Status: Ongoing
First registered on:
19/06/2018
Last updated on:
22/07/2020
1. Study identification
EU PAS Register NumberEUPAS24484
Official titleLong term, prospective, observational cohort study evaluating the safety profile in patients with highly active relapsing multiple sclerosis (RMS) newly started on oral cladribine
Study title acronymCLARION
Study typeObservational study
Brief description of the studyThis Post-authorisation safety study (PASS) is a multi-country, multi-center, long-term, prospective, observational study evaluating the safety in patients with highly active relapsing remitting multiple sclerosis (R(R)MS) newly initiating oral cladribine (cladribine cohort) as compared to R(R)MS patients newly initiating fingolimod (comparator cohort).
The study is projected to last for a maximum of 15 years, with a maximum 5-year recruitment period until both cohorts have reached 4,000 patients and with a follow-up of 10 years for each patient. The study will only use pre-existing registries or databases and is based on a mixed data collection model relying on secondary use of data and additional (primary) data collection.
For each patient, data collection will begin after the signature of the informed consent form – noting that patient consent applies to countries with primary data collection will be conducted and to some countries where secondary use of data will be performed –and continue during 10 years, as each patient will be followed-up for a period of 10 years, except if s/he is lost to follow-up, or withdrawn his/her consent, or die before the end of the follow-up period. Follow-up will continue regardless of oral cladribine or fingolimod discontinuation.
Was this study requested by a regulator?Yes: EMA
Is the study required by a Risk Management Plan (RMP)?
EU RMP category 3 (required)
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicable
2. Research centres and Investigator details
Coordinating study entity
Department/Research group
Organisation/affiliationEPID Research Oy
Details of (Primary) lead investigator
Title Dr
Last name Korhonen
First name Pasi
Is this study being carried out with the collaboration of a research network?
No
Other centres where this study is being conducted
Not applicable (single centre)
Countries in which this study is being conducted
International study
Australia
Belgium
Denmark
Finland
France
Germany
Italy
Netherlands
Norway
Spain
Sweden
Switzerland
Turkey
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed05/10/201705/10/2017
Start date of data collection14/09/201825/09/2018
Start date of data analysis01/09/2033
Date of interim report, if expected30/09/2021
Date of final study report06/12/2034
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesMerck KGaA100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Korhonen
First name Pasi
Address line 1EPID Research Oy
Address line 2Metsänneidonkuja 12
Address line 3
CityEspoo
Postcode02130
CountryFinland
Phone number (incl. country code)358-50-3652990
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Korhonen
First name Pasi
Address line 1EPID Research Oy
Address line 2Metsänneidonkuja 12
Address line 3
CityEspoo
Postcode02130
CountryFinland
Phone number (incl. country code)358-50-3652990
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Product NameMavenclad®
CountryUnited Kingdom
Substance INN(s)CLADRIBINE
7. Medical conditions to be studied
Medical condition(s)Yes
Multiple sclerosis
8. Population under study
Age
Adults (18 - 44 years)
Adults (45 - 64 years)
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects8000
Additional information
The study aims to enroll 8,000 patients (4,000 patients per cohort) from
centers specialized in the management and treatment of multiple sclerosis patients in Europe and other participating countries launched (Australia, Turkey).
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Sources of data
Disease/case registry
Administrative database, e.g. claims database
Routine primary care electronic patient registry
11. Scope of the study
What is the scope of the study?
Risk assessment
Primary scope : Risk assessment
12. Main objective(s)
What is the main objective of the study?
To further characterize and compare the risk, in terms of incidence of AESI (severe infections, herpes zoster infection, tuberculosis, progressive multifocal leukoencephalopathy (PML), other opportunistic infections, and malignancies) in patients with highly active R(R)MS newly initiating oral cladribine or fingolimod.
Are there primary outcomes?Yes
Number of AESIs (severe infections, herpes zoster infection, tuberculosis, PML, other opportunistic infections, and malignancies) in patients with highly active R(R)MS newly initiating oral cladribine or fingolimod
Are there secondary outcomes?Yes
• Number of AESIs in patients with highly active R(R)MS newly initiating oral cladribine or fingolimod by prior use of immunomodulatory/ immunosuppressive agents
In patients with highly active R(R)MS newly initiating oral cladribine:
• Number and duration of severe lymphopenia
• Number of patients by DMT after oral cladribine treatment in patients who experience a recurrence of disease activity
13. Study design
What is the design of the study?
Cohort study
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
For each patient, data collection will begin after signature of informed consent form (if applicable) and continue during 10 years, as each patient will be followed-up for a period of 10 years, except if s/he is lost to follow-up, or withdrawn his/her consent, or die before the end of the follow-up period. Follow up will continue regardless of oral cladribine or fingolimod discontinuation.
15. Data analysis plan
Please provide a brief summary of the analysis method
In the primary analysis, using the intention-to-treat exposure definition,
the crude and adjusted incidence rates of the different AESIs along with
95% CIs will be estimated in both oral cladribine patients and
fingolimod patients.
In the secondary analyses, the crude and adjusted incidence rate of
severe lymphopenia among oral cladribine patients as well as the 95%
CI will be estimated using Poisson regression models. As for the primary
analysis, the adjustments will be done for the key prognostic factors and
results displayed by means of forest plots. Analysis of duration of severe
lymphopenia will be descriptive.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
Yes
17. Full protocol
18. Study Results
Not submitted
Please list the 5 most relevant publications using data from your study
ReferenceLink to web-publication
None
19. Other relevant documents
Other documentsNot
submitted
