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Status unknownNCT03424733Updated Aug 15, 2019

Evaluating the Use of Prednisone to Decrease Pegylated Interferon Beta-1a Side Effects

A Phase 4 interventional study of Plegridy and Prednisone in Multiple Sclerosis, sponsored by Holy Name Medical Center, Inc.. Status unknown at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-08-15.

Sponsored by Holy Name Medical Center, Inc. · Phase 4, Interventional, and Prevention

The sponsor has not verified this record recently (last verified Aug 2019), so the status shown — last known as Recruiting — may be out of date.
Phase
Phase 4
Study type
Interventional
Enrollment
50
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
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Study summary

Some of the most common side effects of the multiple sclerosis drug Plegridy (pegylated interferon beta-1a) include flu-like symptoms and injection site reactions. Physicians often advise patients to take Tylenol or aspirin prior to injection, but in this study the investigators evaluated whether using a low dose of oral steroid in combination with Tylenol reduced flu-like symptoms and injection site reactions.

Read the detailed description

Multiple Sclerosis (MS) is a chronic neurological disease characterized by demyelination of the brain and spine. Currently, there are several treatments designed to decrease the frequency of attacks and delay disease progression. One of these treatments, interferon beta, has shown the potential to decrease relapse rates by approximately 30%, but because the body quickly clears these proteins, patients require more frequent dosing. Another interferon therapy called pegylated interferon beta-1a (Plegridy) was released and it was shown to last longer in the body than interferon beta-1a. This is why Plegridy can be take by an injection into tissue under the skin once every 14 days. However, some of the most common side effects of interferon beta therapy include flu-like symptoms and injection skin reactions, which can often cause patients to want to stop treatment. Clinical practitioners often advise patients to take acetaminophen (Tylenol) or aspirin before the injection in order to prevent the onset or decrease the severity of flu-like symptoms. A previous study with patients taking interferon beta-1a showed that taking a low dose oral steroid (prednisone) in addiction to a medication like Tylenol reduced flu-like symptoms compared to just taking Tylenol by itself. Because Plegridy lasts longer in the body and has more convenient dosing for patients, researchers in this study decided to investigate whether taking prednisone in addition to acetaminophen before the injection would help decrease or prevent the occurrence of flu-like symptoms and injection site reactions in patients taking the therapy.

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Conditions studied

  • Multiple Sclerosis

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Keywords

  • demyelination
  • relapse rate
  • Pegylated interferon beta-1a
  • side effects
  • flu-like symptoms
  • injection site reactions
  • prednisone
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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • diagnosed any form of MS (relapsing remitting, primary progressive, secondary progressive), any EDSS (expanded stability status scale) score

Exclusion criteria

Exclusion Criteria:

  • prior allergic reaction to interferon products, congestive heart failure, elevated liver enzymes
04

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Non-randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
50 participants (estimated)

Study arms

  • Active comparator
    Current Plegridy Users

    Members in this group have been previously titrated and are currently taking the pegylated interferon beta-1 (Plegridy) injection once every two weeks. These patients will complete a total of six study injections of Plegridy (125 micrograms) totaling a 12 week study duration. Subjects must take two 325mg tablets of Tylenol 1 hour prior to each study injection, and one 20mg Prednisone tablet 4-5 hours prior to injections two through six only.

    Drug: Plegridy · Drug: Prednisone · Drug: Tylenol Pill

  • Experimental
    New Plegridy Users

    Members in this group have never taken the pegylated interferon beta-1a (Plegridy) injection, and so they must first by titrated by injecting with a 63 and 94 microgram Plegridy dose. Titrations, along with full dose injections (125 micrograms) occur every two weeks. Patients must take two 325mg tablets of Tylenol prior to each titration injection. The third study dosage involves subjects taking the full 125 microgram Plegridy dosage with two 325mg Tylenol tablets prior to injection. The final five study injections (four through eight) require patients to take two 325mg Tylenol tablets 1 hour prior to injection, and one 20mg Prednisone tablet 4-5 hours prior to injection.

    Drug: Plegridy · Drug: Prednisone · Drug: Tylenol Pill

Interventions

  • DrugPlegridy

    Self injection into area of high adipose content. Injections include 63 and 94 microgram titration doses, and the full 125 microgram dose

    Also known as: Pegylated Interferon beta-1a

  • DrugPrednisone

    Take one 20 milligram prednisone tablet four to five hours prior to injections two through six of the full 125 microgram Plegridy dose.

  • DrugTylenol Pill

    Take two 325 milligram Tylenol tablets 1 hour prior to each Plegridy injection, irregardless of dosage.

    Also known as: Acetaminophen

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What researchers measure

Primary outcomes

  1. Flu-like symptoms

    Reduced flu-like symptoms from Plegridy injections due to taking both Tylenol and Prednisone prior to treatment. Flu-like symptoms are measured every 6 hours for 48 hours after injection by patients self reporting their muscle aches, temperature, chills, and fatigue on a Holy Name administered Flu-like symptom questionnaire.

    Time frame: 12 to 16 weeks

Secondary outcomes

  1. Injection site reactions

    Reduced injection site reactions from Plegridy injections due to taking both Tylenol and Prednisone prior to injection. Injection site reactions are reported to a clinical research assistant approximately one week after injection. If present, patients must record their injection site reactions using a Holy Name administered tape measurer in centimeters, as well as descriptive characteristics of the injection (location on body, swelling, redness, itching, and pain). The clinical research assistant records all of the data on an injection site reaction form.

    Time frame: 12 to 16 weeks

06

Study locations

1 of 1 sites recruiting
  • Holy Name Medical Center
    Teaneck, New Jersey 07666, United States
    Recruiting
07

References and documents

Publications

  • Rio J, Nos C, Marzo ME, Tintore M, Montalban X. Low-dose steroids reduce flu-like symptoms at the initiation of IFNbeta-1b in relapsing-remitting MS. Neurology. 1998 Jun;50(6):1910-2. doi: 10.1212/wnl.50.6.1910. PubMed 9633761 ↗
  • Brandes DW, Bigley K, Hornstein W, Cohen H, Au W, Shubin R. Alleviating flu-like symptoms with dose titration and analgesics in MS patients on intramuscular interferon beta-1a therapy: a pilot study. Curr Med Res Opin. 2007 Jul;23(7):1667-72. doi: 10.1185/030079907x210741. PubMed 17588298 ↗
  • Rio J, Nos C, Bonaventura I, Arroyo R, Genis D, Sureda B, Ara JR, Brieva L, Martin J, Saiz A, Sanchez Lopez F, Prieto JM, Roquer J, Dorado JF, Montalban X. Corticosteroids, ibuprofen, and acetaminophen for IFNbeta-1a flu symptoms in MS: a randomized trial. Neurology. 2004 Aug 10;63(3):525-8. doi: 10.1212/01.wnl.0000133206.44931.25. PubMed 15304586 ↗

Individual participant data

Plan to share: Undecided

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Registry details

Key details

Study ID
NCT03424733
Lead sponsor
Holy Name Medical Center, Inc.
Collaborators
Biogen
Responsible party
Mary Ann Picone, MD (Neurologist, Holy Name Medical Center, Inc.) — Principal investigator
First posted
Feb 7, 2018
Start date
Sep 25, 2017
Primary completion
May 1, 2020 (estimated)
Completion
May 31, 2020 (estimated)
Last update
Aug 15, 2019

Study contacts

Mary Ann Picone, MD
Contact
m-picone@mail.holyname.org
201-837-0727

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is status unknown, as verified in Aug 2019. You cannot join it, but the record below documents what was studied.

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