Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Three Arm, Randomized, Double Blind, Placebo Controlled, Multicenter, Phase II Study to Evaluate the Efficacy of Vigantol® Oil as Add on Therapy in Subjects With Relapsing Remitting Multiple Sclerosis Receiving Treatment With 44mg Tiw of Rebif®
Brief Summary: The drug being tested is called VigantOL® oil - a very effective form of Vitamin D hormone supplement (cholecalciferol). Low levels of Vitamin D have been described to be associated with a higher risk of developing Multiple Sclerosis (MS), and it is known that up to 90% of patients with Multiple Sclerosis have Vitamin D deficiency.

Rebif® is known to be an effective treatment for slowing down the progression of MS. The purpose of this research trial is to evaluate if VigantOL® oil on top of Rebif® has any benefit on the progression of MS compared to Rebif® and placebo.

Disease activity will be assessed by clinical examination and Magnetic Resonance Imaging (MRI). The planned study treatment duration for each study participant is 48 weeks, and the study consists of a total of 8 visits. Study participants who are already passed Week 48 at the time of approval of Protocol Amendment 5 will have a study duration of 96 weeks and a total of 12 visits.

During the study, the participant will undergo physical examination, neurological assessments, safety assessments, blood tests and urinalysis (including pregnancy tests).


Options:
A: Inclusion Criteria:

* Clinically definite MS
* Age 18-55
* EDSS 0-6.5

Exclusion Criteria:

* EDSS =\> 7.0
* Current Vitamin D3 use \>4000 IU/d
* Baseline (25(OH)D) level \<20 mmol/L (frank deficiency) and \>150 mmol/L
* Pregnancy or inability/unwillingness to use contraception
* History of cardiac arrhythmia
* History of renal disease and nephrolithiasis
* History of granulomatous disease or lymphoma
* Relapse activity or steroid use in the past 60 days
B: Inclusion Criteria:

* age 18 to 55 years
* remitting-relapsing multiple sclerosis according to McDonald criteria who fulfill the reimbursement criteria for interferon-beta and have used interferon-beta-1b for at least one month
* EDSS (expanded disability statsu scale) ≤ 5
* no neutralising antibodies to INFB as measured by indirect MxA test
* prepared and considered to follow the protocol
* using appropriate contraceptive methods (women of childbearing potential)
* has given informed consent

Exclusion Criteria:

* serum calcium \>2.6 mmol/L
* serum 25(OH)D2 (kalsidiol) \> 85 nmol/L
* presence of primary hyperparathyroidism (serum intact PTH, parathyroid hormone)\>65 ng/L)
* pregnancy or unwillingness to use contraception
* alcohol or drug abuse
* use of glucocorticoid treatment other than intravenous methylprednisolone for treatment of relapses
* current use of other immunomodulatory therapy than interferon-beta-1b
* known allergy to cholecalciferol or arachis oil (peanuts)
* therapy with digitalis, calcitonin or active vitamin D3 analogues during the previous 12 months or multivitamins containing vitamin D during previous two weeks preceding study entry
* any condition predisposing to hypercalcaemia (such as any type of cancer)
* sarcoidosis
* nephrolithiasis or renal insufficiency, serum creatinine above 1.5 times the normal upper reference limit
* significant hypertension (Blood Pressure \<180/110 mmHg)
* hyperthyroidism, or hypothyroidism in the year before the study began
* a history of nephrolithiasis during the previous five years
* cardiac insufficiency or significant cardiac dysrhythmia
* unstable or advanced ischaemic heart disease
* has suffered a major depression
C: Inclusion Criteria:

* Diagnosis of a relapsing-remitting form of MS
* Brain and/or spinal MRI with findings typical of MS
* A first clinical event prior to Screening.
* Disease activity
* Expanded Disability Status Scale (EDSS) score of less than, or equal to 4.0 at Screening.
* Currently treated with interferon-beta-1a 44mg (tiw) sc
* Willingness and ability to comply with the protocol
* Written informed consent

Exclusion Criteria:

* Pregnancy and lactation period
* Any disease other than MS that could better explain signs and symptoms.
* Complete transverse myelitis or bilateral optic neuritis.
* Currently receiving or use at any time of monoclonal antibodies, mitoxantrone, cytotoxic or immunosuppressive therapy (excluding systemic steroids and adrenocorticotrophic hormone \[ACTH\]), B cell modulating therapies (e.g. RituxiMab or BelimuMab), total lymphoid irradiation or bone marrow transplantation.
* Use of any cytokine other than interferon or anti-cytokine therapy, intravenous immunoglobulin, plasmapheresis, or any investigational drug or experimental procedure
* Use of oral or systemic corticosteroids or ACTH
* Have abnormalities of Vitamin D related hormonal system other than low dietary intake or decreased sun exposure, i.e. primary hyperparathyroidism or granulomatous disorders.
* Have an urine calcium/creatinine (mmol/mmol) ratio greater than 1.0 or hypercalcaemia
* Are taking medications that influence Vitamin D metabolism other than corticosteroids, e.g., phenytoin, barbiturates, thiazide diuretics and cardiac glycosides.
* Are taking more than 1000 IU (25 µg) of Vitamin D supplement daily.
* Have conditions with increased susceptibility to hypercalcaemia, e.g., known arrhythmia or heart disease, treatment with Digitalis, or Hydrochlorothiazide and those who suffer from nephrolithiasis.
* Have inadequate liver function
* Moderate to severe renal impairment
* Inadequate bone marrow reserve
* History or presence of serious or acute heart disease such as uncontrolled cardiac dysrhythmia or arrhythmia, uncontrolled angina pectoris, cardiomyopathy, or uncontrolled congestive heart failure (NYHA class 3 or 4).
* History or presence of severe depression, history of suicide attempt, or current suicidal ideation.
* Epilepsy or seizures not adequately controlled by treatment.
* Current or past alcohol or drug abuse.
* Any major medical or psychiatric illness (such as psychosis, bipolar disorder) that in the opinion of the Investigator could create undue risk to the subject or could affect adherence with the trial protocol.
* Known contra-indication to treatment with vitamin D
* Known hypersensitivity to interferon or its excipient(s)
* Known hypersensitivity to gadolinium.
* Any other condition that would prevent the subject from undergoing an MRI scan.
* Signs and symptoms suggestive of transmissible spongiform encephalopathy, or family members who suffer(ed) from such.
* Positive HIV, hepatitis C, or hepatitis B (HBsAg and HBc antibody) serology (test performed at screening).
* Legal incapacity or limited legal capacity.
* Another current autoimmune disease, except diabetes.
* Have experienced a relapse within 30 days.
D: Inclusion Criteria:

* Age 18 to 50 years
* EDSS \< 4.0 (able to walk without rest some 500 m)
* Women have to be premenopausal
* MS according to the McDonald criteria; prepared and considered able to follow the protocol; using appropriate contraceptive methods (women of childbearing potential)
* Having given written informed consent.

Exclusion Criteria:

* Pregnancy or unwillingness to use contraception; alcohol or drug abuse
* Use of glucocorticoid treatment other than intravenous methylprednisolone for treatment of relapses
* Known allergy to cholecalciferol or arachis oil (peanuts)
* Therapy with digitalis, calcitonin, active vitamin D3 analogues, fluoride, or bisphosphonates during the previous 12 months
* Any condition predisposing to hypercalcaemia
* Nephrolithiasis or renal insufficiency
* Presence of primary hyperparathyroidism, hyperthyroidism, or hypothyroidism in the year before the study began; a history of nephrolithiasis during the previous five years.

Answer: C