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Combination Therapy With Avonex and BiMonthly High Dose Intravenous Methotrexate in Multiple Sclerosis
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: MidAmerica Neuroscience Institute
Consultants in Neurology
Biogen Idec
Information provided by: MidAmerica Neuroscience Institute
ClinicalTrials.gov Identifier: NCT00037102
  Purpose

The participant will receive weekly intramuscular treatment with AVONEX® (interferon beta 1-a) and bi-monthly high dose intravenous methotrexate with Leucovorin rescue.


Condition Intervention Phase
Multiple Sclerosis
Drug: interferon beta 1a
Drug: methotrexate
Phase IV

MedlinePlus related topics: Multiple Sclerosis
Drug Information available for: Leucovorin Calcium Citrovorum factor Folinic acid calcium salt pentahydrate Leucovorin Methotrexate Interferons Interferon beta Interferon-beta Interferon beta 1a
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study
Official Title: An Open Label Study of the Safety and Efficacy of Combination Therapy With AVONEX and Bi-Monthly High Dose Intravenous Methotrexate With Leucovorin Rescue in the Treatment of Multiple Sclerosis

Further study details as provided by MidAmerica Neuroscience Institute:

Estimated Enrollment: 15
Study Start Date: July 2001
Estimated Study Completion Date: December 2003
Detailed Description:

The participant will receive weekly intramuscular treatment with AVONEX® (interferon beta 1-a) and bi-monthly high dose intravenous methotrexate with Leucovorin rescue. Entrance into the study will be based on Multiple Sclerosis Functional Composite Score (MSFC) evaluations at –4 months, and - 1 month prior to study, where a decrease in score is noted. The composite score consists of the Timed 25-Foot Walk, Nine-Hole Peg Test (9HPT), and Paced Auditory Serial Addition Test 3 (PASAT 3). The patient must have been on AVONEX® for at least 6 months.

At study entrance, baseline lab work (complete blood count, platelet count, routine electrolytes, blood urea nitrogen, creatinine, liver function tests, 24 hour urine collection for creatinine clearance, and urine pH), an electrocardiogram (measurement of heart activity) and serum pregnancy test will be done. A complete physical examination will be performed, including measurements of vital signs (heart rate and blood pressure), as well as magnetic resonance imaging (MRI) to document status of disease. A self-administered questionnaire, the MSQLI (Multiple Sclerosis Quality of Life Instrument), will be completed at baseline and at the end of the study. MSFC and safety evaluations (previously mentioned blood and urine tests and electrocardiograms (EKG), will be conducted throughout the study at months 2, 4, 6, 8, 10, and 12. Blood tests of immune cells will also be drawn at these visits. The patient can continue this regimen of treatment at their own discretion and cost, and outside the parameters of this study, if there is apparent efficacy without serious adverse events. This treatment would be under the supervision of Dr. Rowe.

The patients will continue their AVONEX® intramuscular injections of 30 micrograms (administered by patient or caregiver) on a weekly basis with scheduled intravenous high dose methotrexate at 2 Gm/m2 followed by intravenous and oral leucovorin rescue once every 2 months. The methotrexate infusions will be performed in our outpatient infusion center. The patient will be required to complete a patient diary during the course of the trial, participate in and keep all scheduled appointments, and to inform the research staff and physician of any change in concomitant medications or adverse events that they may experience.

  Eligibility

Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

To be eligible for entry into this study, candidates must meet the following eligibility criteria at the time of enrollment:

  • Between the ages of 18 and 60 years, inclusive.
  • Diagnosis of clinically definite relapsing MS.
  • Must have been on AVONEX® therapy for at least six months.
  • Brain MRI scans demonstrating lesions consistent with MS.
  • Subject must have had at least one clinical exacerbation in the last year, and this must have occurred after having been on AVONEX® therapy for at least six to twelve (6-12) months. A clinical exacerbation is defined as a decrease of 0.1 in the MSFC composite or any of the subset domains scores administered 3 months apart.
  • Give written informed consent prior to any testing under this protocol, including screening tests and evaluation that are not considered part of the subject's routine care.

To be eligible for treatment with methotrexate, subjects must have evidence for MS disease activity on their baseline screening MRI.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00037102

Locations
United States, Missouri
MidAmerica Neuroscience Institute
Kansas City, Missouri, United States, 64108
Sponsors and Collaborators
MidAmerica Neuroscience Institute
Consultants in Neurology
Biogen Idec
  More Information

Study ID Numbers: MANI-MTX01-001
Study First Received: May 15, 2002
Last Updated: June 23, 2005
ClinicalTrials.gov Identifier: NCT00037102  
Health Authority: United States: Food and Drug Administration

Keywords provided by MidAmerica Neuroscience Institute:
Multiple Sclerosis
Relapsing
Methotrexate
AVONEX
interferon beta 1a
demyelinating
autoimmune

Study placed in the following topic categories:
Autoimmune Diseases
Demyelinating Diseases
Interferons
Interferon-beta
Leucovorin
Sclerosis
Demyelinating diseases
Folic Acid
Multiple Sclerosis
Interferon beta 1a
Demyelinating Autoimmune Diseases, CNS
Methotrexate
Autoimmune Diseases of the Nervous System

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Immunologic Factors
Antineoplastic Agents
Nervous System Diseases
Physiological Effects of Drugs
Adjuvants, Immunologic
Enzyme Inhibitors
Reproductive Control Agents
Folic Acid Antagonists
Abortifacient Agents, Nonsteroidal
Immunosuppressive Agents
Antiviral Agents
Pharmacologic Actions
Pathologic Processes
Therapeutic Uses
Abortifacient Agents
Antirheumatic Agents
Dermatologic Agents
Nucleic Acid Synthesis Inhibitors

ClinicalTrials.gov processed this record on January 16, 2009