Omar Khan1, Peter Rieckmann2, Alexey Boyko3, Krzysztof Selmaj4, Natalia Ashtamker5, Mat D Davis6, Scott Kolodny7, Robert Zivadinov8. 1. The Sastry Foundation Advanced Imaging Laboratory & Multiple Sclerosis Center, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA. 2. Department of Neurology, Bamberg Academic Hospital, University of Erlangen, Bamberg, Germany. 3. Department of Neurology, Neurosurgery and Medical Genetic of the Pirogov's Russian National Research Medical University and MS Clinic at the Usupov's Hospital, Moscow, Russia. 4. Department of Neurology, Medical University of Łódź, Łódź, Poland. 5. Teva Pharmaceutical Industries, Netanya, Israel. 6. Teva Pharmaceuticals, Frazer, PA, USA. 7. Teva Pharmaceuticals, Cleveland, OH, USA. 8. Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
Abstract
BACKGROUND: The 1-year placebo-controlled (PC) phase of the Glatiramer Acetate Low-Frequency Administration (GALA) study showed that glatiramer acetate 40 mg/mL three times weekly (GA40) significantly reduced annualized relapse rate (ARR) and magnetic resonance imaging (MRI) activity in patients with relapsing-remitting multiple sclerosis. Patients completing the PC phase were invited to an open-label (OL) extension. OBJECTIVE: To evaluate the effects of early start (ES) and delayed start (DS) of GA40 over 3 years. METHODS: A total of 97.2% of patients completing the PC phase received GA40 in the OL extension. ES ( n = 943) patients received GA40 throughout; DS ( n = 461) patients received placebo during the PC phase and GA40 during the OL phase. Relapse, MRI, disease progression, and safety were evaluated. RESULTS: A total of 1041 patients completed 3 years of follow-up. During the OL phase, ES and DS patients showed comparable ARRs (0.20-0.22) and similar numbers of gadolinium-enhancing T1 ( p = 0.49) and new or enlarging T2 lesions ( p = 0.51) at Year 3. ES patients showed significantly smaller changes in gray matter volume than DS patients from Months 12 to 36 (mean difference, 0.371%; p = 0.015), with similar trend in whole-brain volume ( p = 0.080). Adverse events were mild, consistent with the well-established glatiramer acetate (GA) safety profile. CONCLUSION: GA40 conferred treatment benefit over 3 years: sustained low ARR and lesion activity and favorable safety.
RCT Entities:
BACKGROUND: The 1-year placebo-controlled (PC) phase of the Glatiramer Acetate Low-Frequency Administration (GALA) study showed that glatiramer acetate 40 mg/mL three times weekly (GA40) significantly reduced annualized relapse rate (ARR) and magnetic resonance imaging (MRI) activity in patients with relapsing-remitting multiple sclerosis. Patients completing the PC phase were invited to an open-label (OL) extension. OBJECTIVE: To evaluate the effects of early start (ES) and delayed start (DS) of GA40 over 3 years. METHODS: A total of 97.2% of patients completing the PC phase received GA40 in the OL extension. ES ( n = 943) patients received GA40 throughout; DS ( n = 461) patients received placebo during the PC phase and GA40 during the OL phase. Relapse, MRI, disease progression, and safety were evaluated. RESULTS: A total of 1041 patients completed 3 years of follow-up. During the OL phase, ES and DSpatients showed comparable ARRs (0.20-0.22) and similar numbers of gadolinium-enhancing T1 ( p = 0.49) and new or enlarging T2 lesions ( p = 0.51) at Year 3. ESpatients showed significantly smaller changes in gray matter volume than DSpatients from Months 12 to 36 (mean difference, 0.371%; p = 0.015), with similar trend in whole-brain volume ( p = 0.080). Adverse events were mild, consistent with the well-established glatiramer acetate (GA) safety profile. CONCLUSION:GA40 conferred treatment benefit over 3 years: sustained low ARR and lesion activity and favorable safety.
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