Cohen JA, Cameron MH, Goldman MD, Goodman AD, Miller AE, Rollins A, Llorens L, Patni R, Elfont R, Johnson R. A Phase 3, double-blind, placebo-controlled efficacy and safety study of ADS-5102 (Amantadine) extended-release capsules in people with multiple sclerosis and walking impairment.
Mult Scler 2021;
28:817-830. [PMID:
34449295 PMCID:
PMC8978468 DOI:
10.1177/13524585211035333]
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Abstract
Background:
ADS-5102, a delayed-release, extended-release (DR/ER) amantadine, improved
walking speed in MS in a Phase 2 trial.
Objective:
The aim of this study was to present primary results of a Phase 3,
double-blind, ADS-5102 trial (INROADS) for walking speed.
Methods:
Adult participants with MS and walking impairment, not currently using
amantadine or dalfampridine, underwent 4-week placebo run-in before
randomization 1:1:1 to placebo, 137 or 274 mg/day ADS-5102 for 12 weeks.
Primary outcome was the proportion of responders (20% increase in Timed
25-Foot Walk (T25FW) speed) for 274 mg ADS-5102 versus placebo at end of
double-blind (Study Week 16). Additional measures included Timed Up and Go
(TUG), 2-Minute Walk Test (2MWT), and 12-item Multiple Sclerosis Walking
Scale (MSWS-12).
Results:
In total, 558 participants were randomized and received double-blind
treatment. Significantly more participants responded with 274 mg ADS-5102
(21.1%) versus placebo (11.3%). Mean T25FW speed also significantly improved
(0.19 ft/s) versus placebo (0.07 ft/s). Other measures were not significant
using prespecified hierarchical testing procedure. Adverse events led to
discontinuation for 3.8% (placebo), 6.4% (137 mg ADS-5102), and 20.5%
(274 mg ADS-5102).
Conclusion:
INROADS met its primary endpoint, showing a significantly greater proportion
of participants with meaningful improvement in walking speed for 274 mg
ADS-5102 versus placebo. Numeric dose response was seen for some secondary
efficacy outcomes and adverse events.
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