Effect of Adrenocorticotropin Injection With Weekly Interferon Beta in Patients With Relapsing Remitting Multiple Sclerosis (MS)

University at Buffalo

Overview

The purpose of this study is to evaluate whether the use of ACTH in addition to Avonex is effective in the treatment of relapsing remitting multiple sclerosis.

Multiple sclerosis (MS) is a chronic, immune-mediated disease of the central nervous system (CNS). It is a complex, multi-factorial disease that includes inflammatory and neurodegenerative processes manifesting both focally in the form of lesions and diffusely in otherwise normal-appearing brain tissue. Recent data shows that ACTH can have beneficial effects on specific neurodegenerative diseases and it may have superior neuroprotective effects. Adding a regimen of ACTH to standard Avonex treatment may provide neuroprotection and promote remyelination.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Conditions

Multiple Sclerosis

Interventions

repository corticotropin injectionDRUG

IM ACTH: 80 units of Acthra gel I.M. once a day for 5 consecutive days at study time points 0, 3, 6, 9, and 12 months

SalineDRUG

I.M. placebo - 1ml of saline I.M. once per day for 5 consecutive days at 0, 3, 6, 9, and 12 months.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patient diagnosed with MS according to McDonald criteria * Age 18-65 * Have a RR disease course * Have EDSS scores 0-5.5 * Have a disease duration \<20 years * Sub-optimal response to Interferon beta-1a I.M. (Avonex®) while being on therapy for at least 6 months defined as: * presence of a documented relapse within the last 12 months * or the presence of at least one enhancing T1 Gd lesion on an MRI performed within previous 3 months * Signed informed consent * Normal kidney functioning (creatinine clearance \>59) * None of the exclusion criteria Exclusion Criteria: * Presence of relapse or steroid treatment within 60 days prior to study enrollment * Presence of neutralizing antibodies to IFNβ-1a I.M. prior to study enrollment * Presence of optic neuritis within less than 6 months prior to study enrollment * Diagnosis of osteoporosis (T score ≥2.5 SD) * Women who are pregnant, lactating or of childbearing age who do not consent to approved contraceptive use during the study. * Abnormal blood tests, performed during the screening visit including: hepatitis B or hepatitis C, ALT or AST greater than two times the upper limit of normal, abnormal glucose fasting levels or already known diabetes * History of depression while on IFNβ-1a I.M.

Locations (1)

University at Buffalo, Buffalo General Hospital

Buffalo, New York, United States

Outcomes

Primary Outcomes

To define the effect of add-on pulsed IM ACTH vs. placebo to IFNβ-1a I.M. on a voxel-wise MTR dynamic mapping of the lesions and NABT in patients with RRMS

Effect of ACTH in MRI

Time frame: 1 year

Secondary Outcomes

To define the effect of add-on pulsed IM ACTH vs. placebo to IFNβ-1a I.M. in RRMS on anterior optic pathway pathology, as measured by OCT and LCLA in patients with RRMS.

Effect of ACTH on optic health

Time frame: 1 year

Data from ClinicalTrials.gov

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