat

LET OP: eerdere behandeling met AVONEX, REBIF, BETAFERON en COPAXONE mag wel, mits geen antistoffen tegen interferon beta.

Page 34: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Wie kunnen niet meedoen aan de studie

Macula-oedeem

Aktieve infectie, onvoldoende vaccinaties

Nog geen compleet vaccinatie schema

Hart-aandoeningen

Ernstige longziekte

Ernstige nierziekten

Page 35: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Veiligheid

Eerste dosis IN ziekenhuis

Frequente controle:

Bloed

X-thorax

Bot foto’s

MRI-scans elke 6 maanden

ECG

Urine controle

Lichamelijk onderzoek

Neurologisch onderzoek

Long testen

Oog onderzoek

Page 36: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Samengevat

Onderzoek dat de werking van Fingolimod gaat vergelijken met Avonex

Er wordt geloot wie Fingolimod gaat krijgen en wie Avonex

Duur van de studie is 2 jaar. Hierna mag iedereen Fingolimod gaan gebruiken

Studie wordt gedaan in nationaal kinder MS centrum

Onderzoek betaald door Novartis.

Page 37: A two year, double- blind, randomized, multicenter, active ...A two year, double- blind, randomized, multicenter, active-controlled study to evaluate the safety en efficacy of fingolimod

Vragen ?