Conditions: Relapsing Remitting Multiple Sclerosis
Keywords: Multiple Sclerosis brain atrophy Glatiramer Acetate Copaxone Steroids Prednisone
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 414
Healthy volunteers: no

Brief summary:
This is a study evaluating the effect on brain volume of daily glatiramer acetate (GA) and add-on pulse steroids.

Detailed description:
One interim analysis was planned for possible early termination due to proven efficacy when 75% of the preplanned 500 (approx. 375 patients) recruited patients completed the entire study duration or early discontinued.

In addition to the stopping rule already given for proven efficacy, the sponsor was also interested in examining the data for futility (i.e., absence of the desired treatment effect) with the view to terminating the trial if an "insufficient" effect of the treatment is seen. The reasons why the need for futility arose were:

1. Recruitment difficulties
2. Increasing dropout rate
3. Budgetary constraints

The primary efficacy measure is defined as the percent change from baseline to termination (Month 36 or Early Termination) in normalized brain volume (Brain Atrophy) measured according to the SIENA (Structural Imaging Evaluation using Normalization of Atrophy) method. However, since not many patients had completed the entire study at the time of futility analysis, it was the sponsor's decision that the futility analysis be performed on patients with MRI scans at months 24 or 36 or at early termination visits - the latest available.

Based on the recalculation of study power (probability is unconditioned on the interim result and provide the real power of the study if designed anew), conditional power (based on the interim results) and risk assessment of a false negative, the Data Monitoring Committee agreed that the study should be terminated early.

Arms:
arm 1: Glatiramer acetate (GA) 10mg as a subcutaneous injection daily, plus a placebo to mimic prednisone given daily. arm 2: Glatiramer acetate (GA) 20mg daily as a subcutaneous injection, plus 1250 mg of prednisone daily.

Interventions: intervention 1: Glatiramer Acetate intervention 2: Placebo intervention 3: Prednisone
Intervention descriptions: intervention 1: 20mg glatiramer acetate (GA) administered by daily subcutaneous injections intervention 2: Placebo for prednisone given daily intervention 3: Prednisone 1250 mg taken daily

Protocol document: