A Study to Evaluate Efficacy, Safety, and Tolerability of Alemtuzumab in Pediatric Patients With RRMS With Disease Activity on Prior DMT
A Study to Evaluate Efficacy, Safety, and Tolerability of Alemtuzumab in Pediatric Patients With RRMS With Disease Activity on Prior DMT
Primary Objective:

 To evaluate the efficacy, safety, and tolerability of alemtuzumab intravenously (IV) in
 pediatric patients from 10 to <18 years of age with Relapsing Remitting Multiple Sclerosis
 (RRMS) who have disease activity on prior Disease Modifying Therapy (DMT).

 Secondary Objective:

 To assess the pharmacokinetics (PK), pharmacodynamics (PD), anti-drug antibody (ADA)
 formation, and potential effects of alemtuzumab on other multiple sclerosis (MS) disease
 characteristics such as cognition and quality of life (QoL).
The duration of study per patient will be approximately 5 years and 5 months.
Inclusion criteria :

 -  Patients with Relapsing Remitting Multiple Sclerosis (RRMS) aged from 10 years to less
 than 18 years at study entry are eligible. Patients must meet the criteria of
 diagnosis of Multiple Sclerosis as defined by the International Pediatric Multiple
 Sclerosis Study Group (IPMSSG) criteria for pediatric Multiple Sclerosis (MS) and the
 criteria of Multiple Sclerosis (MS) based on 2010 McDonald criteria.

 -  Signed written informed consent/assent obtained from patient and patient's legal
 representative (parent or guardian) according to local regulations.

 -  Expanded Disability Status Scale (EDSS) score of 0.0 to 5.0 (inclusive) at screening.

 -  At least 2 recorded Multiple Sclerosis (MS) attacks and at least 1 Multiple Sclerosis
 (MS) attack (relapse) in the last year during treatment with a beta interferon therapy
 (IFNB) or glatiramer acetate (GA) after having been on that therapy for at least 6
 months, and is currently still taking the same therapy.

 -  At least 1 of the following:

 -  1 new or enlarging T2 hyperintense lesion or gadolinium enhancing lesion* while
 on that same prior therapy (IFNB or GA), OR

 -  Two or more relapses in the prior year, OR

 -  Tried at least 2 Multiple Sclerosis Disease Modifying Therapies (DMTs).

 Exclusion criteria:

 -  Any progressive or non-relapsing forms of MS.

 -  Conditions/situations such as:

 -  Impossibility to meet specific protocol requirements.

 -  Current participation in another interventional clinical study. Patients who were
 treated with a comparator agent approved for screening inclusion (INF or GA) may be
 considered for this trial.

 -  Patient is the Investigator or any Sub-Investigator, research assistant, pharmacist,
 study coordinator, other staff or relative thereof directly involved in the conduct of
 the protocol.

 -  Uncooperative patient or any condition that could make the patient potentially
 non-compliant to the study procedures in the opinion of the Investigator.

 -  Mental condition rendering the patient or parent/guardian unable to understand the
 nature, scope, and possible consequences of the study.

 -  Clinically relevant cardiovascular, hepatic, neurological, endocrine, or other major
 systemic disease making implementation of the protocol or interpretation of the study
 results difficult or that would put the patient at risk by participating in the study
 in the opinion of the Investigator.

 -  History of drug or alcohol abuse.

 -  History of known human immunodeficiency virus (HIV) positivity.

 -  Pregnant or breast-feeding female patients or those who plan to become pregnant during
 the study.

 -  Unwilling to agree to use a highly effective contraceptive method when receiving a
 course of alemtuzumab treatment and for 4 months following that course of treatment
 (fertile patients only).

 -  Female patients who have commenced menstruating (ie, are of childbearing potential)
 and are unwilling or unable to be tested for pregnancy.

 -  Previous treatment with alemtuzumab.

 -  Treatment with natalizumab, daclizumab, fingolimod, methotrexate, azathioprine,
 cyclosporine, or mycophenolate mofetil in the last 6 months prior to screening, or
 determined by the treating physician to have residual immune suppression from these or
 other MS treatments.

 -  Treatment with teriflunomide in the last 12 months except if the patient underwent the
 recommended elimination procedure as per Summary of Product Characteristics (SmPC ).

 -  Previous treatment with mitoxantrone, cyclophosphamide, cladribine, rituximab,
 ocrelizumab, leflunomide, or any cytotoxic therapy.

 -  Previous treatment with any investigational medication (drug that has not been
 approved at any dose or for any indication). Use of an investigational medication that
 was subsequently licensed and nonstandard use of a licensed medication (eg, using a
 dose other than the dose that is stated in the licensed product labeling or using a
 licensed therapy for an alternative indication) is not exclusionary. Prior treatment
 with herbal medications or nutritional supplements is also permitted.

 -  Intolerance of pulsed corticosteroids, especially a history of steroid psychosis.

 -  History of malignancy.

 -  Prior documented history of thrombocytopenia, or platelet count at screening < lower
 limits of normal (LLN).

 -  Any disability acquired from trauma or another illness that, in the opinion of the
 Investigator, could interfere with evaluation of disability due to MS.

 -  Patients with known Type 1 hypersensitivity or anaphylactic reactions to the active
 substances or any of the excipients, or intolerance of acyclovir or its therapeutic
 equivalent.

 -  Major systemic disease or other illness that would, in the opinion of the
 Investigator, compromise patient safety or interfere with the interpretation of study
 results, eg, current peptic ulcer disease, or other conditions that may predispose to
 hemorrhage, immune cytopenias, rheumatoid arthritis, systemic lupus erythematosus,
 other connective tissue disorders, vasculitis, inflammatory bowel disease, severe
 psoriasis.

 -  Medical, psychiatric, cognitive, or other conditions that, in the Investigator's
 opinion, compromise the patient's ability to understand the patient information, to
 give informed consent, to comply with the trial protocol, or to complete the study.

 -  Major psychiatric disorder that is not adequately controlled by treatment in the
 opinion of the Investigator.

 -  Epileptic seizures that are not adequately controlled by treatment.

 -  Magnetic resonance imaging (MRI)-related conditions: conditions that could interfere
 with MRI acquisition and/or interpretation of MRI results (eg, claustrophobia,
 orthopedic implants/treatments, orthodontic treatments etc).

 -  Known bleeding disorder (eg, dysfibrinogenemia, factor IX deficiency, hemophilia, Von
 Willebrand's disease, disseminated intravascular coagulation [DIC], fibrinogen
 deficiency, clotting factor deficiency).

 -  Prior history of invasive fungal infections.

 -  Active infection, eg, deep-tissue infection, that the Investigator considers
 sufficiently serious to preclude study participation.

 -  In the Investigator's opinion, patient is at high risk for infection (eg, indwelling
 catheter, dysphagia with aspiration, decubitus ulcer, history of prior aspiration
 pneumonia or recurrent urinary tract infection).

 The above information is not intended to contain all considerations relevant to a patient's
 potential participation in a clinical trial.