Clinical and experimental evidences suggests an immunomodulatory effect of sex hormones in multiple sclerosis. The role of oral estroprogestins in the pathogenesis and in the clinical course of the disease is actually unknown. The aim of the study is to investigate safety and tolerability of association of estroprogestins in two different doses with interferon-beta 1a in patients with relapsing-remitting multiple sclerosis.
Phase 2, randomised, single blind, three arms study. Follow-up of 24 months. The study will include relapsing-remitting multiple sclerosis female patients. Patients will be equally randomised into three groups: 1) patients treated with IFN-beta 1a (44 mcg for three times a week), 2) patients treated with IFN-beta 1a and lower-dose estroprogestins (desogestrel 150 mcg, etinilestradiol 20 mcg), 3) patients treated with IFN-beta 1a and higher-dose estroprogestins (desogestrel 25 mcg, etinilestradiol 40 mcg). Safety and tolerability of the treatment will be evaluated using neurological examination and MRI analysis. A complete neurological examination (with EDSS) will be performed at month 0, 6, 12, 18 and 24. MRI examination will be assessed at baseline and at month 12 and 24. In the same day of MRI examination we'll collect blood samples for hormonal analysis (we'll measure sex hormones in the follicular and in the luteal phase of a single menstrual cycle). During the follow-up patients will be evaluated also with: MS-Functional Composite at month 0, 6, 12, 18, 24; neuropsychological evaluation at month 0, 12, 24; Fatigue Severity Scale at month 0, 12, 24; Hamilton Depression Scale at month 0, 12, 24; Quality of Life scale (MSQOL54) at month 0, 12, 24.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
200
Department of Neurology - University of Rome La Sapienza
Rome, Rome, Italy
RECRUITINGSafety assessment at 6, 12, 18 and 24 months, including adverse events, physical examination and laboratory parameters
Relapse rate at 6, 12, 18 and 24 months,
EDSS progression at 12 and 24 months,
MS functional composite score at 12 and 24 months,
Number and volume of new gad-enhancing lesions at 12 and 24 months
Number of new T1 and T2 lesions at 12 and 24 months
Brain volume changes at 12 and 24 months
Neuropsychological examination at 0, 12, 24 months
Hamilton scale for depression score at 0, 12, 24 months
MS Quality of Life scale score(MSQOL54)at 0, 12, 24 months
Fatigue Severity Scale score at 0, 12, 24 months
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