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A Multicentre Study of the Efficacy and Safety of Supplementary Treatment With Cholecalciferol in Patients With Relapsing Multiple Sclerosis Treated With Subcutaneous Interferon Beta-1a 44 µg 3 Times Weekly (CHOLINE)

Merck KGaA (EMD Serono) logo

Merck KGaA (EMD Serono)

Status and phase

Completed
Phase 2

Conditions

Multiple Sclerosis

Treatments

Dietary Supplement: Placebo
Dietary Supplement: Cholecalciferol (Vitamin D3)
Drug: Rebif

Study type

Interventional

Funder types

Industry

Identifiers

NCT01198132
2009-013695-46 (EudraCT Number)
701068-524

Details and patient eligibility

About

The aim of this multicentre, randomised, double-blind, placebo-controlled study is to evaluate the efficacy and safety of supplementary treatment with cholecalciferol (vitamin D3) in subjects with relapsing multiple sclerosis (R MS) treated with subcutaneous (s.c.) interferon beta-1a 44 microgram (mcg) [Rebif] 3 times weekly. The subjects will be divided into 2 groups, one receiving cholecalciferol 100,000 IU twice monthly along with Rebif treatment and the other group will be on placebo along with Rebif treatment. A total of 200 subjects will be recruited in 20-30 centres in France.

Enrollment

129 patients

Sex

All

Ages

18 to 65 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Diagnosis of RRMS according to Poser criteria (clinically definite multiple sclerosis [CDMS] or laboratory supported definite multiple sclerosis [LSDMS]) or according to McDonald criteria (2005).

  • Subjects aged between 18 and 65 years.

  • Treated with interferon beta-1a 44 mcg (or 22 mcg in case of intolerance to 44 mcg) 3 times weekly subcutaneously for 4 months ± (2 months) at the randomization visit (V1).

  • Expanded disability status scale (EDSS) score between 0 and 5.

  • At least one documented episode during the last two year.

  • Stable disease with no episodes over the last 30 days.

  • Serum 25-hydroxyvitamin D less than (<) 75 nanomolar per liter (nmol/l) at randomization visit.

  • Women must not be pregnant or breast-feeding, and women of childbearing age must meet the following criteria:

    • Surgically sterilised, or
    • Using a highly effective contraceptive method throughout the entire duration of the study. A highly effective contraceptive method is defined as a method with a very low failure rate (i.e. < 1 % per year) with regular and appropriate use, e.g. implants, injectable contraceptives, combined oral contraceptives, coil, abstinence or vasectomised partner.
    • Menopausal women may be included.
  • Affiliated to French healthcare insurance.

  • Subjects must be ready and able to provide informed consent and comply with the protocol requirements.

Exclusion criteria

  • Hormonal abnormalities associated with vitamin D other than low dietary intake or reduced exposure to sun, for example malabsorption (coeliac disease, Whipple's disease, inflammatory bowel disease, intestinal derivation, short bowel syndrome), cirrhosis, nephrotic syndrome, hyperthyroidism, rickets, hypoparathyroidism, cancer, granulomatous diseases (sarcoidosis, silicosis) and lymphomas known at the initial visit.
  • Patients with osteoporosis or known osteopenia.
  • Use of medicines affecting vitamin D metabolism other than corticosteroids, e.g. anticonvulsants (phenobarbital, primidone, phenytoin), rifampicin, isoniazid, ketoconazole, 5-FU and leucovorin, or thiazide diuretics.
  • Previous or ongoing hypercalcaemia.
  • Situations involving increased susceptibility to hypercalcaemia, e.g. known cardiac arrhythmia or cardiac disease, treatment with digitalis, renal lithiasis.
  • Any contraindication to the treatment (cholecalciferol) stated in the summary of product characteristics.
  • Moderate renal impairment defined as creatinine clearance between 30 and 60 ml/min.
  • An active episode during the month prior to inclusion in the study.
  • Inadequate liver function, defined as total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT) or alkaline phosphatase greater than (>) 2.5 * upper limit of normal.
  • Severe renal impairment defined as creatinine clearance below 30 milliliter per minute (ml/min).
  • Inadequate marrow reserves, defined as white blood cells < 0.5 * lower limit of normal.
  • Serious or acute heart disease such as uncontrolled cardiac arrhythmia, uncontrolled angina, cardiomyopathy or uncontrolled congestive heart failure.
  • History of severe depression, or attempted suicide or ongoing suicidal ideation.
  • Epilepsy inadequately controlled by treatment.
  • Ongoing or previous alcohol or drug abuse (within the last two years).
  • Major medical or psychiatric disease which, in the opinion of investigator, would place the subject at risk or could adversely affect compliance with the study protocol.
  • Known hypersensitivity to gadolinium and/or known inability to undergo MRI.
  • Any medical condition requiring chronic treatment with systemic corticosteroids.
  • Participation in any other studies involving other study products over the 30 days prior to inclusion in this study.
  • Legal incapacity or limited legal capacity.

Trial design

Primary purpose

Supportive Care

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

129 participants in 2 patient groups, including a placebo group

Cholecalciferol
Experimental group
Description:
Subjects receive Cholecalciferol 100,000 IU one dose fortnightly (equivalent to a daily dose of approximately 7142 IU) for 96 weeks treatment period along with subcutaneous Rebif 3 times a week.
Treatment:
Drug: Rebif
Dietary Supplement: Cholecalciferol (Vitamin D3)
Placebo
Placebo Comparator group
Description:
Subjects receive matching placebo to Cholecalciferol once every two weeks along with subcutaneous injection of Rebif 3 times weekly.
Treatment:
Drug: Rebif
Dietary Supplement: Placebo

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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