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NCT02097849

Vaccination Response in Tecfidera-Treated Versus Interferon-Treated Participants With Relapsing Forms of Multiple Sclerosis.

Completed Phase 2 Results posted Last updated 2 June 2017
What this trial tests

Phase 2 trial testing dimethyl fumarate in Relapsing Forms of Multiple Sclerosis in 71 participants. Completed in 2 May 2016.

Timeline
28 February 2015
Primary endpoint
2 May 2016
2 May 2016

Quick facts

Lead sponsorBiogen
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationnon randomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment71
Start date28 February 2015
Primary completion2 May 2016
Estimated completion2 May 2016
Sites14 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Biogen — full company profile →

Who can join

Adults 18 to 55, any sex, with Relapsing Forms of Multiple Sclerosis. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Tetanus Responders (≥ 2-Fold Rise) at Day 28 Compared to Prevaccination Level Primary · Up to Week 4 (Day 28) postvaccination

Percentage of participants with a ≥ 2-fold rise in anti-tetanus serum immunoglobulin G (IgG) levels (responders) from prevaccination to 4 weeks after Td vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations7354 – 87
Tecfidera Treated Plus Vaccinations6851 – 82
Percentage of Tetanus Responders (≥ 4-Fold Rise) at Day 28 Compared to Prevaccination Level Secondary · Up to Week 4 (Day 28) postvaccination

Percentage of participants with a ≥ 4-fold rise in anti-tetanus serum IgG levels (responders) from prevaccination to 4 weeks after Td vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations6142 – 77
Tecfidera Treated Plus Vaccinations4226 – 59
Percentage of Pneumococcal Serotype 3 (≥ 2-Fold Rise) Responders Compared to Prevaccination Level Secondary · Up to Week 4 (Day 28) postvaccination

Percentage of participants with a ≥ 2-fold rise in anti-pneumococcal serum IgG levels against serotype 3 from prevaccination to 4 weeks (28 days) after PPSV23 vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations7961 – 91
Tecfidera Treated Plus Vaccinations6649 – 80
Percentage of Pneumococcal Serotype 3 (≥ 4-Fold Rise) Responders Compared to Prevaccination Level Secondary · Up to Week 4 (Day 28) postvaccination

Percentage of participants with a ≥ 4-fold rise in anti-pneumococcal serum IgG levels against serotype 3 from prevaccination to 4 weeks (28 days) after PPSV23 vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations7051 – 84
Tecfidera Treated Plus Vaccinations4731 – 64
Percentage of Pneumococcal Serotype 8 (≥ 2-Fold Rise) Responders Compared to Prevaccination Level Secondary · Up to Week 4 (Day 28) postvaccination

Percentage of participants with a ≥ 2-fold rise in anti-pneumococcal serum IgG levels against serotype 8 from prevaccination to 4 weeks (28 days) after PPSV23 vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations8872 – 97
Tecfidera Treated Plus Vaccinations9582 – 99
Percentage of Pneumococcal Serotype 8 (≥ 4-Fold Rise) Responders Compared to Prevaccination Level Secondary · Up to Week 4 (Day 28) postvaccination

Percentage of participants with a ≥ 4-fold rise in anti-pneumococcal serum IgG levels against serotype 8 from prevaccination to 4 weeks (28 days) after PPSV23 vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations8568 – 95
Tecfidera Treated Plus Vaccinations8266 – 92
Percentage of Meningococcal Serogroup C Responders (≥ 2-Fold Rise) Compared to Prevaccination Level Secondary · Up to Week 4 (Day 28) postvaccination

Percentage of participants with a ≥ 2-fold rise in anti-meningococcal serum IgG levels against serotype C from prevaccination to 4 weeks after MCV4 vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations5335 – 71
Tecfidera Treated Plus Vaccinations5336 – 69
Percentage of Meningococcal Serogroup C Responders (≥ 4-Fold Rise) Compared to Prevaccination Level Secondary · Up to Week 4 (Day 28) postvaccination

