Actively Recruiting
TOTEM RRMS : TestOsterone TreatmEnt on Neuroprotection and Myelin Repair in Relapsing Remitting Multiple Sclerosis
Led by University Hospital, Strasbourg, France · Updated on 2025-06-29
40
Participants Needed
5
Research Sites
422 weeks
Total Duration
On this page
Sponsors
U
University Hospital, Strasbourg, France
Lead Sponsor
B
Bayer
Collaborating Sponsor
AI-Summary
What this Trial Is About
Centra nervous system (CNF) damage in multiple sclerosis (MS), are mainly attributed to myelin destruction, axonal abnormalities and subsequent degeneration, and are responsible for serious deficiencies. Current therapies are focused on the treatment of inflammation with several types of anti-inflammatory agents. However, there is an urgent need for innovative therapies promoting neuroregeneration and particularly myelin repair. It has been demonstrated that testosterone can act through neural androgen receptors to promote proliferation and differentiation of oligodendrocyte precursors into mature oligodendrocytes in a cuprizone-induced animal model of demyelination. The rare clinical trials on testosterone are mainly exploratory. Here, we sought to demonstrate an effect of testosterone supplementation in testosterone-deficient patients in a multicenter, randomized, parallel-group, double-blind, placebo-controlled phase 2 trial. The main objective will be to determine the neuroprotective and remyelinating effects of testosterone using tensor diffusion imaging techniques and thalamic atrophy analyzes. As secondary objectives, we would like to study the impact of testosterone supplementation on other conventional and unconventional MRI parameters and on clinical outcomes (cognition, fatigue, quality of life, impact on work / activity and anxiety / depression).
CONDITIONS
Official Title
TOTEM RRMS : TestOsterone TreatmEnt on Neuroprotection and Myelin Repair in Relapsing Remitting Multiple Sclerosis
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Male between 18 and 55 years old
- Affiliated to a social health insurance plan
- Able to understand the study objectives and risks and comply with the protocol
- Informed of prior medical exam results
- Signed informed consent
- Confirmed diagnosis of multiple sclerosis by revised McDonald criteria
- Receiving natalizumab, fingolimod, ponesimod, ocrelizumab, or ofatumumab for at least one year before randomization
- Switch between these therapies allowed if for non-neurological reasons
- For ocrelizumab patients, must have received full doses for at least 2 years
- Biological hypogonadism with serum total testosterone below 20 nmol/L
- For natalizumab patients, negative or low JC virus status
- No relapses in the year before inclusion
- Disability score (EDSS) between 0 and 7 at selection
- Stable neurological status in the month before randomization
You will not qualify if you...
- Progressive multiple sclerosis (primary or secondary)
- Hypogonadism treated with androgens or with clinical symptoms
- Prostate specific antigen above age-related thresholds
- Hematocrit level above 54%
- Unable or refusing to undergo MRI
- Other diseases causing neurological symptoms or affecting evaluation
- Signs of progressive multifocal leukoencephalopathy or confirmed leukoencephalopathy
- Untreated sleep apnea
- History of cancer or tumors of liver, heart, kidney, prostate, or breast
- Cardiovascular, renal, hepatic, hematological, gastrointestinal, pulmonary, or uncontrolled diseases
- Planning to father a child during the study
- Chronic infectious diseases
- Psychiatric or organic diseases impairing understanding or protocol compliance
- History of hypersensitivity to study treatments or similar drugs
- Participation in other experimental drug trials in past 6 months
- Subject under legal protection or unable to give informed consent
- Emergency situations or inability to understand study information
AI-Screening
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Trial Site Locations
Total: 5 locations
1
CHU de Besançon
Besançon, France, 25000
Actively Recruiting
2
CHU Nancy
Nancy, France, 54000
Actively Recruiting
3
Hôpital Pitié-Salpêtrière
Paris, France, 75013
Actively Recruiting
4
CHU de Rennes/Pontchaillou
Rennes, France, 35000
Actively Recruiting
5
CHRU de Strasbourg
Strasbourg, France, 67000
Actively Recruiting
Research Team
L
Laurent D KREMER, MD
CONTACT
N
Nicolas COLLONGUES, MD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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