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Treatment of Multiple Sclerosis With Copaxone and Albuterol

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00039988
Recruitment Status : Completed
First Posted : June 20, 2002
Last Update Posted : September 22, 2016
Autoimmunity Centers of Excellence
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)

Brief Summary:

The purpose of this study is to determine the effects of glatiramer acetate (Copaxone) alone compared to Copaxone plus albuterol in patients with Multiple Sclerosis (MS).

MS is thought to be an autoimmune disease of the central nervous system. Certain white blood cells of the immune system become abnormally active and mistakenly attack the myelin of nerve fibers. Myelin is a fatty sheath that surrounds nerve fibers and insulates the nerve like insulation around an electrical wire. Without proper myelin insulation, messages sent between the brain and other parts of the body may be confused or fail completely. Damage to myelin causes the symptoms of MS. The most common form of MS is known as relapsing-remitting (RR), where partial or total recovery occurs after attacks. Four therapies are currently approved for the treatment of MS. These therapies, however, are only moderately effective and can cause undesirable side effects. For this reason, there is a need to find new therapies that have minimal side effects and may stop the disease from getting worse.

Condition or disease Intervention/treatment Phase
Autoimmune Diseases Multiple Sclerosis Drug: Glatiramer acetate Drug: Albuterol Drug: Albuterol placebo Not Applicable

Detailed Description:

MS is a chronic inflammatory disease of the central nervous system characterized by focal T cell and macrophage infiltrates that lead to demyelination and loss of neurologic function. Four therapies are currently approved for the treatment of MS. Three of these are approved for the treatment of patients with the relapsing-remitting (RR) form of MS, in which patients have clinical exacerbations followed by partial or complete recovery of function. These treatments are only modestly effective and are associated with significant toxicity, often causing patients to delay therapy for significant lengths of time. Thus, there is a need to find therapies with low toxicities that can be administered early during the disease course with the potential for arresting the disease.

During the pre-treatment phase, patients undergo neurological exams, including the extended disability status scale (EDSS), Ambulation Index (AI), disease steps (DS) scale MS functional composite score, PASAT, 9 hole peg test, and the 25 foot walking time. A 12-lead electrocardiogram (EKG) and chest x-ray are performed. Serum chemistry is assessed as well as electrolyte and thyroid stimulating hormone (TSH) levels. A brain MRI (with and without gadolinium), urinalysis, and urine pregnancy test (for women of reproductive potential) are performed. Blood is collected for mechanistic studies. In the treatment phase, patients are assigned randomly to 1 of 2 study arms:

Arm 1: Copaxone plus placebo. Arm 2: Copaxone plus albuterol. At the treatment visits, blood is collected and neurological exams and a brain MRI are performed. A pregnancy test is administered to women of reproductive potential. Neurological exams are performed every 6 months. MRIs are performed at baseline, Year 1, and Year 2. At the end of the study, patients have a complete physical exam, a neurological exam, and a brain MRI.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 40 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary Purpose: Treatment
Official Title: Treatment of Multiple Sclerosis With Copaxone (Glatiramer Acetate) and Albuterol
Study Start Date : November 2001
Actual Primary Completion Date : March 2006
Actual Study Completion Date : November 2007

Arm Intervention/treatment
Experimental: 1
Participants will receive Copaxone and albuterol placebo
Drug: Glatiramer acetate
20 mg administered subcutaneously daily

Drug: Albuterol placebo
Oral placebo capsules will be taken daily

Experimental: 2
Participants will receive Copaxone and albuterol
Drug: Glatiramer acetate
20 mg administered subcutaneously daily

Drug: Albuterol
2 mg or 4 mg oral capsules taken daily

Primary Outcome Measures :
  1. Change in each participant's disease status, as measured by the Multiple Sclerosis Functional Composite score (MSFC) [ Time Frame: Throughout study ]
  2. Glatiramer acetate-specific cytokine secretion of IL-13 cytokine secretion and IFN-gamma secretion by glatiramer acetate-reactive T-cell lines [ Time Frame: At Months 3, 6, and 12 ]

Secondary Outcome Measures :
  1. Change in IL-5 secretion in the supernatants of lines stimulated with glatiramer acetate [ Time Frame: Throughout study ]
  2. Change in percentage of IL-12-producing monocytes by intracytoplasmic staining [ Time Frame: Throughout study ]
  3. Time to first exacerbation [ Time Frame: Throughout study ]
  4. Number and severity of exacerbations [ Time Frame: Throughout study ]
  5. MRI evidence as measured by T2 lesion volume, number of enhancing lesions on T1 weighted images, and measurements of atrophy (brain parenchymal fraction, atrophy index) [ Time Frame: At study entry and Months 12 and 24 ]
  6. Expanded Disability Status Scale (EDSS), Ambulation Index (AI), and Disease Steps (DS) scores [ Time Frame: Throughout study ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years to 55 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria

Patients may be eligible for this study if they:

  • Have been diagnosed with RR-MS, within 2 years of diagnosis.
  • Are 18-55 years old.
  • Have RR-MS with evidence of demyelination on MRI scanning of the brain.
  • Have extended disability status scale (EDSS) scores between 0 and 3.5.
  • Have not taken Copaxone or oral myelin.
  • Have not had immunomodulating therapy for the past 3 months.
  • Have not taken immunosuppressants.
  • Have not had steroid treatment 1 month before entry.
  • Have no evidence of active infection or cancer.

Exclusion Criteria

Patients may not be eligible for this study if they:

  • Have a normal brain MRI.
  • Are not willing to practice contraception (applies to women who are able to have children).
  • Are pregnant or breast-feeding.
  • Are currently taking any of the following drugs: beta2-adrenergic agonist or antagonist, diuretics, tricyclic antidepressants, or monoamine oxidase inhibitors.
  • Have heart, blood, liver, or kidney problems.
  • Have a disease that affects blood clotting or lung function.
  • Have abnormalities that relate to the endocrine system.
  • Have a history of alcohol or drug abuse within 6 months of enrollment.
  • Have been diagnosed with primary progressive MS, in which the disease slowly worsens without periods of recovery.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00039988

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United States, Massachusetts
Brigham and Women's Hospital/Harvard Medical School
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
Autoimmunity Centers of Excellence
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Principal Investigator: Samia Khoury Brigham and Women's Hospital/Harvard Medical School

Publications of Results:
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Responsible Party: National Institute of Allergy and Infectious Diseases (NIAID) Identifier: NCT00039988     History of Changes
Other Study ID Numbers: DAIT AMS01
ACE Study AMS01
First Posted: June 20, 2002    Key Record Dates
Last Update Posted: September 22, 2016
Last Verified: September 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Data access including but not limited to participant level data, is available to the public in the Immunology Database and Analysis Portal (ImmPort), a long-term archive of clinical and mechanistic data from DAIT-funded grants and contracts.

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
Treatment Outcome
Multiple Sclerosis
Copolymer 1

Additional relevant MeSH terms:
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Glatiramer Acetate
Multiple Sclerosis
Autoimmune Diseases
Pathologic Processes
Demyelinating Autoimmune Diseases, CNS
Autoimmune Diseases of the Nervous System
Nervous System Diseases
Demyelinating Diseases
Immune System Diseases
Bronchodilator Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents
Tocolytic Agents
Reproductive Control Agents
Adrenergic beta-2 Receptor Agonists
Adrenergic beta-Agonists
Adrenergic Agonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Adjuvants, Immunologic
Immunologic Factors
Immunosuppressive Agents
Antirheumatic Agents