Percentage of participants with a ≥ 4-fold rise in anti-meningococcal serum IgG levels against serotype C from prevaccination to 4 weeks after MCV4 vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations3821 – 56
Tecfidera Treated Plus Vaccinations3722 – 54
Ratio of Serum Tetanus Level at Day 28 to Prevaccination Secondary · Up to Week 4 (Day 28) postvaccination

Median serum titer ratios from prevaccination to 4 weeks after Td vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations6.1282.828 – 8.139
Tecfidera Treated Plus Vaccinations4.4631.955 – 8.244
Ratio of Serum Pneumococcal Antibodies (Serotype 3) Level at Day 28 to Prevaccination Secondary · Up to Week 4 (Day 28) postvaccination

Median serum titer ratios from prevaccination to 4 weeks after PPSV23 vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations9.6674.537 – 18.000
Tecfidera Treated Plus Vaccinations4.7412.000 – 11.000
Ratio of Serum Pneumococcal Antibodies (Serotype 8) Level at Day 28 to Prevaccination Secondary · Up to Week 4 (Day 28) postvaccination

Median serum titer ratios from prevaccination to 4 weeks after PPSV23 vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations27.00012.750 – 49.286
Tecfidera Treated Plus Vaccinations13.8456.000 – 28.250
Ratio of Serum Meningococcal Antibodies (Serogroup C) Level at Day 28 to Prevaccination Secondary · Up to Week 4 (Day 28) postvaccination

Median serum titer ratios from prevaccination to 4 weeks after MCV4 vaccination.

GroupValue95% CI
Non-Pegylated IFN Treated Plus Vaccinations3.3001.000 – 11.159
Tecfidera Treated Plus Vaccinations3.4081.000 – 8.600

Adverse events — posted to ClinicalTrials.gov

Time frame: SAEs: Screening (Within 28 Days Before Day 1) up to Week 4 (Day 28 ±3 Days) or Early Withdrawal. AEs: Day 1 up to Week 4 (Day 28 ±3 Days) or Early Withdrawal. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Non-Pegylated IFN Treated Plus Vaccinations
Serious: 0/33 (0%)
Deaths:
Tecfidera Treated Plus Vaccinations
Serious: 0/38 (0%)
Deaths:
Other adverse events (11 terms — click to expand)

ReactionSystemNon-Pegylated IFN Treated …Tecfidera Treated Plus Vac…
Injection site painGeneral disorders
Injection site erythemaGeneral disorders
Injection site swellingGeneral disorders
PainGeneral disorders
Injection site warmthGeneral disorders
PyrexiaGeneral disorders
Urinary tract infectionInfections and infestations
ArthralgiaMusculoskeletal and connective tissue disorders
Back painMusculoskeletal and connective tissue disorders
HeadacheNervous system disorders
RashSkin and subcutaneous tissue disorders

Data from ClinicalTrials.gov NCT02097849 adverse events section.

Sponsor's own description

Primary objective is to evaluate the immune response to vaccination with tetanus diphtheria toxoids vaccine (Td) in participants with relapsing forms of Multiple Sclerosis (MS) who have been treated with Tecfidera (BG00012) versus those treated with non pegylated interferon (IFN). Secondary objective is to evaluate the immune response to vaccination with 23-valent pneumococcal polysaccharide vaccine (PPSV23) \[a mostly T cell-independent humoral response\] and meningococcal polysaccharide diphtheria conjugate vaccine, quadrivalent (MCV4) \[T cell-dependent neoantigen response\].

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Immune response to vaccines is maintained in patients treated with dimethyl fumarate.
    von Hehn C, Howard J, Liu S, Meka V, et al · · 2018 · cited 62× · PMID 29159204 · DOI 10.1212/nxi.0000000000000409
  2. Recent Advances in Understanding Nrf2 Agonism and Its Potential Clinical Application to Metabolic and Inflammatory Diseases.
    Kim MJ, Jeon JH. · · 2022 · cited 60× · PMID 35269986 · DOI 10.3390/ijms23052846
  3. Induction of Cardiac Pathology: Endogenous versus Exogenous Nrf2 Upregulation.
    Mathis BJ, Kato H, Hiramatsu Y. · · 2022 · cited 5× · PMID 36497112 · DOI 10.3390/cells11233855

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